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The formula for a happy, healthy baby
There's no mistaking what babies do best. Any parent will tell you. They eat. They sleep. They dirty their diapers. And as fast as you can say peek-a-boo, they're letting you know, in no uncertain terms, that they're hungry again. So if you're going to keep that bouncing baby of yours happy and healthy, you'd better be quick on the draw at mealtime.
Medical evidence clearly favors breast milk over formula for its ability to build immunity and ensure nutritional needs of the infant. But the decision, of course, remains a personal one. Parents who choose bottle-feeding have plenty of good options in terms of formula. So read on. But you'd better read quickly, because it won't be long before you-know-who is hungry again.
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Breast Milk: Fueling Healthy Bodies
Breast milk is by far the best nutrition for your baby for the first four to six months. It contains all the necessary nutrients to help your baby grow and develop properly. Also, breast milk contains antibodies and other protective factors that help fend off infection and disease. So stick to breast milk for your baby, if you can. Unfortunately, the world is not ideal: there are time constraints and social, health, or other factors that may prevent breastfeeding. In these instances, formulas are the best alternative.
Moove Over, Cow's Milk
Plain cow's milk -- either whole or skim -- just doesn't cut it for babies. It simply lacks the complete nutrients and fat a baby needs for healthy development and can be tough on the kidneys and digestive tract. Formulas today are specially created to simulate the nutritional content of breast milk. Plain cow's milk should not be fed to babies in their first year of life.
Choosing a Formula
Start with milk-based formulas. If there are problems, you can switch to a soy-based formula and finally to hydroxilized protein-based formulas. It's not uncommon for babies to develop an allergic reaction or lactose intolerance, so it's good to know you have options.
Formula comes in three basic types: liquid concentrates and powder that require water, and ready-made versions in bottles or cans. Be careful to follow measurements and instructions carefully; adding too much or too little water can cause serious medical problems.
Is It Time to Eat Yet?
If your baby's hungry, it's time to eat. In the first few weeks, a baby will typically want to eat six to eight times in a 24-hour period.
You can expect your baby to take approximately 2 to 2 1/2 ounces of formula per day per pound of weight. The amount can vary depending on growth spurts, activity, or illness, but it's a good guideline.
Formula Do's and Don'ts
- Prepare formula no more than 24 hours in advance and refrigerate until ready to use.
- Serve unrefrigerated, prepared formula within four hours.
- When choosing formula, it's probably wise to stick to major brand names.
- Never save leftover formula for future feedings or mix it with a new bottle.
- Do not freeze formula.
- Avoid using hot water from the tap to prepare formula; lead from pipes and water heaters is much more soluble in hot water.
- Microwaving a bottle can result in scalding. Instead, run warm water over the bottom of the bottle for a few minutes, then shake to warm the entire contents.
- Discard formula that looks or smells unusual.
- Do not try to make your own formula at home. Homemade formulas are generally nutritionally inadequate and difficult for a baby to digest.
Formula Can Cause Problems
Your baby might develop cavities if formula use is continued beyond age 6 months. This is a particular concern if your child sleeps with a bottle after age 1. The last bottle of the day that you give to your child should be water only, since the carbohydrates in formulas can lead to cavity formation.
Formulas may cause nutritional deficiencies if they are low in one or more nutrients. Many deficiency states in children such as anemia, convulsions, and goiters have resulted because the babies were fed formulas that lacked those nutrients. Talk to your physician about the nutrients your baby needs and the adequacy of the formula you're using.
Diarrheal Illness Can Cause Problems
Diarrhea causes many problems for your infant.
- Diarrhea may be the first sign of an allergy to the formula.
- Since babies' water balance is so easily disrupted, dehydration is always a concern when your baby has diarrhea.
- Formulas do not adequately replace lost electrolytes or nutrients.
- Usually diarrhea goes away without much of a fuss. Sometimes fluid replacement therapy is necessary.
- It is sometimes advisable to temporarily cease using formulas for one day and only use oral rehydration therapies while your child has diarrhea. Consult a physician before initiating such therapy; oral rehydration therapy should never be continued as the main source of nutrition after diarrhea has ceased.
Enlightening Yourself About Electrolytes
Electrolytes help hold nutrients in the body and depend on fluids to remain active. Diarrhea can quickly lead to a loss of electrolytes and dehydration in babies. Specially developed oral rehydration solutions contain the proper balance of sodium, chloride, and potassium salts to safely replace electrolytes. Consult your pediatrician about their use.
