Infant Formula 101

Cow's Milk Based Formulas - Choose Iron-fortified

US: Enfamil LIPIL, Enfamil Gentlease LIPIL, Enfamil w Iron, Similac Advance, Similac w Iron, Good Start Supreme, Good Start Essentials and NAN

Canada: Enfamil A+, Enfalac w Iron, Similac Advance w Omega, Similac Advance, Good Start w Omega and Good Start

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. To learn about signs of constipation in babies, click here to download a handout developed by South Dakoda Department of Health.

Soy-based Formulas

US: Enfamil Prosobee LIPIL, Isomil, Isomil Advance, Isomil DF, Good Start Supreme Soy

Canada: Enfalac Prosobee, Isomil, Alsoy w Omega and Alsoy

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, please go to AAP website.

Step 2 Formulas

US: Enfamil Next Step LIPIL, Next Step Prosobee LIPIL, Similac 2 Advance, Isomil 2 Advance, Good Start 2 Supreme, Good Start 2 Essentials and Good Start 2 Essentials Soy

Canada: Enfapro A+, Enfapro, Similac 2 Advance, Similac 2, Isomil 2, Follow-up, Good Start 2 w Omega and Alsoy 2

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.

Toddler Formulas

US: Enfagrow

Canada: Enfagrow

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

Allergy: Extensively hydrolyzed formulas ("Predigested")

US: Nutramigen LIPIL, Pregestimil and Alimentum Advance

Canada: Nutramigen, Pregestimil and Alimentum

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.

Acid Reflux: Thickened Formulas

US: Enfamil AR LIPIL

Canada: Enfamil A+ Thickened with Rice Starch

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.

Acute Diarrhea: Lactose-free formulas

US: Enfamil LactoFree LIPIL, Isomil DF and Similac Lactose Free Advance

Canada: Enfalac LactoFree and Similac LF

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).

For Premature babies: Premature Discharge formulas

US: Enfacare LIPIL and Neosure Advance

Canada: Enfacare A+ and Similac Advance Neosure

The AAP recommend 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.