Which Formula Should You Buy?

When you decide to bottle-feed your baby, choosing the right infant milk formula is an important decision. After all, formula is likely to be your child’s exclusive source of nourishment for some time, so it is only natural that you want to do what is best for your child.

With so many different products and brands on the market it can feel difficult to know what to choose. Familiar brands include Aptamil, Cow & Gate, HiPP, and SMA, as well as big store brands, but that’s not all; each of these brands will have a range of different formulas available, from first infant milk to comfort milk and night-time milk through to lactose-free and hypoallergenic formulas.

Is there a difference in brands of formula milk?

According to a survey by Which? 56% of mothers want to know the difference between the different brands of formula, with 27%(1) keen to know whether price should be considered as an indicator of quality.

However, the composition of both infant formula milks and follow-on formulas is tightly regulated by The Infant Formula and Follow-on Formula (England) Regulations. This has led to uniformity of formula milk composition.

What about organic infant formulas?

Organic infant formulas have become more common in recent years, starting with HiPP Organic and now including various brands such as Piccolo, SMA and Holle. There is a general perception that organic foods are healthier for us, but the strict regulations regarding the manufacture of infant formula mean that nutritionally organic formula will be no different to non-organic formula.

The major difference is that the cow’s milk base will come from organically farmed cows, so if that is important to you, then this might be a good choice.

In terms of pesticides, The Infant Formula and Follow-on Formula (England) Regulations set very low acceptable pesticide levels for all formulas, including non-organic (residues must not be higher than 0.01mg/kg of the consumable product),(2) so there is unlikely to be much difference between organic and non-organic formula in this respect.

What about manufacturer claims?

It is common for manufacturers to claim that their products contain some kind of unique benefit such as “complete nutrition”, a “gold advanced system” or being the formula that is “closest to breastmilk”. Generally, however, these claims are misleading at best – for example, the makeup of breast milk varies from mother to mother and, furthermore, breast milk, which contains around 300 ingredients, cannot be usefully compared with infant formula, which usually contains around 75 ingredients.

In fact, in 2020 a team of scientists from Imperial College London published an article in the British Medical Journal that was critical of the ability of current regulations to police misleading claims about formula milk.

Dr Robert Boyle, one of the study’s authors commented, “Infant formula is an important food product, often consumed in high volumes in relation to an infant’s body size. Yet when we look at claims made about the nutritional or health effects of formula products we find little supportive evidence.”(3)

So, choosing a product based on advertising or marketing claims may be making no difference to the nutritional benefits for your baby.

What about added ingredients?

Just as with the “core ingredients”, there is near uniformity with “added ingredients” in infant formulas. Typical added ingredients include the following:

LCPs (long-chain polyunsaturated fatty acids) – for example an Omega-3 called Docosahexaenoic acid (DHA)
Nucleotides
Prebiotics
Docosahexaenoic acid (a type of Omega 3)

However, according to Which?, only DHA has evidence of any benefit.

Powdered formula or ready-made formula?

Infant formula comes in two forms: ready-made formula in cartons or bottles or dry powder that is mixed with water. Although ready-made formula may be more convenient for parents-on-the-move, it is usually more expensive and, because of the amount of packaging involved, has a greater environmental impact. In compositional terms, there is little to no difference between the two different types.

The major types of formula

According to the NHS the following formulas may be suitable for you to bottle feed your child from birth:

Cows’ milk formula: these usually contain whey-based proteins as they are easier to digest than the casein-based alternatives.
Goats’ milk formula: an alternative to cows’ milk formula; however, it carries the same chances of allergic reaction as with cows’ milk formula.
Hungrier baby formula (hungry milk): these have a higher ratio of casein proteins than standard formulas. This makes them harder to digest but there is no evidence that they offer any additional benefit.
Anti-reflux (staydown) formula: these milks are designed for the dietary management of persistent reflux and regurgitation. You should consult your doctor or midwife before feeding your child staydown formula.
Comfort formula: made from partially broken down milk proteins. There is no evidence that they are easier to digest than standard infant milk.
Lactose-free formula: these milks are formulated for babies with confirmed lactose intolerance. Only to be taken under the supervision of your GP or health visitor.
Hypoallergenic formula: these contain fully hydrolysed (broken down) proteins, so are likely to be suitable for babies with a confirmed cows’ milk allergy. Only to be taken under the supervision of your GP or health visitor.

The NHS states that the following formulas may be suitable for your baby from six months but not earlier:

Follow-on formula: this formulation is safe for babies from six months</b., although according to the NHS, babies can continue with infant formula until the age of one.
Good night milk: there is no evidence that these products help babies sleep any better.
Soya formula: sometimes used for children who have an allergy to cows’ milk. However, they contain glucose and may harm your child’s teeth. Furthermore, they are high in phytoestrogens, which may have an impact on the development of your baby’s reproductive system. Only ever give this to your baby if recommended by a health visitor or GP.

Can you switch between formulas?

In the past parents were advised to choose one brand of formula and to stick to it. However, there is no evidence that switching brands causes any harm, although there is always the possibility that your baby might grow accustomed to a particular brand’s flavour and prefer it above others.

Can I give my baby vegetarian or vegan formula?

There are some vegetarian formulas on the market but most contain fish oils and/or animal rennet. However, there are no vegan formulas available in the UK – even soya infant formulas contain vitamin D that is derived from lanolin (the waxy substance in sheep’s wool)(4). Although these soya-based formulas may be suitable for a vegetarian diet, they are not generally recommended for babies under six months.

Summary

Infant formula milk manufacture is highly statandardised and the nutritional values are strictly monitored. There is very little difference between brands and most marketing claims are unfounded.

There are numerous “specialist milks” on the market, but some of these should only be given to your baby under the supervision of a health visitor or GP. If you have questions about feeding infant formula to your baby, speak to your health visitor or GP.

Lastly, let your baby guide you, if your baby does not feed well on a particular brand of formula, it might just be that they don’t like the taste.

1 https://www.which.co.uk/reviews/formula-milk/article/choosing-the-right-formula-milk/are-some-formula-milk-brands-better-than-others
2 https://www.legislation.gov.uk/uksi/2007/3521/regulation/14/made
3 https://www.imperial.ac.uk/news/197360/marketing-claims-infant-formula-should-banned/
4 https://www.vivahealth.org.uk/resources/breast-best/soya-story-babies-online