What to look for when choosing a Formula?

For parents, choosing a lactic formula is one of the most difficult and daunting tasks there is.

It is easy to get confused and lost while reading all the scientific terms, and the variety of brands trying to portrait themselves as the “best choice” can make it difficult to judge what is really important and what is just marketing hype.

The online forums and advice of friends sometimes make it more difficult instead of helping. How do I know if that person knows what they are talking about? Can I trust their opinion?

The idea of this section of our website is to give you the ability to understand what ingredients make a formula premium choice, and what role each of these ingredients/nutrients plays. That way, you can decipher the labels better and make your own informed choice about what is best for your baby.

This article focuses on ingredients that are recommended by the European Society of Paediatric Nutrition and considered optional under EU law. For questions on the standard ingredients that are obligatory by EU regulations and found in all formulas sold in Europe, feel free to Ask Janny our resident nutritionist in child nutrition and one of Europe’s leading experts in the field of child nutrition.

It is important to re-iterate here that breast milk is always the first choice and best option when possible, and that although the advances in science have made formulas today much better that what you may have been given as a baby, they still cannot match up to breast milk from a healthy mother on a well balanced diet. It is also always important to consider the financial implications of choosing to switch from breastfeeding to formula.

If you do decide to use formula, we advise that you use the information from this article to have a conversation with your pediatrician before you make your final choice as they may add insights specific to your baby’s needs that this article does not cover.

1. Make sure you check the full range

Even if you are picking a 1st stage formula, it is important to check the labels of 2nd and 3rd stages as well before you make a final choice to make sure that your baby continues to get those key premium ingredients found in breast milk as their little bodies continue to grow and develop in the first months and years of their lives.

Unfortunately, many brands tend to pack their 1st formula full of all the ingredients, but then cut some of them in stages 2 and 3.

The reason for this is mainly that babies usually start eating solids after the 6th month and the assumption is that they will get these ingredients from the solids they eat. This assumption, however, is faulty since babies do not always eat as per plan. Up till 3 years of age, your baby is growing at an amazing rate, and they need optimal nutrition every day to assure they develop as healthy as can be. Many a time your baby will not eat well, either because of teething, or maybe they are sick from a virus they caught at nursery, or are recovering from the side effects of a vaccine. Sometimes it’s something as simple as baby taking a longer than usual afternoon nap and skipping a meal.

Making sure their milk is fully loaded gives you the safety net you need to be sure your baby gets all they need to grow and develop every day!

2. Omega 3 & Omega 6 Fatty Acids

First thing to know is that not all Omega 3’s and Omega 6’s are the same.

Some Omega Fatty Acids come as PUFAs (Poly Unsaturated Fatty Acids-such as ALA and LA) or as long chain PUFAs (LCPUFAs-Long Chain Unstaurated Fatty Acids such as DHA and ARA) .

PUFA – ALA & LA cannot be made by the human body and must be taken through food, or in this case, through the milk. Breast milk contains ALA & LA.

LCPUFA – DHA & ARA are made in the body from the ALA & LA we get from food, or in the case of your baby, through the milk.

LCPUFAs are key nutrients in the formation of the brain and eyes.
60% of your baby’s brain is made up of fat, 40% of which is DHA and ARA.
50% of your baby’s retina is also made up of DHA.

However, in babies, and because of the high rate of growth, their little bodies cannot make the LCPUFAs as fast as they use them up. That’s why breast milk contains these pre-formed LCPUFAs.

Research shows that the first 3 years of life are critical to your baby’s brain development. During these years, your baby’s brain triples in weight and builds the foundation for what comes later in life.

Studies have shown that when a mother takes DHA supplements during pregnancy and while breastfeeding their children grow up to tend to have higher IQ scores compared to mothers that have not taken DHA supplementation, even if they are on a fish and seafood rich diet. Seafood like fish is very rich in DHA.

All these above facts mean that you need to make sure that the formula you choose provides your baby not only with PUFAs ALA & LA, but with the critical pre-formed LCPUFAs (DHA & ARA) throughout the 1st three years of their life, and not only during the 1st 6 months!

3. Nucleotides

Nucleotides are organic molecules that, when linked together, serve as the building blocks of our genetic material DNA.

Nucleotides are key to cell building and cell division, and play an important role in the development of your baby’s defense system, especially the part that deals with resistance to infections and proper reaction to vaccines.

As adults, the majority of nucleotides in our system are made in the body from the elements we get from food.

Breast milk contains nucleotides because during the first months and years of life, while your baby is growing at accelerated rates, their internal systems cannot make the nucleotides fast enough to support that growth.

As your baby grows and interacts with the surrounding environment they start building the antibodies and immune cells they need to resist diseases. During the first three years, your baby’s immediate environment changes and evolves. In the first month, they are mostly at home surrounded by family, as they grow they start spending time in the park, start going to birthday parties, and at a certain age go to nursery or kindergarten.

Choosing a formula that has nucleotides in all three stages assures you that your baby has the ammunition needed to continuously build the protection they need to stay healthy and deal with the bugs they encounter during all these stages.

4. Prebiotics, Probiotics, Synbiotics and the Bifidogenic Effect

Prebiotics are indigestible fibers also known as oligosaccharides. Oligo comes from the Greek word for few or little, and saccharides means sugars, so basically, they are carbohydrates made up of few (less than 10) mono-sugar molecules linked together in a chain, as opposed to starch, a polysaccharide made of a lot of mono-sugar molecules linked together (poly being the Greek word for many).

