Why are there different types of infant formula?

It can be tough knowing which of the many brands of formula milk on the shelves might be best for your child. Here’s what you need to know about them all…

 

Most brands in the UK are either ‘whey dominant’ or ‘casein dominant’, which refers to the type of proteins in the formula. Both can be used from birth but whey dominant formula is usually best for new or younger babies. That’s because whey proteins are easier for young babies to digest (NHS Choices, 2016; Crawley, 2018).

Here are the different types of formula available…

First infant formula

This type of formula is suitable from birth. It’s based on whey protein as this is thought to be easier to digest (Martin, 2016; NHS Choices, 2016). You do not need to switch to follow-on milk after six months of age (Crawley, 2018).

"Unless a health professional recommends otherwise, first infant formula is the only breastmilk substitute needed during the first year of life."

Current advice suggests that parents and carers who use infant formula continue with a whey-based first infant formula throughout the first year. That’s because it is more similar to breastmilk than follow-on formula (Crawley and Westfield, 2019). When a baby is one year old, they can start to drink pasteurised whole milk (cows’, goats’ or sheep) (NHS Choices, 2016; Crawley and Westfield, 2019).

Goats’ milk based formula

Both first formula and follow-on formulas can be based on goats’ milk rather than cows’ milk. They are produced to the same nutritional standards as cows’ milk formula but are no less likely to cause allergies (Crawley, 2018; Crawley and Westfield, 2019).

From March 2014, regulations throughout the EU infant allowed formula to be based on protein from goats’ milk in infant formula and follow-on formula. There is considered to be no difference between first infant formula made from cows’ milk protein, or goats’ milk protein, in terms of their allergenicity or their digestibility (EFSA, 2012).

Goats’ milk formula is not suitable for babies with cows’ milk protein allergy (Crawley and Westfield, 2019).

Hungrier baby formula

Casein-dominant formula is labelled for ‘hungrier’ babies because the proteins are harder for babies to digest (NHS Choices, 2016; Crawley, 2018). Although this type of formula is advertised as being suitable from birth, there is no evidence it helps babies to sleep better or offers any other advantage over first infant formula (NHS Choices, 2016; Crawley and Westfield, 2019).

Experts recommend sticking to whey-based first formula during the first year of life (Crawley and Westfield, 2019).

Anti-reflux formula

Anti-reflux formula is thickened to prevent babies from bringing up milk after feeds. It's available from birth and can be bought over the counter. It is important to use this type of formula only under advice from your midwife, health visitor or GP (Crawley and Westfield, 2019). See our article about reflux and the NICE guidelines for the management of reflux for more details.

It is also important that such formulas are made up with boiled water cooled for no more than 30 minutes to ensure the milk remains sterile. Some manufacturers recommend making up anti-reflux formula at lower temperatures (NHS Choices, 2016; Crawley and Westfield, 2019). But do speak to your healthcare professional if you need more support with this (NHS 2016).

Comfort formula

Comfort formula contains cows’ milk proteins that have been partially broken down (partially hydrolysed) to make it easier to digest and prevent colic and constipation. There is no consistent evidence that comfort formula improves colic, wind or constipation and these will often improve on their own as babies get older.

Consult a health professional for advice before using this formula. It is not suitable for babies with cows’ milk allergy (NHS Choices, 2016; Crawley and Westfield, 2019).

Lactose free formula

This formula is for babies who are lactose intolerant, meaning they can’t absorb lactose, a sugar found in milk and dairy products. Symptoms include diarrhoea, abdominal pain, wind and bloating.

It is important not to self-diagnose lactose intolerance, as this may be mistaken for other conditions such as cows’ milk protein allergy. Speak to your health visitor or GP.

Lactose free formula should only be used under medical supervision. That’s because the carbohydrates in these milks are more likely to damage teeth (Crawley and Westfield, 2019).

