It can be tough knowing which of the many types of formula milk on the shelves might be suitable for your child. Here’s what you need to know…
The majority of infant formulas are based on cow's milk, although infant milk based on goat's milk or soya bean are also available. The two major proteins in milk are whey and casein. Both are present in cow's milk and breastmilk, but in different proportions. Whey is the main protein in breastmilk whereas casein is the main protein in unmodified cow's milk.
Formula milk labelled as 'First Infant Formula' has a higher proportion of bovine whey than casein, making it easier to digest, and more suited to younger babies (NHS 2019; First Steps Nutrition Trust, 2021a).
Ready made, or powder?
Formula can be bought in two different forms: powdered formula that you make up in water, and ready-to-drink liquid formula. Powdered formula is not sterile in its' container, so it is very important to make it up exactly according to the directions to prevent food poisoning.
Ready-to-drink formula is more convenient but also more expensive. When the carton is opened, any unused formula can be stored in the fridge, at the back of the top shelf (with the container sealed) for up to 24 hours (NHS, 2019; NHS 2021).
Here is more about the different types of formula…
First infant formula
This type of formula is suitable from birth, and for as long as you use formula. It is made with whey protein as this is easy for babies to digest (Martin, 2016; NHS 2019). It is suitable for the whole of baby's first year so you do not need to switch to follow-on milk after six months of age (First Steps Nutrition Trust, 2021a; First Steps Nutrition Trust, 2021b, NHS, 2021).
"Unless a health professional recommends otherwise, first infant formula is the only breastmilk substitute needed during the first year of life."
The recommendation is that parents and carers who use infant formula continue to give first infant formula, which is whey-based, throughout the first year. That’s because this protein is more similar to breastmilk proteins than those in follow-on formula. When a baby is one year old, they can start to drink pasteurised whole milk (cows’, goats’ or sheep) (NHS, 2019; First Steps Nutrition Trust, 2021b).
Goats’ milk based formula
Both first formula and follow-on formulas can be made from goats’ milk rather than cows’ milk. They are produced to the same nutritional standards as cows’ milk formula. The proteins found in goats' milk are very similar to those in cow's milk, so babies who react to cows' milk protein are also very likely to react to goats' milk proteins. So goats' milk-based formula is not suitable for babies with cows milk allergy (First Steps Nutrition Trust, 2021a).
From March 2014, regulations throughout the EU infant allowed infant formula to be based on protein from goats’ milk. There is 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).
Hungrier baby formula
Formula labelled for ‘hungrier’ babies contains more of the protein casein. Babies take longer to digest this protein, keeping them feeling full for longer (NHS, 2019; First Steps Nutrition Trust, 2021a). 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, 2019).
Sticking to whey-based first formula during the first year of life is recommended (First Steps Nutrition Trust, 2021a).
Anti-reflux formula has an added thickener to help prevent babies from bringing up milk after feeds. It is suitable from birth. Although it can be bought over the counter, it is important to get medical advice from your midwife, health visitor or GP before switching to this type of formula (NHS, 2019). See our article about reflux and the NICE guidelines for the management of reflux for more details.
It is very important to follow manufacturers' instructions when making up and storing anti-reflux formula; manufacturers recommend using water at a lower temperature than that recommended for standard formula, to prevent the formula from clumping. So, it's particularly important not to use formula prep machines for this type of formula, as they use boiling water.
However, water at a lower temperature will not sterilise the powder and kill any harmful bacteria that might be present in the formula powder. You could speak to your healthcare professional if you need more support with this (First Steps Nutrition Trust, 2021b; NHS, 2019).
Comfort formula contains cows’ milk proteins that have been partially broken down (partially hydrolysed) to make it easier to digest. Manufacturers claim they 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, 2019).
Lactose free formula
True lactose intolerance in babies is extremely rare, but can be life threatening. Lactose-free formula should only be used under medical supervision. Read more about lactose intolerance. Lactose intolerance is also often confused with cows milk protein allergy.
