There are loads of reasons why families decide to feed their infant formula—and even more varieties of formula to choose from. If you're stressing over which one to choose, take heart: The Food and Drug administration carefully regulates infant formulas to make sure they are safe and that they all contain the same minimum amount of 29 required nutrients, among other criteria, to support healthy growth.
That said, beyond those 29 required nutrients, there are striking differences in the sources of some of these nutrients, and in other ingredients that companies use to give their formulas an edge. Knowing what to look for on the ingredients label and doing some detective work can help you determine what's may most closely meet your baby's needs.
"It's just about finding what suits your baby's digestive system best," says Bridget Young, PhD, assistant professor of pediatrics at the University of Rochester and founder of BabyFormulaExpert.com.
We did the research and talked to experts to find out some of the best formulas available right now for a variety of needs. Let's unbottle the facts:
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As any parent who has rocked a colicky baby in a car seat at 3 (and 4 and 5) in the morning knows, we're not exactly sure what causes the condition, marked by crying that lasts for a 3 or more hour stretch for more than 3 days out of the week in an otherwise healthy infant. Among the possible contributors are gas, which can be caused by difficulty digesting lactose, the sugar that is naturally present in milk. So it is possible that a lower-lactose formula could be helpful to a baby who has colic due to gas.
The protein in milk could be another culprit. "Some babies, especially newborns, can have trouble digesting cow's milk proteins," says Young. Switching to a partially hydrolyzed formula, or one where the proteins have been broken up into smaller pieces that are easier to digest. "The process brings them closer to the size range of breast milk proteins," says Young.
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There's also some research suggesting that a probiotic called Lactobacillus reuteri (L. reuteri) can help. Babies taking the probiotic supplement cried and fussed less than those who had a placebo, according to a review of 4 studies that tracked 345 breastfed infants with colic published in the journal Pediatrics. While the jury is still out on the probiotic's impact in formula-fed babies, experts say it could be worth a try; you can buy drops that contain the probiotic or find it in formula.
Our pick: Gerber Good Start Soothe is a lower-lactose formula made with partially hydrolyzed proteins that also contains the probiotic L. reuteri.
All babies spit up, no matter what they're eating. "Reflux is pretty common and normal in infants," says Angela Lemond, RDN, a board certified pediatric registered dietitian nutritionist based in Plano, TX. There's no specific guideline as to how much is too much when it comes to spit up, says Lemond; keeping up on pediatrician appointments will help you determine if reflux is getting in the way of your baby's growth or if there are any other issues in the feeding process.
It's possible that changing the bottle you use, altering the baby's positioning, or burping more often can work too (hint: gravity is your friend!). Time is also helpful; the immature lower esophageal sphincter that allows contents to creep back up will continue to develop and most babies will outgrow reflux by age 1. Talk to your doctor about what, if any, tweaks might help.
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If your doctor supports trying a new formula to help cut back on reflux, there are a few possible approaches. The reflux formulas on the market are one possibility; they're usually thickened so they'll have a harder time working their way back up the baby's esophagus. A formula made with partially hydrolyzed protein is easier to digest and may help curb spit up. Another possibility, says Young, is to try a formula with more whey protein—whey empties from the stomach faster than casein, the protein that predominates in cow's milk, which standard formulas are made from.
Our pick: Similac Pro-Total Comfort is made from partially hydrolyzed whey protein that reflux-prone babies may digest faster; the double whammy may just help cut back on spit up (and that neverending laundry pile!).
Every baby gets gas sometimes, regardless of how he or she is fed. "Gas is a normal byproduct of digestion," says Lemond. But gas may be a problem if you see a baby crying, grunting, and thrashing around after a feeding as if they are in excessive pain.
There are changes you can make before switching formulas that may help relieve your baby's gas. Switching to a new shape or style bottle can make a difference. "Look for bottles that have a venting system," says Lemond. Gas drops may also help as well as feeding and burping techniques; talk to your doctor about the various options.
If all else fails for gas and your baby is not already on a reduced-lactose formula, you may want to look into trying one—particularly if your baby is in first three months, says Young. Lactose is the predominant carbohydrate in breast milk, and all infants (with the exception of those with a rare disorder) are born able to digest it. However, some parents find that digesting large amounts of lactose in formula seems to cause gas, bloating, and other symptoms of lactose intolerance in their babies, and that switching to a lower lactose formula can help.
The good news is that issues with gas usually, well, pass. "It's a universal problem that babies have, and they have to learn how to pass gas on their own. They'll get there!" says Young. If your baby doesn't seem to be getting the hang of it after 3-4 months, talk to your doctor.
Our pick: Enfamil NeuroPro Gentlease is lower in lactose than standard formulas. It's also made from partially hydrolyzed proteins, which can also be easier on digestion.
Like gas and spit up, constipation happens—and every once in a while, it's not something to worry too much about. Chronic constipation, however, can be uncomfortable for your baby, and can suggest there is a problem with your baby's feedings.
If you're mixing formula from powder, double check that you are mixing correctly. The wrong ratio of water to powder can cause your baby to get stopped up, says Lemond. Inadequate calories and fluid can also be a cause for constipation. Talk to your doctor to learn more about what's normal in terms of baby poop and to help determine if your infant is eating enough.
If you've ruled out other causes and your doctor wants you to experiment with formula, try switching to a formula that is not made with palm oil, as many brands are. When palm oil is digested, it can bind with calcium in the gut, causing firmer stools. "For most babies it's no problem, but for babies prone to constipation it can push them over the edge," says Young.
Our pick: Similac Pro-Advance. All of Similac's formulas are palm-oil free; Pro-Advance also contains a prebiotic that may provide additional help with stool consistency.
The more specialized your formula gets, the more expensive it can get. If your newborn was full-term, is healthy, and your doctor doesn't have any specific recommendations, it's fine to go with a standard, milk-based formula to start. You may also consider a formula made with partially hydrolyzed proteins, which researchers are finding may be beneficial to a baby's developing immune system, in addition to being easier for a small baby to digest.
And for the record, if the newborn formula you start with is working well for your baby, there's no harm in sticking with it until his or her first birthday. All baby formulas in the US must provide adequate nutrition for babies age 0-12 months. "It's perfectly safe and totally fine to be on it for a year," says Young.
Our pick: Gerber Good Start Gentle; a partially hydrolyzed, mostly lactose formula that has added pre and probiotics.
Many parents gravitate toward organic formulas since they just sound healthier. To be labeled "organic," a formula has to be produced using only organic ingredients, which is better for the environment and may mean less exposure to pesticide residues.
Unfortunately, it's harder and pricier for manufacturers to get a hold of organically made ingredients, so there are very few specialized formula options with that coveted USDA organic label. There are good organic options, say experts. But the specifics and cost have to make sense for your family. "If you can get a formula that fits the criteria your baby needs and you can afford it, go for it," says Young.
Our pick: Plum Organics Gentle Infant Formula; the only U.S. brand currently selling organic formula made with partially hydrolyzed whey protein; its carbohydrates are 100% lactose.
If your baby is mostly or partially breastfed, they're already getting many of the nutrients formula companies add in to their products. "Formula manufacturers continue to work hard to mimic the "gold standard" for infants, which is breast milk," says Lemond.
There's no rule that you need to choose a formula that is made just for for supplementing, but using one is a completely suitable option if the other specifics work for your baby. Adding formula into a breastfeeding routine can change the consistency of your baby's poops, so many parents prefer products that contain prebiotic fiber, which can help soften stool.
Our pick: Similac for Supplementation; it contains prebiotics that can help keep baby regular.