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Infant formula: How to choose it & use it
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Infant formula: How to choose it & use it
Earlier this month, we daylighted a CDC report that showed perchlorate contamination in infant formula. Not surprisingly, we received quite a few questions about formula that week, so we put these recomendations together to supplement our perchlorate report FAQ.
Breast milk is best, but most families use formula to supplement or replace it when needed. If you use formula, here are some tips for choosing and using the ones that are safest for baby.

Infants need breast milk or formula.
Information about contaminants in formula and water can be scary, but remember that infants less than 1 year old should not be fed straight cow milk, and other drinks might not meet their complex nutritional needs. Breast milk and formula are the best foods for infants.
Choose powdered.
A toxic chemical called bisphenol-A (BPA) can leach from the lining of metal cans and lids. Liquid formulas have higher levels, so powdered is a better bet. If your pediatrician recommends liquid formula, choose the types sold in plastic containers and avoid ready-to-eat.
Use soy formula only if medically necessary.
The American Association of Pediatricians recommends that soy formula use be limited to infants who need it for medical reasons.
There are longstanding concerns that natural plant estrogens in soy formula may affect the developing baby's body. There is not enough research to make a solid conclusion, but in the meantime we recommend you limit soy formula use when possible.
Use filtered water.
Both bottled and tap water can contain contaminants that are toxic for babies whose sole or main source of food is formula. Examples are fluoride, lead and perchlorate. If you have fluoride, lead or perchlorate in your water, use a reverse osmosis filter. The American Dental Association recommends making formula without fluoridated water.
Avoid bottled water - including 'infant' water - because contaminants are not known. For the safest tap water, contact your local drinking water supplier to identify contaminants, then choose the most effective filter for them.
Choose glass or BPA-free plastic bottles.
Plastic bottles can leach a toxic chemical called bisphenol-A (BPA) into formula. Most companies sell non-BPA plastic. Look for details on packaging or from the manufacturer.
Always avoid
As a mother of one and another on the way- information like this is much appreciated. Thanks!!
It's important to note that EWG does *not* recommend feeding homemade infant formula to your baby. The processed formulas available commercially are specifically made for infants' underdeveloped bodies since they cannot handle certain foods too soon, such as cow milk proteins (which are broken down in the formula manufacturing process specifically for their unique systems).
We created this "guide" to help people navigate the many choices out there with an eye towards environmental health.
This advice to not make homemade formula does not extend to homemade first solid foods for baby once they are old enough, which can be done safely.
Of course, consulting your pediatrician with any questions about your infants' nutrition is advised.
Lisa, my baby can only tolerate ready to feed alimentum formula in the plastic container. She cannot tolerate the powdered form. Also, I spoke with similac and they stated their powdered forms are not sterilized. Is the ready to feed in the plastic container labeled #2 HDPE on the bottom ok?
I am sad and disturbed that you are still saying breastmilk is "best" and doing nothing to make it easier for parents to choose to breastfeed. Breastmilk isn't best it is the SPECIES NORMAL way to feed human infants. The benefits of breastfeeding are what is NORMAL for human development, they aren't benefits at all, what we have is an array of risks associated with not breastfeeding.
That you are then suggesting that formula and breastmilk are essentially equivalent "Breast milk and formula are the best foods for infants." contravenes the WHO Code on the Marketing of Breastmilk Substitutes. It's also simply not true. Breastmilk is a live food that is unique to each mother and baby pair. Formula is the quintessential industrial food system concoction and it is associated with all the same problems any other industrial food has including frequent contamination with dangerous bacteria. The infant mortality rate associated with formula feeding even in industrialized nations, is significantly higher than that for breastfeeding babies. Formula feeding is frequently necessary, because of the lack of social and cultural support for childbearing women but it is risky business and not saying so is irresponsible.
I realize that breastfeeding is NOT culturally normal, and as a result most women don't have- the information and support to make it work. The lack of adequate parental leave, unique to the USA is also to blame. This is not about mother guilt, and I think that is a false premise. Saying that we can't talk about the risks of second hand smoke because we'll make smokers feel guilty is the same thing. Mothers make the absolute best decisions they can for themselves and their families, and if they make informed choices there need not be guilt. The circumstances especially in the US makes it incredibly difficult to get the support and information necessary to be successful. The only feeling moms who learn something new about breastfeeding should feel is maybe regret. We can't change the past and we do our best.
The ones who should feel guilty are the health care professionals, child care providers, workplace HR staff and organizations like yours that do not provide complete information and frequently undermine breastfeeding. All the more reason you have a responsibility to be connecting parents to alternatives beyond: "breastfeeding is best but here's how to choose your formula since you're guaranteed to use it." We must start calling the kettle black and changing our language to more appropriately describe what the real choices are in infant feeding.
Another option for supplementation that is completely ignored here is breastmilk banking, formula as the 4th best infant feeding choice according to the World Health Organization (1st is breastmilk at breast, second is mother's breastmilk in another feeding device, 3rd is donated breastmilk) should be a last ditch medical intervention, not the quintessential baby food.
