Guide for Formula Feeding and its Types

Introduction:

Formula feed is recommended when the mother cannot breastfeed for certain reasons. Nothing can replace breast milk, but infant formula contains cow’s milk, vitamins, minerals, and other nutrients. Plain cow’s milk cannot be given directly since certain components in cow’s milk are difficult to digest and lack certain nutrients that infants require. The formula differs from breast milk because breast milk contains antibodies to fight off diseases and has fewer proteins; hence, it does not make babies overweight.

What Are the Reasons to Prefer Formula Feeding?

• Insufficient supply of breastmilk.

• Certain medications and surgery on the breasts can affect breastfeeding.

• Working mothers.

• Adopted kids.

How to Choose a Baby Formula?

The United States Food and Drug Administration (FDA) has developed guidelines for commercial infant formulas to ensure their safety and nutrition. Baby formula can be chosen in the following ways:

• Child’s Health: Choose a formula feed based on the child’s health after consulting a pediatrician. Care must be taken for infants with constipation, acid reflux, eczema, or other issues.

• Formula For Healthy Baby: Formula based on cow’s milk must be preferred in babies born normally and healthy.

• Quality Over Price: Ready-to-feed formulas are costlier than powdered formulas, but a choice should be made based on something other than price.The label and instructions must be carefully read, and then a decision must be made based on what will be suitable according to the baby’s age and requirements. Also, one must not be carried away with fancy labels like superior quality, premium, etc.

• Package Check: Expiry date must be checked. Any tampered, rusted, protruded, or leaky packages must be avoided.

• Low Protein Formulas: Baby formula with a low protein content must be chosen, so the baby does not become obese.

• Single Formula: It takes time for babies to get used to formulas, and care must be taken to keep the same brands of formulas. After starting a new formula, sleepiness, colic, gas, fussiness, and puking in infants must be monitored. In case of any issues, necessary changes in the formula can be made after consulting a pediatrician.

What Are the Various Types of Formula Feeds?

Different formula feeds include:

• Milk-based Formulas: These are the most common type of formulas in which the milk in these formulas undergoes a certain heating process so that it becomes easily digestible for babies. Also, milk fats are substituted with vegetable oils and other fats. These are also enriched with vitamins, minerals, and iron. More lactose is added to match the lactose concentration in breast milk.

• Soy-based Formulas: Protein (soy) and carbohydrate (sucrose or glucose) are preferred for infants with lactose and galactose (a component of lactose) intolerance and milk allergy. In certain babies, lactose intolerance can be temporary, such as after diarrhea. Amino-based specialized formulas are a choice for infants with a soy allergy. Babies with milk allergies are usually tolerant towards soy also.

• Iron-fortified Baby Formulas: Though there is added iron in milk-based formulas, iron-fortified formulas are recommended for infants with iron deficiency. Parents may be apprehensive about iron causing constipation, but minimal amounts of iron in formulas do not cause constipation.

• Specialized Formulas: Babies with milk allergy, gut, digestive issues, and soy allergy are given specialized formulas. Hypoallergenic formulas contain broken-down (hydrolyzed)proteins, so they do not trigger antibody production. Specialized formulas are also preferred for babies with certain disorders and preterm babies. Pediatricians’ guidance is required in these cases.

Formula feeds are available in powder, liquid, and ready-to-feed forms.

How to Prepare an Infant Formula?

The following instructions are to be followed while preparing infant formula:

• Hands must be washed with warm water and soap before formula preparation. The preparation area must be kept clean. Bottles, nipples, and teats must be sterilized.

• Boil fresh water and allow it to cool for at least 30 minutes so that it is slightly warm.

• Add water to the sterilized bottle and then the powder.

• Read the instructions on the pack thoroughly and add the recommended scoop of infant powder using a dry scoop provided by the manufacturer. Level off using the back of a sterilized knife. Close the pack tightly and store it in a cool and dry place.

• Place the cap on the bottle and shake it thoroughly to let the powder and water mix.

• Check the temperature of the prepared formula by placing a drop on the inside of the wrist. It should be lukewarm.

What Must Not Be Done While Preparing a Formula?

• Never heat the bottle in a microwave oven, as uneven heating can burn the child’s mouth. The bottle can be warmed by placing it in hot water if necessary.

• Adding extra powder might cause constipation, and less powder might not give the baby the needed nutrients. So, adding the correct amount is mandatory. Only the scoop used by the manufacturer must be used.

• Do not add any sugar, salt, or honey.

• Never dilute the formula. Adding extra water can cause an imbalance in electrolytes and minerals such as calcium, potassium, and sodium, which can severely impact the infant’s health.

• The leftover formula must be discarded. Formula kept at room temperature for less than an hour can be stored inside a sterile container in a refrigerator for up to 24 hours.

• Wash the bottle and the teats immediately. The scoop must be discarded along with the empty pack.

• Preparation must be done before feeding time and early enough.

How to Sterilize Baby Bottles?

The bottles used for feeding must be thoroughly washed in hot, soapy water and rinsed completely to remove the soap. Bottles can also be sterilized by boiling in water for 5 minutes or using an approved sterilizing agent.

What Is the Guide for Formula Feeding?

It is to be noted that the above values are just a guide. It is always better to follow the pediatrician’s recommendations based on the infant’s requirements or to follow the instructions on the pack.

Can Formulas Be Prepared at Home?

It is advised not to prepare formula feed at home using certain ingredients because these may contain particular nutrients in less or excess amounts. Growth till one year of age is crucial, and care must be taken to ensure proper growth and development of the child. The manufacturing units and the ingredients used by the manufacturers of formula feed are monitored regularly by the respective authorities, such as the Food and Drug Administration (FDA), making them safe for infants. Likewise, imported feeds are also not to be used as these might not be approved by the regulatory authorities.

How to Transport a Formula Feed?

It is advisable to avoid transporting prepared formula feed in bottles as bacteria can manifest in warm, moist conditions. However, in such situations, the following points should be kept in mind.

• Prepare the feed before transporting it and store it in a refrigerator.

• The bottle must be removed from the refrigerator before leaving.

• Keep the feed in a cool bag with ice packs and use it within 2 hours as it may cool down completely afterward.

• The feed can be warmed at the destination for less than 15 minutes. A container with hot water can be used to rewarm.

• The formula feed kept in a cool bag can be refrigerated for up to 24 hours from the preparation time if the destination arrives within 2 hours.

Conclusion:

Breast milk is undoubtedly the ‘liquid gold’ for a baby, and all mothers must exclusively prefer breastfeeding over formula feeds. However, formula feed can be given in unavoidable situations. Cow’s milk must never be given directly as the underdeveloped kidneys of infants might find it difficult to metabolize the complex proteins and minerals in cow’s milk. They also lack adequate proportions of iron, fat, vitamins, minerals, and other essential nutrients. Further, they can irritate the stomach and intestinal lining, causing stool bleeding and iron deficiency anemia. Probiotic formulas induce good gut health by promoting the growth of ‘good’ bacteria. As mentioned above, formula feed can be given to infants with proper care and caution.