Best Formulas to Supplement Breastfed Babies
This post was written in partnership with Kabrita Goat Milk-Based Infant Formula. All opinions are my own. If you are a healthcare provider, join Kabrita’s Medical Herd to get access to new research, free continued education to share with your patients and peers, and invites to in-person and virtual events. This blog contains affiliate links, meaning that if you choose to purchase a product through a link, I will receive a small commission - this in no way impacts the amount you pay. Affiliate links are marked with an asterisk (*).
Breast milk is uniquely designed to meet the nutritional needs of infants and is widely recognized as the ideal source of nutrition for infants for the first six months of life due to its numerous benefits.
However, there are instances when supplementing breast milk with infant formula becomes necessary or preferable. Some mothers may have difficulty producing enough milk, while others may face medical conditions or personal circumstances that make breastfeeding challenging. Some pediatricians may recommend supplementing to help with extra calories and growth or if a baby has severe jaundice.
In such cases, supplementing breast milk with infant formula can ensure the baby receives the necessary nutrition for healthy growth and development.
Choosing the best formula to supplement breastfed babies requires careful consideration of several factors, including the nutritional composition, ingredients, potential allergens, what type of formula the product is (infant formula, toddler formula, etc.), and the baby's individual needs.
As a pediatric dietitian specializing in infant feeding, my goal here is to help guide you through the process of choosing the best formula to supplement your breastfed baby.
What to look for in an infant formula to supplement breastfeeding?
The best types of baby formulas to supplement breastfeeding are those that closely mimic breast milk in terms of their nutritional composition, are easily digestible for infants, and meet all safety requirements as outlined by the FDA. Ideally, formulas should be fortified with iron, as breast milk alone may not provide sufficient iron after the first six months of life.
Breast milk also contains unique probiotics and an important prebiotic called oligosaccharides, which benefit the gut microbiome. Evidence about the long-term benefits of probiotics and prebiotics for infants is still mixed. However, some formula brands have chosen to add these substances for their potential benefits.
Two of the main substances that have been discussed in more recent years are the addition of docosahexaenoic acid (DHA) and arachidonic acid (ARA) to infant formulas. These are long names for fatty acids essential to infant growth and development, namely of the brain, nervous system, and eyes.
DHA and ARA can be found in fish oils, algae and fungi, eggs, and human breast milk. Infants (and people of all ages) can make these particular fatty acids from other essential fatty acids in our diets, but it’s not a very efficient process. Some studies suggest that some infants, such as premature infants, may benefit from consuming DHA and ARA directly, but we don’t currently have any studies that show long-term benefits.
It is also important to pay attention to the ingredients used in the formula. Opt for formulas free from artificial additives, colors, and flavors. Avoid formulas that contain excessive amounts of sugar or high-fructose corn syrup.
Should I use an organic infant formula?
Organic formulas are produced without synthetic pesticides, genetically modified organisms (GMOs), and certain additives, making them a potentially appealing choice for health-conscious parents.
However, according to the American Academy of Pediatrics, "Current evidence does not support any meaningful nutritional benefits or deficits from eating organic compared with conventionally grown foods, and there are no well-powered human studies that directly demonstrate health benefits or disease protection as a result of consuming an organic diet."
It is also important to note that conventional and organic formulas alike are subject to strict regulations and safety standards per the FDA.
Ultimately, whether to use organic baby formula is a personal choice and one that is best discussed with your pediatrician or dietitian, taking into consideration the baby's specific needs and health concerns, and balancing any potential advantages of organic products with individual circumstances.
Which infant formula is best for babies who need a specific diet or hypoallergenic option?
Some babies may have allergies or sensitivities to specific proteins found in standard formulas. In such cases, hypoallergenic formulas may be recommended. These formulas are designed to be easily digestible and contain proteins that have been partially or extensively hydrolyzed, reducing the likelihood of an allergic reaction.
