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Next best after breast milk – what formula?

What Formula should my baby have?  This is the desperate question that many mothers ask me.  They know that cow’s milk is making their baby sick, and now they are searching for the best alternative.  They are ready to wean, but they are unaware of the various choices and what will best suit their baby.

Correct formula feeding is very important

There is no question that “breast is best”. However, it is important that a “next-best” option is available. This is otherwise known as artificial or formula feeding. The decision of how to feed a new baby is not a menu choice.  Formula feeding is not equivalent to breast feeding.  But it is an important strategy in some food allergy children.

What is a “Formula”?

A formula is a combination of food components that are manufactured to be as close as possible to the food value of breastmilk. At this stage these formulas do not have the same biological advantages of breastmilk and will never capture to depth of breast feeding.  However, they are an important part of nourishing children.

Possible food and nutritional components in formula

  • Protein: Cow’s milk casein & whey (standard cow’s milk formulas).
  • Goat milk casein & whey. (Karicare Goat)
  • Cow’s milk hydrolysates. (Pepti-Junior)
  • Amino acids (Neocate, Elecare)
  • Soy protein (Karicare soy, Infasoy S26)
  • Carbohydrates: Lactose, Glucose, Corn starch
  • Fats: Polyunsaturated fatty acids (PUFA)
  • Minerals (calcium, iron) and vitamins
  • Fibre and prebiotics.
  • Added thickeners (the AR anti-reflux milks)
  • Water

Some concerns of formula feeding

Infection: sterilization of bottles, teats, storage of made up milk.

Cow’s Milk Intolerance: 5% of infants develop cow’s milk intolerance. As up to 40% of infants with gastro-oesophageal reflux have been shown to have cow’s milk intolerance.

Anaemia: unmodified cows milk feeding is associated with iron deficiency anaemia.

Obesity: growth rates of formula fed babies is faster. Feeding may not be well regulated.

Intestinal flora: lactobacillus, acidophilus growth is important.

What Formula are available for my baby?

Breastfeed for as long as you can. Breast milk exclusively to 4-5 months and then add solids from 5 months – keep breastfeeding to 12 months if possible.  But there comes a time when formula feeding is a good for your baby.  What are your options?

 Cow’s milk

  • Standard cows milk formulas are based combinations of casein whey proteins.
  • Whey-based formula are usually recommended for a start. 
  • Follow-on formulas have a little more iron and are for babies over 6-months old.
  • Anti-reflux (AR) formulas have added thickeners to help reduce vomiting.
  • Lactose-free formulas are for lactose intolerance but not for babies allergic to cow milk

Other formulas (see dairy free formula)

  • Goat milk (can have similar problems to cow’s milk)
  • Soy milk (needs to be fortified – some concerns with phyto-oestrogens)
  • Rice “milk” (lacks adequate proteins)
  • Special milks (see Special milk formula):
       Partial cow’s milk hydrolysates (known as HA hypo-allergenic formula).
       Extensive cow’s milk hydrolysates (such as Pepti-Junior)
       Amino acids based formula (such as Neocate and Elecare).

 We can help you work out the best formula for your child at the Childrens Clinic | Allergy Centre