How to Choose a Baby Formula

How to Choose a Baby Formula

June 10, 2020

How to Choose a Baby Formula

How to Choose a Baby Formula

There’s no shortage of selection when it comes to baby formula (check out our guide on the best baby formulas). A quick walk through the baby aisle at your local Target or a scroll through formulas on Amazon can leave you pretty confused pretty quickly. So how do you even begin to know what formula is right for your baby?

Thankfully, it’s simpler than it may seem if you keep some basics in mind and some expert advice top of mind. We spoke with Kelly Fradin, MD—a pediatrician, writer and New York City-based public health advocate for evidence-based information—on all things formula and how to know what’s right for your little one.

Know Your Options

Before you can figure out the best baby formula for your little one, you need to learn about the different types of infant formula available and some of the pros and cons of each.

Types of Infant Formula

There are four main types of infant formula:

  • Cow’s milk-based formula. According to the American Academy of Pediatrics (AAP), cow’s milk-based formula makes up about 80% of all formula sold. As its name implies, cow’s milk is the main ingredient in this type of formula—but the milk is modified to make it safe and more easily digestible for infants. Keep in mind that some babies are allergic to the protein in cow’s milk and may need an alternate type of formula.
  • Hydrolyzed formula. These types of formulas contain protein that has already been broken down (hydrolyzed) into smaller proteins that can be more easily digested. Often marketed as “calm” or “gentlease,” these predigested formulas may be either partially or exclusively hydrolyzed. According to the Mayo Clinic, they’re designed for babies who can’t tolerate cow’s milk or soy-based formulas or for babies who have a protein allergy.
  • Soy formula. Formulas made from soy milk contain a protein (soy) and a carbohydrate like glucose or sucrose. They are useful if you’re looking to exclude animal products from your baby’s diet or if your baby is unable to digest lactose.
  • Specialized formula. Specialized formula is available for babies with certain medical needs or preterm babies.

Infant formula also comes in three forms:

  • Powdered formula needs to be mixed with water.
  • Concentrated liquid formula also needs to be mixed with water.
  • Ready-to-use formula, also called ready-to-feed, is premixed and doesn’t need any additional water added.

How to Choose a Baby Formula

You know your options—but now what? Here’s what to consider when choosing a baby formula.

Accessibility

Accessibility is one of the biggest factors to consider when choosing a baby formula.

“I recommend families prioritize having an infant formula that’s accessible,” says Dr. Fradin. “If it’s hard to obtain from a local store or if you travel, that may cause unnecessary stress.”

Don’t spend too much time stressing over store brand formula versus a name brand. “Store brand formula, for all intents and purposes, is the same as brand name formula,” she says. “Most doctor moms I know choose store brand formula to save money.”

The same goes for organic versus non-organic. “Organic formulas should not contain ingredients that are genetically modified and may be less likely to contain traces of pesticides and growth hormones. If you can afford it, I would use organic, although the evidence for benefit from organic formula is slim. Certainly I would prefer a baby be fed non-organic formula than a family be stressed and rationing a more costly organic formula.”

Fradin also warns against using imported formulas like HiPP or Holle. “Since they are not approved by the FDA, companies that sell do so without oversight. There are many concerns including safety, unclear mixing instructions, and lack of FDA regulation,” she says.

“Most babies should be offered a standard iron-fortified milk-based infant formula,” she says, citing brands like Similac, Enfamil, Earth’s Best and many store brands that are readily available. “If you plan to deviate from these standard formulas, I recommend parents discuss this decision with their pediatrician.”

Cost and convenience

Next up on your list of things to think about? How much of you’re willing to spend on your baby’s formula and what formulation fits most easily into your lifestyle.

  • Powdered formula is the least expensive of all types of infant formula available. It’s also more convenient to store—but keep in mind that it does need to be measured and mixed appropriately, something to think about if you’ll frequently be feeding your little one while on the go.
  • Concentrated formula is more expensive than powdered formula. It also has to be mixed with water, but it’s a bit less messy to prepare than powdered formula.
  • Ready-to-feed formula is the most expensive of all types of infant formula. It has more waste and is the heaviest to transport; however, it’s the most convenient as it doesn’t require any additional water or any mixing.

Can you rely primarily on one form of formula then switch things up every once and a while for the sake of convenience? (Powdered formula on the regular, for example, and then ready-to-drink if you’re feeding your baby on a plane.) Sure, say pediatricians—just make sure you’re feeding your baby the same type of formula in both forms.

Use science, not marketing

From promising to help soothe a fussy baby to claiming to boost brain development, it’s easy to be swayed by the promises that lots of formulas make. But take these claims with a grain of salt, says Dr. Fradin.

“Many of these claims are based in scientifically valid theories,” she says. “However, at best, there is indirect evidence of benefit.”

She cites a four-month randomized trial that compared the growth of infants fed lutein-fortified infant formula with that of infants fed formula without lutein fortification. (Lutein is a nutrient in breast milk that has been linked to healthy eye development.) “No differences were seen in babies’ lutein levels,” says Dr. Fradin.

“It’s likely that the benefit exceeds the harm of thoughtfully adding these nutrients,” she points out. “Many of these modifications may be good, but just lack strong evidence.”

Stay the course

It’s best to stick to a formula once you find one that works for you and your baby, says Dr. Fradin, even during particularly fussy times.

“While many parents are quick to blame the formula contents, fussiness is often developmental,” she says.

“Changing formulas may stress an already fussy baby. If a change is made it can take up to two weeks for the baby to adjust. For this reason, I recommend keeping the formula consistent when possible and taking the time to speak with your doctor before changing to one of the specialty formulas.”

Signs your baby may be experiencing an intolerance or allergy to a formula rather than just everyday fussiness include reflux, blood in their stool or a rash. If you’re not noticing any of these symptoms but are still dealing with a cranky baby, here are a few things to try:

  • Extra burping. Spend a little more time burping your baby to try to ease any stomach discomfort they may be experiencing by swallowing too much air while feeding.
  • A slower-flow nipple. A nipple with too fast of a flow can also cause your little one to gulp down too much air while eating. Level down to a nipple with a slower flow to see if that helps.
  • Teething relief or an extra nap. Teething discomfort and being overtired are both common reasons your baby may be acting extra grumpy. Over-the-counter medications like acetaminophen can help with teething, while implementing a healthy sleep routine can help your baby (and you!) get a bit more rest.

“Pediatricians can work with parents on improving these common things before blaming the formula as the culprit,” Dr. Fradin says.

Formula Feeding Tips

There are a few other things Dr. Fradin suggested to keep in mind if you decide to feed your baby formula.

  • Always mix formula properly. “Likely the most important part of feeding your baby is not the brand you select but whether you mix it correctly,” she says. Mixing errors are common and can lead babies to drink too concentrated or too diluted milk, which can be detrimental to their health. Pay attention to the specific mixing instructions for your formula and always follow them closely.
  • Stir, don’t shake. If you mix formula by shaking the bottle, you run the risk of introducing extra air, which can lead to more burping and a baby with an unhappy tummy. Dr. Fradin recommends the Dr. Brown’s Formula Mixing Pitcher to help make this task a little easier.
  • Know your water. “One thing many families get confused about is that in most parts of the US, tap water works great to mix formula,” says Dr. Fradin. Some water marketed as “baby water” does not contain fluoride and may actually do more harm than good, so be sure to ask your pediatrician about your town or city’s water.
  • Prevent bacteria. Formula can be contaminated with bacteria, says Dr. Fradin, so also be sure that you’re storing and discarding formula according to your brand’s specific directions.
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