I call it the Great Wall of Formula at Babies R Us. It’s that quarter mile long aisle of infant formulas that's supposed to hold the ticket to a content, care-free baby. But if you spend any time there you’re apt to wind up more bamboozled than anything else.
Here’s why: Your baby doesn’t need most of ‘em.
Let’s talk about 4 types of formula your baby will likely never need:
Lactose-free formula. As a baby stomach specialist at the largest children’s hospital in the U.S. I have yet to figure out why lactose-free formula is produced. This is a formula without any indication. It is a regular old cow’s milk based formula without lactose. But here’s the problem: babies don’t have issues with lactose. While there is a brief period during the first week of life when babies don’t produce lactase (the enzyme in the lining of the intestine for digesting lactose), a baby’s body universally kicks in and produces lots of lactase.
Here’s what formula manufacturers want you to think: Lactose-free formula is for babies with milk allergy. But it has all the milk protein of a standard infant formula so we would never use a lactose-free formula in cases of milk protein allergy. Not nowhere, not no how. This is a market-driven formula placed on shelves with the sole purpose of bamboozling you, the parent consumer.
Soy formula. Soy formula is one of the oldest infant formulas on the market and represents about 20% of all infant formula sold. But it’s a bit of an oddball – there’s really no clear medical reason why any baby would need it. Allergy perhaps? No, definitely not. Approximately 50% of babies allergic to standard cow’s milk formula will react to soy. Soy formulas are lactose free but as we’ve learned, lactose free formulas are almost never medically necessary in a baby. But what about parents who want to avoid any type of animal products? While I’ll concede this as one of the textbook roles for soy formula, I have never encountered a parent who has chosen it for this reason. Most are so driven to breastfeed that the issue of formula is never addressed.
Low-iron formula. Among the great urban legends circulating in pediatric offices worldwide is the idea that iron in infant formula causes constipation. But the fact is that no such association exists and it has been proven in multiple blinded, controlled studies (you can find them here and here). And as someone who has made a career working with the most constipated of the constipated, I can attest to the fact that there’s no connection. In a previous post I run the numbers illustrating the potential dangers of low-iron infant formula. And at the risk of repeating myself, low-iron formulas have no place on store shelves or in your diaper bag.
Mead Johnson made the right decision for babies by discontinuing their low-iron preparation last year. As of recent I see that Similac low-iron is no longer available. Hopefully, this is the end of the road for low-iron formula.
Toddler formula. I’ve been a pediatric gastroenterologist for over 10 years and I’ve yet to find a patient who needs a toddler formula. After weaning from the breast of bottle, toddlers almost universally meet their needs with solid food and a variety of drinks including a little bit of milk. Admittedly toddler formulas offer a more appropriate balance of iron and vitamins than cow’s milk, the point is moot in all kids except the most miserable of feeders. And in this case we’ll often supplement with something even more complete than a toddler formula – I like Nutren Jr. or Pediasure. Save your money and avoid toddler formulas unless your pediatrician has a very good reason.
So breastfeed if you can. And if you use infant formula, remember that it’s unlikely that your baby will ever need anything other than Nestle Good Start (I like Good Start with Natural Cultures), Enfamil Lipul, or Similac. But talk to your doctor, ask questions and don’t forget that an informed parent is an empowered parent.
You can read all that I’ve written on baby formula here.