Baby Formula

Baby formulas come in three main types: Cow’s milk formula, soy formula and specialized formula. These formulas are available in three forms: Powder you mix with water, liquid concentrate you mix with water and formulas that don’t require mixing that come in ready-to-feed bottles.

The U.S. Food and Drug Administration regulates the contents and safe production of all infant formulas sold in the U.S., and all formulas have to contain sufficient nutrition, including iron.

• Cow’s Milk-Based: These formulas make up about 80% of all formulas sold. The cow’s milk in formula is treated to make the protein more digestible, and milk sugar (lactose) is added to make it more equal to breast milk. Vegetable oil replaces the butterfat so infants can more easily digest it.
• Soy-Based: These formulas use soy proteins and do not contain lactose. These formulas may help babies that are allergic to lactose found in cow’s milk. According to the American Academy of Pediatrics (AAP), up to 50% of  babies who are allergic to milk protein may also be sensitive to soy protein.
• Specialized Formulas: Designed for babies with certain conditions, they should not be used without your pediatrician’s recommendation. These include:
  • Premature Baby or Preemie Formula, specifically designed for preterm infants.
  • Extensively Hydrolyzed containing broken-down protein for easier digestion and less risk of triggering an allergic reaction to milk protein.
  • Hypoallergenic Amino Acid-Based, the most hypoallergenic type of baby formula made with individual amino acids not sourced from dairy or soy.

The AAP and other experts recommend breastfeeding as the optimal way to nourish your baby. But some women might not be able to breastfeed for various reasons. Manufactured baby formula hasn’t been able to completely match breastmilk. But some brands such as Enfamil and Similac add ingredients like probiotics and Lactoferrin, a key component of breastmilk, and claim they are “close to breastmilk.”

However, parents are filing baby formula lawsuits after their premature babies developed necrotizing enterocolitis (NEC) after consuming Enfamil and Similac cow’s milk-based formulas. NEC is a potential baby formula side effect that causes intestinal inflammation and can lead to tissue death and blood infections. NEC can be fatal.

Always consult your pediatrician when it comes to choosing the best formula for your child. Most experts recommend cow’s milk formula over other types, unless a baby has a special condition. A parent’s formula choice is usually unique to the baby’s needs and your budget.

When feeding your baby, make sure to look out for signs of milk or food allergies. Symptoms include: Breathing problems, coughing, diarrhea, vomiting, hives and itchy eyes. If your baby has food allergies, you will want to opt for a formula that is hydrolyzed or amino acid-based. Your doctor can recommend a good brand.

Brand name or generic versions are similar in ingredients, but the generic version will be less expensive. Organic formulas have to follow the same baby formula standards as non-organic brands but they don’t contain GMOs and have certified organic ingredients. This means they are usually more expensive.

Most experts agree that there is no good evidence that shows which formula is best or that one formula is better than another. But CDC cautions against using homemade baby formulas or formulas purchased online from third party distributors because these formulas are not regulated by the FDA and might not be safe or nutritionally complete.

How much formula to feed a baby is unique to each baby. The average baby should take about two and a half ounces of formula a day for every pound of body weight, according to the APP. The CDC recommends feeding your baby when they are hungry and stopping when they are full.

Signs of hunger include: Putting hands in mouth, licking lips, clenching hands, showing excitement when food is around or turning toward the bottle. Signs of fullness include: Closing the mouth, turning away from the bottle, relaxing hands, pushing food away or making noises to let you know they are full.

You should give a baby formula until they are about a year old, according to the CDC. After 12 months, babies can transition to solid foods and whole cow’s milk or unsweetened soy beverage.

The switch away from formula should be gradual. Parents can start replacing one formula feeding with cow’s milk and gradually decrease the formula feedings.

Unopened containers of baby formula will last until the expiration date on the package. Make sure you don’t use expired baby formula. You should store unopened containers in a cool, dry place indoors.

You should use prepared baby formula within two hours. Infant formula not used within two hours can last up to 24 hours in the refrigerator. Throw away any leftover formula your baby doesn’t eat because baby saliva mixed with formula may cause bacteria to grow and cause side effects and health problems.

Opened containers of baby formula typically last about one month. Make sure to label opened formula containers with dates to prevent using old formula.

In February 2022, Abbott Nutrition issued a recall on baby formula for Similac, Alimentum and EleCare powdered baby formulas after it received reports that five babies became sick with Cronobacter sakazakii and Salmonella Newport infections. Abbott’s Sturgis, Michigan, facility produced the affected formulas. All the infected infants were hospitalized, and two babies may have died from their infections.

In a preliminary inspection report called from March 2022, FDA inspectors observed that Abbott didn’t have a system in place to ensure infant formula wouldn’t get contaminated with microorganisms.

In April 2022, Abbott released a statement addressing the baby formula shortage that the recall had exacerbated. The manufacturer told consumers it will increase production at its plants in Ohio and Ireland to combat the shortage.

In June 2022, the FDA reported another baby had died of a bacterial infection. In the same month, Abbott reopened its Sturgis, Michigan plant to help ease baby formula shortages.

Consumers can search for affected baby formula lots on Abbott’s website. This particular recall is not related to baby formula lawsuits that claim there is a link between Abbott’s baby formula and NEC.