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    The Formula Conundrum

    The Right Stuff

    WebMD Feature
    Reviewed by Gary D. Vogin, MD

    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 iron.

    "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.

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