As postpartum doulas, we often get asked questions about infant formula and formula-feeding. While we advocate and promote breastfeeding, and thoroughly believe in the magic of breastmilk, we also recognize that there are many women who choose not to breastfeed or are unable to breastfeed or pump milk, and so use formula to feed their babies. Sometimes, this is not a choice, due to physical factors in the mother or the baby. And other times, it is a choice, perhaps made in order to protect a mother’s mental health. Yes, breastmilk is magical, but a healthy, happy mom is pretty magical, too. And sometimes, this means formula. Regardless of why a family is using formula to feed their baby, there are lots of great questions out there. Here are the five formula-related questions we get asked the most often.
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Which type of formula is best? The American Academy of Pediatrics has not taken a stand on which formula is better. All they officially recommend is that breastfeeding is preferred over formula and that you shouldn’t use a low-iron infant formula. All infant formula brands sold in the United States must meet the minimum nutritional requirements of the Federal Food, Drug and Cosmetic Act (the “Infant Formula Act”) and FDA regulations. In the United States, most infant formulas, even across brands, are made at the same factories by the same manufacturers, so while the prices and marketing are different, the processes used to create the formulas are the same. The most common type of infant formula is cow/dairy-based, with whey and or casein from cow’s milk in it. There are also soy-based and other lactose-free formulas on the market. Pediatricians will generally advise you not feed soy-based formula unless absolutely necessary, as there are many uncertainties and concerns about the phytoestrogens in soy formula. Whenever possible, we encourage parents to buy organic formula. If you’re buying U.S. brands, there is no reason to not buy a store brand infant formula. They can be much less expensive and have virtually identical ingredients as the more expensive name brands. Overall, though, our recommendation is to consider some European brands. Europe has much more strict laws regulating chemical usage and ingredient safety in formulas. Unfortunately, European formulas are not commonly sold or easy to find in the U.S. If you can find the, we’ve heard great things about HiPP Organic and Holle formulas, in particular. Holle makes a goat milk formula as well, which may be appealing because in its composition, goat milk is actually the closest animal milk to human milk.
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Can my baby try different types of formula? Yes, generally babies will easily move from one type of formula to another. Some parents prefer to make these changes gradually, while others switch immediately. It’s up to you, and we always advise parents watch their baby closely for the first week of using a new formula, for signs of constipation, gassiness, allergy, or general upset.
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How long can prepared formula be used before you have to throw it out? If powdered formula is prepared with water and then refrigerated, it can be used for up to 24-hours from mixing. Once baby’s mouth has made contact with it (through a bottle nipple, for example), it needs to be tossed from 1 hour of baby’s mouth contacting it. This is because new bacteria has been introduced and will grow rapidly. A tip: if you’ll be using formula multiple times in the next 24 hours, make a large bottle or even a small pitcher like this one and stick it in the fridge. Then, you can just pour out exactly the amount you need for each feeding, with less waste.
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Can you mix formula and breastmilk together in the same bottle? The short answer is yes, you can. However… It’s generally advised to not mix formula and breastmilk in the same bottle, because we really want to make sure baby gets all the breastmilk available first, and then formula if more is needed. If you mix the two, then you’re not really sure how much breastmilk baby got, and you also have to throw out the whole bottle within an hour of starting to feed it to baby. If, for some reason, you absolutely do need to mix breastmilk and formula in the same bottle, it’s important to mix the formula with water separately first, and then to pour the prepared formula in with the breastmilk. It’s never a good idea to add powdered formula right to breastmilk, because that will lead to an over-concentration of nutrients that could be dangerous to your baby’s system.
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Can I make my own baby formula? Experts recommend buying commercially-prepared infant formula rather than making homemade formula for infants. Crafting precisely the right blend of ingredients and nutrients is not easy, and the potential for error and unsanitary workspace is high. Some homemade infant formula recipes call for ingredients that are considered unsafe for infants, such as unpasteurized animal milks. Babies require a very specific balance of protein, fats, carbohydrates, vitamins, and minerals. Without professional regulation of homemade formulas, the baby may get too much or not enough of each particular nutrient. And, as with the multiple steps that are required to prepare DIY formulas, there is a risk of errors in measurements. Whether the recipe isn’t nutritionally adequate to begin with, or you make a mistake with the measurements during the prep work, an improper balance of nutrients can lead to malnourishment, excessive weight gain, or other health complications.
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