“I recently gave birth and despite my best efforts, breastfeeding did not work out for us. Can you provide some kind of framework to make a good choice of formula? I’m sad I can’t give my son breastmilk and I want to give him the next best thing. Are there certain ingredients to look for or to avoid ? Is organic worth it?
Although breast-feeding is considered to be ideal, there are many for whom this is not possible. (As a side note, my sympathy goes out to those who are made to feel guilty or inferior for feeding their infants formula. Promoting the benefits of breast-feeding is one thing; demonizing or criticizing women who cannot or do not breast-feed is another.)
I also sympathize with parents faced with the daunting prospect of choosing the “right” formula from an overwhelming array of options. Let me start by ratcheting down the angst: Babies are remarkably resilient. Like larger humans, they have the ability to thrive even when they do not always have perfect diets. That said, of course we want to do the best we can for them.
Although this should not take the place of the advice of your pediatrician, here are a few thoughts on what to look for and/or avoid in a baby formula.
Milk or Soy?
If your baby is allergic to milk, soy formula is a perfectly acceptable choice. But in the absence of an allergy, a cow’s milk based formula is preferable. Note that lactose intolerance is different than milk allergy. Milk allergies are triggered by the proteins in milk (usually, casein), while lactose intolerance is the inability to digest the sugar in milk. If your baby has trouble with lactose but is not allergic to milk, look for a lactose-free, dairy-based formula.
Advantages of Whey-Based Formulas
Whey and casein are two types of protein, found in both cow’s milk and human breast milk. However, while cow’s milk is about 20% whey, human milk is up to 80% whey. As a result, standard cow’s milk baby formulas tend to be much higher in casein and lower in whey than human breast milk.
But the distribution of essential amino acids in casein is not as optimal as in whey. In order to ensure that the baby gets adequate amounts of certain essential amino acids, standard formulas are higher in protein, containing about 2.4 g of protein per 100 calories vs around 1.5 g in human breast milk.
Some experts believe that the higher protein content of standard formula may be part of the reason why formula-fed babies are more likely to be overweight. A whey-based formula can provide the amino acids necessary for growth without overloading the baby with excess protein. Lower protein, whey-based formulas (providing about 1.8 g of protein per 100 calories) more closely resemble breast milk, both in terms of the amino acid profile as well as the total amount of protein, and have been shown to support healthy growth.A whey-based formula can provide the amino acids necessary for growth without excess protein. Click To Tweet
DHA and ARA
Human breast milk contains DHA and ARA, two long-chain fatty acids that are critical for healthy brain and neural development in infants. One of the biggest improvements in modern baby formula has been to fortify it with these two important nutrients. I would definitely look for a formula that contains both. (Note to breast-feeding moms: Eat seafood and eggs regularly to pump up the level of DHA in your milk.)Note to breast-feeding moms: Eat seafood to pump up the level of DHA in your milk. Click To Tweet
Even breast fed babies usually require a supplemental source of iron. Unless your doctor has specifically advised otherwise, make sure your formula is fortified with iron.
Here’s where we start to get into shakier territory. There’s little doubt that human breast milk contains beneficial bacteria that help build baby’s microbiome. This has prompted many formula manufacturers to add probiotics to their formula. However, the benefits of probiotic-enhanced formulas have yet to be rigorously studied. Are the bacteria being added to the formula really the same as what baby gets from breast milk? Are any of these added bacteria making it into baby’s digestive tract? Are babies who consume probiotic-fortified formula any healthier than those who don’t? All unanswered questions at this point.The benefits of probiotic-enhanced baby formulas have yet to be rigorously studied. Click To Tweet
Fortunately, your baby is exposed to beneficial bacteria in many other ways.
Many parents are dismayed to see things like vegetable oil listed in baby formula ingredient lists. Unfortunately, it’s not really possible to formulate a complete baby formula without ingredients like this. Formulators attempt to mimic the fatty acid ratio in human breast milk as closely as possible.
Sugar is another common ingredient that may seem worrisome. Again, these are used to create a nutritional profile similar to breast milk, which is relatively high in sugar. Most of the sugars in breast milk are lactose and there is at least one brand that boasts lactose as the only source of sugar. You’ll pay quite a bit more for this and I’m not really sure it’s worth it. In fact, if your baby is lactose intolerant, alternative forms of sugar will be far preferable.
Some brands also tout various compounds found in breast milk and said to boost various aspects of cognitive or immune function. Studies to show that the inclusion of these compounds leads to any significant or lasting benefit are lacking, but having formula that more closely mimics breast milk seems like a no-brainer for many parents. For now, I’d put these ingredients in the “might help, couldn’t hurt” category.
Is Organic Essential?
Finally, is organic formula is essential? For those who want (and can afford) to support organic agriculture, organic formula is a great choice. If it’s a stretch, however, I don’t think that non-organic baby formula exposes your baby to any measurable risk.
Just because the ingredients used to produce the formula were not organic doesn’t mean that the formula is laden with pesticides! In fact, tests of non-organic baby formula found no detectable pesticide residues. Ironically, the biggest recent contaminant scare for baby formula had to do with arsenic, specifically in the brown rice syrup used in some organic formula brands.
And, finally, I’ll point out that most human breast milk would not pass organic standards (i.e. that the producers ate a 100% organic diet and were never treated with antibiotics!).
If buying organic baby formula makes you feel good, go for it. If not, I wouldn’t lose any sleep over it.