Infant formulas

Alternative names 
Formula feeding; Bottle feeding

Definition
Infant formulas are food products designed to provide for the nutritional needs of infants. They include powders, concentrates, or ready-to-use forms. See also breastfeeding, appropriate diet for age.

Function
Infant formulas act as a nutritional source for infants less than one year of age.

Food Sources

A variety of formulas are available for infants younger than 12 months of age if breast milk is not used. These formulas vary in caloric density, nutrient composition and ingredients, digestibility, taste, and cost.

Guidelines for infant formulas and standards for normal infant feeding based on human breast milk have been provided by the American Academy of Pediatrics (AAP).

Specific types of formulas include:

     
  • Standard milk-based formulas  
  • Soy protein formulas  
  • Formulas for premature infants  
  • Formulas for infants with metabolism problems

The standard milk-based formulas contain heat-treated cow’s milk protein (at reduced concentrations), lactose and minerals from cow’s milk, vegetable oils, minerals and vitamins. The amount of each nutrient is set to standards based on levels in breastmilk.

The AAP recommends iron-fortified formulas for all infants. Standard formulas contain 20 Kcal/ounce and .45 grams of protein/ounce. Additional vitamin supplements are not usually recommended.

Consuming more than the daily requirement of vitamins is unnecessary and potentially harmful. Depending on the water supply, pediatricians may prescribe a fluoride supplement to help the infant develop strong teeth and bones.

Management of infants with metabolic problems should be discussed with an experienced dietitian and physician. Formula choices may be affected by the condition of the infants’ gastrointestinal track and metabolism.

Side Effects
Improper mixing of infant formulas can result in abdominal pain, improper caloric intake, or other problems. Never water down the formula, as that can alter your baby’s salt balance, which can cause seizures. Using the wrong type of formula for infants with special needs can cause the baby’s condition to become worse.

Recommendations

The AAP recommends that infants be fed formula or breast milk for a minimum of 12 months.

Cow’s milk alone is not an appropriate diet for infants because the baby’s kidneys may not work as efficiently as an adult’s. Cow’s milk also has too much protein (and in particular, too much casein, a type of protein). The minerals are not easily absorbed, and there is an increased risk for sensitization to milk proteins. Low-fat and skim milk are also inappropriate for use in the first year of life. They do not provide enough calories for growth nor enough of some nutrients needed for normal development.

Formulas based on cow’s milk are appropriate for full-term and pre-term infants having no special nutritional requirements.

SPECIAL FORMULAS
Special formulas should be used under a physician’s supervision.

     
  • Infants with lactose intolerance or a milk-protein allergy cannot drink standard cow’s milk-based formula. Soy-based formulas do not contain milk protein; they use soy protein instead.  
  • Formulas for premature, low birth weight infants are designed to encourage rapid growth.  
  • There are other specialized formulas, such as those for infants with heart disease, malabsorption syndromes, inability to digest fat, and other conditions.

MIXING FORMULA
Improper mixing of formula is common and may harm the infant. Follow the instructions on the formula container carefully.

Johns Hopkins patient information

Last revised: December 5, 2012
by Potos A. Aagen, M.D.

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