Formula - so many choices

The first choice you will have had to make to have this post be useful to you is to either supplement your breastfeeding with formula or exclusively formula feed. Yes, the American Academy of Pediatrics recommends breastfeeding exclusively for the first six months of your baby's life, but that does not work for every mom. I also note that this post is meant to discuss formula for infants, birth to 12 months. For those of you with babies older than one year, this will not apply.

Major brands of formula:
Enfamil (Mead Johnson)
Good Start (Nestle)
Similac (Ross)
Store Brands (Target Up-and-up, etc.)

Formula types:
Powder in a can
Powder in individual packets
Concentrate
Ready-to-feed

Ready-to-feed is generally considered to be the most convenient. If your baby does not have a preference about the temperature of his bottle, you just open and feed with this stuff. It is also the most expensive. Powder in a can takes the most effort, but it is also the least expensive. If you use powder in a can, I highly recommend using the Dr. Brown's pitcher. In addition to helping you make all of the bottles at once, it drastically reduces the bubbles, which are so often a cause of gas in our little ones.

I started this post with the major brands and types because your baby may react very differently to formula based on these two things. One baby will perfectly digest Enfamil's powder in a can, while another will not tolerate anything other than Similac's ready-to-feed liquid. So how do you know what to buy?

In large part, you play the try-and-hope-you-succeed game. You should know going in that you are also playing the I'll-probably-guess-wrong game. It may take some trial and error to find the right match for your baby. Just watch for signs like gassiness, extra fussiness, and constipation. Those types of things (unless a medical condition is involved) will tell you the formula is not the right match for your baby. *Remember, constipation is not inability to have a bowel movement. It is actually passing hard stool. It is not uncommon for a baby to go three days without a bowel movement. That said, you will (scarily) get to know your baby's poop habits and know when something is amiss.*

What if you have tried every combination and nothing is working? Specialty formulas are out there, too. I would definitely recommend keeping an open discussion with your pediatrician about the types of formula you are using, thinking of trying, etc. Be prepare for direction/advice from the doctor if your baby is not gaining weight or is otherwise seemingly not getting the right nutrition.

Types of specialty formulas:
Soy
Allergy (a.k.a. predigested)
Thickened (for acid reflux)
Lactose-free (for acute diarrhea)
Premature discharge (for preemies)

What did we do?
We started off exclusively breastfeeding. When we made the move to formula, we started on Enfamil Premium. My son tolerated it, but was very gassy. We switched to Enfamil's Gentlease (reduced level of lactose) for about a month and then went back to the Premium. When we switched back, he tolerated the Premium perfectly. His little belly just needed some extra time to learn to handle the lactose content!

One last reminder - no cow's milk for babies until they are one year old. They just can't digest it until then!

One last note, too - The AAP recommends that you do not exceed 32 ounces of formula for your baby per 24 hours. Many pediatricians will tell you that you can go to 35 or 40 ounces. If your child is still seemingly hungry after 32, try a pacifier to see if it is really just a sucking need, not a feeding need, that needs to be satisfied. If that and distraction play do not work, consider whether you are ready for your baby to start solids (with pediatrician agreement, of course). There is a balancing act on this one - start solids early (which is controversial and against what the AAP advises) or feed more formula (which is controversial and against what the AAP advises). Ah... the tough calls of mommydom.