Formula feeding; Bottle feeding

Infant formulas act as a nutritional source for infants less than 1 year of age.

A variety of formulas are available for infants younger than 12 months of age if breast milk is not used. These formulas vary in caloric density, nutrient composition and ingredients, digestibility, taste, and cost.

Guidelines for infant formulas and standards for normal infant feeding based on human breast milk have been provided by the American Academy of Pediatrics (AAP).

Specific types of formulas include:

• Standard milk-based formulas
• Soy protein formulas
• Formulas for premature infants
• Formulas for infants with metabolism problems

The standard milk-based formulas contain heat-treated cow's milk protein (at reduced concentrations), lactose and minerals from cow's milk, vegetable oils, minerals and vitamins. The amount of each nutrient is set to standards based on levels in breast milk.

The AAP recommends iron-fortified formulas for all infants. Standard formulas contain 20 Kcal/ounce and 0.45 grams of protein/ounce. Additional vitamin supplements are not usually recommended.

Consuming more than the daily requirement of vitamins is unnecessary and potentially harmful. Depending on the water supply, pediatricians may prescribe a fluoride supplement to help the infant develop strong teeth and bones.

Management of infants with metabolic problems should be discussed with an experienced dietitian and physician. Formula choices may be affected by the condition of an infant's gastrointestinal tract and metabolism.

Improper mixing of infant formulas may result in abdominal pain, improper caloric intake, or other problems. Never water down the formula, as that can alter your baby's salt balance, which can cause seizures. Using the wrong type of formula for a special-needs infant may cause the baby's condition to become worse.

The AAP recommends that infants be fed formula or breast milk for at least 12 months.

Cow's milk alone is not an appropriate diet for infants because the baby's kidneys may not work as efficiently as an adult's. Cow's milk also has too much protein (and in particular, too much casein, a type of protein). The minerals are not easily absorbed, and there is an increased risk for sensitization to milk proteins. Low-fat and skim milk are also inappropriate for use in the first year of life. They do not provide enough calories for growth or enough of some nutrients needed for normal development.

Formulas based on cow's milk are appropriate for full-term and preterm infants having no special nutritional requirements.

SPECIAL FORMULAS

Special formulas should be used under a physician's supervision.

• Infants with lactose intolerance or a milk protein allergy cannot drink standard cow's milk-based formula. Soy-based formulas do not contain milk protein.
• Formulas for premature and low birthweight infants have extra calories and minerals to meet the needs of these infants.
• There are other specialized formulas, such as those for infants with heart disease, malabsorption syndromes, inability to digest fat, and other conditions.

MIXING FORMULA

Improper mixing of formula is common and may harm the infant. Follow the instructions on the formula container carefully.