If You Don’t Breastfeed

Babies who are not breastfed should eat only infant formulas (fortified with iron), with the introduction of age-appropriate solid foods beginning at 4-6 months of age. Cow’s milk as purchased in the liquid form from the dairy case at the grocery (whole, 2%,1%, or skim) or any unpastuerized milk is NOT suitable for infants under the age of 12 months.

Cow’s milk not properly processed into infant formula (and fortified with iron) is not good for your baby. The digestive system of the newborn and infant is still somewhat immature compared to that of older children and adult. Because of this, whole cow’s milk promotes loss of blood through the infant intestinal wall. This progressive loss of blood will result in iron-deficiency anemia if the iron is not replaced. And to worsen matters, whole cow’s milk probably disrupts iron absorption due to its high concentration of calcium and phosphorus (and its low concentration of Vitamin C).

Thus, if a baby is not breastfed, the first choice of foods should be a cow milk-based, infant formula fortified with iron. These can be purchased either in powder (for mixing with WATER) or in liquid form.

A small percentage of newborns and infants may show intolerance to the sugar, lactose, in cow’s milk or to cow’s milk proteins. These babies may need a formula produced mostly from soy proteins which is fortified with other nutrients to produce a food which meets their nutritional needs. However, soy-based formulas have their potential problems and should be used only on advice of a pediatrician after your baby has been properly examined for a true milk allergy, lactose intolerance, or a rare condition called galactosemia. Another use of soy-based infant formula is in the infants whose parents chose a vegetarian diet and are unable to breastfeed. However, soy-based formulas should not be used in small, pre-term infants.

Soy-based formulas are often overused in infants who exhibit signs of allergy or colic. But studies have shown that both cow’s milk formulas and soy-based formulas are approximately equally allergenic. A baby should have tests that demonstrate a true cow’s milk allergy before switching to soy-based formula. The presence of colic and signs of allergy should not be used as the sole indications for the use of soy-based formula. Colic is relatively common and should be viewed as a condition which the infant will outgrow by 4-6 months of age……soy-based infant formulas should not be used to treat or prevent colic.

Although full-term infants may have their nutritional needs met by soy-based formulas, they should be reserved for use only if breastmilk or cow’s milk-based formula cannot be used and then only on the advice of a pediatrician. Studies are still needed to investigate some of the properties of soy-based formulas and their long-term effects. These include high levels of aluminum, phytoestrogens, and the reasons that small, preterm infants do not grow well when placed on soy-based formula.

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