Infant Formula 101

baby resting in hand

(HealthCastle.com) All pediatric experts agree that breast milk is the best food for a growing baby. It provides a perfect balance of nutrients as well as antibodies to protect your baby from disease. A qualified lactation consultant can coach and provide breast-feeding support. Visit Le Leche League for more information.

Infant Formula - Which Brand?

There are slight differences among brands such as the oil ingredient they put in, the protein profile, or the amount of omega 3 & 6 fatty acids. The fact is - all brands of formula including the store brand formulas meet the requirements regulated by the FDA to provide sufficient nutrients for your growing baby.

Standard Infant Formulas

Cow's Milk Based Formulas - Choose Iron-fortified

The American Academy of Pediatrics AAP recommends iron-fortified formulas for all infants. Dr Klish, chairman of AAP Committee on Nutrition concurs that "There should not be a low-iron formula on the market" because "a low-iron formula is a nutritionally deficient formula". There is a misconception by parents that infants fed iron-fortified formulas will have constipation. Mothers often associate iron with constipation from their own experience of taking iron supplements or prenatal vitamins during pregnancy. However, clinical studies found no such association among babies being fed iron-fortified formulas.

It is not unusual for a baby to not pass stool for 2 or 3 days. In addition, it is normal for a baby to grunt or get red in the face when having a bowel movement. Click here to learn about signs of constipation in babies.

US Brands: Enfamil Newborn, Enfamil Infant, Similac Advance, Similac Advance Organic, Gerber Good Start, Gerber Good Start Protect

Canadian Brands: Enfamil A+, Enfamil with Iron, Similac Advance with Omega, Similac Advance, Nestle Good Start Probiotic, Nestle Good Start, Nestle Good Start with Omega

Soy-Based Formulas

The sale of soy-based formulas nearly doubled in the 90s . In 1998, the AAP published a policy statement stating that the routine use of soy-based formula has no proven value in the prevention or management of colic, therefore should not be used as a routine formula.

Babies with documented cow's milk protein allergy are often just as sensitive to soy protein. In fact, the AAP recommend against routinely giving soy-based formulas to these babies. Instead, extensively hydrolyzed formulas or amino acid based formulas should be given. For more information, go to AAP website.

US Brands: Enfamil Prosobee, Similac Soy Isomil, Gerber Good Start Soy

Canadian Brands: Enfamil Soy A+, Isomil with Omega, Isomil, Nestle Good STart Alsoy

Step 2 Formulas

These formulas (cow's milk or soy based) are designed to provide nutrients for babies 6 months and older. These formulas usually contain a higher level of calcium to meet the increasing needs of older babies.

US Brands: Enfagrow Toddler, Enfagrow Soy Toddler, Similac Go & Grow, Similac Go & Grow Soy, Gerber Good Start 2, Gerber Good Start 2 Soy, Gerber Good Start Protect 2

Canadian Brands: Enfapro A+, Enfapro, Similac Go & Grow with Omega, Similac Go & Grow, Isomil Step 2, Nestle Good Start 2 Probiotic, Nestle Good Start 2, Nestle Good Start 2 with Omega, Nestle Good Start 2 Alsoy

Toddler Formulas

Toddler formulas are appropriate for toddlers between 1 and 3 years of age. They are designed to supplement, not replace, food intake.

US Brands: Enfagrow

Canadian Brands: Enfagrow

Specialty Infant Formulas

Allergy: Extensively hydrolyzed formulas ("Predigested")

If your baby develops rashes, is colicky or is extremely fussy, make sure to see a pediatrician right away as these may be symptoms of allergy. To manage cow's milk protein allergy, the AAP recommended the use of extensively hydrolyzed formulas. These types of formulas are usually referred to as "predigested" formulas. The protein content of these formulas have been broken down or "predigested". Extensively hydrolyzed formulas are usually 3 times more expensive than standard formulas. In more extreme cases, completely predigested formula (amino-acid based) such as Neocate is required.

Note: Your pediatrician may also prescribe extensively hydrolyzed formulas for your babies for medical reasons other than allergy.

US Brands: Nutramigen, Pregestimil, and Similac Expert Care Alimentum

Canadian Brands: Nutramigen A+, Pregestimil A+ and Alimentum

Acid Reflux: Thickened Formulas

This type of formula will thicken by itself once it reaches the stomach; hence minimizing the possibility of regurgitation. Some pediatricians may also recommend soy or extensively hydrolyzed formulas for babies with acid reflux.

US Brands: Enfamil AR and Similac Sensitive for Spit-Up

Canadian Brands: Enfamil A+

Acute Diarrhea: Lactose-free formulas

Lactose-free formulas may temporarily be used for babies suffering from acute diarrhea. Secondary lactase deficiency (i.e. the enzymes required to digest lactose are temporarily unavailable due to an infection) usually occurs. In this case, your pediatrician may temporarily recommend lactose-free or soy formulas (also lactose-free).

US Brands: Enfamil Gentlease (lactose-reduced; not entirely lactose-free)  and Similac Sensitive

Canadian Brands: Engamil Lactose Free A+, Enfamil Gentlease A+ (lactose-reduced; not entirely lactose-free) and Similac Sensitive

For Premature babies: Premature Discharge formulas

The AAP recommends using a premature discharge formula for premature babies to 9 months of age. Using these formulas in premature babies can result in greater length and weight gain compared to the use of standard formulas. Premature discharge formulas are more appropriate for premature babies as they provide more calories, higher levels of protein, vitamins and minerals.

US Brands: Enfamil Enfacare and Similac Expert Care NeoSure

Canadian Brands: Enfamil Enfacare A+ and Similac Advance Neosure

Bottom Line

Your pediatrician often keeps a set of growth charts to keep track of progress of your growing baby.  It's always better you have a copy for your own record anyway.  Go to CDC to print a set of growth charts (just scroll towards the bottom and you'll see a list). In Canada, a different set of growth charts are adopted - they're called the WHO growth charts.

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