Bottle feeding with formula

Breastfeeding is best for your baby. If breastfeeding isn’t possible or you choose not to breast feed, commercial infant formulas should be used as an alternative until 12 months of age. Lots of different brands of infant formula are available from your supermarket, chemist or local shops. When prepared correctly, they all contain enough nutrients for healthy growth in babies.

Most infant formula is made by taking cow’s milk and treating it so it is suitable for human babies. Formula can come as:

• a powder, which you make up by adding it to water that you have sterilised by boiling
• a liquid, which is sold in a carton and is sterile and ready for you to feed your baby

It’s usually more economical to buy infant formula as a powder and prepare it as you need it.

How much formula and how often?

Feed your baby on demand, whenever they show signs of hunger.

Up to the age of about 6 months, most babies will drink around 150ml of formula per kilogram of body weight, each day. This is just an estimate — some will need more formula, some will need less. Every baby is an individual.

Signs that your baby is getting enough formula include:

• they have 6 or more wet nappies per day
• they are gaining a healthy amount of weight
• they are active, alert and happy

Which formula is best for my baby?

There is no evidence that one brand of formula is better than another. However, you should consider:

• choosing a formula based on cow’s milk, unless there is a cultural, religious or health reason to use a different formula
• choosing a formula with a lower protein level, which may reduce your baby’s risk of being overweight or obese in later life
• only using special formulas (HA, AR, lactose-free or soy formula) if they are recommended by a doctor
• taking into account price and affordability

Whey or casein-based formula?

Whey and casein are the 2 main types of protein in infant formula, and in breast milk.

Your baby’s first formula should usually be one that contains whey protein as the main type of protein. These formulas are often labelled as ‘suitable from birth’, ‘newborn’ or ‘whey dominant’.

You may notice that some formulas are labelled as ‘follow-on’ or ‘Step 2’ formula. These are casein-dominant formulas and they should only be given to babies aged 6 months and over.

Generally speaking, there is no need to switch from a whey-dominant formula to a follow-on formula as your baby gets older. Your baby can stay on their first formula as you start to introduce solids, and until they are 1 year old.

Is ‘gold’ formula better than standard formula?

‘Gold’ formula contains some extra ingredients (described below) that are not strictly necessary for your baby, but which may be beneficial.

Don’t feel that you have to pay more to buy the ‘gold’ version of a formula if there is a cheaper standard version available.

Added extras

Many formulas today contain extra ingredients. Some of these are explained below:

• LCPUFAs (DHA and AA) — These are long-chain polyunsaturated fatty acids thought to be important in the development of the brain and eyes. Breast milk contains LCPUFAs (especially DHA and AA), and LCPUFAs are now commonly added to infant formulas as well.
• Alpha-lactalbumin (Alpha-Pro or OPTIPRO) — This is thought to be especially nutritious for babies because it is the main type of whey protein present in breast milk. Some formulas have been developed to contain higher levels of alpha-lactalbumin, and a slightly lower overall protein content. This might be beneficial for babies.
• Probiotics and prebiotics — Just like adults, babies have ‘good’ bacteria living in their bowel to help keep them healthy. These bacteria are affected by the type of food your baby eats. Probiotics (good bacteria such as Bifidobacteria or Lactobacillus) and prebiotics (sugars that help promote the growth of good bacteria) are added to some formulas because they may help maintain a healthy balance of gut bacteria.
• Lutein — This is a nutrient that may play a role in eye health.

Special types of formula

These formulas are also available in supermarkets, and are designed for babies with special nutritional needs. The vast majority of babies don’t need a special formula, and it’s best to only use these formulas under medical supervision.

• HA or hypoallergenic formula — This is cow’s milk-based formula in which the large protein molecules have been broken down (hydrolysed) into smaller pieces. Studies have shown there is no solid evidence that hydrolysed formulas can help in preventing allergies in infants or children. Talk to your doctor, pharmacist or community nurse if you are worried about allergies in your baby.
• Lactose-free formula — These formulas are for babies with a diagnosed lactose intolerance. Lactose intolerance is quite rare in babies under one year old.
• Soy formula — These formulas are made with soy protein and don’t contain any dairy products or lactose. Soy formulas may be used in babies who have to avoid dairy-based products for cultural or religious reasons. They are also sometimes used in babies who have been diagnosed with a lactose intolerance.
• AR (anti-regurgitation) formula — These are specially thickened formulas that are sometimes used to treat refluxin formula-fed babies. Reflux, which causes spitting up in babies, is a normal occurrence and it usually improves by itself as your baby gets older. Special treatment is only necessary if your baby has severe reflux with poor weight gain and a lot of discomfort.

What about plain cow’s milk?

Cow’s milk and milk from other animals (such as goats or sheep) should not be given instead of infant formula. Neither should plant-based milks, such as soy, rice or almond milk. Wait until your baby is 12 months old before you introduce any of these as a regular drink.

More information

If you have any other questions on bottle feeding or types of formula, ask your child and maternal health nurse, or your doctor.