What You Really Need to Know About Formula and How to Choose the Right One for Your Baby

Ignore the labels, it’s all about the ingredients

The red-bolded words “anti-colic remedy” on the front of a formula tub can seem pretty promising when you’re standing in the formula isle of Target after several evenings with a fussy baby. This is exactly what the manufacturer intends when marketing their formula brands to parents. They knowingly get paid by targeting vulnerable new moms who are sleep deprived and desperate. Formula brands will advertise products made specifically for things like reducing spit up and gas or to help improve sleep. But, like most things baby related, it’s not a “one size fits all” solution.

The ingredients and how they react to your baby’s specific dietary and digestives needs are most important to understand when you’re in the process of choosing a formula. And I say process because you are most likely going to need to change formulas at least once or twice, and that is totally okay. I would actually recommend it. But where do you start? Read below for help navigating formula ingredients so you can become a confident formula consumer.

Casein vs. Whey

Pay specific attention the casein and whey protein ratios found in all cow’s milk formula (opposed to a soy based formula). Casein protein will curdle when it meets stomach acid and will sit for longer in the stomach. Whey protein stays in a liquid form and is digested much quicker than casein. If your baby is often constipated, a higher amount of the casein protein may not be the best choice, since it sits in the stomach and isn’t easily digestible. A symptom like spit up could be resolved with a higher whey protein formula because it leaves the stomach faster and won’t linger in the stomach.

Intact Proteins vs. Hydrolyzed Proteins

Intact proteins can be found in the cow’s milk you buy straight from the store. Intact proteins have not been processed or altered in any way. Meaning, nothing has been done to change the shape or size of the protein itself. This is key when thinking about proteins in formula (whey, casein, nonfat milk). For formula’s with full sized, intact proteins (meaning unprocessed and large in shape) we can expect a baby’s digestive system to have to work extra hard at breaking down those proteins. Your baby’s digestive system needs to break them down small enough to be absorbed. This is a lot of work and can cause tummy troubles in your little.

Cow’s milk proteins are often found to be larger than breastmilk proteins. So, in order to make the cow’s milk protein more easily absorbed in formula, companies will break down those proteins in the making of their formula brands. This makes it more comparable to human milk. The process of formula companies breaking down proteins into smaller pieces is called hydrolysis. There is fully hydrolyzed (hypoallergenic formulas) and partially hydrolyzed formula. The larger the protein, the more effort is needed from your baby’s digestive system to breakdown and digest the protein. In order to make your baby more comfortable, consider moving to a smaller sized protein which is less work on your babies digestive system. The protein size found listed on baby formula from largest to smallest is: Fully intact (or just listed as nonfat milk on the ingredients label), partially hydrolyzed, fully hydrolyzed, and free amino acids (found in specialized prescription formulas).

Lactose

At birth, babies are born with low quantities of the enzyme needed to digest lactose since it is not needed in the womb. This enzyme increases in response to increased lactose ingestion once earth side. Lactose is found in high quantities of breastmilk. If your baby is going from breast milk to formula, they should be okay tolerating a higher lactose formula. If your baby is experiencing bouts of diarrhea or painful gas, it could be a reaction to the higher levels of lactose and not having enough enzymes to break it down. It may be wise to try and transition to a lactose free diet for yourself if you are breastfeeding and/or a low-lactose formula. Go slow when increasing lactose exposure in babies to allow time for their enzymes to rebuild.

Other important things to note:

• - When reading ingredient labels on formula, pay attention to everything listed before the “less than 2%”. Anything after is less likely to be causing symptoms of discomfort in your baby.
• - Ingredients are listed on labels in order of greatest amount. The first ingredient takes up the most volume, the second listed ingredient is the second largest, etc.
• - Ratio of proteins in cow’s milk is about 20% whey and 80% casein. Human milk is about 60% whey and 40% casein. Consider this when choosing a formula that best resembles breast milk. Added whey in formula is usually ideal since cow’s milk has much less than human milk.
• - Studies have shown partially hydrolyzed formula can help clear up eczema and other whole body conditions.
• - Babies born before 40 weeks, or infants who have recently experienced a stomach bug will have less of the lactose enzyme needed to breakdown lactose. Temporality consider a low lactose formula in these cases. (premature baby formula does not have lactose for this reason).
• - Palm oil could be the cause of your baby’s constipation. Consider formula without palm oil in these cases
• - Allow for a slow transition when introducing a new formula. A cold turkey change could cause more upset than the ingredients themselves and will give you a false representation of how your baby’s digestive system is handling the new ingredients. When transition from one formula to another, take at least 7-10 days before going 100% to the new formula.
• - Compare ingredients when choosing a new formula. What was in the original formula that could be causing your baby discomfort and what does the new formula have that could elevate the symptom?
• - Name brand vs generic, it’s all the same. What is important is the ingredients and how your individualized baby is reacting to those ingredients.

Blog written by Caitlin LeBeau, member of the Tranquility by HeHe doula team.  Referenced from Baby Formula Expert.