Infant formulas are designed to meet the nutritional needs of babies during the first year of life. The formulas try to match the nutritional qualities of human breast milk. These formulas come in several forms. Powdered formulas and liquid concentrates are mixed with water. Infant formula also comes in a ready-to-use form.
Infants should be fed breast milk or infant formula for the first year of life. Cow's milk should not be used because human babies have special nutritional needs different from those of calves. Cow's milk has more protein and minerals than breast milk or formula. An infant's kidneys cannot handle the extra protein. Cow's milk does not have enough vitamin C, iron, zinc, and essential fatty acids to satisfy an infant's nutritional needs.
Standard milk-based formulas
Standard milk-based formulas are made from cow's milk. The cow's milk is modified in several ways. The protein is changed to make it more digestible. The butterfat is decreased or removed. Vegetable fats are added to provide more essential fatty acids and to make the fat more digestible. More lactose is added. Vitamins and minerals are adjusted.
Standard formulas are made with and without extra iron. The American Academy of Pediatrics recommends iron-fortified formulas for all infants.The caloric content of standard formulas is 20 calories per ounce. Standard milk-based formulas are adequate for infants with no special nutritional needs. These include: Enfamil (Mead-Johnson)Goodstart (Carnation)Similac (Ross)
Soy-based formulas are also available. Soy formulas are useful for infants with galactosemia. These babies cannot effectively use the sugars produced when lactose breaks down. Parents who prefer a strict vegetarian diet may also choose soy formulas.
Because soy formulas contain compounds that may decrease the amount of nutrients absorbed, more vitamins and minerals are added to compensate, Like milk-based formulas, soy formulas provide 20 calories per ounce. Soy formulas include: Alsoy (Carnation)Isomil (Ross)Isomil DF (Ross)Prosobee (Mead-Johnson)
Formulas for premature infants
Formulas for premature infants are made to help babies with low birth weights grow quickly. All these formulas are milk based and contain from 20 to 24 calories per ounce. They have more protein, vitamins, and minerals than standard formulas. Formulas for premature infants include: EnfaCare (Mead Johnson)Enfamil Premature (Mead Johnson)Neosure (Ross)Similac Special Care (Ross)
Formulas for infants with digestive problems
These formulas contain amino acids, which are the products of protein digestion, and may also have special types of fat. These formulas are designed for infants with food allergies, such as colic caused by protein sensitivity. They may also be recommended for babies who cannot digest and absorb certain nutrients. Babies with cystic fibrosis can benefit from special formulas. These formulas include: Alimentum (Ross)Neocate (SHS)Nutramigen (Mead Johnson)Pregestimil (Mead Johnson)
Formulas for babies with inborn errors of metabolism
There are also formulas for infants with inborn errors of metabolism. These babies cannot break down and effectively use specific nutrients. These formulas are designed to prevent the buildup of toxic products in the body. Some formulas for metabolism conditions include: Lofenalac (Mead Johnson)MSUD 2 (Mead Johnson)Portagen (Mead Johnson)RCF (Ross)Similac PM 60/40 (Ross)soy formulas
Babies should be fed when they are hungry. Formula feeding should be allowed on demand. An infant is consuming an adequate volume of formula when he or she is able to gain 3/4 to 1 ounce per day in body weight during the first 6 months of life, 1/2 to 3/4 of an ounce per day from 6 to 12 months of age.
Mixing the formula improperly can harm a baby. Carefully follow the mixing instructions on the formula container, because they vary from one formula to another. Formula powders and liquid concentrates can be used together but only with the guidance of a healthcare professional.
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Tang et al., The Lancet, 1996; 348:429-432.