Formula 411

by Alison Bell

Formula 411

Milk or soy? Brand name or generic? To add or not to add DHA and ARA? These are just a few of the decisions facing you if you've decided to formula-feed your baby. It's reassuring to know that all formulas on the market have met an acceptable level of nutrition for infants. But beyond that, there are many distinctions. Here, a guide to help you select the best one for your baby (always check with your pediatrician before switching formulas):

Iron fortification

This is a must for any formula. The American Academy of Pediatrics recommends using iron-fortified formulas until a baby is 12 months old, because some infants don't have enough natural reserves of the nutrient to meet their needs. Iron deficiency can cause anemia and impair mental and motor development, so make sure that any formula you buy is labeled "iron-fortified" or "with iron."

Cow's milk vs. soy

Most doctors recommend cow's milk—based formula because it resembles breast milk most closely and the majority of babies tolerate it, says pediatrician Ari Brown, M.D., author of Baby 411: Clear Answers & Smart Advice for Your Baby's First Year. Cow's milk is also a better source of protein than soy formula, and infants can absorb the calcium in cow's milk more efficiently than they can with soy.

Soy formula, though, which uses soy protein in place of cow's milk protein, is a perfectly safe alternative for full-term infants if your family does not eat animal products. (Talk to your doctor about what's best for your preemie.) Pediatricians may also recommend it if your child is unable to digest lactose (milk sugar) or if she seems intolerant to cow's milk formula and becomes gassy, fussy, or vomits during feedings.

If you decide to feed your full-term baby soy formula, your pediatrician might recommend additional vitamin and mineral supplements for you to give her.

Hypoallergenic formula

Up to to 30 percent of infants who are allergic to milk are also allergic to soy, says Dr. Brown, a condition that can cause hives, intestinal problems including blood in the stool, and failure to thrive. For these children, doctors recommend special predigested (the proteins of milk have been broken down into their most basic elements so they're easy to digest), hypoallergenic formulas, such as Nutramigen and Alimentum. Hypoallergenic formulas are also recommended for babies at high risk for developing allergies due to a strong family history of them.

Lactose-free formula

This is a cow's milk formula for babies who are sensitive to lactose, a condition which can cause fussiness, gas, and/or diarrhea. Lactose intolerance is actually rare in infants and usually develops in older children or adults. Sometimes, though, babies have trouble digesting lactose after a stomach virus, and may need this special formula for a few weeks  — with your doctor's approval.


Recently, the polyunsaturated fatty acids DHA (docosahexaenoic acid) and ARA (arachidonic acid) have been added to many formulas such as Enfamil LIPIL, Similac Advance, Nestle Good Start Supreme, and Bright Beginnings. Abundant in breast milk, these two nutrients aid in the development of a baby's brain, eyes, and nervous system. While infants' bodies can make DHA and ARA from oils already present in formula, it's believed that the addition will provide an extra benefit. Some research shows that babies given formula with DHA and ARA have improved vision and score higher on infant development tests than babies fed regular formula, but other research has not shown these correlations. More research is being done, but in the meantime, says Dr. Brown, feeding your baby formula with DHA and ARA certainly won't hurt, though it does have a higher price tag.

Organic formula

Organic brands, such as Horizon Organic Infant Formula with Iron, contain all the nutritional value of regular formula but are produced without antibiotics, hormones, and pesticides.

Generic vs. brand name

While there may be a few slight differences in makeup, both are essentially the same product, says Dr. Brown, and all formulas must be approved by the Food and Drug Administration. Generic formulas may not come in as many variations (with DHA and ARA, lactose-free, etc.), however, so if you prefer or if your baby needs a special formula (or simply enjoys the taste of one over another), brand name may be the way to go.