How do i know what formula to feed my baby

Choosing an Infant Formula | Nutrition

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Information about finding infant formula can be found

here.external icon

Additional information to help families during the infant formula shortage can be found

here.

alert iconCDC’s investigation of Cronobacter infections in infants who consumed powdered infant formula from the Abbott Nutrition facility in Sturgis, MI, is now closed. No new cases have been identified. Get updates about FDA’s investigationexternal icon.

No brand of infant formula is best for all babies. You should pick an infant formula that is made especially for babies. The US Food and Drug Administration (FDA) regulates commercial infant formulas to make sure they meet minimum nutritional and safety requirements. Iron-fortifiedalert icon infant formulas are recommended, and most commercial infant formulas sold in the United States contain iron. Commercial infant formulas come in liquid and powdered forms.

When choosing an infant formula:

Make sure it is not expired.
Make sure the container is sealed and in good condition. If there are any leaks, puffy ends, or rust spots, do not feed it to your baby.
Make sure it is not labeled for toddlers.

Talk with your child’s doctor or nurse if you have questions about choosing an infant formula for your baby or if you are thinking of switching infant formula brand or type.

Homemade Infant Formula

FDAexternal icon and the American Academy of Pediatricsexternal icon warn against using recipes to make homemade infant formula. Using homemade infant formula can lead to serious health problems for your baby. Your baby’s nutritional needs are very specific, especially in the first year of life. Homemade infant formulas may contain too little or too much of certain components, such as vitamins and minerals (like iron).

Homemade infant formula may also have an increased risk of contamination, which could lead to your baby getting sick or developing an infection. Commercial powdered formulas are also not guaranteed to be sterile. However, FDA regularly inspects these products and the manufacturing facilities where they are made to help make sure these products are safe.

Imported Infant Formulas

There are some public claims that infant formulas sold in other countries and promoted as “natural” or “organic” are better for babies. However, there is no scientific evidence that these infant formulas are better for babies than commercial infant formulas sold in the United States. All infant formulas legally sold in the United States—whether made in the United States or imported from other countries—must be reviewed by FDA. The American Academy of Pediatrics warns against using illegally imported formulas, such as products ordered online from third-party distributors. FDA may not have not reviewed these products. Illegally imported formulas also may not have been shipped and stored properly.

FDA reviews all infant formulas sold legally in the United States to make sure they meet minimum nutritional and safety requirements. FDA also makes sure that the water used to make formulas meets safety standards set by the US Environmental Protection Agency.

Toddler Milks, Drinks, or Formulas

Toddler milks, drinks, or formulas are not needed to meet the nutritional needs of young children. They typically have added sugars. At age 12 months, your child can be introduced to plain whole cow’s milk or fortified unsweetened soy beverage.

Babies younger than age 12 months should be fed infant formulas specifically designed to meet their nutritional needs. They should not be fed toddler milks, drinks, or formulas labeled for toddlers.

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Choosing Formula for Your Baby: A Guide

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Healthline only shows you brands and products that we stand behind.

Our team thoroughly researches and evaluates the recommendations we make on our site. To establish that the product manufacturers addressed safety and efficacy standards, we:

Evaluate ingredients and composition: Do they have the potential to cause harm?
Fact-check all health claims: Do they align with the current body of scientific evidence?
Assess the brand: Does it operate with integrity and adhere to industry best practices?

We do the research so you can find trusted products for your health and wellness.

A note about the baby formula shortages

Due to supply chain issues secondary to the COVID-19 pandemic, as well as recent safety recalls from major formula companies, many baby formulas are currently out of stock.

If you’re having difficulty finding the baby formula you need, call your pediatrician’s office. They may have sample cans available or be able to advise you on the closest match to your baby’s formula.

Other resources may include your local WIC office (a federal assistance nutrition program for women, infants, and children), social media infant feeding groups, or large online grocery retailers.

The Federal Drug Administration (FDA) and American Academy of Pediatrics (AAP) both strongly advise against making homemade baby formulas.

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Protein, carbohydrates, and fat make up 98% of infant formula. Protein and carbohydrates have the most impact on your baby’s comfort while digesting, so I always recommend parents choose a formula based on these ingredients.

You can literally ignore the front of the formula label. What a relief! These labels are full of competing messages. Words like “sensitive” and “gentle” are not regulated and don’t mean anything.

