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Infant formula is a nutritional product that is made from processed cow's
milk or soybean products. Special processing makes cow's-milk formula more
digestible and less likely to cause an
allergic reaction than regular cow's milk.
minerals are added to infant formula. Formula can be
used to provide all of a baby's nutritional needs before the age of 4 to 6
Commercial formulas are
made to be as similar to breast milk
as possible. The safety and nutrient content of infant
formula is regulated by the U.S. Food and Drug Administration (FDA).
About half the calories
in formula come from vegetable oils or a mixture of vegetable and
animal fats. A baby's body requires fat for the production and
growth of new cells and for high energy needs.
Milk sugar (lactose) is the main source of
carbohydrate in most cow's-milk
formula, just as in breast milk.
Several types of infant formulas are
available. Usually cow's-milk formulas are tried first. Babies absorb minerals
and nutrients better from cow's-milk formulas than other types of
Babies need iron in addition to other vitamins and minerals. The iron in
human milk is much more easily absorbed by infants than the iron in cow's milk.
(But even breast-fed babies need iron added to their diet.) Formula-fed babies can become iron-deficient if iron-fortified formulas
are not used.
Iron deficiency may cause severe complications in
babies, such as weakness, abnormal digestion, and permanently reduced learning
abilities. In the United States, a formula with an iron concentration of 6.7
mg/L or higher is considered iron-fortified. And the
label must say that.1 The American Academy of Pediatrics recommends testing for anemia in babies at 12 months of age.
Some caregivers may be hesitant to feed an infant iron-fortified formula
because of concern about side effects, such as gas or constipation. But these
concerns have not been proved by research, and low-iron formulas are not
recommended as a remedy for such symptoms. Although low-iron formulas are
available, they should only be used in extremely rare situations on the advice
of your doctor.
Other types of formulas are available for babies
who have trouble digesting cow's-milk formulas. These are for babies who are at high risk of allergies or with a cow's milk allergy. Talk to your doctor
before giving your baby one of these formulas.
Do not use homemade formulas, such as those that use
evaporated milk. These do not contain the nutrients and supplements your baby
needs. They could also make your baby sick.
You can buy
formula as a powder or as a concentrated or ready-to-feed
liquid. Ready-to-feed formulas cost the most. But
some caregivers find their convenience worth the extra cost. You must add
safe water to powders and concentrates. Be sure to follow the
directions on the label and use the measuring device that comes with the
Cover and store your open
cans of ready-to-feed and concentrated liquid product in the refrigerator for
no longer than 48 hours. Cover and store both opened and unopened cans of
powder formula in a cool, dry place, not in the refrigerator. You can use the
powder product for up to 4 weeks, if it's stored right. Don't leave prepared
formula out of the refrigerator.
Also, follow-up formulas for
toddlers are available and usually contain more iron and other nutrients than other
formulas. They can be used for older babies who are
switching from formula to whole cow's milk. Most babies make this transition
In some cases, doctors recommend adding a thickening agent to a baby's formula. Before you use one, talk to your doctor about the risks and
benefits. If you have any trouble feeding your baby, talk to your doctor or nurse.
American Academy of Pediatrics (2009). Formula feeding
of term infants. In RE Kleinman, ed., Pediatric Nutrition Handbook, 6th ed., pp. 61–78. Elk Grove Village, IL: American Academy of
Other Works Consulted
American Academy of Pediatrics (2010). Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0–3 years of age). Pediatrics, 126(5): 1040–1050. Available online: http://pediatrics.aappublications.org/cgi/content/full/126/5/1040.
June 3, 2013
John Pope, MD - Pediatrics & Thomas Emmett Francoeur, MD, MDCM, CSPQ, FRCPC - Pediatrics
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