According to the American Academy of Pediatrics, infant formula is “excellent nutrition” for when a baby isn’t breastfed. But parents hear all manner of scary things on the internet about formula, such as that it has a “high sugar content” and contains ingredients like corn syrup, palm oil, and preservatives. The names of ingredients on the label are also usually unfamiliar and unpronounceable—much like the ones found in this peach:
Here is some actually factual information about formula to ease your concerns.
Sugars in Formula
Sugar is a type of carbohydrate. Carbohydrates are important nutrients that fuel all of our cells—they're so important in fact, that if you do not consume them, your body will break down its own tissues in order to make them.
Infant formula is high in sugar because breastmilk is high in sugar. Humans have the sweetest milk of almost all mammals, because we have big brains that need that amount of fuel. The growing brains of infants need even more fuel.
Although you may have heard sugar is not good for you, that is not actually true—it’s excess sugar that can be a problem, and both breast milk and formula have the exact right amount to provide the energy babies need. Toddler formulas do have added sugars, and they should be avoided. Cow’s milk or even infant formula can be given to babies over one year, as can other dairy products. Drinking water is also a good habit to instill at that age. (Juices are not ideal, as they're mostly empty calories, but not every molecule that goes into your child's mouth must be "ideal"; if you choose to give juice occasionally, it's a good idea to water it down.)
Carbohydrates in formula typically come from lactose (milk sugar) or corn syrup solids. Corn syrup is essentially just glucose—one of the components of lactose. Corn syrup is very different from “high fructose corn syrup”; HFCS is harmful, but chemically they are as different as sodium chloride (salt, a necessary nutrient) and sodium hydroxide (a corrosive chemical used in explosives).
Fats in formula
Fat is an important nutrient that helps babies’ brains grow, helps with temperature regulation, and allows many vitamins to be absorbed.
The types and ratio of fats in formula (e.g., saturated, monounsaturated, polyunsaturated, cholesterol, etc.) are based on the types and ratios of fat in breastmilk. The fats typically come from vegetable oils, and sometimes a mixture of vegetable oils and bovine milk fat (cream).
Palm oil is one of those vegetable fats, and it is often chosen to help match the typical fatty acid profile of human milk. There has been concerned raised about mineral absorption when palm oil is used, which is explained further in this comprehensive article by registered dietician Laura Creek Newman. Some are concerned about the environmental impact of palm oil production, so if you share this concern you may want to avoid formulas containing it.
Proteins in formula
Most formulas are made from cow’s milk, which is higher in protein than human milk. Babies cannot drink straight cow's milk because the high protein content would put stress on their kidneys, and the type of protein in it can cause irritation to the lining of the stomach and intestines. In addition, cow's milk lacks sufficient iron, vitamin C, and other nutrients that infants need.
In order to turn cow's milk into a safe and nutritionally appropriate milk for infants, it must be processed to break down the proteins, and the types of protein must be adjusted, as seen in this diagram:
Human milk and formula contain more whey than casein, making them more easily digested by human babies. For babies who have difficulty digesting cow's milk protein in general, there are formulas containing 100% whey protein, and formulas with the proteins further broken down (hydrolyzed).
Vitamins and minerals
We have come a long way in our understanding of optimal nutrition for infants since the days when formula was made from canned milk, water, and karo syrup. Formulas today must contain exact levels of micronutrients such as iron, calcium, zinc, iodine, potassium, Vitamins A, C, D, E, K, and the B vitamins.
Some formula companies have started adding new ingredients like milk fat globule membrane (MFGM), human milk oligosaccharides (HMOs), and A2 milk, in an attempt to make their formulas closer to breast milk. There is as of yet no evidence that MFGM or A2 milk make any difference for babies, and they are costly; the long-term effects are also unknown. HMOs are probably beneficial, and they are now also in generic formulas.
Probiotics and prebiotics are also being added to some formulas (HMOs are a prebiotic). Scientists are just beginning to learn about the infant microbiome, so it is unclear how beneficial this may or may not be. (If you are partially breastfeeding, your baby is also getting some pro- and prebiotics through your milk.)
Formula contains other ingredients, such as emulsifiers, stabilizers, and natural preservatives. These ingredients are safe for human consumption and found in many foods and drinks. The role of these components is to (1) prevent formula powder from clumping, (2) prevent separation of the oil and water components in liquid formula, and (3) allow it to be shelf stable for about a year (always check the expiration date).
The emulsifier (anti-separation ingredient) in formula is typically made from soy lecithin (a dietary supplement that can prevent or treat plugged ducts in lactating breasts). Stabilizers are things like carrageenan (made from seaweed) and xanthan gum (made from fermented sugars). Preservatives include things like beta carotene (also found in breast milk, spinach, and carrots) and ascorbyl palmitate (a type of Vitamin C). These things are found in many foods and have been for decades.
Bottom line: formula is basically just food. You do not have to be afraid to give properly prepared formula to your baby.
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