As per FDA regulation, every infant formula in the US must contain minimum amounts for 29 nutrients and maximum amounts for 9 of those nutrients. This can make for a long list of ingredients! And, when you add additional, voluntary ingredients like DHA with complex names like Crypthecodinium Cohnii Oil, the label can become even more daunting! Here we break down the necessary components of infant formula and de-mystify some of the most commonly found ingredients.
The gold standard
Human milk is the optimal source of nutrition for infants in their first year of life. Research confirms that breast milk is a complex and dynamic fluid: it contains macronutrients (carbohydrates, proteins, and fats), micronutrients (vitamins and minerals), as well as bioactive factors with health-promoting qualities (such as immunoglobulins, hormones, and growth factors to name a few).
If breast milk came with a label, the list would be longer than infant formula! And, some of the ingredients would have unfamiliar, scientific names.
Infant formula is patterned after the macro and micronutrients found in breast milk. And, as no animal or soy milk is able to supply the appropriate levels of nutrients for babies, all formulas are adapted and fortified to meet their health and developmental needs.
Protein is a critical macronutrient that supports a wide range of body functions, including structural support, healthy growth and development, and a robust immune system.
Cow milk protein has been the standard protein source used in formula for many years. Cow milk has a whey to casein ratio (the major types of protein in milk) of 20:80. This protein ratio is adapted in many formulas to more closely match the 60:40 ratio found in breast milk by adding additional whey.
In hydrolyzed cow milk formula, the protein is either partially or fully (extensively) broken down. Extensively hydrolyzed formula is the first line choice for the majority of children with cow milk protein allergy (CMPA). CMPA affects about 2-3% of infants.
Soy is an alternative protein source to cow milk protein. It may be recommended for infants with rare conditions such as galactosemia or hereditary lactase deficiency.
For some children, cow milk protein may be difficult to digest and may cause mild to moderate symptoms such as spit-up, constipation, and eczema. Goat milk protein is naturally easy to digest and may alleviate the symptoms often associated with cow milk sensitivity*.
Goat milk, like cow milk, has a whey to casein ratio of 20:80, which is adapted in some formulas with additional whey. Like whole cow milk, whole goat milk is not suitable for infants; in addition to lacking nutrients (most notably folate), it contains too muchprotein for tiny kidneys. Goat milk is also not appropriate for children with a confirmed cow milk protein allergy.
In 2012, goat milk protein was approved for use in infant formula in the European Union (EU), and in 2014 goat milk toddler formula became available in the US market. Unlike many other countries, including the EU, the US requires that each new infant formula participate in a clinical trial to demonstrate safety and tolerance before being marketed. Currently, there is no goat milk infant formula approved for sale in the US. The trial to bring KABRITA Goat Milk Infant Formula to the US market is currently in progress.
Lactose is the primary carbohydrate in breast milk.
All babies need carbohydrates for energy. Lactose is the primary carbohydrate source in breast milk. Contrary to popular opinion, lactose intolerance is uncommon in young children – babies are ‘programmed’ to break down the lactose in their mother’s milk. Lactose intolerance attributable to the relative or absolute absence of the lactose enzyme that develops at various ages in different social groups is uncommon across all populations before 2 or 3 years of age.
Companies may use one or a combination of several carbohydrate sources to meet babies’ energy needs. Lactose (which is molecularly identical regardless of the source), corn syrup, maltodextrin, brown rice syrup, and sucrose are examples of carbohydrate sources found in many formulas.
According to the American Academy of Pediatrics, low-lactose and lactose-free formulas have no clinical advantages compared with standard lactose-containing formulas (except in severely under-nourished children). In fact, the presence of lactose in a formula increases absorption of calcium and may play a role in the developing intestinal microbiota and innate immune response.
For babies with the rare conditions of galactosemia or hereditary lactase deficiency, soy formula is recommended as the lactose is replaced with glucose or sucrose.
Fat is a critical macronutrient for babies and young children. It is essential for the rapid growth phase following birth, to help in the delivery of fat-soluble vitamins (such as A, D, E and K), and to support neurological development and brain function.
Breast milk fat is composed of a range of fatty acids, and about 20-25% of the fat in breast milk is palmitic acid, The fat in infant formula should match, as best possible, the fatty acid profile found in human milk.
In the US, the infant formula industry standard is to replace animal fat with a vegetable oil blend in order to best match the complex fatty acid composition found in breast milk. However, no one vegetable oil has a comparable fatty acid profile to that of breast milk! As a result, all commercially prepared formulas contain a vegetable oil blend.
Infant formula is one of the most highly regulated foods
Formulas vary, in terms of ingredients, or whether they are organic or non-GMO, and it may feel challenging to understand all the ingredients in infant formula at first glance. However, you can be confident that all infant formula in the US meets strict FDA regulatory standards.
At Kabrita USA we believe in full label transparency. We explain each ingredient in our formula in our FAQ and support it with a detailed series called ‘Behind the Label’ on our Nourish Blog. You can also review our series of nutrition comparison charts to compare Kabrita to US FDA regulations as well as other types of milk. For parents who would like to ask their questions directly we provide phone and online support with access to our in-house Naturopathic Doctor, Dr. Annie Salsberg.
*Not suitable for children with cow milk protein allergy