Instead, flip over the can and look at the list of ingredients. Focus on the first few ingredients before the “less than 2%” long list of vitamins and minerals. Those first few ingredients will tell you what type of protein and carbohydrates are used in that formula.

Yes, there are both dairy-based and soy-based formulas. But the more important digestion question is: How BIG are the proteins your baby is drinking?

Standard (full-size) protein formula

Standard formulas do not break down the protein at all. They are exactly the size they were when they came out of the cow or soybean. That size is big. Cow’s milk and soy proteins are much bigger than breast milk proteins. If they were a car, they’d be a monster truck.

You will see full-size proteins on the list of ingredients as: “nonfat milk”, or “milk protein isolate,” or “whey protein” (a component of cow’s milk protein), or “soy protein isolate” in soy formulas. These formulas are the standard formulas with full-size proteins.

Most healthy babies handle these big proteins just fine! However, they do take more digestive work to absorb.

Examples of standard protein formula

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Similac Advance
Enfamil Infant
Enfamil ProSobee
Similac Soy Isomil

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Partially hydrolyzed protein formula

Partially hydrolyzed protein is smaller. Hydrolyzed literally means “broken apart.” The proteins in partially hydrolyzed formulas are broken down to be smaller in size, closer to the size of breast milk proteins. If these proteins were a car, they’d be a Honda Civic.

On the list of ingredients, you will see the words “partially hydrolyzed” in front of the protein. For example, Enfamil Gentlease is a partially hydrolyzed formula, and the list of ingredients includes “partially hydrolyzed nonfat milk.”

The only real way to know if a formula is partially hydrolyzed is to look for those words on the ingredients list. For instance, Gerber Good Start Soy formula is a partially hydrolyzed protein, which is different than the full-size soy protein in Enfamil ProSobee and Similac Soy Isomil.

Examples of partially hydrolyzed protein formulas

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Enfamil Gentlease
Gerber Good Start SoothePro
Gerber Good Start GentlePro
Similac Pro-Total Comfort
Enfamil Reguline
Gerber Good Start Soy

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Because partially hydrolyzed proteins take less digestion to be absorbed, they may be a good choice for some newborn infants or infants who are experiencing discomfort digesting the full-size proteins, or who have a history of digestive issues.

Fully hydrolyzed protein formula

Fully hydrolyzed proteins are tiny. If you can partially hydrolyze a protein, then (you guessed it) you can fully hydrolyze a protein! In our car analogy, fully hydrolyzed proteins are more like a skateboard.

Fully hydrolyzed proteins are also hypoallergenic. These protein pieces are so small that they won’t trigger an allergy in a child who is allergic to full-size cow’s milk protein. You’ll see the word “hypoallergenic” clearly on the front of the can.

These formulas are for infants with a cow’s milk allergy or babies who have had severe digestive issues. But these are not common issues. For that reason, fully hydrolyzed formulas are specialized enough that you should not just try them without a doctor specifically recommending it.

Fully hydrolyzed protein formula

These formulas should only be used after your doctor has given the OK.

Similac Alimentum
Enfamil Nutramigen
Gerber Good Start Extensive HA

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Lactose is the carbohydrate source in breast milk, and all healthy babies are able to digest lactose. If your healthy baby is starting off on formula for the first time, I say start with a lactose-based formula and see how it goes.

There are reasons that some babies thrive on a formula that is lactose-reduced. Babies who were born early or who have immature or irritated digestive tracts may make less of the enzyme that digests lactose.

Babies recovering from diarrhea or babies who have been consuming low-lactose formulas for a long time will also have less lactose-digesting enzymes and may be more comfortable on a lactose-reduced formula.

If lactose is removed from a formula, some other carbohydrate must be added to ensure babies get enough carbohydrate energy. There are only two other carbohydrates small enough that infants can digest them well. These are sucrose (table sugar) and glucose sugars.

While both are deemed safe for babies, my personal preference is glucose sugars. There are several different types of glucose sugars used in formulas these days, including corn syrup, corn syrup solids, brown rice syrup, glucose syrup, and maltodextrin.

The only way to know if a formula is lactose-reduced is to look for these other carbohydrate sources on the list of ingredients.

