Infant formulas

What are infant formulas and what's in them?

Infant formula is a nutritional product that is made from processed cow's milk or soybean products. Special processing makes cow's milk formula more digestible and less likely to cause an allergic reaction than regular cow's milk.

Vitamins and minerals are added to infant formula. Formula can be used to provide all of a baby's nutritional needs before the age of 4 to 6 months.

Commercial formulas are made to be as similar to breast milk as possible. The safety and nutrient content of infant formula is regulated by the U.S. Food and Drug Administration (FDA).

About half the calories in formula come from vegetable oils or a mixture of vegetable and animal fats. A baby's body requires fat for the production and growth of new cells and for high energy needs.

Milk sugar (lactose) is the main source of carbohydrate in most cow's milk formula, just as in breast milk.

What types of formulas are there?

Several types of infant formulas are available. Usually, cow's milk–based formulas are tried first. Examples of brand names include Enfamil, Similac, and Good Start. Babies absorb minerals and nutrients better from cow's milk–based formulas than other types of formulas.

Babies younger than 12 months who are not breast-fed almost always need iron-fortified formula. The iron in human milk is much more easily absorbed by infants than the iron in cow's milk. (But even breast-fed babies need iron added to their diet after 6 months of age.) Formula-fed babies can become iron-deficient if iron-fortified formulas are not used. Iron deficiency may cause severe complications in babies, such as weakness, abnormal digestion, and permanently reduced learning abilities. In the United States, a formula with an iron concentration of 6.7 mg/L or higher is considered iron-fortified. And the label must say that.1

Some caregivers may be hesitant to feed an infant iron-fortified formula because of concern about side effects, such as gas or constipation. But these concerns have not been proven by research, and low-iron formulas are not recommended as a remedy for such symptoms. Although low-iron formulas are available, they should only be used in extremely rare situations on the advice of your doctor.

Other types of formulas are available for babies who have trouble digesting cow's milk-based formulas. Talk to your doctor before giving your baby one of these formulas.

  • Soy formulas, such as ProSobee and Isomil, may be recommended for babies who are unable to tolerate cow's milk formulas or for vegetarian parents who don't want to feed their baby animal products.
  • Lactose-free formulas, such as LactoFree, are used for babies who are lactose-intolerant. This is a rare condition in babies.
  • Hypoallergenic or protein hydrolysate formulas, such as Nutramigen, Pregestimil, or Alimentum. These are used for babies who cannot tolerate formulas made from cow's milk or soy.

Do not use homemade formulas, such as those that use evaporated milk. These do not contain the nutrients and supplements your baby needs. They could also make your baby sick.

How do I prepare them?

You can buy formula as a powder or as a concentrated or ready-to-feed liquid. Ready-to-feed formulas are the most expensive, but some caregivers find their convenience worth the extra cost. You must add cool, safe water to powders and concentrates. Be sure to follow the directions on the label and use the measuring device that comes with the product.

Cover and store your open cans of ready-to-feed and concentrated liquid product in the refrigerator for no longer than 48 hours. Cover and store both opened and unopened cans of powder formula in a cool, dry place, not in the refrigerator. You can use the powder product for up to 4 weeks, if it's stored right. Don't leave prepared formula out of the refrigerator.

Toddler or transitional formulas, such as Next Step, usually contain more iron and other nutrients than other formulas. They can be used, but are not necessary, for older babies who are switching from formula to whole cow's milk. Most babies make this transition easily.

Citations

  1. American Academy of Pediatrics (2009). Formula feeding of term infants. In RE Kleinman, ed., Pediatric Nutrition Handbook, 6th ed., pp. 61–78. Elk Grove Village, IL: American Academy of Pediatrics.

Last Updated: August 6, 2009

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