“We had to switch him to Enfamil because he was vomiting up the Similac.”
I clarify. “So he was vomiting on Similac Advance?”
Mom agrees.
“Unfortunately,” I tell her, “we only have a limited selection of formulas we can offer your baby, and that specific formula you’re providing your baby now isn’t one that I can give him. We could try Similac-”
As soon as I say the word, mom visibly starts and begins shaking her head.
I try to push through. “We could try Similac Total Comfort, which is another milk-based formula except that it has some of the proteins broken down so they’re…”
Mom is having none of it. “You can’t give me any Enfamil?”
“Not the type you’re using,” I say. “The only Enfamil product we provide is Enfamil ProSobee, a soy-based formula. That’s going to be different from what you’re using right now because you’re currently using a milk-based formula.”
I never did manage to get it through to mom that the BRAND isn’t the important thing to look at when you’re evaluating formula.
You, dear readers, will listen, won’t you?
When your child seems to be having tolerance issues to a formula, switching brands may help–but the brand isn’t really the issue. The issue–if there’s a formula issue at all (most of my clients wouldn’t believe it, but most of the things people switch formulas over are actually normal parts of infancy and the “improvement” they see once they switch has more to do with baby getting a bit older than with the new formula). Anyway, enough rabbit trails. The issue with the formula is that there’s some ingredient in that particular formula that baby isn’t tolerating.
So, you want to find another formula without that ingredient–except that you don’t know what the ingredient is, so you’re going to be playing a bit of a guessing game.
Almost every formula manufacturer (I’ve used Abbott/Similac and Mead Johnson/Enfamil, the two biggest formula suppliers, for my examples in the following list, but there are other brands of formula available) has at least four or five different varieties of formula*.
- Standard milk-based formula
This formula contains milk proteins (from whey and casein) and milk carbohydrates (lactose). Examples include the aforementioned Similac Advance, as well as Enfamil for Infants. Most babies do well on this type of formula. - Low/No Lactose milk-based formula
This continues to use milk proteins, but exchanges some or all of the lactose with another sugar. Most of these types of formulas also have other changes (such as adding rice starch or partially or fully breaking down the milk proteins), but one formula (Similac Sensitive for Fussiness and Gas) is virtually identical to the standard milk-based formula except for this change. Infants who have a hard time digesting lactose (which is less common than many parents think) will do better on this type of formula. This type of formula is often used if a child seems unusually bloated or gassy. - Milk-based formula with hydrolyzed proteins
This type of formula uses milk proteins but breaks them down into smaller pieces, which may be more easily digestible by infants. The proteins may be partially hydrolyzed into small protein fragments (Gerber Good Start does this) or fully hydrolyzed into the component amino acids. Most of the fully hydrolyzed milk-based formulas are also lactose-free. Examples include Enfamil Gentlease and Similac Total Comfort. Hydrolyzed protein formulas are used if a protein allergy or intolerance is suspected, often when an infant experiences constipation. - Soy-based formula
This type of formula uses soy proteins and a non-lactose form of sugar. Examples include Similac Soy and Enfamil ProSobee. These are used by parents who are vegetarian or when milk-protein allergy or lactose intolerance is suspected. - Formulas for Acid-Reflux
Maybe you’ve heard the old wive’s tale about adding rice cereal to a bottle to keep baby from spitting up. Maybe you’ve even heard it from a doctor. Like many old wive’s tales, there’s a grain of truth and plenty of risk in following this advice. Added rice starch does seem to reduce acid reflux for many babies. But adding rice cereal to a bottle can pose a choking or aspiration (getting food in lungs) risk and can increase risk of obesity. Choosing a formula specially formulated with added rice starch may help with the reflux while minimizing the risk associated with adding cereal to a bottle. (Please note that there is virtually NO evidence that adding cereal to a bottle will help a baby sleep through the night. All the risks, none of the benefits–DON’T do it!) Examples of these formulas include Enfamil A.R. and Similac Sensitive for Spit Up. Infants with acid-reflux (this is spitting up beyond the normal spit up 0-3 month olds do after every feeding and includes additional symptoms) may benefit from this type of formula.
So, now that you know a little bit about formula, you can educate your friends. If someone is having a problem with their formula, let them know that it doesn’t matter which BRAND they’re using. It matters what KIND they’re using.
Compare apples to apples, people.
*Actually, the big couple have dozens of formulas–but most of the other types of formula NOT noted in the above have changes made to treat specific conditions and should only be used on a doctor’s recommendation.