The sugars in lactose-free milks are more likely to damage teeth (First Steps Nutrition Trust, 2021a).
This type of formula is available only 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. There is no evidence that this type of formula reduces allergies (First Steps Nutrition Trust, 2021). Read more about cows’ milk protein allergy.
Follow on formula
While ‘follow on’ formulas are advertised as being suitable for infants from six months of age, there is no evidence of any health benefits or nutritional advantage for your baby by switching to this milk. They were invented by formula companies to avoid the ban on advertising infant milk products under six months of age.
The Department of Health and World Health Organization recommend you continue to use whey-based first infant milk throughout the first year (NHS, 2019; NHS, 2021; First Steps Nutrition Trust, 2021).
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, 2019). There is no evidence that this helps babies to sleep better and it is not recommended by health professionals (First Steps Nutrition Trust, 2021).
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).
Infants who are allergic to cows’ milk protein may also be allergic to soya. The source of carbohydrate in soya-based protein is malt-dextrin, which can harm babies’ teeth (First Steps Nutrition Trust, 2021a). So it is only recommended to use this product for babies over six months and 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 (First Steps Nutrition Trust, 2021b).
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.
Health professionals 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 being overweight in childhood (First Steps Nutrition Trust, 2021).
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. It is recommended that children drink approximately 350ml of animal milk a day alongside a balanced diet (First Steps Nutrition Trust, 2021a).
Semi-skimmed milk is suitable from two years of age as long as children are eating well (First Steps Nutrition Trust, 2021a).
Vegetarian and non-dairy milks
The majority of formulas are not suitable for vegetarians as they are made from cows or goats milk. They usually contain fish oils and used animal enzymes in their production.
While more plant-based alternative milks are now available in the UK, there is no regulation, so they have no standard composition (First Steps Nutrition Trust, 2021c). Better guidance on packaging is important so you can choose an appropriate product for your child (First Steps Nutrition Trust, 2021c).
Soya-based formula is vegetarian, but not advised for babies under six months (First Steps Nutrition Trust, 2021b).
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 many are not as energy or nutrient dense as animal milks (First Steps Nutrition Trust, 2021c).
Milk to avoid
The following milks should not be given to babies under 12 months to drink: (First Steps Nutrition Trust, 2021b; NHS, 2019).
- Condensed milk.
- Evaporated milk.
- Whole cows' or other animal milk, as their main drink. They can be used in cooking from six months.
- Nut or vegetable 'milks' such as soya, nut, oat, hemp, coconut based milk alternatives.
Children under five shouldn't be given rice milk (First Steps Nutrition Trust, 2021).
This page was last reviewed in February 2022.
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EFSA (2012) Scientific Opinion on the suitability of goat milk protein as a source of protein in infant formulae and in follow-on formulae, EFSA Journal 2012;10(3):2603 Available at: https://doi.org/10.2903/j.efsa.2012.2603
First Steps Nutrition Trust (2021a) Infant Formula, Available at https://infantmilkinfo.org/type-of-infant-milk/infant-formula/ [Accessed February 2022]
First Steps Nutrition Trust (2021b) Infant milks; a simple guide to infant formula, follow on formula and other infant milks. Available from: https://www.firststepsnutrition.org/parents-carers [Accessed February 2022]
First Steps Nutrition Trust (2021c) Plant based milk alternatives in the diets of 1-4 year olds. Available from: https://www.firststepsnutrition.org/milks-marketed-for-children [Accessed 28 Feb 22]
Martin C, Ling P, Blackburn G. (2016) Review of infant feeding: key features of breast milk and infant formula. Nutrients. 8(5):279.
NHS. (2021) Guide to bottle feeding. Available at: https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/bottle-f… [accessed February 2022]
NHS. (2019) Types of formula milk. Available at: ttps://www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/bottle-feed…; [Accessed February 2022]