What's in the Bottle? A Review of Infant Formulas

Abstract

Infant formulas are designed to be a substitute for breast milk. Since they are sole source of nutrition for growing and developing infants, they are highly regulated by the government. All ingredients in infant formulas must be considered "generally recognized as safe." Manufacturers are continually modifying their products to make them more like breast milk. Functional ingredients added to infant formula include long-chain polyunsaturated fatty acids, nucleotides, prebiotics, and probiotics. The most common breast milk substitutes are standard cow's milk-based term infant formulas, which include subcategories of organic and breast milk supplementation, and come in standard dilutions of 19 or 20 calories per ounce. In addition to standard cow's milk-based term infant formulas, there is a line of term infant formulas marketed for signs and symptoms of intolerance. These products include modifications in lactose content, partially hydrolyzed protein, added probiotics, or added rice starch. There are also specialized formulas for medical conditions such as prematurity, gastrointestinal disorders, allergy, disorders of fat metabolism, and renal insufficiency. Infants on specialty formulas should be monitored closely by medical professionals. Formulas come in ready-to-feed, liquid concentrate, and powder forms. Each offers advantages and disadvantages. Each step in the formula mixing process or each manipulation required for the feeding is another opportunity to introduce bacteria to the formula. There are guidelines for preparing formula in institutions. Standard dilution and mixing instructions are different for each formula, so individual recipes are needed. Caregivers should also be educated on proper hygiene when preparing formula at home.

Standard and Specialized Infant Formulas in Europe: Making, Marketing, and Health Outcomes

“…Human milk is the gold standard for infant feeding, and so infant formula manufacturers modify cow's milk to be more like human milk. Cow's milk–based infant formula contains added antibodies, nucleotides, long‐chain polyunsaturated fatty acids, prebiotic oligosaccharides, probiotic bacteria, vitamins, minerals, and some bioactive peptides . Among amino acids, only L‐forms may be added, while D‐forms are removed, as D‐lactic acidosis may occur.…”

“…DHA and ARA are important for regulating growth, inflammatory responses, immune function, vision, and motor and cognitive development in infants . Their average calorie concentration is 0.64–0.67 calories/mL . Some subcategories of standard term infant formula based on cow's milk are organic and “for breastfeeding supplementation.” Standard formulas must meet all of the infant formula guidelines and support normal growth.…”

“…Their average calorie concentration is 0.64–0.67 calories/mL . Some subcategories of standard term infant formula based on cow's milk are organic and “for breastfeeding supplementation.” Standard formulas must meet all of the infant formula guidelines and support normal growth. They are suitable as human milk substitutes.…”

“…The most common infant formula is standard formula based on cow's milk . Specialized infant formula (SIF), or “formula for special medical purposes intended for infants,” is designed to satisfy the nutrition requirements of infants with specific medical conditions, including prematurity; allergy; or gastrointestinal, metabolic, or renal diseases . In the last few years, SIF sales have increased significantly .…”

The Role of Hydrolyzed Formula in Allergy Prevention

“…Typical infant formulas for full-term infants have 19-20 calories per ounce and approximately 1.3-1.4 g of protein per 100 mL [4] . Although there are a variety of potential protein sources for infants, the typical protein source is cow's milk proteins.…”