Keep an eye out for signs of dehydration:
- Sunken eyes
- Dry lips and wrinkled skin
- No tears
- Reduced urination
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Water
Babies have a higher percentage of body water than adults, so it's important that your baby's formula contain adequate amounts of it. Some conditions that may increase your baby's water loss (and increase the need for water) are diarrhea, fever, and increased breathing rates.
Carbohydrates
Carbohydrates are necessary for the your baby's proper metabolism. A carbohydrate-free diet can result in using stores of fat and protein, as well as electrolyte and water loss. Lactose is the primary carbohydrate in breast and cow milk. It's broken down in the body by the enzyme lactase into glucose and galactose. Some infants are deficient in the enzyme, especially premature and lactase-deficient infants. If your infant has problems digesting lactose, find formulas that are not based upon cow milk or look for ones that have predigested lactose.
Protein
Your baby needs protein to grow. Not only is ingestion of adequate amounts of protein necessary, but the protein composition is also important. Protein composition must include adequate amounts of essential, nonessential, and conditionally essential proteins. Premature infants need more proteins.
Fats
Fats are high in energy when compared to carbohydrates; each gram of fat contains nine calories, while each gram of sugar contains only four calories. Your baby needs these extra calories to help maintain rapid growth and development. Unlike adults, babies are encouraged to consume about 30% to 40% of their calories from fat.
Cow-milk based
A formula is necessary when an infant is not breastfed. Infant formulas use whole or nonfat cow milk as a base. Vegetable oils are added to create the proper fat content and vitamins and minerals are included to resemble the composition of human breast milk. Cow milk provides easily absorbed calcium and protein. Carbohydrates come mainly in the form of lactose, which has the potential to cause stomach upset in your baby. Cow milk proteins may also cause stomach upset. If digestive irritation occurs, you should try using a different type of formula. Hydrolyzed-protein formulas are an alternative to traditional cow-milk-based formulas. The cow-milk proteins in this type of formula have been broken up (predigested). This lessens the chance of diarrhea due to cow-milk protein. However the lactose is still present and can still potentially cause diarrhea. There is also a lactose-free formula that is milk based, but does not contain lactose.
Soy-based formulas
Soy-based formulas should only be used if your baby has an allergic reaction to products derived from cow milk. The protein in these formulas is from soybeans and the carbohydrates are made up of sucrose or corn syrup. This reduces the likelihood of your baby experiencing diarrhea. Though soy proteins are not as nutritious as milk proteins and calcium is not as easily absorbed from soy formulas as from cow-milk formulas, irritation and stomach upset is less likely to occur when using these products. Soy formulas also come in a carbohydrate-free product. This is useful for babies who have special dietary needs and cannot properly digest carbohydrates.
Low birth weight and preterm formulas
These formulas try to compensate for the increased nutritional needs of premature, low weight, and very low weight infants. No commercial formula is ideal for these infants, though.
Electrolyte solutions
Electrolyte solutions are used to prevent dehydration after your baby has experienced vomiting or diarrhea. They contain water, carbohydrates, and electrolytes such as sodium, potassium, chloride, citrate, and phosphate. The electrolytes help restore your baby's ability to regulate water loss, while the water helps to rehydrate your child. These solutions also contain glucose to help with the rehydration process.
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Appropriate Uses
Concentrated liquid formula
Satisfies nutritional needs during the first six months of life when the baby is too young to eat solid foods.
Powdered formula
Satisfies nutritional needs during the first six months of life when the baby is too young to eat solid foods.
Ready-to-feed formula
Satisfies nutritional needs during the first six months of life when the baby is too young to eat solid foods.
Bottle heater
Warms prepared baby bottles.
Bottle sterilizer
Sterilizes empty baby bottles.
Common Misconceptions
Homemade formula
Claims to satisfy a baby's nutritional needs. This claim is misleading because homemade formula does not contain enough nutrients and is generally difficult for a baby to digest. If prepared inappropriately, homemade formula may affect the electrolyte status of the infant.
Low-iron formula
Claims to contain enough iron to satisfy a baby's nutritional needs. This claim is misleading because formula needs at least 12 mg of iron per liter to be nutritionally adequate. This formulation is for a select patient population.
