Baby Formulas: Is mixing them OK?

I regularly receive questions from concerned parents about what types of formula are best, and if they can be mixed or changed from time to time. Before I comment on this, I first want to make very clear that I strongly recommend exclusive breastfeeding for the first several months of your baby’s life. There is quite honestly nothing better than breast milk for your baby’s neurological and emotional development, immune system and overall well-being. Furthermore, I recommend not giving cow’s milk until your baby is 18 months of age. However, when it is necessary to introduce infant formula, there are the only two criteria that matter to me. The first is that your baby accepts and likes the taste of that formula and second, that it does not cause constipation.

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Often parents worry that mixing or changing infant formula may cause their baby fussiness, stool changes, or stomach upset. However, it is safe to mix infant formulas if you follow the standard mixing instructions on the label. It is OK to make a bottle that is ½ formula from the blue can and ½ formula from the yellow one. It is also fine to serve one brand one week, and another brand the next. Experimenting with different formula brands in a healthy newborn is okay, but it’s not necessary. I recommend parents don’t switch often and I suggest you give your baby at least two weeks to adjust before you try switching to a new brand.

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Here are a few more important guidelines;

· Never add sugar or juice or cow’s milk to infant formula.

·Don’t fix what is not broken. Do not switch formula if your baby seems happy and healthy with the current brand.

·Never dilute or concentrate the formula you make for your baby. Standard powdered formulas usually mix one scoop to every 2 ounces of water. Follow directions carefully and use the scooper that comes with the formula.

·In Thailand, always use bottled water or boil the tap water first. Standard bottled water is fine, no need to use special mineral water.

· If your baby is cranky, does not react well to a change to the formula, or you’re worried about an intolerance or allergy, talk with me about a plan to select the best formula.

· Continue to feed infant formula until 18 months of age. No mixing with cow’s milk or other milk-substitutes prior to 18 months.

Here is some physician-reviewed information on infant formulas from the US National Institutes of Health:

Standard milk-based formulas: 
Almost all babies and infants do well on these formulas. Most of the time, cow’s milk formulas are not the cause of fussiness and colic, and parents do not need to switch to a different formula. These formulas are made with cow’s milk protein (lactose) that has been changed to be more like breast milk. They also have vegetable oils, vitamins and minerals.

Soy-based formulas:
These formulas do not contain lactose. The American Academy of Pediatrics recommends soy formulas for parents who do not want their child to eat animal protein, and for    infants with galactosemia or congenital lactase deficiency. Soy-based formulas have not been proven to help with milk allergies or colic. Babies who are allergic to cows’ milk may also be allergic to soy milk.

Hypoallergenic formulas (protein hydrolysate formulas): This type of formula may be helpful for infants who have true allergies to milk protein, and for those with skin rashes or wheezing caused by allergies. Hypoallergenic formulas are generally much more expensive than regular formulas.

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