The variety of protein options layered on top of the variety of carbohydrate options results in the large number of formulas that overwhelm you at Target. But now you know how to choose your formula based on the protein and carbohydrate ingredients.

Prioritize your protein choice first since protein is the most likely factor affecting digestibility and comfort. From options with the protein source you are looking for, pick the formula with the carbohydrate blend closest to what you want. Then give it a shot.

You made your decision based on science. If you need to change formulas in the future, you know how to select your next formula the same way. That’s the best you can do.

I can’t emphasize enough that there is no “perfect” formula. Every baby is unique! This means the “best” formula for your baby is likely totally different than the “best” formula for your neighbor’s kid or your favorite celebrity.

If you want to start or switch formulas, talk to your pediatrician. Here are some suggestions that might help that conversation.

If your baby has reflux

Acid reflux — or chronic spitting up — is rough! There is sadly no magic pill to make it go away. But you might consider a formula with a high whey content.

Milk proteins come in two categories: whey and casein. Whey proteins stay liquid in the stomach and so empty out of the stomach more quickly. Enfamil Infant is a full-size protein formula that is 60% whey — the highest whey in the full-size protein category.

Gerber Good Start GentlePro, Gerber Good Start SoothePro, and Similac Pro-Total Comfort are all formulas in the partially hydrolyzed category that are each 100% whey.

You could also consider a thickened formula for acid reflux. Enfamil AR adds thickeners to the formula so that gravity works with the baby to help keep contents in the stomach.

These formulas are each full-size protein formulas that are mostly casein protein. Thus, thickened formulas may potentially help reflux symptoms for a different reason than whey-predominant formulas.

If you’re dealing with baby eczema

Partially hydrolyzed protein formula has been shown to help infant eczema. Similac Pro-Total Comfort and Gerber Good Start GentlePro and Gerber Good Start SoothePro all have the same protein base – partially hydrolyzed whey.

Enfamil Gentlease and Enfamil Reguline use a partially hydrolyzed mix of two types of proteins found in cow’s milk — whey and casein proteins. One is not better than the other. They are just different, and different babies may thrive on one versus the other.

So if you start with Gerber Good Start GentlePro and things improve but you think your baby can be even more comfortable, then consider trying Enfamil Gentlease to see if that difference in protein source helps your baby digest more easily.

Be careful with generic brands!

Pro tip: Some generic brands of partially hydrolyzed formula use a blend of partially hydrolyzed and full-size proteins, and could be harder for your baby to digest. So while you may think you’re getting the same formula at a savings, they’re actually pretty different.

The generic brands of Gerber Good Start GentlePro, on the other hand, typically do use a protein that is partially hydrolyzed. So if you need a budget-friendly, partially hydrolyzed formula, stick with the generic version of Gerber Good Start GentlePro.

If you’re not sure, look for the protein on the label (often called whey, casein, or milk protein) and see if it says “partially hydrolyzed.” If it doesn’t, there may be some full-size proteins in the formula.

If you’re not sure whether a specific generic product is a good fit for your baby, run it by your pediatrician. You can also check out my specific guide on brand-name versus generic formulas here.

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If your baby is constantly constipated

If your baby really suffers from constipation, then ask your doctor about switching to a formula that does not contain palm oil.

Palm oil can cause babies’ stool to be more firm and can increase constipation. Currently, only Similac brand formulas do not use palm oil in their ingredients. Similac offers many options, so you can get the protein size you want.

Extra ingredients are… well, extra. This article focused on the main ingredients (protein and carbohydrate) since they impact digestion the most.

However, we’ve all noticed that most formula marketing focuses on all the other sexy, extra ingredients (DHA, MFGM, lactoferrin, HMOs…. to name a few). While these are all nice to have, they are all nonessential extras. And they will not be the deciding factor in whether or not your baby gets into Harvard.

When considering these extras, I suggest parents first focus on finding a protein and carbohydrate blend that keeps their baby comfortable and happy.

Once there, if there is an option with that blend and some sexy extras, and you can easily afford it… go for it! If these ingredients are out of your price range, then do not give them another thought.

Now you know that ingredients should be the number one factor in a formula choice. If you can find your dream ingredients in a store-brand formula… celebrate! That’s what I call shoe money! But let’s be honest, we both know you’ll spend it on diapers.

