The Formula Conundrum
The Right Stuff
Jan. 28, 2002 -- There's no real formula for choosing a baby
formula, and this poses a puzzle for parents. Soy, hypoallergenic, low-iron --
moms and dads can get dizzy staring at the formula choices on grocery shelves.
But experts advise keeping it simple: Most infants will do just fine on the
standard variety, which is made from cow's milk protein supplemented with
"Optimally, every child should be breast-fed, but given
that breast-feeding doesn't work for everybody, I think a standard formula is
the place to start," says Melvin Heyman, MD, professor of pediatrics and
chief of the division of pediatric gastroenterology, hepatology, and nutrition
at University of California, San Francisco.
Most babies tolerate regular baby formula well, says Heyman.
Only about 2% of infants develop a food allergy, and cases of colic and other
symptoms that can be cured by switching formulas are much less common than
parents -- and even some pediatricians -- believe.
"Many people change formulas for no good reason,"
agrees William Cochran, MD, associate professor of pediatrics in the department
of pediatric gastroenterology and nutrition at Jefferson College of Medicine's
Geisinger Clinic in Danville, Pa.
If you're considering a switch, check with your child's doctor
first. "He or she can give you advice about the risks and what else you may
need to do," Dr. Cochran says. For example, introducing new foods early to
a baby with a confirmed food allergy could increase the probability the child
will develop another allergy.
Soy's Good, Iron's Bad?
Many parents lean toward soy formulas because they've heard
that babies tolerate soy better than they do cow's milk concoctions. But the
fact is, at least half of all infants who have milk allergies are also
sensitive to soy protein and should be consuming hypoallergenic formulas.
"Some babies who do OK on soy wouldn't do well on cow's
milk formulas," says Heyman, "but the problem is, there's a lot of
overlap in reactions, so if somebody has a severe reaction to cow's milk
formula, I don't recommend soy."
Another common misconception is that iron-fortified formulas
cause constipation or other stomach problems. "Parents will come in and
say, 'My kid has gas, he has colic, he's constipated, he has belly pain, and
it's due to the iron,'" says Cochran, and the physician will often react to
this complaint by switching to a low-iron formula.
In reality, says Cochran, studies indicate that the iron in
formula typically is not associated with stomach problems. Moreover, he says,
giving babies formula with low-iron concentrations (under 6.7 mg of iron per
liter of formula) can increase their risk of iron-deficiency anemia.
The American Academy of Pediatrics recommends iron-fortified
formula with 4-12 mg of iron per liter for all bottle-fed infants from birth to
1 year of age. That's because infants don't have enough natural reserves to
meet their iron needs. Many baby foods, especially fortified cereals, provide