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Which milk when? A guide to choosing your baby's milk

Need I say it? Breast milk is best. Always! Unless there is an inborn error of metabolism or congenital lactose intolerance...breast milk will always be best! The benefits are huge ranging from better cognitive function, improved immunity and decreased risk of food allergies.

Breast milk contains over 300 components...formula milk is sitting at around 80 odd. We just cant replicate breast milk. And your breast milk is specific to your baby. A boy's breast milk is different to a girls breast milk and the composition of your milk changes with time. For example, Tryptophan = Increased melatonin and serotonin = better sleep...this hormone doubles at night in breast milk!! Wow!

But there are reasons why you may not be able to breastfeed or why you choose not too...that's ok! We see so many mums getting really down and stressed out under the pressure to breastfeed. Seek help as (and I vouch for it!!) it does not come naturally. If you can get it right it's an absolute triumph - from a financial and convenience point of view too! But if you do decide to give it up then your baby will need a formula.

Standing in that supermarket aisle deciding how best to nourish your baby is daunting! Soooooo many choices! So here is a little summary of a few of your choices...

1. Standard formulas

These will suit most babies and all of them meet a minimum requirement. Some contain pre/probiotics which is nice but the evidence around which probiotic and in what amount is not quite there.

2. Standard formulas containing HMOs (Human milk oligosacharides).

This is fairly new to the market and promising. HMOs are non digestible carbohydrates found in breast milk. They play a role in the immune system. Interestingly not all mums are secretors of HMOs but when they are, breasmilk contains over 200 HMOs. This formula contains 2 (two). And they come with a price tag! Watch this space!!

3. Lactose free formulas

For babies with a lactose intolerance. Now remember that lactose intolerance is incredibly rare in babies. A congenital lactose intolerance you will know about at birth and its so rare. A primary lactose intolerance doesn't usually show itself till the toddler years and a secondary lactose intolerance which occurs after a bout of gastroenteritis resolves after a couple of weeks. The use of these formula should be temporary.

4. Hypoallergenic formulas (HA / comfort formulas)

For babies with an increased risk of food allergy. So if mum or dad has asthma, eczema or hayfever i.e there is an atopic family history then this would be the formula of choice. The key however is that it needs to be the first formula. It can then reduce the risk of allergy by 50%.

5. Antireflux formulas.

If your baby is refluxy then these may help. They make use of a thickener to help keep the formula down.

6. Extensively hydrolyzed formulas.

These are based on cows milk protein but that protein is very broken down and the body no longer recognizes it as cows milk protein. These are used first line if there is a cows milk protein allergy and in certain medical conditions.

7. Amino acid formulas.

These are also based on cows milk protein but that protein is completely broken down and unrecognizable.

A very very small percentage of babies with a milk allergy will still react to an extensively hydrolyzed formula. They will need an amino acid formula. It is also used in certain medical conditions.

8. Soya formulas.

Where cows milk protein is contraindicated or unwanted then we have soya formulas. They are never first line though due to their phyto oestrogen content (the evidence around this is debatable still) and the risk of cross reaction with cows milk protein.

9. High energy formulas

We would use these in babies who have increased energy requirements, who are struggling to meet their energy requirements or who are fluid restricted. There use should be temporary!

10. Acidified formulas.

These are great when your environment does not allow for 100% clean preparation of your baby's bottles. They will inhibit the growth of harmful bacteria to a point.

Hope that helps clear things up a little. If you are struggling to find the right fit then do seek advice from a registered dietitian.

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