Similarly, organic ingredients are desirable to many families. However, the ingredients matter more. If full-size proteins cause your infant to be uncomfortable and sleep less, then an organic full-size protein formula is not the best choice for your unique baby. The ingredients are all that matter.

If you are switching formulas, I always recommend going slowly. Over a few days, slowly decrease the amount of old formula in each bottle as you increase the amount of new formula.

This is especially important if the new formula has a larger protein or more lactose. Your baby will have to make more digestive enzymes to digest bigger proteins and more lactose.

Don’t worry — your baby is a rock star — they can totally do that. But giving them a few days to ramp up these enzymes will help the transition go more smoothly.

Most importantly, love your baby and yourself. All babies have gas. All babies fuss. Is your baby loved, fed, and cared for? Then you are doing an amazing job. Be kind to yourself. Trust your intuition… and parent on!

How do I know which formula is right for my baby?

The good news is that according to the AAP, all formulas sold in the United States have to meet FDA standards and should provide adequate nutrition for your baby. The Centers for Disease Control and Prevention (CDC) says, “No brand of infant formula is best for all babies.”

As daunting as it can be, finding the right formula for your individual baby is often a process of trial and error. If your baby has a known milk protein allergy, colic, gas, or other specific concerns, you can start with a formula made for those issues and see how your baby reacts.

Otherwise, you can choose a formula that fits your budget and ingredient preferences and see how your baby tolerates it.

Things to watch for as your baby starts a new formula include:

changes in sleep pattern
changes in stool
daytime fussiness
spit up
acceptance of bottles

If you’re not sure where to start, call your pediatrician and ask for a recommendation.

What is the closest formula to breast milk?

In reality, no formula can completely mimic human breast milk. However, scientific and nutritional advances have come a long way in recent years, and there are some great options available.

The formulas sold in the United States should be FDA approved and meet your baby’s nutritional needs for the first year of life, providing your baby doesn’t have a special medical condition.

Generally speaking, the formula with ingredients most similar to human breast milk is Similac 360 Total Care. This formula contains an unprecedented five HMOs, which are prebiotics found in breast milk that should help babies digest and absorb nutrients.

The formula also contains DHA (which is found in varying amounts in human milk), ARA, carbs, fats, and vitamins that are meant to mimic those found in breast milk.

However, this formula does contain cow’s milk proteins that aren’t hydrolyzed, so they are still quite a bit larger than the proteins found in human milk. A formula with high lactose content and partially hydrolyzed whey protein, such as Gerber GoodStart GentlePro, may better mimic the digestibility of human breast milk.

What is the most recommended formula?

Cow’s milk-based formulas, such as Similac Advance and Gerber GoodStart GentlePro, are among the most commonly recommended.

Often, pediatricians’ offices are provided with free samples of Similac and Enfamil formulas, so these tend to be among the top recommended products.

These companies have a long history of researching and producing quality infant formulas. They also offer many types for you to try (such as full-size cow’s milk protein formulas, formulas with partially broken down proteins, and hypoallergenic formulas).

However, it’s worth noting that the ingredients in a formula are much more important than the brand, or even how many people recommend the formula. If you do a little research (like reading this article!) and read the ingredient labels on the container, you’ll be well on your way to choosing a great formula for your baby.

Your pediatrician may be able to give a more specific recommendation for your little one, too.

Bridget Young, PhD, CLC, is an assistant professor of pediatrics at the University of Rochester where she studies how variation in breast milk composition and infant formula ingredients impact infant growth and development. As the founder of BabyFormulaExpert.com, she has supported countless families working through formula tolerance issues, helping them find the perfect feeding solution for their baby. You can learn more about working directly with Dr. Young here.

How to choose powdered milk formula?

You are faced with the need to transfer the child (in whole or in part) to artificial feeding, and the pediatrician prescribed a specific formula for your baby. Before you go shopping, read the recommendations of a specialist.

Elena Simonenko

Head of Department, Research Institute of Baby Nutrition, Branch of the Federal State Budgetary Institution "Federal Research Center for Nutrition and Biotechnology"

The choice of a mixture is not rushed, even when you have been assigned a specific product. Read the information on the bank carefully. Look at what age the formula is for (for example, for infants from birth to six months) and what the formula is intended for (for example, powdered adapted milk formula). This information is located on the front or back of the package.

