1) The ingredients
Most infant formula milks are based on cow’s milk. “Cow’s milk is a good place to start, but it’s very different from breast milk, so we adjust it to bring it as close as possible to human milk,” explains Helen Messenger of Nutricia, which produces Cow & Gate and Milupa infant milk. The carbohydrate, protein and fat levels are adjusted, and vitamins and minerals are then added to conform to government guidelines.
2) The extras
Some infant formulas also contain prebiotics: food substances intended to promote the growth of certain bacteria, which are similar to the ones found naturally in breast milk. These act as food for the friendly bacteria in your baby’s tummy, which helps to fight off infections and boost her immune system, while also reducing the number of harmful bacteria.
3) The stages
There are lots of different types of formula milk, and all these options can be confusing! Most formulas, however, are divided into ‘first-stage’ and ‘second-stage’.
The protein in milk can be broken down into curds (or casein) and whey. First-stage formulas contain more whey than casein, and are more similar to breast milk: they are thought to be easier to digest and are suitable for babies from birth. Second-stage or ‘follow-on’ formulas contain more casein than whey. They take longer to digest and are generally suitable from 6 or 9 months. However, some manufacturers also produce first-stage formula that is casein dominant, for ‘hungrier’ babies.
There are also formulas for ‘sensitive’ tummies – the complex proteins found in cow’s milk are broken down to make them less likely to provoke a reaction. These tend to be a bit thicker, so can be useful if your little one is sick a lot.
“If your baby isn’t getting on with the formula milk you’ve chosen it’s worth having a word with your health visitor before you swap, to check that the one you’re thinking of using is suitable for your baby,” advises Helen.
4) The know-how
Formula milk can be a breeding ground for harmful bacteria, so you need to be scrupulously clean about washing out bottles and teats and preparing your baby’s milk. All equipment must be thoroughly sterilised (in a steriliser or with steriliser fluid, or by boiling for 10 minutes). You should use sterilised tongs to assemble your baby’s bottles, and your hands and work surfaces must be clean.
You should make up your baby’s milk fresh for each feed and use it immediately. Boil fresh tap water and leave it no more than half an hour, and follow the manufacturer’s instructions for making up the formula. Test the temperature of the milk on the inside of your wrist. If it feels too hot, put the cap over the teat and hold the bottle under cold running water. When your baby has had enough, throw away any leftover milk.
If you are going out, take a thermos of boiled water with you to make your baby’s milk or try using a ready-made milk.
5) The alternatives
There are alternatives to cow’s milk-based formulas, but you should only use them under medical guidance. The most common are soya based. Designed for babies with a cow’s milk intolerance or allergy, they are made from soya beans that have been modified with vitamins, minerals and nutrients. However, there are also cow’s milk alternatives (the proteins are broken down partially or completely, depending upon the level of intolerance). If you suspect your baby has an intolerance or allergy she should be referred to a dietician who will advise you.
Goat’s milk-based formula is also often promoted as being suitable for babies who can’t tolerate cow’s milk. However, the Department of Health does not recommend this for babies under 1, as it’s not nutritionally adequate. It also advises that it’s not suitable for babies who are lactose intolerant as it contains similar levels of lactose to cow’s milk formulas.