A big decision new moms must make for their little one’s nutrition is breast milk or formula. The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for 6 months, with a continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant.

For a variety of reasons, a mother may choose formula as breastfeeding may not be possible for all women. For many, the decision to breastfeed or formula feed is based on the mother’s comfort level, lifestyle, and specific medical situations. If a mother decides to bottle feed using infant formula, for any reason, they should not be shamed.

For moms who cannot breastfeed or who decide not to, infant formula is a healthy alternative. Formula provides babies with the nutrients they need to grow and thrive. The primary objective is a well-fed and healthy baby and that can be achieved with either breast milk, formula or a combination of the two.


Formula is Regulated

In the US, commercial infant formulas are regulated by the Food and Drug Administration (FDA). There are 3 major types of baby formulas – cow’s milk protein-based formulas, soy-based formulas and protein hydrolysate based. Most infant formulas are made with cow’s milk with added nutrients and components to make the formula easier to digest. Most babies do well on cow’s milk formula.

Some babies need other types of infant formula. Soy-based formulas can be useful if the goal is to exclude animal proteins from the child’s diet. Soy-based infant formulas might also be an option for babies who are intolerant or allergic to cow’s milk formula or to lactose, a carbohydrate naturally found in cow’s milk. However, babies who are allergic to cow’s milk may also be allergic to soy milk.

Protein hydrolysate formulas contain protein that has been broken down (hydrolyzed) into smaller sizes than are those in cow’s milk and soy-based formulas. Protein hydrolysate formulas are meant for babies who do not tolerate cow’s milk or soy-based formulas. Extensively hydrolyzed formulas are often an option for babies who have a protein allergy. Specialized formulas are available for premature infants and babies who have specific medical conditions.

Breast milk contains a blend of monounsaturated, polyunsaturated, and saturated fat. Formulas use a variety of oils to match the fat makeup of breast milk. They include soy oil, coconut oil, palm or palm olein oil, and high oleic sunflower oil. Although palm and palm olein oil are widely used, research has shown that these fats can reduce absorption of fat and calcium. This would mean that the baby would not absorb as much fat and calcium as she would from a formula that does not contain this oil. The FDA has approved the addition of two long-chain fatty acids to formula: DHA (docosahexaenoic acid) and ARA (arachidonic acid), which are now standard ingredients. Both substances are found in breast milk when the mother’s diet is adequate, and both are important for brain and vision development.


Parents have a lot of options

Infant formulas come in three forms: powdered, concentrated liquid and ready-to-use. The best choice often depends on the budget and desire for convenience. Powdered formula is the least expensive. Each scoop of powdered formula must be mixed with water. Concentrated liquid formula must be mixed with equal amounts of water. Ready-to-use formula is the most convenient type of infant formula. It does not need to be mixed with water and as the most convenient, it is also the most expensive option.

Parents have a lot of choices when it comes to formula brands. All infant formulas sold in the United States, including generic brands, must meet the nutrient standards set by the FDA. The FDA’s requirements for infant formula include minimum amounts for 29 nutrients and maximum amounts for nine nutrients to ensure the formula provides for the infant. In many instances, the only difference between generic and brand name is the price.


‘Speciality’ Formulas

There are a lot of ‘specialty’ formulas on the market. They are generally higher priced and are marketed to specific demographics. For example, as our society is more aware of the potential negative impacts of chemicals, organic formulas appeal to parents who want to limit their baby’s exposure to herbicides, pesticides, and other chemicals. Formulas labeled “organic” must be certified by the U.S. Department of Agriculture. However, according to the AAP, no research to date has proven that organic milk is healthier for children than regular milk.

Hypoallergenic formulas are usually made with cow’s milk that is processed so that the allergy-causing protein is broken down, so it is easily digestible for baby. Insurance companies may cover the cost of hypoallergenic formula if it is deemed medically necessary as documented by a prescription from the baby’s pediatrician.

The FDA and AAP warn against using recipes to make homemade infant formula. Using homemade infant formula can lead to serious health problems for the baby. A baby’s nutritional needs are extremely specific, especially in the first year of life.

A well-fed and healthy baby can be achieved with either breast milk, formula or a combination of both. Mothers can choose to augment breastmilk with formula or choose to feed their infant formula. While breast is best, formula is an acceptable option to provide for their baby’s nutrition.


Nannies can learn more about formula in the Advanced Newborn Care class at the Nanny Institute.