I decided to put together this blog post because I work in a NICU (Neonatal Intensive Care Unit) and we work with a lot of breastmilk and baby formula to feed our patients. This is my area of expertise and I had the pleasure of recently attending lunch with a formula rep and talking about formula. This luncheon, brought this topic to the fore front of my mind - Not all formula is created equal. I don't want this post favor one brand over another. I just want to bring some facts to light that you might find helpful. My perspective is that for all babies, breastmilk is best and is a very unique substance. We have worked for years and years to try to create a formula that mimics breastmilk. For some of our babies in the NICU, we have to add things to the breastmilk to increase nutrients because our patients are born early and breastmilk isn't designed to meet their unique nutrition needs.
That being said ... I wanted to discuss all the different types of formula and how there are various brands. In the US, we have Similac, Enfamil, Gerber and Store brand options. All of these companies abide by rulings set out by Congress in the 1980s, referred to as The Formula Act. This piece of legislation has been around for awhile and unfortunately hasn't been totally updated since then. There have been guidances given for the formula industry and an example in includes the health claims made by formula companies (September 2016). Baby formula always ends up being a controversial topic. Thankfully all of these companies continue to create and work on new research in the area of baby formula even though the standards they have (required by law to follow) are now ~35 years old. There are lots of different types of formula options within each brand and some times the options can be overwhelming for parents. The main focus that I wanted to bring to your attention is that the brand name formulas may cost more, but there is more research being done in those products and they are up to date with the best nutrition compared with the generic products. Just so you are aware, the generic version of the formulas are the older recipes from the brand name companies. This means they may not contain some of the important nutrients that we have discovered and are now able to add to formula. This means that as the consumer you are getting a product that is based on older research and may not be as helpful for their baby's growth and development. This is the one time in your baby's life when they are eating 1 food item to get all the nutrients that they need to grow and develop. Whether it is breastmilk or formula this is a very unique time for your child (the 1st 12 months of their life).
For example, we have learned that DHA (docosahexaenoic acid or omega-3 fatty acids) and ARA (arachidonic aicd or omega-6 fatty acid) are very important for brain development in infants. These fatty acids have been around awhile and most of the generic formulas that I looked at had at least DHA in them. Another important phytonutrient that is now being added to formula is Lutein. It helps with eye health and is a carotenoid that has an important role to play in brain function/development. We didn't necessarily have this information back when the Formula Act was put together so if you read the label for a generic baby formula and make sure that these formulas have these nutrients added. Most of the ones that I glanced at, did have these nutrients added, which was reassuring. These nutrients are naturally found in breastmilk and has we do more research they are being added to infant formulas as well.
I wanted to also just touch on the different types of baby formula so that you know what you are looking at when you go to the baby aisle of the grocery store. There are lots of options and often the challenging is just determine, which product is appropriate for your baby.
- Cow milk protein-based formulas. Most infant formula is made with cow's milk that's been altered to resemble breast milk. This gives the formula the right balance of nutrients — and makes the formula easier to digest. Most babies do well on cow's milk formula. Some babies, however — such as those allergic to the proteins in cow's milk — need other types of infant formula.
- Soy-based formulas. Soy-based formulas can be useful if you want to exclude animal proteins from your 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 might also be allergic to soy milk.
- Protein hydrolysate formulas. These types of formulas contain protein that's been broken down (hydrolyzed) — partially or extensively — into smaller sizes than are those in cow's milk and soy-based formulas. Protein hydrolysate formulas are meant for babies who don't tolerate cow's milk or soy-based formulas. Extensively hydrolyzed formulas are an option for babies who have a protein allergy.
*In addition, specialized formulas are available for premature infants and babies who have specific medical conditions.
My intent with this blog post is not to make you hate formula or purchase only a certain type of formula. I just wanted to make sure that you knew how much research goes into infant formula and how it is always being updated and our knowledge base is growing. Breastmilk is an amazing substance that women's body can produce and we have spent lots of time and money trying to find ways to create a formula that mimics what nature can create. I am a huge proponent of additional research and I am always excited to hear what companies have learned and are able to add to their formula products.
If you end up with questions about formula, please don't hesitate to get in touch with me and I would be happy to talk with you more about this fascinating topic of infant nutrition!