It is tragic that an environmental group even needs to talk about formula, but because so many parents end up using it, it is important to make an informed choice, but an informed choice also includes looking at formula recalls and bacterial contamination (powdered formulas despite less BPA are frequently recalled for making babies really sick), and the tremendous impacts on the waste stream, the carbon footprint of the processing and transportation of formula, the significant and sometimes life threatening health effects, and the appalling corporate practices of the companies that are making this stuff. Just as the formula manufacturers should have warning labels on their cans like cigarettes do (the risks are equivalent!), you should be clear about the risks associated with not breastfeeding and provide information for parents to help them be successful.
Thanks for addressing the important topic of infant nutrition but I would disagree with one of your statements. You said, "breastmilk and formula are the best foods for infants". Actually, the CDC and the American Academy of Pediatrics and many others agree that breastmilk is the best source of infant nutrition. Formula is inferior when compared to breastmilk. Although many use formula as a "supplement" to breastmilk, it is not the same as breastmilk.
I say this not to be nit-picky but to be sure moms make an informed decision about feeding their infant. Too many people think that formula and breastmilk are essentially the same. They are not and the risks and benefits of each are very different. A great visual to show the vast difference between the two can be found at:
http://www.cdph.ca.gov/programs/breastfeeding/Documents/MO-HowDoesForWAFBF-Eng.pdf
In a world of many contaminants, breastmilk remains the healthiest and most nutritious way to feed your child. I hope more moms choose to breastfeed - for the health of their child, their own bodies and the environment!
Hi Maria,
I contacted Similac via email about BPA in the new white recycle #2 containers and a representative replied that she "felt my questions could be best answered over the phone." I then called Similac, and after putting me on hold several times, a representative told me that the new containers do NOT have BPA in them. The recycle number 2 means it should be made of polypropylene - the same thing that is used for milk containers - and recyclable. My understanding is that anything that can't be recycled might contain BPA.
I totally agree with you. I am from Canada and I definatly do not feel support when trying to breastfeed my child in a public place. People stare at me like I am doing something wrong! I wish that more was done to make people aware of how important it is to breastfeed!
Studies: All Infant Formula Contains Fluoride at Tooth-Discoloring Levels
All infant formulas, whether ready-to-feed,
concentrated or organic, contain fluoride at levels which can discolor
developing teeth, reports the October 2009 Journal of the American
Dental Association (JADA) (1).
Fluoride, added to some bottled and public water supplies ostensibly
to prevent cavities, is also in many foods and beverages, including
infant formula. Excessive fluoride discolors and/or weakens permanent
teeth (moderate fluorosis).
Researchers measured fluoride content of 49 infant formulas. See:
http://www.freewebs.com/fluoridation/infantformulafluoride.htm
The research team concludes, "Most infants from birth to age 12
months who consume predominantly powdered and liquid concentrate
formula are likely to exceed the upper tolerable limit [of fluoride]
if the formula is reconstituted with optimally fluoridated water (0.7
- 1.2 ppm).”
Surprisingly, the study reveals that all 6-month-olds and younger will
also exceed the lower “adequate intake” (0.01 mg/day) from all
formulas (concentrated or not) risking moderate dental fluorosis from
formula, alone. (2)
Breast milk contains about 250 times less fluoride than "optimally"
fluoridated water and isn't linked to fluorosis.
References:
http://tinyurl.com/AllFormulaContainsFluoride
Two words - Goat Milk - for those who canNOT breast feed (like me.) It is the closest thing to human breast milk when not available...yes we have a long way to go as far as creating an acceptance and norm with breast feeding, but with all the medical problems today, we still need to address those who can not breast feed for medical reasons.
I tried everything (you name it, I did it) I could to produce and only got 1 cc a day of colostrum - not enough for twins. I had to relent to formula because that is what the state helped me pay for and they had to eat! when a really good friend, who is a Montessori teacher told me about goat milk, I switched right away and the boys had no problems. they accepted it just fine (the smell or taste didn't even phase them.)
Thank-you Kirsten Goal - a few responses up - for standing up for breastfeeding. Furthermore, if more mothers would take the time to become informed (please read the books: The Politics of Breastfeeding, The Womanly Art of Breastfeeding or Making More Milk) and get help from a lactation consultant very very few would not be able to breastfeed. No excuses, most of you! Formula is ALWAYS a risk to your infant's health.
I agree with and support mothers that choose to breastfeed vs. formula. I'm a mother of 4 myself and have breastfed my two oldest for 2 months while I was on maternity leave and tried to continue to pump for 2 more months before reluctantly switching to formula.
At the time, I was working and because of the demands of work and even though they "supported" me with pumpping breast milk, I was away from my desk several times a day at work(which in the end, my supervisor and boss didn't like).
In the end, I chose to be a stay-at-home mom and our fanancial situation was in good order so I naturally chose to breastfeed my 2 youngest. I strongly believe that nothing can compare, come close or is better than breast milk.
I also support mothers who have to work and choose formula because it maybe convenient or they can't breastfeed for medical reasons.
I don't completely trust formula because you never know what is really in there and what can that stuff do to your baby, especially with all these recalls, it is scary.
My advice to new moms out there, get informed and ask questions. The best way to go for your baby's health is and always be breast milk but if you have to go to formula, do your research.