🍼 Infant formula

Infant formula is a manufactured substitute for breast milk for babies who are not breastfed, or not breastfed exclusively. First infant formula is usually based on cow's milk proteins; in the EU, goat's milk proteins, soy protein isolate and protein hydrolysates are also permitted. EU Regulation 2016/127 sets its nutritional composition: 60–70 kcal per 100 ml, and docosahexaenoic acid (DHA) is mandatory.

The World Health Organization and UNICEF recommend putting the baby to the breast within the first hour, giving breast milk only for the first six months, and then continuing breastfeeding up to two years and beyond alongside complementary foods. To protect breastfeeding, the World Health Assembly adopted the International Code of Marketing of Breast-milk Substitutes in 1981. In the EU, formula packaging has to carry a statement on the superiority of breastfeeding, and formula may be advertised only in baby-care and scientific publications, without discounts or free samples.

Powdered formula is never sterile: it may contain Cronobacter sakazakii and Salmonella bacteria. Newborns, babies under two months and premature infants are the most vulnerable. WHO and FAO advise making up the powder with water no cooler than 70 °C and feeding straight away.

Formula or breast milk? Formula is a manufactured substitute for babies who are not breastfed, or not exclusively. WHO and UNICEF recommend breast milk only for the first six months, so formula is an alternative, not an equal. First formula is usually built on cow's milk proteins, and the EU also allows goat's milk, soy protein isolate and hydrolysates. Formula is not ordinary cow's milk either: the NHS says cow's milk becomes a main drink only from 12 months.

On the pack look for "infant formula" or "first infant milk", and the statement on the superiority of breastfeeding that EU rules require. EU Regulation 2016/127 sets 60–70 kcal per 100 ml and mandatory DHA. Formula is sold in pharmacies, baby shops and the baby aisle of supermarkets; discounts, free samples and consumer advertising are not allowed in the EU. Ask your paediatrician rather than follow a shop display.

Why it matters to you. Decide on formula together with your paediatrician. Prepare it strictly according to the instructions, do not warm the bottle in a microwave, and throw away any leftovers after two hours. According to the NHS, a more expensive formula is no better than a cheaper one, and ordinary cow's milk should be given as a main drink only from 12 months.