Infant Formula Safety 101

Contributors: Esther Ellis, MS, RDN, LDN and Kimberly Zeender Christy, RD, LD, CLC and Lucille Beseler, MS, RDN, LDN
infant formula

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Infants require a specific balance of nutrients that are easily digested. While exclusive breastfeeding provides optimal nutrition and other health benefits, commercial iron-fortified infant formulas are an option for infants of families who cannot or choose not to breastfeed. Infant formulas regulated by the U.S. Food and Drug Administration must adhere to specific criteria and will provide proper nutrition for infants when prepared and used as directed.

Are store brand infant formulas a safe alternative?

The FDA requires all infant formulas to meet standard requirements for ingredients. Store brands (also known as "private label") are acceptable substitutes for nationally known brands.

Can I add more water to formula to make it last longer?

Diluting formula or breastmilk is not recommended. Adding more water to formula to make it last longer could lead to a serious condition called water intoxication. This results in electrolyte imbalances and other complications such as poor growth. Following directions on commercial infant formulas that are regulated by the FDA will ensure a child is getting an appropriate ratio of nutrients at each feeding.

Can I make my own formula?

You may have seen online blogs and social media accounts sharing recipes for homemade infant formula in response to infant formula shortages. It is strongly recommended that infants not be fed homemade formula as this is not safe for many reasons. Parents and caregivers may not realize the potential harm that could occur from using homemade infant formula — putting a child's health, or even life, at risk.

Can I feed my infant other types of beverages?

Only breastmilk or commercial iron-fortified infant formula should be given to a child during the first 6 months of life. Cow's milk, goat's milk, milk from other animals and plants (including fortified soy milk) are not recommended before a child's first birthday. In addition, nutrition supplements intended for adults or for use in weight loss, body building or as meal replacements should not be used as a substitute for human milk or infant formula.

For a child older than 6 months, ask your pediatrician about incorporating regular yogurt and fortified soy-based yogurts with no added sugars into the diet to reduce reliance on infant formula.

The American Academy of Pediatrics offers alternative options for introducing certain milks to infants 6 months or older (in an emergency and under a pediatrician's supervision) for a brief period of time;however, this practice is not recommended under normal circumstances or long-term and could pose health risks for an infant without a health care provider's assistance. Animal and plant-based milks do not provide the optimal nutrition that infants need. For example, cow's milk can inhibit the absorption of iron. Goat's milk,plant-based beverages and milk alternatives, such as almond milk, oat milk and coconut milk, differ in the nutrients they provide and should not be given to infants.

Is sharing donor milk safe?

Infants who are at high-risk, such as very low birthweight infants, may be eligible for pasteurized donor human milk that is carefully screened and treated to ensure it is safe and is prescribed by a health care provider. Buying what is advertised as breast milk from internet sources could result in exposure to unsafe toxins, bacteria and viruses such as HIV, tuberculosis or hepatitis B. These products should not be used.

I am combination feeding or only recently stopped breastfeeding. Can I start again?

It may be possible to increase your breastmilk supply if you are currently breastfeeding and thus reduce your need for infant formula. This can be a safe and effective way to decrease the need for formula if you work with a trained health care provider who can help you increase your milk supply. It is important that the baby gets enough breastmilk and formula so communicating with your baby's doctor is important if you choose this option.

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This article is intended to provide practitioners and the public with information believed to be current and accurate at the time of posting. It is not intended as, nor should be construed as legal, medical or consulting advice.

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