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Choosing a Baby Formula

Child Nutrition Basics

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Updated May 28, 2014

Mother holding daughter (6-9 months) drinking from bottle, eyes closed, close-up
Ryuichi Sato/Taxi Japan/Getty Images

While maybe not in the same class of decision as deciding whether or not to breastfeed, choosing a baby formula can be difficult, too.

Baby formula companies aren't making it any easier as they continue to come out with new baby formulas, each of which claims to be better than all of the rest.

Baby Formula Brands

One of the first choices you will have to make when choosing a baby formula is deciding which baby formula brand to buy.

In general, remember that all baby and infant formula brands that are sold in the United States must meet the minimum nutritional requirements of the Federal Food, Drug and Cosmetic Act (the 'Infant Formula Act') and FDA regulations.

That doesn't mean that all infant formula brands are the same, but any of the major brands, such as Enfamil, Similac, or Nestle Good Start, and store brands from Walmart, Target, or Kroger, etc., should meet your baby's basic nutritional needs.

Baby Formula Types

There are several basic formula types, including:

  • cow's milk-based formula - the type of formula that the average baby should be on if not being breastfed (examples: Enfamil Lipil, Nestle Good Start Gentle Plus, Similac Advance)

  • "gentle" formula with less lactose than regular milk based formula - for babies with some gas or fussiness on milk-based formula (examples: Enfamil Gentlease Lipil and Nestle Good Start Gentle Plus)

  • lactose-free formula - for babies with lactose intolerance (examples: Enfamil LactoFree Lipil and Similac Sensitive_

  • added rice starch formula - for babies with acid reflux (examples: Enfamil A.R. Lipil and Similac Sensitive R.S.)

  • soy formula - for babies with galactosemia, lactose intolerance, and milk protein allergies (examples: Enfamil Prosobee Lipil, Nestle Good Start Soy Plus, and Similac Isomil Advance)

  • formula for premature babies - have more calories and other nutrients for premature and low-birth weight babies (examples: Enfamil EnfaCare Lipil and Similac Neosure)

  • next-step or toddler formula - for older infants and toddlers between the ages of 9 and 24 months of age (examples: Enfamil Next Step Lipil, Nestle Good Start Gentle Plus 2, and Similac Go & Grow)

  • elemental formula - for babies with milk protein and soy allergies (examples: Nutramigen Lipil, Pregestamil Lipil, and Similac Alimentum)

  • amino acid based formula - for babies with milk protein and soy allergies who don't tolerate an elemental formula (examples: Neocate and Nutramigen AA Lipil)

If your baby is having a real problem with her formula, then choosing another type of baby formula can be important. Simply changing brands, unless you also change formula types, doesn't usually help, though.

Although parents often move from one type of formula to another when their babies continue to not tolerate their formula, it is almost always better to talk to your pediatrician before changing formula.

Signs of a formula intolerance might include unexplained fussiness, excessive gas, diarrhea (which may be bloody), spitting up, vomiting, and poor weight gain.

Baby Formula Differences

In addition to the different types of baby formula, there are also some differences between brands among the same types of baby formula.

For example, one difference between Similac Advance and Enfamil Lipil is that Similac Advance doesn't use palm olein oil as its source of fat, instead using soy and coconut oil. While the makers of Similac and some studies suggest that palm olein oil lowers the absorption of calcium and bone mineralization, other formula makers and other studies dispute that claim.

Both Similac Advance and Enfamil Lipil differ from Nestle Good Start in the makeup of the milk proteins they contain. While Similac Advance and Enfamil Lipil are a combination of whey and casein proteins, like breast milk, Nestle Good Start is made of 100% whey proteins ('Comfort Proteins').

Other things that have been added to baby formula lately include:

  • DHA and ARA - now present in most brands and types of baby formula, including Enfamil Lipil, Nestle Good Start Gentle Plus, and Similac Advance. In fact, Nestle Good Start Nourish Plus seems to be the only brand name formula that is still available without DHA and ARA.
  • Prebiotics - Enfamil PREMIUM with Triple Health Guard and Similac Advance EarlyShield
  • Probiotics - Nutramigen with Enflora LGG and Nestle Good Start Protect Plus
  • Antioxidants - Similac Advance EarlyShield and Nestle Good Start Protect Plus
  • Organic Ingredients - Similac Organic and Earth's Best Organic Infant Formula

Many of these new types of baby formulas are also available in store brand baby formulas, such as Bright Beginnings (CVS) and Parent's Choice (Walmart), which -- like many store brand baby formulas -- are made by PBM Nutritionals.

Choosing a Baby Formula

Although breast milk is a clear first place favorite between formula feeding and breastfeeding, few experts will tell you which brand of formula comes in second.

Very few experts will tell you that you can't save money by choosing a less expensive store brand formula over the latest name brand formula. Keep in the mind that you should never try to save money by diluting baby formula. Whichever baby formula you buy, always carefully follow the mixing instructions.



Sources:

Koo WW. Reduced bone mineralization in infants fed palm olein-containing formula: a randomized, double-blinded, prospective trial. Pediatrics - 01-MAY-2003; 111(5 Pt 1): 1017-23.

Young RJ. Neonatal and infant feeding: effect on bone density at 4 years. J Pediatr Gastroenterol Nutr - 01-JUL-2005; 41(1): 88-93.

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