Infant formula

Infant formula is commercially prepared liquid milk formulations for the nutrition of infants. It is fed to those babies with special requirements or suffering from milk hypersensitivity or those whose mothers are unable to breastfeed them.

Why should I be aware of this?

Most parents who use infant formula at one time or another — know little about it. This is due to

• The difficulty in finding an unbiased, unpoliticized source of information about formula which either comes from those who would prefer parents did not use it or others who openly promote it, offering vague and sometimes misleading marketing information but few details.
• Most do not provide detailed clear information about differences between formula and human milk.

How does this affect me?

• Commercial infant formulas do not contain the immunity-boosting elements of breast milk. But when prepared as directed with clean water, infant formula poses no risks to healthy babies with typical dietary needs.
• Statistically, formula-fed babies are more likely to get colds, ear infections, milk allergies, diarrhea, urinary tract infections and bacterial meningitis.
• Improper preparation of formula can have an adverse impact on baby's health.
• During the first weeks of life, when a baby’s gut is vulnerable to infection, babies most miss a biologically active protein of human milk which fights these infections. Advances in hygiene and sanitation, plus ready access to treatment, have made life-threatening gastrointestinal infections rare in babies in developed countries. But they still cause considerable illness and many infant deaths in the developing world, where powdered formula is sometimes mixed with contaminated water.

All about infant formula

Most infant formula comes from cow’s milk with a few exceptions such as soy formula.

Cow's milk vs breast milk

• Cow’s milk is very high in saturated fat, which human babies have trouble digesting, and low in monounsaturates, the main fats in human milk.
• Cow’s milk has three times as much protein as breast milk. Calves need this because they grow so quickly, but for human babies it would put too much of a load on the liver and kidneys.
• Cow’s milk also has a higher proportion of casein to whey — the two kinds of proteins in mammal milks — than breast milk does.

Manufacturing infant formula from cow's milk

The cow's milk goes through a manufacturing process that literally takes it apart and puts it back together again with some components left out and others added.

1. First all the fats are removed and the overall amount of protein is also reduced.
2. The resulting skimmed milk is heated, then dehydrated if it’s going to be in powdered form.
3. Then new fats, in the form of vegetable oil blends, are added along with proteins, milk sugar (lactose) and a long list of nutrients, vitamins and minerals that are required by federal regulation to approximate their levels in breast milk.
4. Extra whey is added to mimic the protein balance found in breast milk.
5. Other ingredients prevent the mixture from separating or going bad. Some formulas have thickeners, and specialized formulas for premature babies have enhanced levels of nutrients.

Formula milk vs breast milk

Human milk has many components that infant formula milk does not have. As James Friel, professor of human nutrition at the University of Manitoba puts it, "Human milk is alive. Some components are biologically active. They play a role that goes far beyond nutrition. For example, if you put an oxidant stressor — something like cigarette smoke — in breast milk, it resists the stressor, and breastmilk does this better than formula even though formula contains more antioxidants."

Infant formula vis a vis breast milk?

• As compared to breast milk, infant formula milk does not have enzymes, hormones, growth factors and substances that fight infection and help develop the immune system.
• Another biological capability, present in breast milk but not formula, is the ability to alter itself. Breast milk changes, both as the baby grows and during each feeding.
• Nutrients in a man-made substance do not work the same way as they do in a naturally occurring substance.
• Iron was added to formula in the 1980s. However, the iron in formula is not nearly as well absorbed as that in breast milk, so formula must contain considerably more for a baby to get the same amount.
• Nucleotides, are the building blocks of DNA and RNA and help strengthen the immune system. After they were added to formula in the ’90s, the expected immunity benefit did not happen.
• Secretory immunoglobulin A (sIgA), a biologically active component of human milk, has the ability to bind to foreign substances (including harmful bacteria) so they can be eliminated from the body. It lines the wall of the gut, which is one of the main entry points for infection. Colostrum, the thicker milk that a mother’s body produces in the first few days, is especially high in sIgA.
• The immune resistant bacteria present in infant formula are fewer in numbers and are bovine immunglobulins, programmed to recognize micro-organisms that cause disease in cattle rather than humans. These operate in the bloodstream rather than the gut.

Similarity

• Both are milks that can sustain fledgling human life.

Risks associated with infant formula

• Improper mixing -- Over-diluted powdered formula, which can lead to malnutrition. Improper dilution results in concentrated liquid formula which can lead to dehydration and kidney problems.
• Contamination -- Though manufacturers maintain quality control and product safety, there can be instances of contamination as in other man made things.
• Illness

New developments in infant formula

Manufacturers have added new varieties. These include

• Lactose-free formulas
• Special formulas for premature and ill babies
• Hydrolyzed formulas with predigested protein, for infants with digestion problems.

What can I do?

• Maintain good hygiene standards while preparign formula milk.
• Measure the formula correctly.
• Use the exact amount of water the manufacturer specifies on the label.
• Wash your hands with a good anti bacterial soap.

Useful tips

• Sterilization of the water and equipment used in preparing baby formula is recommended.
• To warm infant formula milk, bottles should be warmed in a pot of water heated on the stove.
• Never warm formula in the microwave. Microwaving causes “hot spots” and can therefore lead to serious burns.
• Baby formula that is removed from refrigeration should be used within two hours or discarded. Because of possible bacterial contamination, baby formula remaining in a bottle one hour after the start of feeding should also be discarded.
• Once baby formula is warmed it cannot be put back in the refrigerator.
• Powdered baby formula cannot be frozen or stored in the refrigerator as moisture and bacteria from the refrigerator or freezer will get into the powder.
• Powdered baby formula can be used for one month after it has been opened. After this time fats and oils oxidize.
• You should not freeze ready-to-feed baby formula because it will change the composition of the product.
• Cans of commercially prepared baby ready-to-feed or concentrate baby formula may be safely stored in the refrigerator for up to 24 hours after opening.

Unlearn

The law does not require that FDA approve infant formulas but instead requires companies to provide certain information to FDA before they market new infant formulas. Manufacturers must provide assurances that they are following good manufacturing practices and quality control procedures and that the formula will allow infants to thrive. If such assurances are not provided, FDA will object to the manufacturer's marketing of the formula; however, the manufacturer may market the new infant formula over FDA's objection

90 degrees

Soy formula was developed for babies suffering from lactose intolerance or those having trouble digesting cow’s milk formula. There have been concerns about soy formulas contain high levels of isoflavones, a plant-based form of the hormone estrogen, which have been found to affect the fertility and sexual development of rats. No clear link has been made to problems in humans, although researchers are conducting further tests.

CopperBytes

• Mother's milk is low in iron as iron competes with zinc, which is needed for neurological development.
• If the baby reacts to yeast present as an additive in several commercially prepared cow milk infant formula, then the baby could be shifted to goat milk based formula.

References

• Infant formula: Which formula is right for your baby?
• Breast-feeding and guilt: Interview with a Mayo Clinic specialist
• Infant formula USFDA
• Hot Milk; The unbottled truth about formula
• Frequent Answers & Questions