Bottle feeding - nutrition

Breast milk or a suitable infant formula is recommended as the main milk source for all babies less than 12 months of age. Breast milk is the feeding option of choice, but infant formula is a nourishing alternative when breast milk is not available. Infant formulas have been developed to contain similar amounts of nutrition to breast milk.

Caution on changing formula
There are many different infant formulas available. If given in correct quantities, infant formula alone provides enough nutrition for your baby until you introduce solids at around six months.

If your child sleeps or feeds badly or is unsettled or ‘colicky’, you may think you need to change the formula you are using. There is little evidence that this is helpful for the majority of babies. Seek the advice of your Maternal and Child Health nurse or doctor before switching formulas.

Starter or first formula
There is a variety of starter formulas based on cows milk protein (whey or casein). These formulas:

• Are suitable for babies from birth to 12 months
• Can be confusing – the label may list a number of additions such as LCPUFAs (long chain polyunsaturated fatty acids or omega-3 fatty acids), pro-biotics or pre-biotics. These are ingredients added to make formula more closely resemble breast milk. The most important thing to remember is to choose a starter or first formula if your baby is under six months of age.
• Formula based on soy or goats milk are also available – again, choose a product that is suitable for your baby’s age.

• Are made for babies over six months of age
• Contain higher protein and mineral content than starter formulas
• Contain lower carbohydrate content than human milk.

• Severe allergy or intolerance
• Fat or carbohydrate malabsorption
• Severe digestive disorders.

• Low lactose – used for lactose (milk sugar) intolerance.
• Modified protein content – in some formulas, the cows milk protein is broken down into smaller units. In other formulas, the whole protein is replaced by amino acids, the individual building blocks of protein. These preparations are used for severe dietary protein allergy, malabsorption and digestive disorders like short gut syndrome and severe failure to thrive. Other formulas may have changed amounts of specific amino acids and may be used for metabolic conditions like phenylketonuria (PKU) and tyrosinaemia (amino acid disorder).
• Modified fat content – this includes formulas with a high concentration of triglycerides and lower levels of fatty acids. These may be used for babies with conditions such as chylothorax, gastrointestinal disorders like protein-losing enteropathy, and liver disease.

• Fatty acids called DHA (docosahexaenoic acid) and AA (arachadonic acid)
• Biologically active substances that are thought to be good for the immune system
• Nucleotides – breast milk is a rich source of nucleotides, a substance that plays a role in immune functions of the gastrointestinal system. These can now be added to infant formula with possible benefits to immunity.

• Your Maternal and Child Health nurse
• Your paediatrician
• An Accredited Practising Dietitian, contact the Dietitians Association of Australia
• Royal Children’s Hospital Tel. (03) 9345 5522
• Advisory Panel on the Marketing in Australia of Infant Formula (APMAIF) Tel. (02) 6289 5181

• Breast milk is the feeding option of choice for infants.
• If breast milk is not available then infant formula is a suitable alternative.
• Breast milk or formula should be the main forms of milk used until the baby is 12 months old.
• Choose a formula to match the age and needs of your baby.
• Different brands of first or starter formula are all suitable for babies under six months. If you believe your baby has a problem with feeding, discuss this with your Maternal and Child Health nurse or doctor before switching brands.

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