Depending on the age of the child, the amount of vitamins and minerals in the mixture changes, so it is not recommended to feed the newborn with a mixture intended for older children.

Read baby formula research results HERE.

The gradation of mixtures by age is indicated by a numerical value:

With the prefix "pre" in the name, mixtures for premature or low birth weight babies are indicated;
"1" - for children from birth to 6 months;
"2" - for babies from 6 months to 1 year;
"3" - for children older than a year;
"4" - as a rule, starting from 18 months.
Also on the market is a category of adapted milk formulas with average indicators for feeding children from birth to 12 months.

For newborns, you need to take only adapted mixtures. They are closest in composition to breast milk and are easily digested and absorbed by the baby's body.

If the baby has any health problems, in particular with digestion, choose therapeutic or specialized mixtures.

Tatiana Butskaya

pediatrician, founder of the all-Russian movement "Council of Mothers" and the national award "Parents' Choice", international expert in children's products

Do not try to figure out on your own which mixture is best to buy for a child. If there is a need for artificial feeding, contact your pediatrician. The introduction of supplementary food into the infant's diet is always metabolic stress. The mixture should be treated as a medicine, which is selected according to indications and taking into account individual characteristics.

Attention to detail

The composition of the product for children of the first year of life should be as close as possible to human milk, meet the age norms and physiological needs of the child.

If the baby has flatulence and frequent regurgitation, the specialist will recommend a mixture with special thickeners (starch).
If constipation and dysbacteriosis - mixtures with additives (probiotics and prebiotics).
If the child has sleep problems - substitutes with a "night formula".
If you are allergic to cow's milk protein - a mixture of highly hydrolyzed proteins based on whey and casein.

You can be sure that the doctor will choose the best option. One hundred percent it will be a well-known brand. Let me explain why: world-famous leaders in the production of formula value their reputation, and their products comply with existing international standards and are as close as possible to the composition of breast milk.

What should be the composition of the mixture

Protein. According to the latest scientific data, excessive intake of protein in the first year of a child's life can lead to obesity in the future. That is why the recommended rate per liter of the mixture is no more than 12-15 grams.
Proportion of whey to casein. It is important that there are more whey proteins.
Fat composition.

It includes vegetable oils (eg soybean, corn, sunflower), which are sources of all fatty acids and fat-soluble vitamins.

The composition of the mixture should include milk fat. Please note that it is not completely excluded from the product. Milk fat provides the body with important saturated fats, cholesterol, phospholipids, gangliosides and other substances necessary for cell function, as well as for strengthening the body's defenses and developing the child's brain.

Polyunsaturated fatty acids. Very important! Their lack leads to a slowdown in the overall development of the child and a decrease in immunity. The mixture must contain linoleic (omega-6) and linolenic (omega-3) acids. It is also desirable that the mixture contains docosahexaenoic and arachidonic acids. They improve vision and promote brain development.

In addition, the mixtures should contain probiotics (bifidobacteria and lactobacilli). They form the basis of a healthy intestinal microflora. Their presence in mixtures contributes to the formation of the intestinal ecosystem and the prevention of dysbacteriosis. Probiotics are needed for calcium metabolism, the formation of vitamins and hormones, as well as strengthening local and general immunity. Thanks to modern technology, beneficial microorganisms remain viable throughout the entire shelf life of the mixture. Their effectiveness has been clinically proven.

Prebiotics (galactooligosaccharides, fructooligosaccharides, oligosaccharides) serve as a nutrient medium, in other words, food for beneficial intestinal bacteria.

Quality enhancing biological ingredients

Choline (vitamin-like substance) - helps to eliminate harmful compounds, is needed for fat metabolism and muscle growth.
Tryptophan - has a positive effect on the quality of a child's sleep, his mood and appetite.
Nucleotides - improve the absorption of iron, promote the growth of healthy microflora, strengthen the defenses of the child's body.
Taurine - improves vision.

What to look for when buying

Do not go to grocery stores for formula. Go to the pharmacy. This is where you need to buy the mixture for the child. If for some reason the pharmacy does not have the product you need, go to the children's store.

When buying, pay attention to the packaging. Do not accept damaged or wrinkled packages. The deformation on the packaging raises great doubts about the correct storage and transportation conditions of the product. Don't forget to check the expiration date.

