Choosing the Best Formula for Your Baby

With so many options and varieties, choosing a baby formula that's best for your child can be as difficult as it is important. Your decision on what to use will hinge on several factors, from your baby's health needs to cost, and many things in between. But most of all, it will depend on what your child will accept.

Breast milk or formula should be your baby's exclusive source of nutrition for the first six months of life and the primary source (supplemented with solid food) for the first year. If you formula feed, know your options so you can buy wisely.

All Formula Brands Are Safe

It's always helpful to ask your child's pediatrician for specific recommendations, but generally speaking, all baby and infant formula brands sold in the United States—whether generic or brand-name—are safe to use. Every formula is regulated by the U.S. Food and Drug Administration (FDA) and must meet the minimum nutritional requirements of the Federal Food, Drug and Cosmetic Act (the "Infant Formula Act").

This means that all of the major brands, such as Enfamil, Similac, Gerber Good Start, or Earth's Best, plus all store brands from Walmart, Target, or Kroger, etc., are safe to use and will meet your baby's basic nutritional needs.

Forms of Baby Formula

There are three options for preparation methods to consider when choosing a formula for your baby.

• Powdered: Powdered formula must be mixed with clean water. It can be purchased in large quantities, making it the most economical option, but it may be slightly less convenient than pre-mixed forms.
• Liquid concentrate: The benefit of using concentrate is being able to make up a batch of formula and keep it in the refrigerator for 48 hours. It is slightly more costly than powdered versions.
• Ready-to-feed: With zero mixing or measuring, ready-to-feed options are the simplest to use. Opened containers can be stored in the refrigerator for 24 to 48 hours. These are the most expensive options.

Baby Formula Types

In terms of formula makeup, all formula is designed to be similar to breast milk, but ingredients may vary. Plus, no two babies are alike, and that's especially true when it comes to feeding. What one of your children may have sucked down happily may be rejected outright by their sibling—or not appropriate for them altogether. There are several basic formula types, including:

• Cow's milk-based: Suitable for most babies, these formulas are made from cow's milk that has been treated to make it more digestible by infants. Most cow's milk formulas also contain added iron. Examples: Enfamil Enspire, Gerber Good Start, Similac Advance, Earth's Best Organic, Honest Co. Organic Premium.
• Gentle: These formulas have less lactose than regular milk-based formulas, making them more suitable for babies with some gas or fussiness. Examples: Enfamil Gentlease, Gerber Good Start Gentle Plus.
• Lactose-free: These formulas are still milk-based, but lactose sugars are removed, so they are suitable for babies who may have lactose intolerance. Example: Similac Sensitive.
• Added rice starch: These are for babies with excess spit-up or acid reflux, as added rice starch helps keep the formula down. Examples: Enfamil AR, Similac for Spit-Up.
• Soy: This alternative is for babies with galactosemia, lactose intolerance, and milk protein allergies. Examples: Enfamil Prosobee, Earth's Best Soy.
• Hypoallergenic: These are for babies with milk protein and soy allergies, as they feature pre-digested (hydrolyzed) proteins for easier absorption. Examples: Nutramigen, Pregestamil, Similac Alimentum.
• Amino acid-based: These formulas are appropriate for babies with milk protein and soy allergies who don't tolerate an elemental formula. Examples: Neocate, Nutramigen AA.
• Formula for premature babies: These options have more calories and added nutrients for premature and low-birth-weight babies. Example: Similac Neosure.
• Next-step or toddler: Older infants and toddlers between the ages of 9 and 24 months can progress to this type of formula. Examples: Enfamil Enfagro, Nutramigen Toddler, Gerber Good Start Gentle Plus 2, Similac Go & Grow.

Differences Between Brands

In addition to the different types of baby formula, there are also some differences between brands among the same types of baby formula. It can be helpful to see a side-by-side comparison of the key ingredients when choosing between two formulas. Here's a comparison of Enfamil Enspire and Similac Pro-Advance. Both are non-GMO and Kosher certified. Similac Pro-Advance is also Halal certified.

The ingredient breakdowns appear pretty similar, as most formulas have similar ratios of protein, fat, and carbs, plus necessary vitamins and minerals. One difference is that Similac Advance doesn't use palm olein oil as its source of fat, instead using high oleic safflower oil, soy, and coconut oil.

While the makers of Similac and some studies suggest that palm olein oil lowers the absorption of calcium, other formula makers and different studies dispute that claim. Enfamil Enspire, on the other hand, contains lactoferrin and milk fat globule membrane (MGFM), which the company suggests supports immune and cognitive development, respectively.

Special Ingredients in Most Baby Formulas

As scientific research becomes more advanced, many formulas are now able to more closely mimic breast milk, plus several are made from non-GMO/organic ingredients. Most types of baby formula now include the following nutrients and compounds naturally found in breast milk.

• Iron: Necessary for blood formation; supplementation can be helpful especially for premature babies
• DHA: Essential for healthy brain, eye, and nervous system development
• Prebiotics/probiotics: Necessary for healthy digestion through gut microbiome maturation, as well as immune support
• Antioxidants: Can help decrease inflammation

Many formulas containing these nutrients and ingredients are also available in store brand baby formulas, such as Bright Beginnings (CVS) and Parent's Choice (Walmart).

Cost

Breast milk is the most cost-effective way to feed your baby. If you need to supplement or choose formula as a primary option, you can often opt for a less expensive store-brand formula to save money without sacrificing most nutritional benefits.

There are several ways to save money on brand-name formula, too: Powdered versions are the least expensive option, and being loyal to one formula brand may allow you to enroll in a coupon or loyalty program, which could help defray the cost.

Should You Switch?

Remember that the best formula is the one your baby will accept. Signs of a formula intolerance include:

• Unexplained fussiness
• Excessive gas
• Diarrhea (which may be bloody)
• Spitting up
• Vomiting
• Poor weight gain

If your baby is having a problem with their formula, choosing another type could help. Simply changing brands, unless you also change formula types, doesn't usually help, however. Bring any problematic symptoms to your pediatrician's attention to get advice before changing formulas.