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Am Fam Physician. 2009;79(7):online

See related article on infant formula.

When should I use baby formula?

Breastfeeding gives your baby the best nutrition, but formula can be used if you are unable to or choose not to breastfeed. Formula gives your baby most of the calories, vitamins, and protein he or she needs. It also gives your baby all the liquids he or she needs. Formula should be used until your baby is one year old.

How do I choose which formula to use?

Most babies need regular formula with iron. Formula comes as a powder, concentrated liquid, or ready-to-use liquid. Powder and concentrated liquid must be mixed with water. Ready-to-use formula does not need to be mixed with water. Powder formula is the least expensive, and ready-to-use formula is the most expensive. Many stores make their own brand of formula. All regular formulas (brand name or store brand) have the same nutrition, so you can choose the formula based on cost and how easy it is to use.

Do I need to buy formula with DHA and AA?

Docosahexaenoic (doe-KOE-sah-HECK-sah-ee-NO-ick) acid (DHA) and arachidonic (UH-rack-uh-DON-ick) acid (AA) are fatty acids that are found in breast milk. They are also added to some formulas. DHA and AA are advertised to improve eye and brain development. There is no proof that adding DHA or AA to formula provides any benefit. Formulas with DHA and AA cost more than regular formula.

If my baby has an upset stomach, will using a low-iron formula help?

Iron in formula hardly ever causes stomach upset or constipation in babies. Babies actually need more iron to prevent a deficiency, which can cause anemia (having fewer or smaller red blood cells than normal) and learning problems. Never switch to low-iron formula without talking to your doctor first.

If my baby has colic, will changing formula help?

Most colic goes away on its own when your baby is four to six months old. Formula does not usually cause colic; so, you do not need to switch formula. Soy formula does not seem to help with colic either. Talk to your doctor about ways to respond to your baby's crying. Less stimulation for your baby may help (for example, a quiet room, low voices, few visitors). If your baby's colic is bad, your doctor may have you try lactose-free or hypoallergenic formula for one or two weeks. These formulas cost more than regular formula.

If my baby spits up a lot, will antireflux formula help?

Parents often worry about gastroesophageal (GAS-tro-eh-SOFF-ah-GEE-al) reflux, also called spitting up. Almost all babies spit up, but it gets better as the baby gets older. Reflux usually goes away when your baby is six to 12 months old.

If your baby is growing well, you can be sure that enough formula is staying down, and no treatment is needed. If your baby has bad reflux, antireflux formulas may help. Talk to your doctor if you are worried about reflux.

Can I keep giving my baby formula if he or she has diarrhea or is throwing up?

Many sicknesses can cause your baby to throw up or have diarrhea. You should take your baby to the doctor to make sure your baby is not dehydrated, especially if he or she has a fever. It is best to keep giving your baby breast milk or regular formula while he or she is sick. It will not make the symptoms worse. It is not safe to give babies only water. Ask your doctor before giving your baby rehydrating drinks (one brand: Pedialyte).

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