Infant formula: Your questions answered

If you're planning to feed your baby infant formula, you might have questions. Is one brand of infant formula better than another? Are generic brands OK? Is soy-based formula better than cow's milk formula? Here's what you need to know about infant formula.

What are the main types of infant formula?

Commercial infant formulas are regulated by the Food and Drug Administration (FDA). Three major types are available:

• Cow milk protein-based formulas. Most infant formula is made with cow's milk that's been altered to resemble breast milk. This gives the formula the right balance of nutrients — and makes the formula easier to digest. Most babies do well on cow's milk formula. Some babies, however — such as those allergic to the proteins in cow's milk — need other types of infant formula.
• Soy-based formulas. Soy-based formulas can be useful if you want to exclude animal proteins from your child's diet. Soy-based infant formulas might also be an option for babies who are intolerant or allergic to cow's milk formula or to lactose, a carbohydrate naturally found in cow's milk. However, babies who are allergic to cow's milk might also be allergic to soy milk.
• Protein hydrolysate formulas. These types of formulas contain protein that's been broken down (hydrolyzed) — partially or extensively — into smaller sizes than are those in cow's milk and soy-based formulas. Protein hydrolysate formulas are meant for babies who don't tolerate cow's milk or soy-based formulas. Extensively hydrolyzed formulas are an option for babies who have a protein allergy.

In addition, specialized formulas are available for premature infants and babies who have specific medical conditions.

What infant formula preparations are available?

Infant formulas come in three forms. The best choice depends on your budget and desire for convenience:

• Powdered formula. Powdered formula is the least expensive. Each scoop of powdered formula must be mixed with water.
• Concentrated liquid formula. This type of formula also must be mixed with water.
• Ready-to-use formula. Ready-to-use formula is the most convenient type of infant formula. It doesn't need to be mixed with water. It's also the most expensive option.

Be sure to wash your hands before handling formula and carefully follow any mixing and storage instructions.

What's the difference between generic and brand-name infant formula?

All infant formulas sold in the United States must meet the nutrient standards set by the FDA. Although manufacturers might vary in their formula recipes, the FDA requires that all formulas contain the minimum recommended amount of nutrients that infants need.

Is it important to buy iron-fortified infant formula?

Yes. Your baby needs iron to grow and develop, especially during infancy. If you're not breast-feeding, using iron-fortified formula is the easiest way to provide this essential nutrient.

What about enhanced infant formula?

Some infant formulas are enhanced with docosahexaenoic acid (DHA) and arachidonic acid (ARA). These are omega-3 fatty acids found in breast milk and certain foods, such as fish and eggs. Some studies suggest that including DHA and ARA in infant formula can help infant eyesight and brain development, but other research has shown no benefit.

In addition, many infant formulas include pre- and probiotics — substances that promote the presence of healthy bacteria in the intestines — in an effort to mimic the immune benefits of breast milk. Early studies are encouraging, but long-term benefits of these substances are unknown.

If you're unsure about enhanced infant formula, ask your child's doctor for guidance.

How important is the expiration date on infant formula?

Don't buy or use outdated infant formula. If the expiration date has passed, you can't be sure of the formula's quality.

How long should a child drink infant formula?

Infant formula is generally recommended until age 1, followed by whole milk until age 2 — but talk to your child's doctor for specific guidance. Reduced-fat or skim milk generally isn't appropriate before age 2 because it doesn't have enough calories or fat to promote early brain development.