Hypoallergenic formula

This type of formula is suitable from birth but only available on prescription from your GP or paediatrician. It is made from fully hydrolysed proteins and is suitable for the management of cows’ milk protein allergy. If you suspect your infant may have cows’ milk protein allergy, speak to your GP for advice (Martin, 2016; Crawley and Westfield, 2019).

Follow on formula

While ‘follow on’ formula are advertised as being suitable for infants from six months of age, there is no evidence of any health benefits for your baby. They were largely invented by formula companies to avoid the ban on advertising infant milk products under six months of age (Crawley and Westfield, 2019).

There are no nutritional advantages to switching to follow on milk after six months. The Department of Health and World Health Organization recommend you continue to use whey-based first infant milk throughout the first year (Crawley and Westfield, 2019).

Good night milk

This is follow-on formula with cereal added. It is sold as a special formula for babies to have at bedtime (NHS Choices, 2016, Crawley, 2018). There is no evidence that this helps babies to sleep better and it is not recommended (Crawley and Westfield, 2019).

Soya formula

Soya formula is made from soya beans instead of cows’ milk. It is not recommended for babies under six months of age. That’s because soya contains phyto-oestrogens, which can mimic sex hormones in the body (Martin, 2016; Crawley and Westfield, 2019).

Infants who are allergic to cows’ milk protein may also be allergic to soya (Crawley, 2018). The source of carbohydrate in soya-based protein is glucose, which can harm babies’ teeth (NHS Choices, 2016; Crawley and Westfield, 2019). So it is only recommended to use this product under advice from your GP or health visitor.

Growing up milk (toddler milk)

Growing up milks are marketed as an alternative to cows’ milk for children aged over one year. There is no evidence these milks have additional benefits and they are not recommended (Crawley, 2018).

Toddler milks and growing-up milks contain more sugar than animal milk and less of some important nutrients, such as riboflavin, calcium and iodine. Manufacturers add some nutrients to toddler milks – such as iron, vitamin D and omega 3 fatty acids. But they don't replace all the nutrients that may have been destroyed in processing.

Experts across Europe have agreed that young children do not need fortified milks. There is even some evidence that giving lots of extra nutrients may be bad for health in the longer term. Offering sweetened drinks to young children may also contribute to development of a sweet tooth and to overweight in childhood (Crawley and Westfield, 2019).

Full fat animal milk

Full fat cows’, sheep or goats’ milk can be given as a main drink to children over one year of age as long as it is pasteurised (Crawley, 2018). It is recommended that children drink approximately 350ml of animal milk a day alongside a balanced diet (Crawley and Westfield, 2019).

Semi-skimmed milk is suitable from two years of age as long as children are eating well (Crawley and Westfield, 2019).

Non-dairy milks

Unsweetened calcium-fortified milk alternatives, such as soya, oat, hemp or nut based milks, may be used from one year of age. Seek advice from a health professional before using these milks as they may not be as energy or nutrient dense as animal milks (Crawley and Westfield, 2019). Children under five shouldn't be given rice milk.

This page was last reviewed in May 2019.

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

You might find attending one of NCT's Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

Crawley H. (2018) Infant milks: a simple guide to infant formula, follow-on formula and other infant milks. First Steps Nutrition Trust, London. Available at : https://www.firststepsnutrition.org/infant-milks-in-uk [Accessed 9th May 2019]

Crawley H, Westfield. (2019) Infant milks in the UK: a practical guide for health professionals. First Steps Nutrition Trust, London. Available at : https://www.firststepsnutrition.org/infant-milks-health-workers [Accessed 9th May 2019]

Martin C, Ling P, Blackburn G. (2016) Review of infant feeding: key features of breast milk and infant formula. Nutrients. 8(5):279. Available at : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4882692/ [Accessed 9th May 2019]

NHS. (2015) Guide to bottle feeding. Available at : https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2008/… [Accessed 9th May 2019]

NHS. (2016) Types of formula milk. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/types-of-infant-formul… 9th May 2019]

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