Infant formulas are designed to provide an acceptable substitute
for human milk. Their use is indicated for (1) infants whose mothers
choose not to breast-feed, (2) infants for whom human milk is contraindicated, (3)
infants who require a supplement to human milk because of slow growth,
and (4) infants whose mothers choose to discontinue breast-feeding
before the infant is 1 year old. Despite successful efforts to increase
breast-feeding to levels that exceed 90% in developing
countries and 50% to 90% in industrialized countries
following birth, fewer than half of infants in many countries are
exclusively breast-fed by 3 to 4 months postpartum.1 Thus,
infant formula provides a significant portion of the nutrient intake
for many infants.
Guidelines for specific nutrient intakes by the infant intakes
are detailed in Chapter 23. Infant formulas
are regulated by the Food and Drug Administration in the United States2 and
the European Food Safety Authority to ensure that they provide adequate nutrients
at optimum bioavailability for complete nutrition for the first
4 to 6 months of infant life. Regulatory requirements include (1)
nutrient content and quantity requirements, with minimum levels
for 29 nutrients and maximum levels for 9 nutrients; (2) quality-control
procedures ensuring bioavailability of nutrients, adequate content throughout
the shelf life of the product, and avoidance of contamination; (3)
record keeping on testing; (4) recall procedures for removal of
unsafe formulas; and (5) labeling requirements.
Infant formulas commonly available in the United States are detailed
in Table 25-1. These are generally available
in ready-to-feed, powder, and liquid concentrate forms. Nutrient
composition is nearly identical among the various formulations of
any specific formula brand, although there may be small differences
due to technological requirements in production. Calorie density
of standard term infant formulas is about 20 calories per ounce
with an osmolarity of 280 to 300 mOsm/kg, both being similar
to mature human milk. Infant formulas can be categorized as either
standard term infant formulas or specialized formulas. Standard
term infant formulas are further categorized according to their
protein type and composition: (1) cow milk based, (2) soy based,
(3) hydrolyzed, and (4) elemental. Specialized formulas have altered
macronutrient or electrolyte content specific for management of
a medical condition.
25-1. Common Infant Formulas Available in the United States |Favorite Table|Download (.pdf)
25-1. Common Infant Formulas Available in the United States
|Formula Name||Protein Source||CHO Source||% CHO||Fat Source||% Fat||Miscellaneous Information|
|Cow milk–based formulas |
|Similac Advance/Similac (Ross)||Nonfat milk||Lactose||100||High-oleic safflower oil||40||Available with and without DHA/ARA|
|Whey protein|| || ||Soy oil||30|
| || || ||Coconut oil||29|
|Enfamil Lipil (Mead Johnson)||Nonfat milk||Lactose||100||Palm olein||44||60:40 whey-to-casein ratio|
|High-oleic sunflower oil||14.5|
|DHA/ARA oil blend||2.5|
|Good Start Supreme/Supreme DHA & ARA (Nestle)||Whey protein, partially hydrolyzed||Lactose||70||Palm ...|
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