Editor's Note: Planning to formula feed? Whether in addition to breastfeeding, or if you're opting for bottles the whole way, this can be a daunting decision for families. Our Lactation Consultant and Infant Feeding Specialist, Victoria Facelli, offers the following advice for those making these choices right now. (Yes, you, currently standing the store Googling your burning questions on your phone.)
The formula aisle has about 9,000 slightly different products, each making a slightly different claim. The choices can feel... well, overwhelming to say the least.
Do we want “for supplementing breast milk” or “DHA for brain development”? If only there was one that promised “sleeping through the night and never spitting up on your best, black coat”.
The first thing you need to know is the formula is one of the most carefully marketed products in the world. It also one of the most closely regulated. What that means is that the FDA very closely regulates the nutritional values in formula and standardizes it.
The quick and dirty details of the following thoughts: Go for the generic brand of normal infant formula at the place where you usually shop. It has been approved by the FDA to give your baby everything they need. That's it. Really.
Now, for my fellow Research Geeks who are unsatisfied with the fast answer above, come with me into a "Choose Your Own Adventure" of Formula-Feeding Wonder:
- Pre-mixed, name brand formula: The formula in hospitals and in the gift box that arrived at your door is their most expensive. That's done on purpose. It is sterile pre-mixed, name brand formula. While sterile formula is important for preterm babies, it is not necessary for term babies. It is much more expensive, but does offer a marginal convenience factor. Formula companies spend a lot of money making sure that their brand, and their most expensive product is your babies first formula because it feels scary to switch formula.
- Switching Formula: It is recommended that you stick with one brand as much as possible in case we need to diagnose an allergy. That being said, since most formula is basically identical it isn’t a huge deal, either. I usually suggest parents use what they give you at your birth place and switch to something less expensive when you get home, but then stick with it unless you and your pediatrician think it would be a good idea to try something else.
- Generics vs. name brands: As I mentioned above, infant formula is one of the most regulated substances that the FDA deals with. Because of this, generics are identical to brand-name formula in everything that actually matters. They may have different additives and less convenient packaging, but they are identical otherwise.
Remember that giant box of fancy pre mixed formula you got int the mail without ever asking for it? Someone has to pay for that. That's what you are buying with the name-brand mark-up. I often recommend that people identify the store you go to most (Costco? Target? Kroger?) grab their generic and call it a day. Take what you save in not having a fancy blue container with a cute animated owl on it and buy yourself a Honda Odessy (or a swanky Volkswagon if that's more your speed).
Bonus: a quick Google search or close look at the box will tell you which name brand factory your generic is made in. That way if you run out of formula and don’t have your Costco card or there isn’t a Target for miles, you can grab a box of the brand stuff and switch back when you have a chance to restock.
- Understanding formula additives: Formula companies are allowed to add-on to that "basic recipe" as long as it doesn't impact the basic nutritional balance and structure. A good example of this if Gerber Soothe. The basic formula is standard and they have added a probiotic to help develop a babies gut and support digestion. The thing is, whatever additive they add, you can probably do them one better. If you are a big fan of probiotics (as I am) and your pediatrician feels they are a good idea for your baby. Try a refrigerated multi-strain probiotic powder for babies. They are available at most health food stores, and are going to do a better job than the shelf-stable version in Gerber Soothe. This example extends to most of the additives hyped on the front of the formula can. DHA, lutien, choline, etc. are already in formula to the levels that the FDA deems essential, if your pediatrician agrees that more is better, they can recommend a supplement.
- Formula for supplementing: This is another formula marketing tactic. There is no real difference. If supplementing breastmilk with formula is part of your plan or a necessity for your family, any formula of your choosing will do.
- Hypoallergenic vs Soy: Some babies do have cow’s milk allergies. This should be diagnosed by your doctor; not by your mom, your neighbor, a favorite Facebook group, or our dear friend, Google.
Soy formulas are plant based, and not mammal based and are not recommended. Humans are mammals and mammal proteins are important for early brain development. Hypoallergenic formulas are based on cows milk formula and are broken down into their elements. They are expensive (and stinky), but the most gentle possible option for baby stomachs and are the best option if your baby has a cow milk allergy or you are very concerned about allergies present in your baby’s genetic family.
- Whole milk protein vs Organic formula: Many of our clients have strong feelings about whole foods vs. processed foods. If this is very important to you, organic formulas are often made with milk that wasn’t treated with rBGH hormones, have less corn base and may better fit your family’s food values. These larger cow milk proteins are harder to digest and are very new to the market. That means that we have fewer studies on the long term health risk and benefits of this formula than we have of traditional formulas.
- International brands: We live in the future! You can have literally anything you want delivered to your house in two days. (Side bar: how exactly did people have babies before Amazon Prime?) This has led to the rise of people importing European (usually German) formula brands. The two most popular are HIPP and Holle. Many people find the tighter food regulations in Europe reassuring. They are whole milk protein formulas, and thus have the same possible risks and benefits as American organic formulas. They are not regulated by the FDA.
IMPORTANT: You should not purchase formula from an international grocery store. Some international brands have histories of toxicity in infant formula and there can be bootleg versions of American brands. In fact, these concerns have resulted in much of the world relying on German brands which has made them harder to get. Any international formula should be purchased directly from the manufacturer.
- Homemade Formulas: Some people who value homemade unprocessed foods often find themselves wondering if a homemade, food-based formula would be a better choice for their family. In short hand, it isn’t. Hang onto that feeling for 6 months and go to town making your own baby food. The risk of contamination and malnutrition with home made formula is very high and thus this option is not recommended.