How to store?

Powdered milk formulas for children, regardless of the type (first, second or third steps), have general storage rules.

Dry mixes, subject to the integrity of the packaging, are designed for a long period of storage.
If you bought a mixture packaged in jars, you can store it at home in the original packaging.
If the mixture is packed in bags or cardboard boxes, after opening the contents must be poured into a hermetically sealed container. Ware for storing baby food can be glass or plastic, but always with the appropriate marking indicating the absence of toxic impurities in the composition of the material.
When you open the package, stick a label on it with the date you opened it or put it in an airtight container.
The mixture in an open package or poured into an airtight container can be stored for exactly as many days as indicated on the package!
To make it easier to comply with the established shelf life, put a label on the package with the date you opened it.
Store dry mixes in a ventilated cabinet, protected from light, at room temperature. The optimum temperature is 12–24 °C.
Diluted infant formula can be stored at room temperature for no more than three hours.
In the refrigerator, the diluted mixture can be stored for no more than a day.

What if the formula is not suitable for the baby?

If the mixture is not suitable for the baby, he may be disturbed by flatulence, colic, constipation, diarrhea, skin rashes. Any of the symptoms requires finding the culprit of such a reaction and replacing the mixture. Therefore, I advise you to contact the pediatrician again. After buying a new mixture, carefully, within a week, introduce the mixture into the baby's diet. Do not mix milk replacers from different manufacturers in one bottle, use two for this. If the introduction of the mixture is accompanied by a deterioration in the child's well-being, consult with his doctor.

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which one to choose for feeding the child and what to consider when feeding?

The benefits of mother's milk for a child cannot be overestimated. It has been scientifically proven that this unique food created by nature itself fully meets the needs of the baby's body in the first year of life, provides him with the necessary substances and strengthens the immune system [1] . But what if the mother does not have enough milk or not at all? Then pediatricians recommend mixtures for children. They differ in composition and properties, we will help you understand their diversity.

If, for one reason or another, a mother cannot breastfeed her baby for a long time, the pediatrician prescribes infant formula [2] .

At the same time, mixtures for feeding children are diverse in purpose. In addition to basic products for healthy babies, there are therapeutic and preventive infant formulas recommended for babies with certain disorders (or a predisposition to them). Which mixture to choose for the child, the pediatrician should decide, based on the state of health of the baby. But mom should understand how different products differ from each other, so we will talk about the most commonly prescribed types of infant formula.

Base mixes . They are intended for healthy full-term babies who do not have allergies and hereditary predisposition to it, digestive disorders and other disorders. Mixtures are usually made on the basis of cow's milk (sometimes goat's is used). And they are called adapted because they are as close as possible to breast milk in terms of the amount and ratio of proteins, fats, carbohydrates, vitamins and minerals to meet the needs of the child [3] .

Note

In addition to proteins, fats and carbohydrates, the mixture is similar to human milk in terms of vitamin and mineral composition. They reduce the content of mineral salts that can adversely affect the functioning of the digestive system and kidneys, and also add the missing trace elements and vitamins [4] .

Hypoallergenic Prophylactic Formulas are indicated for healthy children with a predisposition to allergies. One of the main risk factors is heredity: if one of the parents has allergic diseases, the probability of developing them in a child is approximately 30%, but if both have them, the risk doubles [5] . The main food component that causes allergies in early childhood is cow's milk protein. Therefore, a formula based on cow's milk is usually not prescribed for such babies. Doctors recommend using a hypoallergenic mixture, the main difference of which is partially hydrolyzed, that is, split, protein. In this form, it is much better absorbed, and its allergenicity is reduced [6] .

Formulas for children with allergies . If the baby already has an allergy to milk protein, preventive nutrition will not help - you need a therapeutic mixture. Formulas for children with allergies are made from fully digested protein or amino acids. Due to this, they are much less allergenic. But in terms of taste, such a product is inferior to basic and prophylactic mixtures, and some babies have to get used to clinical nutrition for a long time [7] .

Formulas for children with constipation and colic . In the first months of life, many babies suffer from colic, constipation, flatulence. With natural feeding, digestive disorders are less common: breast milk contains components that promote the growth of “good” bacteria in the intestines. Similar properties of the mixture are achieved by adding probiotics and prebiotics to its composition. The former include beneficial bifidobacteria and lactobacilli, while the latter include substances that help their growth (oligosaccharides, lactulose, inulin) [8] .

