It’s been well established that breastfeeding is best for babies. Yet, for a variety of reasons, breastfeeding may not always be possible. This has spawned a major formula industry. Formulas are closely regulated by the Food and Drug Administration, and while the information put out by companies who make and market the product is generally true, that hasn’t stopped a lot of folklore about formulas from being passed around. Indeed, there is almost a certain mystique around finding “the perfect formula”!
Any formula-feeding decisions should be discussed with your pediatric provider. That said, here is a collection of largely mythical statements about formula and some information debugging all or part of them.
Myth #1: Formula is identical to breast milk. Infant formula companies have worked very hard over the years to make their formulas ever closer to breast milk. They’ve modified types and levels of fats, proteins, and carbohydrates. However, it’s impossible to duplicate what nature provides. Not only does breast milk provide infection fighting antibodies from Mom, but it also contains many compounds, some not well elucidated, that may be beneficial.
Myth #2: It’s best to look for formula that’s low in iron. This myth largely stems from the misperception that iron negatively affects baby’s bowel movements. Studies have shown that although iron can turn the stools green, there is not enough iron in the formula to affect bowel movements in any other way.
However, bowel movements aside, let’s look at why the iron is in there in the first place. Iron began getting added to formula in the 1970s due to the high prevalence of iron deficiency anemia. One of the issues with anemia is that to many, it might just seem like a number: you generally can’t see (except, perhaps, with severe anemia, when someone might appear pale), smell, feel or taste anemia. However, the effect on growth and development of a child is real. Although no one wants a baby to be uncomfortable from constipation, it’s a tragedy to set a child up for complications from iron deficiency anemia. Bottom line: if you feel that your baby might be constipated, talk to her provider for remedies. But realize that low-iron formula is not one of them!
Myth #3: A change in formula will usually help a spitty baby, or a fussy baby, or a baby with bowel movements that don’t look normal. While it is true that your infant’s provider may diagnose a true milk allergy or lactose intolerance that may be helped by a change of formula, these problems are not as common as many parents might think. More often than not, the baby’s formula is changed, the problem—spittiness, colic, or a bowel movement issue—persists, and before you know it, there are several types of formula in the kitchen cabinet!
Many pediatricians would say, “If you find a formula that seems to help your baby’s problem, go with it.” However, they would likely favor a different approach. First off, is the problem really a problem? Some babies are simply spitty and will grow out of it, and similarly, there is a variety of normal bowel movement patterns. Spittiness might be fixed by upright feeding, or more frequent small feedings, or your provider may need to test for a more concerning issue. Fussiness may respond to soothing measures like frequent holding and rocking. Discuss the issue with your provider, who may recommend any one of a number of actions that don’t involve a formula change.
Myth #4. If the formula doesn’t seem to be filling my baby up, I should start putting cereal in the bottle. No! Regular visits to your pediatric office will ensure that your baby is getting enough. Young infants are programmed to suck on anything that comes in contact with their mouth. In addition, they cry for many reasons, some of which have nothing to do with hunger. Even infants that “want to eat every hour” don’t necessarily need large amounts, and certainly don’t need cereal.
While cereal is sometimes used at a young age for certain conditions—gastroesophageal reflux disease, for example—in most young babies it can cause more problems than it solves. Certainly, the nutritional balance of what the baby is getting changes when cereal is added. It’s best added later, by spoon, when infant swallowing is more established. And although there are no good studies regarding early solids and the ever-increasing incidence of obesity in children, it’s certainly plausible that such a practice is a setup for overfeeding later on.
Myth #5. If my baby receives assistance through WIC or other supplemental feeding programs, all I need is a signed paper from my baby’s provider and I can get whatever formula seems to help him.
Supplemental feeding programs have really made a difference in infant nutrition, but their budget is limited. In order to stretch dollars, they contract with infant formula companies that can provide formula at lower cost. No one will deny a family a special infant formula for a true medical problem, and even without such a problem, there is usually some choice. However, many of the issues that seem to be made better by a change of formula are temporary and not true medical problems.
Bottom line: if you do change to a non-WIC formula which seems to help your baby’s problem and you can’t afford it, it’s best to talk to your provider about other solutions, some of which have been mentioned above.
It’s tough to navigate the maze of information regarding infant formulas. Even pediatric providers differ somewhat in how they handle formula issues. Yet, they are still the best resource in debugging what your little one’s issue is, what the fixes are, and whether they include a formula tweak. In the absence of a true medical issue, more often than not the answer is no!
