Saturday, December 3, 2011

Is There Any Difference Between Infant Formulas?


Infant Formulas are based on Cows Milk, Soy Milk or Goats Milk.  And they are categorised as:
  1. 100% Whey dominant = HA Formulas
  2. Whey dominant = most Birth-6mth Formulas / Infant Formulas / Step 1 Formulas
  3. Casein dominant = From 6mth Formulas / Progress Formulas / Step 2 Formulas or Toddler Formulas
Within the Cows Milk range, there are choices of  Lactose Free, Anti-Reflux, and HA (Hypo-Allergenic), Gold (contains LCPs), and of course Organic.

Cow's milk, Goat's Milk, Soy Milk and all other milk besides human Breastmilk, was never intended for human infants.  Each mammal species produces a milk composition ideal for it's own particular species. Therefore, the composition of Whey proteins to Casein proteins in Cow's milk or Goats milk (and every other milk) will be different to breastmilk.  The nutritional content (vitamins, minerals and enzymes) of other milk will also be vastly different to breastmilk, and will lacks many key nutrients present in breastmilk, which is vital for the development of human babies.
It is actually dangerous to feed any fresh milk that is not breastmilk, to human babies, as it is not only completely unsuitable for a human baby's gut but it also does not support the vital growth and development of human babies.  Other than breastmilk, any fresh milk (meaning unmodified and unfortified milk) must not to be given to infants, and not to be given to older babies as a food until after at least after 12 months of age, or older if possible.  All milk sources for Formulas must first be modified in both protein composition, as well as nutritional composition, with the goal of becoming as close to breastmilk as possible.

Once you've made the decision to complementary feed with Formula or fully Formula feed, there are some factors to take into consideration before selecting the most appropriate Formula type and Formula brand.

For a healthy baby without any allergies or intolerances, these are my tips for selecting formula:
  1. Choose a Whey dominant formula or preferably 100% Whey formula, known as HA Formula.  Whey dominance is extremely important because cows milk proteins are larger than breastmilk proteins and therefore more difficult to digest.  HA Formulas ensure that these proteins are partially hydrolysed, which means they are broken down to help babies to digest properly and thereby reducing digestive problems like constipation, wind, making it the best choice for baby, if breastmilk is not an option.  Breastmilk is Whey predominant until around 8mths where Whey to Casein ratio is 50:50
  2. Choose an accessible Formula.  It's convenient to choose a formula that you can purchase from most places, rather than an exclusive Formula that can only be found in certain stores.  This avoids the frustration of when you run low on Formula at home, or when the manufacturing of the Formula is short on supply,
  3. Consider selecting a certified Organic Formula.  Organic Formulas are not as readily available as some other Formulas (however, many supermarkets and pharmacies DO stock them), and they are, to date, not available as HA Formulas, but the benefits of having a Formula made from certified organic milk, free from chemicals is something that all new mothers should explore before taking the plunge into a 'regular' non-organic Formulas.
  4. Selecting a formula with Gold or LCP containing formulas is optional, and may be of benefit, but this option would come well after points 1-3 as we don't know for sure if babies can or can not absorb these properly, and there are some babies who may not tolerate the LCPs and do better on formulas without the added oils.
  5. Choose a formula based on price AFTER all the other criterias have been met.  HA Formulas are the most expensive and Whey dominant Formulas come a close second, in pricing.  Casein Formulas are cheapest and there's not much modification of the proteins which tends to cause belly aches, constipation and wind in babies.  It is the Casein protein in milk that is linked to dairy-based allergies in babies.  The metabolism of Casein proteins produces larger amounts of end products and electrolytes in the urine, which can pose a problem for babies who are not adequately hydrated with water. 
  6. For healthy babies, there is no need to consider Soy or Goats Milk Formulas.  There are some discussions about Phyto-oestrogens and Thyroid disease surrounding Soy formulas which are better left alone if there is no need to go down this path.  Goats Milk Formula is an unnecessarily expensive option for a healthy baby.
  7. From 6 months of age, there's usually no need to change your baby from an infant/Step1/from birth Formula (Whey dominant formula) to a progress/Step2/from 6mths Formula (Casein dominant formula).  Breastmilk becomes equal in Whey and Casein at around 8 months, which is still much less in Casein proteins than the progress formulas which start at 6 months of age. Manufacturers will argue that the proportion of nutrients has been adjusted to suit an older baby, however, from 6 months, additional nutrients will be gained by the introduction of solid food.
  8. Casein dominant Formulas definitely satisfy the "hungry" baby for longer, but it's at the expense of proper digestion in baby's gut - a fullness caused by bloating and indigestion.  Just think, if you eat something that makes you feel bloated because you can't digest it properly, you'd feel full, wouldn't you?! But it's a very uncomfortable fullness.  
I hope this has been helpful :)

Uyen Dinh
Consultant Pharmacist