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Frequently
Asked Questions About Formula
Make sure your
baby gets all the nutrition he needs.
The benefits
of a mother's milk are unparalleled--it contains every nutrient your
baby needs, is easily digested, boosts immunity, and is linked to
lower rates of asthma and other chronic illnesses later in life. But
some women can't nurse or choose not to, and countless others supplement
the breast milk they feed their baby with formula. In all, a whopping
85 percent of new mothers use formula. Although how to bottlefeed
may seem like a no-brainer, many parents have questions and concerns.
The first and foremost: Is formula really okay? The experts fill us
in.
1. I breastfed for four months, but my work schedule makes it too
crazy to pump, so I've gradually switched over to formula. I feel
guilty, though--is formula good enough for my baby?
There's no reason
to feel guilty. Some of the most intelligent, healthy people were
bottlefed as infants, according to Nancy Krebs, MD, an associate professor
in the department of pediatrics at the University of Colorado Health
Sciences Center and the chairwoman of the American Academy of Pediatrics
(AAP) nutrition committee. Although they can't pass along the resistance
to infection that breast milk does, formulas do provide adequate nourishment
for a growing baby. Formulas contain a comparable balance of protein
and sugar and match the calorie content in mother's milk. And just
like breast milk, formula gets about half its calories from fat, which
is crucial to brain development. Formulas are also supplemented with
various vitamins and minerals, including calcium, iron, and vitamins
C, D, and K.
Of course, no
infant formula exactly duplicates breast milk. Human milk is incredibly
complex, notes William Klish, MD, head of gastroenterology and nutrition
at Texas Children's Hospital in Houston. According to Dr. Klish, "Just
being able to identify all of the ingredients in breast milk--there
are hundreds--is a challenge. And then we don't know whether all of
those substances play an important biological role or if they just
happen to be there."
2. I've seen
store-brand formulas on the shelves next to the big-name brands, and
they're less expensive. Are they just as good?
There are some differences, notes Robert Baker, MD, co-chief of gastroenterology
and nutrition at the Children's Hospital of Buffalo and a member of
the AAP's committee on nutrition, but the generic formulas are definitely
adequate. That's because all formulas sold in the U.S. must comply
with minimum health standards set by the FDA. However, unlike brand-name
formulas, store brands aren't continually tinkering with their recipes--adding
extra ingredients, for example, or making changes to the protein makeup
or the ratio of one nutrient to another. And this tweaking, which
aims to make formula more like breast milk, may add benefits in terms
of baby's growth and development.
"But none
of the evidence definitively states that the newer formulas are better,"
says Dr. Baker. So if parents are trying to save money, they can consider
using the store brands.
3. I'm thinking of switching to a low-iron formula because my baby
is constipated. Is that a good idea?
No. Iron deficiency is the number one nutritional deficiency in the
country and the most frequent cause of anemia, a serious health condition
for a child, so it's important that a baby get enough of this mineral.
Pediatricians will prescribe low-iron formulas in rare circumstances;
because of this, the FDA has permitted their marketing. But these
products have led to suspicions--all of which are false--that the
iron in iron-fortified infant formulas cause diarrhea, constipation,
and colic. Parents then start reaching for the low-iron formulas without
first consulting their pediatrician.
"There is
absolutely no reason for any parent to purchase a low-iron formula
unless their child's doctor calls for it," says Dr. Klish. "They
are simply not nutritionally adequate." In fact, studies have
shown that school-age children who were fed low-iron formula as infants
tend not to do as well on standardized developmental tests as children
who received iron-fortified formula.
4. I'm a vegetarian and would like to give my child a soy formula.
Is it just as good as one with cow's milk?
Yes. Soy formulas are nutritionally equivalent to milk-based formulas.
The soy formulas of years past were questionable because they didn't
have quite the same quality of protein as cow's-milk formula, but
doctors consider today's versions perfectly healthy. Babies also like
soy formulas because they seem to taste a little sweeter than regular
formula, adds Dr. Krebs.
