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Picking the Right Formula

In this day and age, a parent might just look down the formula aisle in the grocery store and easily get overwhelmed by the vast variety and brands of formulas that are available. So, I am going to simplify it for you and provide a brief overview of the infant formulas.

Over the last 10 years, we have seen more varieties being added than ever before. It is very crowded and competitively marketed; sometimes the different companies are quite creative with their naming and labeling strategies- all of them are fiercely competing for your attention and your business, trying to entice the newborn’s parent towards them.

The formulas can be broadly categorized into 4 different categories:

  1. Cow’s milk-based formula- made of cow’s milk protein and has lactose as a sugar. Some may come as ‘lactose free.’
  2. Soy-based formula- made with soy based protein and they are always lactose free
  3. Protein hydrolysate formulas- the proteins are broken down into simpler particles called amino acids. These are used for babies who have true protein allergy.
  4. Formulas for premature and low birth weight babies- they have extra calories and minerals for catch up growth.

The cow’s milk or soy based formulas might also have enhancements like a rice formula thickening agent to help with reflux. Formulas that are specifically made to help with reflux or spit-ups contain rice cereal and they are labeled ‘AR’ for ‘added rice’ and ‘anti-reflux.’

Some other formulas have the proteins a little bit more broken down and/or contain less lactose for easier digestion. They have labels like ‘gentle,’ ‘sensitive,’ or ‘hypoallergenic.’

Whether a formula is brand name or it is store brand, they are all made per the strict guidelines of the FDA. Therefore they are quite comparable. You do not necessarily need to pay more for the name brand formulas.

All of the formulas have certain common characteristics, whether or not the manufacturer is making big claims on the label or packaging. All formulas have iron supplementation though some might claim to be low-iron. Iron supplementation is important for the baby until the baby starts eating iron rich foods.

In recent years, 2 fatty acids known as DHA (docosahexaenoic acid) and ARA (arachidonic acid) have increasingly been added to formulas. These lipids are crucial for the development of the eyes and the brain. The formula might have prominent labeling with words such as “lipids,” “lipil,” “advance,” or just plain “DHA and ARA.”

Some formulas are also fortified with probiotics, which are types of “friendly” bacteria. Others are now fortified with prebiotics, which are natural food substances that promote healthy intestinal lining.

Infant formulas come in 3 different kinds:

  1. Ready to Feed
  2. Liquid Concentrate
  3. Powder

Which kind you choose to use will depend upon how much you will use, where you will use it (ready to use being easiest when you are on the go) and how much you want to spend. The liquid and the powder formulations are comparable in price and the ready to feed is more expensive than the other two.

Some basic measurements to remember are as follows

1 ounce= 30cc or 30 ml

8 fluid ounces= 1 cup

32 fluid ounces= 1 quart

Most babies do fine on cow’s milk or soy-based formula. Babies have a natural tendency to have spit ups and gas, and it is not always necessary to change formulas for these conditions because the formula may not be the cause for the baby’s symptoms. Please consult with your pediatrician before you make rapid changes to the baby’s formula.

However, about 10% of babies are truly intolerant of milk or soy-based formulas- a condition known as Milk Soy Protein Intolerance, which is caused due to the baby’s intestines truly being intolerant of the proteins in these formulas. These babies are not happy. They might have symptoms of fussiness, spit up a lot or become excessively gassy, or they may develop constipation or diarrhea. In this case, your pediatrician will probably recommend that you try one of the special formulas in which the proteins are broken down.

Other babies just show a clear preference for one type or even brand of formula over another or a preference between the consistency of powder-based versus liquid formula. Parents are prone to a fair bit of trial and error when they have a picky eater. I do caution the parents that once a formula change is made one should give it for a few days before deciding whether or not it is a good fit for the baby. After all, it might take a day or two before the old formula clears the baby’s gut and the new formula shows its effects.

The good news is that most newborns do quite well with whatever brand or type of formula they are given. Some do fine even with switching between

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