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| |    An Overview of Infant Formulas by Mary Silva, M.S., R.D. reviewed by Laura Jana, M.D., F.A.A.P. There's no question that breast milk is ideally suited for an infant's nutritional needs, but unfortunately, the actual process of breastfeeding is not always ideal for mothers or their infants. That's where commercial infant formula comes in. Formulas, which generally are made to mimic the nutritional content of breast milk, are a fine substitute for the real thing. The nutrients that they contain are based on recommendations by the American Academy of Pediatrics and the Food and Drug Administration (FDA). Infant formula comes in a variety of forms, available through several major manufacturers. The following list describes the pros and cons of each: Cow's-milk-based formula This formula is made from cow's milk that has been modified by the removal of butterfat and the addition of vegetable oil. To better mimic the composition of breast milk, more carbohydrate is added, often in the form of lactose, and some protein is removed. Standard formula is appropriate for most full-term babies. Parents should watch for signs of intolerance or allergy--such as vomiting, excessive spitting up, diarrhea, skin reactions, or breathing problems--and if present, discuss them with their child's healthcare provider. Soy-based formula This formula is made from soybeans. Like milk-based formula, it also contains vegetable oil and an added carbohydrate, although it's not in the form of lactose. It contains higher levels of soy protein than its cow's-milk-based counterpart because soy protein is not as easily absorbed as the protein in cow's milk. Ultimately, it's important that your baby receive the right amount of protein to achieve normal growth, but not so much that it taxes her kidneys. Families in which one or both parents are vegetarian or lactose intolerant (that is, unable to digest milk sugar) tend to be the typical users of soy formula. Also, if your baby does not tolerate milk-based formula following a bout of diarrhea, your provider may advise you to use a soy-based product for a few days because the diarrhea may have caused temporary lactose intolerance. Soy formula is usually not used when a baby has a cow's-milk allergy since it often is not tolerated either. Babies with rare conditions such as galactosemia or lactase deficiency often use it because it does not contain lactose. Cost-wise, soy formula generally costs about the same as cow's-milk-based formula. Protein hydrolysate This formula (sometimes called predigested formula) is made from cow's milk that has been specially treated to break down the protein into smaller units. The extra processing involved makes it--not surprisingly--a more expensive option than other formulas. It's intended to feed infants who cannot drink standard or soy formulas because of an allergy, and for babies who have other conditions that affect their absorption (such as those born prematurely). The types of fats and carbohydrates added vary among the different brands; however, most do not contain lactose. Follow-up formula This type of formula, which generally is based on cow's milk, is usually given to older infants who have begun eating solid foods. Its nutritional makeup is different from standard cow's-milk formula in that it contains less fat but more protein and minerals. Although it provides adequate nutrition, there's no advantage to using this over other formulas. Despite that fact, follow-up formula continues to sell. Evaporated milk Some years ago, it was common to feed babies a homemade formula that consisted of a mixture of evaporated milk, water, and sugar (or corn syrup). This turned out to be a dangerous approach for many reasons. First, the mix was found to cause iron-deficiency anemia because of intestinal bleeding and its low iron content. Experts also learned that the higher amount of protein and minerals force an infant's maturing kidneys to work harder and that the fat is difficult for babies to digest. In addition, the mix has low levels of vitamins C, A, and D unless the milk used is fortified; and using corn syrup increases the risk of infantile botulism, since it often contains botulism spores. For all of these reasons, evaporated-milk formula is not recommended for babies. If you must use it because other formulas are beyond your budget, be sure to give your baby a supplement that includes vitamin C and iron. And keep in mind that A and D vitamin supplements, as well as fluoride, may also have to be given. Deciding which is best for you Rest assured, manufactured formulas can provide your baby with the nutrition she needs. Your child's healthcare provider should be able to guide you to the type of formula best suited to your infant. In the case of a baby with special nutrition needs, your pediatrician will no doubt tell you exactly which formula to use. As mentioned earlier, be sure to tell your doctor if you note signs of intolerance (or any other problems related to your infant's formula). She can tell you whether a change is necessary.
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