Although these fibres cannot be digested by humans, they act as food for the healthy bacteria that lives mainly in our large intestines.

On food labels of babyfood products they are usually found as GOS (Galactooligosaccharides) or FOS (Fructooligosaccharides).

Breast milk contains prebiotics like GOS. It helps support your baby’s well-being and assures soft and frequent stool because:

• It feeds the good bacteria in the baby’s gut, making sure that the balance of good vs. bad bacteria stays on the healthy side. This is what is known as the Bifidogenic Effect, and is important for promoting soft and regular stool.
• In addition to the complex cellular mechanisms the balance of good vs. bad bacteria prevents opportunistic bacteria that naturally occur in the gut as part of normal flora from causing disease, especially tummy infections which cause tummy aches, diarrhea and vomiting.
• When the good bacteria eat the GOS, they produce Short Chain Fatty Acids (SCFAs). These SCFAs are an important source of food for the cells that make up the lining of the intestine and assure that this important defensive barrier to contaminants and harmful bacteria stays strong and difficult to penetrate. These lining cells also produce antibodies that fight infections before they can pass through the gut wall and enter the system.
• In addition to SCFAs, the good flora also attracts free water as a result of eating the GOS. This water moistens the baby’s stool and adds to its volume helping assure soft and regular bowel movements.
• GOS, being a fiber, stimulates the peristaltic movement of the intestine further encouraging regular bowel movements and soft stools.

Selecting a formula with added GOS helps assure that your baby gets the benefits of the Befidogenic Effect and reduces the risk of constipation and hard stools.

Probiotics is another word for the good bacteria in the gut. So, the probiotics eat fibres and the prebiotics.

The average human gut has 0.5-1kg of microbes, most of which is bacteria. Bacteria make up to 60% of the dry mass of feces.

Over 500 different species live in the gut, but 99% of the bacteria come from about 30-40 species.

The good bacteria, or probiotics are Bifidobacteria and Lactobacilli.

Although some researchers have reported finding probiotics in breast milk, there is not enough scientific evidence to support this as an absolute fact yet. Most studies done are small, and some theories say the bacteria found in the samples come from the mother’s skin during breast milk collection with the breast pump and not from the milk itself.

Adding a probiotic to formula helps boost the population of that specific species of bacteria in your baby’s gut, and does promote the Bifidogenic Effect for a given period of time. Some studies suggest benefits such as reduced allergies and fewer tummy infections, however, there is little evidence to suggest that this will help promote frequent and soft stools.

Synbiotics refers to adding the combination of multiple oligosaccharides (for example, GOS & FOS) or the combination of pro & prebiotics to formula.

The hope is that these combinations will create a synergistic effect that will result in maximizing the Befidogenic Effect. However, there is not enough evidence to suggest that these combinations provide any real added value beyond interesting marketing claims.

5. Lactose

Lactose is milk sugar and is the main source of energy in breast milk.

In addition to this being an important ingredient, the reason this sugar makes our list is because some brands tend to replace lactose, in part or fully with maltodextrin in their stage 1 formulas.

Maltodextrin is a polysaccharide made of a lot of mono-sugar molecules linked together (poly being the Greek word for many) produced from starch.
It is commonly used in the food industry because it is easily digestible, absorbed well, and is moderately sweet to flavorless so it has minimum impact on taste.

So, Maltodextrin is not bad perse.

However, European regulations define the 1st stage as an alternative to breast milk during the 1st six months of life when most babies are exclusively fed with milk. Where the 2nd and 3rd stages are considered by law to be the milk supplement to a balanced diet after the 6th month.

As an alternative to breast milk, the 1st stage formula should mimic breast milk as much as possible to assure maximum benefit to the baby, that’s why most paediatricians will tell you that it is preferred that the formula you choose be 100% lactose in the 1st stage formula with no maltodextrin.

6. Sucrose

Unlike maltodextrin, which we discussed in point 5, sucrose is bad for you. Sucrose can causes teeth decay, and when started early in life may lead to the development of an affinity for sweets which could result in problems with weight control later on in life.

Some formulas add sucrose and/or vanilla flavoring to their 3rd stage formula to make it more palatable for older babies over 1 year old that eat solid foods, and may as a result, be less interested in drinking neutral milk.

Although the end is noble (trying to make sure toddlers drink their milk), it does not justify the risk involved in the means.

You should try your best to avoid formulas that add sucrose and flavorings. Instead, if your toddler does not like their milk anymore, try adding cacao (without sugar), making the milk into a healthy shake with fresh fruits, or add cereals.

7. Taurine

Yes, Taurine! The same stuff you find in Red Bull and other Energy drinks! And perhaps surprising to most, taurine is found in breast milk too.

It is an important amino acid, a kind of protein, and an anti-oxidant that protects the brain against potential damage by so called free radicals.

Just like many other nutrients in this list, Taurine exists in breast milk, and is good to have in formula because the baby’s body cannot produce enough of it to cope with the high demand caused by the rapid growth early in life.

We hope this article will help you feel more confident and comfortable as you read and compare formula labels, and when you discuss your options with your paediatrician.

If you liked this article, and think other might benefit from it, please you can share it.

If you have any other questions that this article did not answer, or if you want additional clarification on any of the points in this article, feel free to send us an inquiry by clicking here, or just feel free to Ask Janny our resident nutritionist.