share this post

Life doesn’t come with a manual; it comes with a mother. - Anonymous

I don’t know about you, but sometimes I wish babies did come with a manual. Being a parent has a surreal quality sometimes, and it’s both purposeful and fun to relish in the mystery of who our little ones are and who they are becoming. But man, there are some tough decisions to make as a parent. It’s the most vulnerable and scary role I’ve ever had. In my head, I entertain every thought from irrational fears like, “Will letting him cry too long cause him to have an anxiety disorder?” to concerns like, “What formula is going to be best for his health?”

While the information and ‘expert’ opinions are constantly evolving (my parents placed me and all my siblings on our stomachs to sleep), we know that eating overly processed foods has negative impacts on our bodies And as we take steps toward a healthy diet of natural, whole, and unprocessed foods, we have to look at the nutritional value of infant formula. Truly, it’s more important than any other food on the market because it is our babies’ sole source of nutrition in cases where moms are not breastfeeding.

If you want to skip the heady and science-y stuff, I wrote this article on choosing the right formula for your baby. But I wanted to spend the time here diving deeper into the health standards of infant formula.

For example, many major formula retailers include this statement on their packaging: “Trace amounts of genetically engineered material may be present in the product, such as from manufacturing environments and process sources.” So, we know that many formulas contain “trace amounts of genetically modified materials,” but do we know what effect trace amounts have on our babies? The human body, after all, is amazingly adaptable. But many studies indicate otherwise, especially when it comes to babies and children, and that’s enough for me to want to play it safe.

Whether you’re researching alternatives to breastfeeding or in the process of trying to choose an infant formula for your baby, this article lays out what to look for and how each vital nutrient plays its role in your baby’s sweet little body.

When did infant formula become a thing?

Infant formula has only been available as a commercial product since the 1930s, during which time it was accessible only through pharmaceutical companies. Before that, the ideal solution was to employ a wet nurse (or call on a friend); however, not all families had the option or the means. Hence the creation of a “formula” of ingredients, made right at home. In the 1950s, infant formula became a main item on grocery store shelves, and moms were led to believe that formula was actually superior to breast milk. A sticking point in the timeline was the year 1979, when a recall on a major formula brand resulted in the creation of The Formula Act of 1980 by the Food and Drug Administration. This law outlines the specific nutrients required for infant formula at their minimum and maximum levels. There have been other recalls since that time, and in 2014, the FDA added new rules requiring formula manufacturers to 1) test for harmful pathogens, 2) demonstrate that formulas support normal growth and development, and 3) test for nutrient content in final product stages.

(Note: If you order formula from a European company, the standards are set by the European Commission.)

Interestingly, this is why homemade infant formula can be a healthy alternative to manufactured infant formula. We all know there are medical and public warnings against homemade formula because the wrong combination of nutrients or unsafe preparation will have serious health implications for your baby. But…it is possible to develop a healthy recipe that includes the proper balance of nutrients and meets all the criteria of The Formula Act of 1980, such as this popular homemade recipe by the Weston A. Price foundation or this homemade infant formula kit from Mt. Capra farms. Another great benefit is that it’s made from whole food ingredients rather than processed in a factory.

Let’s look at what all formulas should be made of.

Balance of Nutrients

All infant formulas, whether commercial or homemade, should be designed around the ideal balance of nutrients for baby’s developing body. There are two main groups of nutrients: 1) Macronutrients - a) Protein, b) Carbohydrate, and c) Fat and 2) Micronutrients - a) Vitamins and b) Minerals. There is some “wiggle room” in the sense that some formulas are specialized for babies with allergies or digestive disorders and may contain a different ratio of ingredients.

Protein

The protein source differs depending on the type of formula you choose for your baby.

• Cow milk - listed as milk, nonfat milk, organic milk or nonfat milk

• Hydrolyzed cow milk (for sensitive or hypoallergenic formula) - listed as whey protein concentrate, partially hydrolyzed milk, casein hydrolysate

• Goat milk - listed as goat milk, nonfat goat milk

• Amino acids, which are the building blocks of protein (for elemental formulas) - listed as amino acids, medium-chain triglycerides

• Soy milk - listed as soy protein isolate

There are important differences between these proteins, and your baby may require a specific kind in order to ease digestion and absorption, acid reflux, or prevent an autoimmune response due to allergies. There are two types of proteins in milk: casein and whey. Milk that has a larger quantity of whey proteins is easier to digest, so when you are reading labels, lean towards whey over casein (although some hypoallergenic formulas, such as Similac Alimentum, use casein hydrolysate). Breast milk has a casein to whey ratio of 40:60 while cow milk and goat milk proteins are 80:20 casein to whey. This is a big difference when you consider digestibility for your baby’s tummy!

