Definition Infant formulas are designed to meet all, or nearly all, of the nutritional needs of infants during the first year of life. The formulas try to match, as closely as possible, the nutritional qualities of human breast milk. These formulas come in several forms. Powdered formulas and liquid concentrates are mixed with water. Infant formula also comes in a ready-to-use form.
There are infant formulas for many different needs. These formulas vary in calorie content, ingredients, nutrient composition, digestibility, taste and cost. All infant formulas must meet standards developed by the American Academy of Pediatrics.Infant formulas fall into the following categories:
standard milk-based formulas
soy protein formulas
formulas for premature infants
formulas for infants with digestive problems
formulas for infants with metabolism problems
formulas for infants with medical conditions affecting their ability to break down and effectively use specific nutrients in food
What food source is the nutrient found in?
How does the nutrient affect the body? Infant formulas act as a source of nutrition for infants less than 1 year of age.
Information It is best if infants are fed breast milk or infant formula for the first year of life. Cow's milk should not be used instead of breast milk or infant formula. Babies have special nutritional needs. Cow's milk has more protein and some minerals than breast milk or formula. An infant's kidneys cannot handle the extra protein and minerals. Cow's milk does not have enough of some nutrients such as vitamin C, iron, zinc, and essential fatty acids, the part of dietary fat that is used to build body tissues, to satisfy an infant's nutritional requirements.
Standard milk-based formulas are made from cow's milk. The cow's milk is modified to adjust the amount of some nutrients. The protein is changed to make it more digestible. The butterfat is decreased or removed. Vegetable fats are added to provide more essential fatty acids and to make the fat more digestible. More lactose is added and vitamins and minerals are adjusted. Standard formulas are made with and without extra iron. The American Academy of Pediatrics recommends iron-fortified formulas for all infants. The caloric content of standard formulas is 20 calories per ounce. Standard milk-based formulas are adequate for infants with no special nutritional needs. Standard milk-based formulas include:
Enfamil (Meade-Johnson)
Similac (Ross)
Goodstart (Carnation)
Enfamil AR
Soy-based formulas are also available. At first, they were made for infants who could not tolerate the lactose or protein in cow's milk. However, few infants are lactose intolerant. The protein in soy milk can cause the same allergic reaction as the reaction caused by the milk protein. Soy formulas are useful for infants with galactosemia, who cannot effectively use the sugars produced when lactose breaks down, and for parents who prefer a strict vegetarian diet. There is some debate concerning whether or not soy formulas allow a baby's bones to develop properly. Soy formulas are not recommended for premature infants.
Greater amounts of vitamins and minerals are added to soy formulas. This is because the soy formulas contain compounds that may decrease the amount of nutrients that are absorbed. Like milk-based formulas, soy formulas provide 20 calories per ounce. Soy formulas include:
Isomil (Ross)
Prosobee (Mead-Johnson)
Alsoy (Carnation)
Isomil DF
Formulas for premature infants are made to help babies with low birth weights grow quickly. These formulas are all milk-based. The formulas contain from 20 to 24 calories per ounce and have more protein, vitamins and minerals. The formulas designed for premature infants should only be used under a doctor's supervision. Formulas for premature infants include:
Enfamil Premature (Mead Johnson)
Similac Special Care (Ross)
Enfamil 22 (Mead Johnson), soon to be renamed Enfacare.
Neosure (Ross)
Some formulas contain peptides or amino acids, which are the products of protein digestion, and special types of fat. These formulas are designed for infants with food allergies or for babies who cannot digest and absorb certain nutrients. These include:
Nutramigen
Pregestimil
Alimentum
Neocate
There are also formulas for infants with inborn errors of metabolism, who cannot break down and effectively use specific nutrients. These formulas are designed to prevent the build-up of toxic unmetabolized products in the body. Feeding babies with metabolic problems can be complicated. The problem should be discussed with an experienced dietitian and physician.Some formulas for metabolism conditions include:
Soy formulas
Lofenalac
MSUD powder
PM 60/40 is designed for infants who must have limited amounts of certain minerals. Portagen is often given to infants whose medical conditions require that they not have too much of certain kinds of fat. RCF is for infants who cannot tolerate carbohydrates.
A baby should be fed when it is hungry. Formula feeding should be allowed on demand. An adequate volume of formula is being consumed when an infant is able to gain three-quarters to one ounce per day in body weight during the first six months, and half to three-quarters of an ounce per day in body weight from six to twelve months of age. Vitamin/mineral supplements are not usually needed.
Mixing the formula improperly can harm a baby. Carefully follow the mixing instructions on the formula container. Mixing instructions vary from one formula to another. Formula powders and liquid concentrates can be used together, but only with the advice of a healthcare professional.
Author: Lanette Meyer, CD Reviewer: Sandy Keefe, RN, MSN Last Updated: 02/26/00 Contributors Potential conflict of interest information for reviewers available on request