5. My baby has colic. Should I switch to a different kind of formula?
Colic--frequent inconsolable bouts of crying--can sometimes be a sign
of a milk allergy, especially if baby's crying spells and discomfort
come right after feedings and he has other symptoms, including digestive
difficulties and blood-tinged stool. Your pediatrician may suggest
switching formulas as a way to rule out an allergy, since cow's-milk
formula is the most common allergy trigger in infancy. He may recommend
switching to a hypoallergenic formula, which is made with hydrolyzed,
or predigested, protein. Soy formula is another alternative, but babies
who are allergic to cow's milk are often allergic to soy too, so doctors
may skip this option.
If you're pregnant
and have a family history of serious allergies, discuss with a pediatrician
whether you should put your baby on a hypoallergenic formula from
the start, suggests Dr. Krebs. If your child's colic does turn out
to be an allergy to cow's-milk formula, the good news is that most
kids outgrow milk allergies and can tolerate regular cow's milk by
the time their digestive system is mature enough for it, at age 1.
6. Is it better to use bottled water when I make formula for my baby?
You may be tempted to buy bottled water to mix with formula, but in
general, tap water is safe. In fact, since there aren't clear standards
for the filtering process used in bottled water's production, it may
not be any better than your local tap water and could be worse, says
Dr. Klish. Bottled water also lacks fluoride, important for healthy
teeth, so if you use it, ask your doctor about starting baby on fluoride
drops at 6 months.
Whatever kind
of water you use, it's best to sterilize it first. "Bring the
water to a running boil for one minute and then turn it off,"
says Dr. Klish. "If you let it boil for too long, concentrated
salts and minerals can build up." You can stop sterilizing water
once you've introduced your baby to solid food, at 4 to 6 months,
since your child's system will be exposed to bacteria in real food.
When preparing
formula, be sure not to add more or less water than recommended. If
formula is too diluted, your baby will be undernourished; formula
that's too strong can dehydrate your baby. Concentrated liquid formulas
should be mixed with an equal amount of water, and powdered formulas
require measuring out a specific amount of water. Ready-to-feed formulas,
of course, don't require any additional water.
7. I've heard about a new supplement being added to formulas. Should
I make sure to buy it for my baby?
In their quest to make formula more like breast milk, manufacturers
are considering adding two polyunsaturated fatty acids, docosahexaenoic
acid (DHA) and arachidonic acid (ARA) to formula. These nutrients,
naturally present in breast milk and already in formulas in Europe
and Japan, are important for visual acuity and in brain development.
"Infants
can't make their own DHA and ARA," explains Barbara Levine, PhD,
codirector of the Human Nutrition Program at Rockefeller University
in New York City. "They get them through the placenta during
pregnancy and from breast milk after birth." That leaves formula-fed
babies at a disadvantage, but by putting DHA and ARA into formula,
some experts hope to make up the difference. In recent studies, preterm
babies seemed to benefit dramatically from the supplemented formula--demonstrating
better motor skills, visual acuity, and cognitive development at age
1 than preterm babies on regular formula. That's undoubtedly because
preemies receive significantly less DHA and ARA in utero since they're
born early. The results of studies on full-term babies are more mixed:
Some have positive results similar to the preemie studies, while others
don't show much of a difference. "The jury is still out,"
says Dr. Baker. "I'm not convinced yet that full-term babies
will benefit from DHA formula." Dr. Krebs agrees: "Whether
adding DHA and ARA to formula is going to produce lasting benefits
five years down the line remains to be seen."
Perhaps more
will be known within a year or so, when DHA formulas are projected
to hit the shelves as a new (and more expensive) option.
Your
should know:
The
information on this Web site is designed for educational purposes
only. It is not intended to be a substitute for informed medical
advice or care. You should not use this information to diagnose
or treat any health problems or illnesses without consulting your
pediatrician or family doctor. Please consult a doctor with any
questions or concerns you might have regarding your or your child's
condition.
Rebornne Baby. American Baby
