Infant Formulas Demystified

Posted on January 26th, 2013 by Denise | No Comments

Infant Formulas Demystified


Denise Koonce OTR

Have you been down the infant formula isle lately?  Shelf upon shelf upon shelf of formulas, it can be overwhelming.  There are at least four main manufactures of infant formula which service the U.S. with a brand name product.  Two of these are U.S. owned pharmaceutical companies, Mead -Johnson and Abbott – Ross, and two are European companies, Nestle and Danone-Nutricia.   Most of these manufacturers produce at least 10 different formulas including Good Start Probiotic, Good Start Alsoy, Enfamil A+, Enfamil Lower Iron, Enfamil Lactose Free, Similac Advanced, Similac Lactose free and many more.  In addition to the brand name formulas, there are now a multitude of generic formulas produced mainly by one pharmaceutical company’s Nutritional division, Perrigo Nutritionals, formally PBM Products.  They produce the majority of infant formula sold under a store label such as Wal-Mart, Target, Walgreens, CVS, Sam’s Club, and Albertsons.  With so many brands, offering so many choices, how do you know which one is best?  The infant food market is continually evolving making it difficult to know what each of them provide and which one works best for which child.  In order to clear it up, I thought I would break it down.

Infant formula comes under the control of the FDA and they set the guidelines for the ingredients contained within infant formulas.  Each ingredient has a minimal and maximum standard amount that is required.  These ingredients make up the four basic types of infant formula:  Cow’s milk, Soy, Protein Hydrolysate and amino acid formulas.

Cow’s milk based formula is made from cows milk proteins (whey and casein) but altered to resemble breast milk and has vitamins, minerals – including iron and calcium, and fat added.  This category is the most standard and commonly used infant formula.  Examples include:  Enfamil Lipil, Good Start Essentials, and Similac Advance with Iron

Soy milk based formula is made from the soybean plant and does not contain animal products.  This product is used with infants who exhibit lactose intolerance or for cultural and religious reasons.  Examples include:  Similac Isomil, Enfamil Prosobee, Good Start Alsoy, and Enfamil Soy

Partially Hydrolysate (or Hydrolyzed) formula breaks down the proteins both partially and extensively that is found in both cow (whey and casein) and soy based formulas.  By breaking the protein down into smaller particles, it makes it easier for the infant to digest the formula.  This formula is an option for infants with a protein allergy.  Examples include:  Alimentum, Nutramigen, and Presgestimil

Amino Acid based formula is a chemical defined formula with no protein peptide links leaving only individual amino acids. This formula can be recommended for infants with gastrointestinal issues and severe allergies.  Examples include:  Neocate, Elecare and Nutramigen AA

In addition to the basic makeup of the formulas listed above, infant formula companies have added additional ingredients to enhance the formula.  Some of these ingredients include DHA and ARA or Omega-3 and Omega-6, Probiotics, Rice Starch and oils for weight gain.  These additions have come about from consumer need and/or research suggesting the infant would benefit from the added ingredients.  Formula is also made available in three different forms powder, concentrate (liquid) and ready to feed or ready to use (liquid).  Here again only adding to the numerous possible choices.

As a therapist, when you work with infants or the 0-12 month population, it is important to have a basic understanding of infant formulas.  It is especially important if you are working with the infant on feeding.  While formula is not the essential component of therapy, it is important to know the types, what they consist of, why a physician has recommended it, and the signs and symptoms an infant can exhibit if there is an issue.  By doing so you will be more prepared when speaking to the parent and physician regarding the patients feeding and if necessary, offer recommendations in regards to the formula. 

Hopefully this information has demystified to some extent the world of infant formula.  However, it is only the beginning, so join me next week as we continue demystifying infant formula and infant feeding.  Also, please share with us your experiences of the infant formula isle and insights that you may have.

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