Baby formula is a specially designed breast milk substitute that provides essential nutrients for infants. Formula meets specific dietary needs and sensitivities but requires careful preparation and storage to prevent contamination, burns or spoilage. It comes in various forms.
Baby formula is a human breast milk substitute containing the nutritional elements infants under 12 months of age need to grow and develop. These elements include proteins, carbohydrates, fats, vitamins and minerals.
Formula is often necessary because many new parents cannot provide enough nutrition to their baby through nursing alone. It is available as a powder, concentrated liquid or ready-to-use liquid.
While most formula-fed newborns drink cow’s milk formulas, other options are available. There are differences between each formula type, but they all include the nutrients infants require to grow.
The three main types of formula are cow’s milk, soy and hypoallergenic. Regardless of which one you choose, opting for an iron-fortified formula can be beneficial.
All commercial formulas meet standard nutritional requirements, but the best formula for your infant depends on their age, weight, food sensitivities and other medical needs. Talk to your child’s pediatrician before starting or changing your baby’s formula.
A comprehensive global survey published in the British Medical Journal in February 2023 evaluated infant formula products’ health and nutrition claims.
The findings revealed that most products had at least one benefits-related claim. However, many claims were not backed by strong scientific evidence. The authors worry that these claims could make people think that formula is better than breastfeeding, which could affect mothers’ choices.
Your baby may not be on the right formula if they aren’t gaining weight or are very fussy, constipated, spitting up excessively or experiencing bloody stools. Some babies are also allergic to certain formulas and may develop rashes, swelling or other symptoms.
If your baby experiences any of these issues, speak to your doctor immediately to get them on the right formula.
When starting formula feeding, you can use plastic, stainless steel, disposable or glass bottles and the appropriate nipple size for your baby’s age. A newborn should have the slowest flow nipple.
Follow the directions on the formula’s label. Use the required amount of water and the scoop provided to ensure the correct ratio of powder formula to water.
It’s advisable to use liquid (concentrated or ready-to-feed) formula for infants who are at risk of infection, immunocompromised, premature or younger than two months.
It’s normal for feeding habits to fluctuate with changes like teething or growth spurts. Every baby is different, so follow your infant’s cues and guidance from their pediatrician.
A study published in Frontiers in Pediatrics investigated the risks of burn injuries in babies caused by hot water used to prepare powdered infant formula.
Although the number of burns directly connected to making formula was not high, the study emphasized the importance of providing clear guidance for preparation. Guidance should focus on avoiding bacteria and on preventing burns from hot water.
Follow package instructions and use safe practices when preparing your baby’s formula. Ensure bottles are clean and sanitized.
If you use powdered infant formula, using bottled or clean tap water is recommended. Many experts suggest heating water to at least 158 degrees Fahrenheit and letting it cool for no more than 30 minutes before preparing the formula.
For your child’s safety, use any prepared formula within two hours of preparation or store it in the refrigerator and use it within 24 hours. You can store the open container in your fridge for 48 hours for ready-to-feed formulas.
Keep unopened powdered formula in a cool place. You should use opened formulas within a month of opening. Never use formula past its “use by” date.
Experts suggest avoiding homemade formula. Making formula at home can leave out essential nutrition for your baby.
In August 2023, the FDA provided a significant update on its initiatives to enhance the safety of infant formula.
As part of these efforts, the agency conducted 47 inspections of formula production facilities to ensure compliance with safety standards. The FDA issued warning letters to three infant formula manufacturers (Mead Johnson Nutrition, ByHeart Inc. and Perrigo Wisconsin, LLC) that were not meeting safety requirements.
To further educate the public, the agency expanded its educational materials focused on the risks associated with Cronobacter sakazakii, emphasizing the importance of formula safety for infants.
The risks of baby formula feeding can include bacterial contamination, allergic reactions and gastrointestinal problems.
Contamination is more likely with imported formulas subjected to less regulation and oversight. For example, researchers found antibiotic-resistant bacteria strains Enterobacteriaceae and Enterococcus in formulas manufactured in Chile and Mexico. These harmful products pose a significant health risk to infants.
Cow’s milk allergies can occur in infants and young children. Babies might be allergic to the milk proteins casein, whey or both. A milk allergy is different from lactose intolerance. Symptoms of an allergic reaction include raised red bumps, eczema, digestive problems and a runny nose or itchy eyes.
Recent studies also identified a link between a severe gastrointestinal problem and premature babies on baby formula. The condition is called necrotizing enterocolitis (NEC). Families have filed several baby formula lawsuits because of this link. However, this link is still being debated in court, and the formula is unlikely to harm full-term, healthy babies.
A voluntary recall from Abbott on February 17, 2022, led to a baby formula shortage. Recalled formulas included Similac, Alimentum and EleCare. Abbott ordered the recall after four consumer complaints related to Cronobacter sakazakii and Salmonella Newport.
The U.S. Food and Drug Administration commissioner further attributed formula shortages in certain locations to “distribution inefficiencies.”
Since Abbott’s 2022 baby formula recall, the FDA has taken steps to prevent baby formula shortages from happening again. The agency has been checking local and international formula production facilities more often and updated its protocols to prevent Cronobacter sakazakii infections.
To help ensure a steady supply, the FDA has simplified importing formulas from new suppliers by easing import rules and temporarily lowering taxes on these products. It also established new methods to handle customer complaints and whistleblower reports and created a special office focused on overseeing baby formula.
Additionally, the FDA is working with health agencies and outside researchers to improve its long-term plans for ensuring a reliable supply of baby formula.
Editor Lindsay Donaldson contributed to this article.
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