Certain medical conditions or specific dietary needs may require specialized formulas. For example, preterm babies may benefit from preterm formulas that have higher calorie and nutrient content. If there are concerns about cow's milk protein allergies, extensively hydrolyzed or amino acid-based formulas may be recommended.
Does it matter which brand of infant formula I choose?
Choose formulas from reputable brands that adhere to strict quality control standards. Make sure that the can is sealed and not expired. Look for formulas that have been tested for safety and are compliant with relevant regulations and guidelines.
As long as you buy an infant formula sold in the US, it must adhere to the nutrition and safety standards outlined by the Infant Formula Act of 1980. The FDA requires certain nutrients, recall procedures, and inspection requirements, defines adulteration, and establishes quality controls.
Some parents may be interested in using a European formula because it is made with higher DHA levels and without corn syrup and other fillers. However, most European-made infant formulas are not under FDA oversight, meaning there are some safety considerations due to how it is imported. The only European-made infant formula that meets all FDA infant formula requirements is currently Kabrita.
Consider the ease of preparation and convenience of the formula. Some formulas are sold as ready-to-feed formulas or come in liquid concentrate forms, while other powdered formulas require mixing with water. Assess the practicality of the chosen formula and ensure that it fits your lifestyle and preferences for formula feeding.
**TOP TIP: Make sure you choose an infant formula that is, in fact, for babies ages 0-12 months. “Toddler formulas" can look very similar to infant formulas but are not appropriate for infants!
Can I use a homemade formula to supplement breastfeeding?
No. Some unreputable sources claim that homemade formula is safe, but they are wrong. Unfortunately, there are many risks associated with homemade formulas. The main issues with homemade formula include lack of essential nutrients leading to incorrect nutrient balances, electrolyte imbalances, poor growth, and malnutrition.
Another concern is that homemade formula is not created in a sterile environment which can allow for contamination and foodborne illness. As a result, homemade formulas can cause infants to become very sick and should always be avoided.
What if my baby gets gassy or spits up after drinking formula?
Some babies have difficulty digesting formula and problems with increased gassiness or small amounts of spit-up. Often these issues resolve as their digestive systems mature, but for some babies, it may be beneficial to try using a formula with a different protein size, such as a goat milk-based formula, partially hydrolyzed formula, or fully hydrolyzed formula, which means that the proteins are already partially broken down.
If your baby has trouble with frequent reflux or significant distress, decreased appetite, poor weight gain, and/or a chronic cough or wheeze, or if you have any concerns or questions about your infant formula choice, follow up with your healthcare provider for further evaluation.
My Top Picks for Formula to Supplement Breastfeeding
The base of this infant formula— goat milk—is easier to digest and naturally closer in nutrient composition to breast milk than cow milk; Kabrita also adds evidence-based ingredients, such as iron, folic acid, high sn-2 palmitic acid, DHA, ARA, and prebiotics, to even more closely mimic the composition of breast milk, making it an excellent option for families looking to supplement while breastfeeding
2. Similac 360 Total Care* - This formula is designed to closely resemble the composition of breast milk, providing all essential nutrients and DHA; it also contains five human milk oligosaccharides (HMO) structurally identical to those found in breast milk
3. Similac Soy Isomil Infant Formula* - This organic plant-based formula is fortified with DHA and is a great soy-based formula for babies whose families prefer a vegetarian option
4. Gerber Good Start Gentle Pro* - This milk-based formula is partially “predigested” and is designed to be gentle on a baby's digestive system, which may reduce fussiness and gas; it also has added DHA, prebiotics, and probiotics
5. Similac Alimentum* - This extensively hydrolyzed, hypoallergenic formula is designed for babies who have cow's milk protein allergy
As always, every baby is unique, and what works for one may not work for another. Pay attention to your baby's reactions and tolerance to the formula when you feed your baby. Observe for any signs of discomfort, digestive issues, or allergic reactions. Consult with a pediatrician, dietitian, or lactation consultant for further guidance in choosing the best formula to supplement breastfeeding.
Please schedule a virtual one-on-one consult with me if you need additional support with specific nutritional concerns. Thanks for reading!