Bottle heater
May claim to sterilize baby bottles, however, the heater does not get hot enough to sterilize the bottle.
Your Baby's First Food Is Extremely Important
- Consult with your physician about choosing a suitable formula.
- Formula comes in three forms: concentrated liquid, powder, and ready-to-feed liquid.
- Carefully measure and dilute formulas according to package instructions.
- Notify your physician if your baby shows any signs of allergies (such as skin rashes, clear mucus running from the nose, frequent crying spells, or frequent colds) or has diarrhea, constipation, or spits up frequently. GI effects generally are the first signs of allergies to formulas.
Lots of Fuel for Little Bodies
- For a couple weeks after giving birth, you will need to feed your baby about six to eight times in every 24-hour period or whenever your baby seems hungry or starts to cry.
- Nighttime feedings may be more frequent than daytime ones, since studies have shown that babies tend to be nocturnal.
- Newborns usually eat about 2 to 4 ounces of formula during each feeding.
- The amount of formula for each feeding will constantly increase as your baby grows older.
- Your baby needs about 2.5 ounces of formula per day for every pound of weight.
- Since many things (growth spurts, activity, illness) can affect feeding amounts and frequency, daily formula requirements will vary.
Storing Formula
- Use formula before the expiration date.
- Prepared formula can be refrigerated for up to 24 hours.
- Always discard formula left in the bottle after feeding. Milk is easily contaminated with bacteria.
- Cover any opened cans of powdered formula and store up to four weeks in the refrigerator.
- Cover and refrigerate opened liquid formula for up to 48 hours.
- Do not freeze formula.
- Throw away any formula with a strange odor or texture.
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Follow the Directions Carefully
- Follow written instructions for preparation carefully.
- If the formula is too concentrated, it will disrupt electrolyte balance and serious kidney damage could result.
- Overdilution of formula can cause malnutrition or overdilution of your baby's body fluids.
Babies Require Carefully Balanced Nutrition
- Fruit juices containing sorbitol may cause diarrhea, abdominal pain, and bloating when consumed in excessive amounts.
- Citrus juices (including orange, tangerine, grapefruit, pineapple, and tomato) may cause allergic reactions in children under age 6 months.
- Juices, sweetened powder drinks, and caffeinated beverages can contribute to tooth decay.
- Juices do not add much nutritionally to a baby's diet, so they should not be a substitute for breast milk or formula.
- Avoid giving babies bottled water, as it can have many negative effects:
- May cause seizures in babies under age 6 months who are not eating solid food yet.
- May contain lower sodium levels than babies need.
- May contain contaminants and bacteria.
- Symptoms of food allergies include diarrhea, constipation, wheezing, vomiting, skin rashes, and watery eyes within 24 to 48 hours of exposure.
- Avoid feeding honey to babies, as it can cause botulism poisoning. Symptoms of botulism include listlessness, irritability, diarrhea, droopy eyelids, and difficulty swallowing and breathing 24 hours after exposure.
Tiny Little Systems Need Extra Care in Feeding
- Check labels carefully for the expiration date.
- Consult with your physician about choosing a suitable formula.
- Be very sure of the ingredients if you use lesser known brands or unconventional formulas. Check with your doctor.
- Do not use a particular formula if your baby is allergic to any ingredient in the product.
Be Conservative About Storage and Use
- Throw away formula with strange odor or texture.
- Do not save partially used bottles of formula.
- Do not store open, prepared formula for longer than 24 hours in the refrigerator.
A Baby's System is Delicate
Do not administer electrolytes if the baby has kidney complications or is vomiting. Consult a doctor when administering replacement electrolytes for diarrhea or dehydration.
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Websites, Organizations & Manufacturers
Sources & Further Reading
Books
- 1. Covington, TR; RR Berardi, LL Young, SC Kendall, MJ Hickey.Handbook of Nonprescription Drugs. American Pharmaceutical Association, Washington DC, 1996.
- 2. Jones, S; W Freitag.Guide to Baby Products, 5th ed. Consumer Reports Books, Yonkers, NY, 1996.
Find more books on health and wellness at  barnesandnoble.com.
Articles
- 1. Stehlin, IB.Infant Formula: Second Best but Good Enough. FDA Consumer. US FDA, June 1996.
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