1. If your baby has an allergy to cow milk protein, you may need to change to a hypoallergenic formula, which contains hydrolyzed proteins. These proteins are broken down in advance into smaller, more digestible molecules since cow milk proteins are large and often difficult to digest. (Imagine taking a chain of sausage links and pulling each of the links apart.)

2. If your baby has a sensitivity to cow milk but not an allergic response, then she may only need a “sensitive” or partially hydrolyzed formula. These contain a greater concentration of whey protein to casein protein as it is easier to digest, or they may use a concentrate or isolate version of the protein.

3. If your baby has a severe allergy to cow milk formula, then an elemental formula may be necessary. These are made of individual amino acids (the building blocks of protein) so there is no “protein” to recognize as an allergen.

4. Soy can be a good option if you are trying to avoid dairy and don’t need pricey hypoallergenic or elemental formulas, but there is still circling controversy over the health implications of soy. Many moms believe soy is a health saboteur and do not use any products with soy - even soybean oil or soy lecithin. Some are more concerned with soy protein isolate in particular - not soy in its pure form - specifically how it affects estrogen levels in the body.

Carbohydrate

The main carbohydrate source in breast milk is lactose, making lactose the most natural option in formulas as well. And while many infant formulas contain lactose, you may notice that once you move to sensitive, hypoallergenic, or soy formulas, the carbohydrate source is usually an artificial sugar. The most common are corn syrup, glucose syrup solids, corn maltodextrin, brown rice syrup, and starch (which is typically used to thicken hypoallergenic or elemental formula).

Glucose and brown rice syrup are a little better than corn syrup, corn maltodextrin, sucrose (table sugar), and fructose. The latter are harder to digest and have a greater effect on blood sugar levels, but all refined sugars affect the body differently than lactose. However, corn syrup and corn maltodextrin are still not the same as high fructose corn syrup, which has additional fructose and couldn’t dare be in infant formulas. None of these are preferable over lactose as the carbohydrate, but if your baby needs a specialized formula, that’s more important than getting one with lactose!

Fat

The fat source in formula comes from various types of oils. While fat is less likely to cause an allergy or digestion issue, some babies do have trouble digesting fats and require a special formula like Pregestimil. Moreover, some oils are better than others and you can check the label to see which you’re getting.

• Better oils - high oleic sunflower oil, grapeseed oil, coconut oil (easier to digest)

• Cheaper oils - soybean or soy oil, canola oil, high oleic safflower oil (harder to digest)

Many formulas now add two additional fatty acids after discovering these in breast milk - DHA and ARA. You’ll see on many labels, “ARA & DHA for brain development!” or “HMO formula!” which stands for Human Milk Oligossacharides (although they are not actually from human milk). Currently, they are thought to be beneficial but not essential - but their main function is to support healthy brain function and eye development.

Vitamins and minerals

Some vitamins and minerals are naturally occurring in milk, but formula is supplemented with all that are missing - especially since processed, powdered forms of milk lose some of their nutrients through processing. For example, any type of milk is fortified with Vitamin D, as it is crucial for calcium absorption and bone development. As scientists learn more about the composition of breast milk, new ingredients are added to the mix - like the ARA, DHA, and HMO mentioned above. If you choose a homemade formula, you can use vitamin packets like these.

Thoughts on growth hormones

Cows being treated with rBGH or rBST (synthetic growth hormones) was approved by the FDA in 1993 and has not yet changed. Most formula retailers who source their milk from cows treated with these hormones site studies that say no significant differences have been found between cows treated with rBGH/rBST and cows not treated with these hormones. If you’re looking to avoid products from cows treated with growth hormones, the most common options are goat milk formula, soy formula, or organic cow milk formula (make sure the label or website clearly states that they use milk from cows who are not treated with hormones).

Conclusion…

Many companies will advertise “our closest ever to breast milk,” but the going can only get so good when it comes to mimicking breast milk. It is an amazing, ever-changing nutritional powerhouse. Nonetheless, researchers continue to study it and develop better options. In the meantime, we educate ourselves on what to look for when choosing a healthy alternative for our little ones!

If you could not make breastfeeding work and are curious about alternatives other than infant formula, read this article about some other options for feeding your baby.