In this article, we’re answering top 10 questions that parents and caregivers have about baby formula.
Are some formulas more nutritionally sound than others? What formula should I use? If you decide to formula-feed your baby, you likely have lots of questions. Today, we’re answering 10 common questions that parents and caregivers have about formula-feeding, to empower you to make informed feeding decisions for your baby.
1. Is formula as nutritious as breastmilk?
Yes. Just like breastmilk, baby formula contains all the nutrients needed to help baby grow. In fact, the nutrient amounts in formula are carefully selected to replicate the vitamin, mineral, protein, and carbohydrate amounts in breastmilk.
Since the 1980s, baby formula manufacturers have had to follow strict FDA regulations. All formulas must have specific amounts of vitamins, minerals, proteins, and carbohydrates under these regulations, to promote baby's healthy growth just like breastmilk does.
2. Will baby’s brain develop the same on formula vs. on breastmilk?
Yes. Since today’s baby formula contains the exact same vital nutrients as breastmilk, it promotes baby’s brain health in the same way as breastmilk.
The vast majority of modern formulas also contain DHA and ARA, which are two of the major brain-building nutrients found in breastmilk. Clinical studies haven’t yet conclusively shown if these particular ingredients play a role in boosting baby’s brain health
Still, many studies, including one published in the British Medical Journal, show that "breastfeeding has little or no effect on intelligence in children" compared to formula feeding.
So, breastfed babies no longer have an edge in brain health, like they did many years ago when formula didn’t properly meet a baby’s nutritional needs.
3. What formula should I start with if I’m exclusively formula-feeding from birth?
Dr. Bridget Young from The Baby Formula Expert channel offers advice:
4. Can formula feeding cause obesity?
Some evidence shows a connection between formula-feeding and obesity, but the ingredients of formula are not to blame. Rather, if your baby gains too much weight during formula-feeding, it’s because they’re being overfed.
It’s easier to overfeed formula than to overfeed while breastfeeding. To help reduce the risk of obesity, you’ll need to:
- Pay attention to how much baby is drinking (stick to your doctor’s guidelines and watch the general guidelines for your baby’s age).
- Know the signs of fullness (see the next question below).
- Use a bottle with a slow-flow nipple, so baby can’t drink too much at once.
- Never force a baby to finish a bottle if they seem done. It’s most important that baby has control over when to stop a feed, so they learn how to regulate their appetite and develop healthy eating habits for life.
5. Are more expensive formulas better for baby’s nutrition than others?
Even if pricier formulas seem more attractive and “high-end,” less expensive formulas provide the same benefits, as all formulas must meet the same strict nutritional standards. So, picking a more expensive formula, say, because it’s organic or because it bears a well-known brand name, is just a matter of preference. Brand-name and organic formulas may be designed to mimic breastmilk “more closely,” but in reality, all formulas mimic breastmilk closely enough.
6. Can I feed baby formula while breastfeeding?
Most babies can switch back and forth between the breast and the formula bottle without problems. And if baby does start to refuse the breast---or the bottle--- the bottle is probably causing the problem.
If you're mixing breastfeeding and formula-feeding, choose a bottle that closely mimics your breast. It should have a breast-like nipple, and a slow flow to mimic your own milk flow. Also, position your baby and the bottle to mimic the position they use to suck at the breast--- this will help them drink slowly. Then, baby should be able to switch back and forth with no issues. But what if baby starts to prefer the bottle? This is a sign to give them more time on the breast, so they become equally happy with both.
Another thing to keep in mind: if you’re using formula to supplement breastfeeding, you’re probably concerned about your milk supply. To maintain or increase your milk supply, you’ll need to pump breastmilk every time you give baby a bottle.
7. Does formula make baby more likely to develop a food allergy?
No. Don't worry that your decision to feed formula will increase your baby’s risk of developing a food allergy.
A recent study has shown that feeding cow's milk-based formula can actually help reduce a baby's milk allergy risk.
Results of the breakthrough SPADE study indicate that feeding cow's milk-based formula to babies who are 1-2 months old can help reduce a baby's milk allergy risk by up to 88%. (Read our guide to the SPADE study here.)
And formula-feeding hasn't been shown to increase or decrease baby's risk of developing other types of food allergy.
8. Is soy-based formula as good as cow’s milk-based formula?
For most babies, soy-based formula is a viable option. Soy-based formula contains the same nutrients as cow’s milk-based formula, because of the strict nutritional requirements that all formulas have to follow. And soy-based formula works particularly for babies who can’t tolerate cow’s milk (due to an allergy or intolerance).
However, soy-based formula isn’t recommended for preemies born at less than 4 pounds, and isn’t recommended to prevent colic. It also isn’t recommended for babies with FPIES, as babies with milk-based FPIES often have soy-based FPIES as well.
9. What should I do if baby is allergic to a formula ingredient?
If baby has a confirmed food allergy to a formula ingredient (usually milk or soy), you’ll need to switch to a formula that does not contain the ingredient(s) baby is allergic to. In the case of a milk allergy, you may also sitch to hydrolyzed formula, or a specialty formula made for babies with milk allergies.
Keep in mind, though, that according to a recent study in JAMA Pediatrics, milk allergies are over-diagnosed. So, if you think your baby has a cow’s milk allergy, this may not actually be the case. While 14% of families think their baby has a milk allergy, only 1% of babies actually have a milk allergy (the others may have milk intolerance, which is different from an allergy). You can read our overview of this study here.
So, talk to your doctor to understand why they gave your baby the allergy diagnosis, and ask if it makes sense to perform any tests to be sure baby has an actual allergy. Ideally, work to get a clearer picture before switching formulas. If your doctor says that your baby may have an allergy, remember that a food challenge is the only way to know for sure.
10. What is hydrolyzed formula?
Hydrolyzed formula is a specialty milk-based formula made for babies whose bodies have adverse reactions to milk (such as an allergy or intolerance).
Partially hydrolyzed formula contains milk proteins that are broken down into smaller pieces.
This helps make the formula easier to digest for babies with a milk intolerance, reflux, or colic, and helps cut down on symptoms of digestive discomfort like gas and fussiness.
Extensively hydrolyzed formula is designed for babies with a milk allergy or intolerance. The milk protein is broken down into small enough pieces that the baby's immune system or digestive system will not recognize and react to it.
Two popular types of hydrolyzed formula are Nutramigen and Alimentum.
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