What’s the right formula?

Which type and brand of milk powder should you buy for your baby? We ask doctors for tips.

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Which type and brand of milk powder should you buy for your baby? We ask doctors for tips.
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Which type of formula is best?There are so many to choose from.

No milk formula is perfect – breastfeeding is best. If you’re unable to breastfeed, then a formula is a reasonable substitute, says paediatrician Nancy Tan from SBCC Baby and Child Clinic (Gleneagles). There is no way to predict if a particular formula is best for your baby – every child has his own unique digestive system and nutritional needs. Dr Tan gives these examples:

• Premature or low birth weight babies may need formulas with a higher protein or caloric content to help them grow and gain weight.

• Those with severe cows’ milk allergy may require soya, extensively hydrolysed or amino acid formulas.

• Babies with reflux problems may need anti-reflux formulas with thickeners to help them keep the milk down better.

• Babies with lactose intolerance may need a lactose-free formula.

• Those with a strong family history of allergies and eczema may do better on a hypoallergenic formula.

When is a good time to switch from breast to milk formula?

There is no ideal timing. Breastfeeding can continue as long as you’re still lactating and meeting your baby’s demands, according to Wong Boh Boi, assistant director (clinical) and senior parent craft/ lactation consultant at Thomson Medical Centre. The World Health Organization (WHO) recommends exclusive breastfeeding for at least six months from birth. You can consider switching to formula for medical reasons, like when you’re put on medication or when your child suffers from medical conditions like galactosaemia (a genetic disorder which affects the body’s ability to process a simple sugar called galactose). Other practical reasons include returning to work, or when you’re experiencing fatigue. When in doubt, check with a lactation consultant or your baby’s paediatrician.

Everyone says I shouldn’t be stingy when it comes to choosing follow-on milk. Are pricier brands better?

All infant formulas must meet basic nutrient standards to promote optimal growth and development. Less expensive ones are just as good as pricer brands, as they meet the nutritional requirements for infants, says paediatrician Wendy Sinnathamby at Raffies Children Centre. Although manufacturers vary their formula recipes, all approved formulas contain the minimum and no more than the maximum recommended amount of nutrients babies require.

My little one has had constipation since he started on follow-on formula. Should I change brands?

It’s not uncommon for infants to get constipated when they switch to a follow-on formula, Dr Sinnathamby says. This is because whey – usually the main form of protein in newborn formula – is replaced by casein in follow-on formula. Casein moves through the gut slower than whey. This allows more water to be reabsorbed within the gut and makes the stools harder. Furthermore, follow-on formulas have a higher iron content, which can also contribute to constipation, she adds. Here’s what she says you can do to relieve his constipation:

• Massage his abdomen using circular movements.

• Hold onto his legs and move them quickly in a cycling motion.

• Give him a warm, relaxing bath.

• Feed him cool, boiled water at regular intervals. If these methods fail, it might help to change to a different formula brand gradually.

I don’t want Junior to become too reliant on one brand of formula. Should I alternate between two brands at the same time?

Different brands may have variations, such as differences in scoop size and milk to water ratio, so Boh Boi from Thomson Medical Centre says she wouldn’t recommend it. Stick to one brand, and change only if Baby has problems with it.

If my baby is on a soya or hypoallergenic formula, when can I introduce cow’s milk?

Babies who are drinking soya or hypoallergenic formula generally do so for a period of either six months or nine months to a year, shares paediatrician Eugene Han from Thomson Paediatric Centre. After that, the doctor may recommend a skin prick test to determine if your child still has cow’s milk protein allergy.

Can he get the goodness of milk from other sources?

Most babies still rely on milk for most of their intake of calcium, which is particularly important for building strong bones, teeth and muscles. But you can also offer plain whole-milk yogurt and pasteurised cheese after your child turns six months old, Dr Han says. Don’t opt for low-fat versions, though, as they lack the fat your baby needs for healthy growth.

Whole-milk yogurt contains more calcium than breast milk. But do note that your baby absorbs calcium better from breast milk than from other milk sources, like yogurt and formula.