Some parents are going to great lengths to get European baby formula because they think it's safer and more nutritious than American formula—even when you can't legally buy it here. Is it worth the risk? Here's the scoop.

By Sally Kuzemchak, MS, RD
September 06, 2019
Alex Segre/Alamy

There's a trend right now among some American parents when it comes to feeding babies: using infant formula imported from Europe. They're buying it online from importers or even having overseas friends and family send it over. They think it's healthier, better-regulated, and "cleaner" than U.S. formula. Here are the facts.

Is European formula healthier?

"Nutritionally, they both grow healthy babies just fine," says Bridget Young, Ph.D., a certified lactation counselor and an assistant professor of pediatrics at the University of Rochester. But there are some differences. European formulas contain less iron than U.S. formulas. Though that might be appealing to parents who think iron is constipating, it's important to know that the American Academy of Pediatrics says U.S. formula doesn't contain enough iron to cause constipation and warns that low-iron formula should not be used because it doesn't support proper growth and development for babies.

Another difference: regulations around the type of carbohydrate used. Many formulas have lactose as the main carb source in formula to mimic breast milk (and because it's easy to digest), but they may also include other carbs. Some U.S. brands use corn syrup and sucrose, which parents may not like to see on ingredient lists. European formulas don't allow sucrose in standard formula, but you can find U.S. formulas without sucrose too.

Is European formula "cleaner"?

One reason parents may think that European formula is better is because of simplified labeling. European formulas use plain language on their ingredient lists. So instead of the intimidating-sounding "cyanocobalamin" on the U.S. label, the European label reads "vitamin B12"—even though they're the same thing. "All the vitamins and mineral names are confusing to parents, and they think those are scary ingredients," says pediatric dietitian Jessica Gust.

Some parents who have been trained to look for shorter ingredient lists on their own packaged food are also seeking the same things for their babies. In fact, one of the most popular imported brands is a stripped-down formula with just the basics. But it's questionable whether a shorter ingredient list is necessarily better since many of the extra ingredients used in formula (like DHA and prebiotics) are meant to better replicate breast milk.

Europe also has formula that's both organic and made with grass-fed milk, something that's not available in the U.S. yet. But keep in mind there's no published evidence proving that organic (or grass-fed) formula is healthier for babies than conventional, says Dr. Young.

Is European formula better regulated?

The FDA regulates U.S. formulas and has specific, strict requirements for what they must contain, including minimum amounts for 29 nutrients and max amounts for nine. Some companies also include extra ingredients such as probiotics or the beneficial fatty acids DHA and ARA. Though there's a distrust of the U.S. system among some people, Dr. Young says parents should feel confident. "Nothing gets added to formula without extensive research," she says.

But the FDA does have concerns about certain European formulas. Earlier this year, they issued an advisory to parents to avoid using a German formula they said was too low in iron and didn't provide information about the amounts of many nutrients. "The absence of any of these key nutrients in infant formula may lead to poor growth, nutrient deficiencies, and/or serious health problems for developing infants," they said in the advisory.

Is European formula safe to use?

There are risks to using European formula, explains Dr. Young. For starters, it's designed for certain stages of development. Stage 1 is typically for babies 0-6 months and has less iron than stage 2. Parents may not understand this system or forget to switch stages as their baby gets older.

Other complications: The instructions on the container may not be in English, which can lead to confusion when mixing it. The scoop sizes are different, which introduces risks of improperly measuring if you misplace the scoop. You may not find out about potential recalls on the formula you're using. And third-party suppliers may suddenly shut down operations (as happened recently with one popular website). That means a sudden formula switch that can be hard on your baby's system.

Bottom line:

There's really no reason to choose European baby formula over ones in the U.S., but whatever kind of formula you choose to use, it's best to run it past your pediatrician. Formula choice should be made by the parents and the pediatrician together based on the needs of the child, and the baby's age, medical history, and any other sources of nutrition, says Dr. Young.

Finally, there are loads of options among U.S. formulas, including organic formulas, at least one made with grass-fed milk, and formulas that don't use sucrose. So talk to your pediatrician and do some research, but don't rely on rumor for your information. "Parents should be able to make decisions for their baby from a place of empowered knowledge," says Dr. Young. "Not fear."

For a more in-depth comparison between European and U.S. formulas, check out this post from Dr. Young.

Sally Kuzemchak, MS, RD, is a Contributing Editor for Parents magazine and a registered dietitian who blogs at Real Mom Nutrition, a no-judgements zone about feeding a family. She is the author of The 101 Healthiest Foods For Kids and Cooking Light Dinnertime Survival Guide. You can follow her on Facebook, and Instagram. In her spare time, she loads and unloads the dishwasher. Then loads it again.

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