Anti-reflux mixtures . The reasons for frequent regurgitation are varied: disorders of the nervous system, problems with the gastrointestinal tract, improper feeding technique. As a symptomatic remedy, pediatricians recommend anti-reflux mixtures that contain gum or starch (rice, potato, corn) as a thickener. Due to the presence of a thickener in the composition, this mixture prevents regurgitation [9] .

Lactase deficiency formulas . Their main difference is the low lactose content or its complete absence. The use of a therapeutic mixture can reduce the manifestations of lactase deficiency - diarrhea and colic [10] .

Preterm formulas . Babies born prematurely weigh very little and need an increased amount of nutrients. Premature infant formula should contain more protein, calories, vitamins, and minerals than term infant formula. At the same time, it is important that they have the ability to form normal intestinal microflora [11] .

In addition to the functional purpose, mixtures differ in age of application. Most base mixes are presented in four stages. The first stage, often indicated by the number 1 on the package, is for feeding babies up to six months of age. After six months and up to a year, a subsequent mixture is applied (stage 2), from 12 months the baby is transferred to stage 3 and after 18 months to stage 4 [12] .

How to choose a formula for your baby: in search of the best options

Breast milk replacer is prescribed by a pediatrician, taking into account the health and individual characteristics of the baby. But the mother must understand why the doctor recommends this or that product. Therefore, it is useful for her to know everything about the mixture for the child: which is better in this case and why. Here are the main factors that are taken into account when choosing.

Physician's recommendation . This is the most important and mandatory selection criterion. The pediatrician will study the characteristics of the baby's body, the history of childbirth, family history and, based on these data, will tell which mixture is best to feed the child.

Product type . It is necessary to choose a mixture suitable for age (up to six months - the initial mixture, then the subsequent one). If the child is prone to constipation or colic, there are allergic diseases in the family, or there are some other features, they should be reported to the doctor: he will help you choose the right type of product.

Composition . Formulas for artificial feeding are not only adapted in terms of protein, fat and carbohydrate components, but also enriched with substances necessary for the health and normal development of the child. When examining the composition, pay attention to the following ingredients (their presence is highly desirable):

probiotics and prebiotics - help to populate the intestines with beneficial bacteria and maintain them in the right amount and ratio. This serves to prevent digestive disorders, protects against allergies and immune problems [13];
breast milk oligosaccharides. These substances perform several functions at once: they protect the children's body from infections (preventing harmful microbes from attaching to the gastrointestinal mucosa), support the immune system, and also work as a prebiotic [14] . This component is not found in all mixtures, but its importance is obvious. The most common type of human milk oligosaccharides are 2'-FL oligosaccharides. It is they that can be found in the “nutrition value” or “composition” block on the packaging of the mixture;
omega-3 and omega-6 polyunsaturated fatty acids — they ensure normal metabolism and are involved in many biochemical processes [15] ;
vitamins and minerals. Pay attention to the content of lutein in the mixture - this component, which is part of breast milk, is important for eye health. It is not produced in the body, so a baby on artificial or mixed feeding can only get it with food. Of the minerals, iron, iodine, zinc, selenium, copper, and manganese are especially important for the child's body [16];
nucleotides. They help to normalize the balance of intestinal microflora and strengthen immunity [17];
taurine is an amino acid that is important for the proper development of the brain and retina. In the first months of life, it is not produced in the body, so it must be supplied with food [18] .

This is important

Breast milk oligosaccharides (HMO) are unique components that are of great benefit to the child's body. In terms of content in breast milk, they are in third place after lactose and fat - this fact alone makes it possible to see how important these substances are. Until recently, manufacturers could only add HMO analogues to mixtures - galactooligosaccharides and fructooligosaccharides, which are not a full replacement for them, do not have the same range of biological effects [19] . But in recent years, a way has been found to obtain HMO, and now this valuable component is in some mixtures.

The presence of certain ingredients should be taken into account as they may not be suitable for all babies. It is primarily palm oil (otherwise known as palm olein). The peculiarity of this component is that it forms insoluble compounds with calcium and therefore interferes with its absorption, and can also cause constipation in the baby [20] .