Infants require breastmilk or formula for the first 12 months of life. It is well known that breastmilk is best for infants. Most expectant parents plan to breastfeed. Unfortunately, statistics show that many fall short of the goal of breastfeeding for the first 12 months. The Center for Disease Control (CDC) 2017 U.S. National statistics show that 84 percent have breastfed, 58 percent are breastfeeding at 6 months and only 35 percent are still breastfeeding at 12 months. Babies who are no longer breastfed need to be on a safe, nutritious infant formula.

During the 19th century, bottles containing animal’s milk was used. Unfortunately, improper milk storage and improper cleaning of bottles led to the death of a third of all bottle-fed infants. Between 1890 and 1910, cleaning and sterilization of bottles was stressed. By 1912 easy to clean rubber nipples were available. In 1929 the first non-milk formula was available to the public, but it lacked vitamins. Vitamins were eventually added to formula.

During the 1940s and 1950s, infant formulas were popular and recognized as safe for infants. Formula was so heavily marketed that the global rates of breast-feeding dropped during this time. This decline prompted a movement to promote breastfeeding in the 1970s. This movement caused an increase in the number of breastfed infants as well as in the duration of breastfeeding.

In 1988 formula manufacturers began an advertising campaign to the public causing the American Academy of Pediatrics (AAP) to oppose such advertising in 1990. The AAP noted concerns that formula feeding may contribute to the development of atopy (the tendency to develop allergic rhinitis, asthma, or eczema), obesity, and even diabetes.

Throughout history and into the present, breastfeeding is the best, most nutritious, safest, cost-effective, healthiest way to feed an infant. Still, there are safe, nutritionally balanced formulas for those who cannot or choose not to breastfeed. Commercial formula has been extensively researched and studied for safety. It contains complete nutrients and vitamins for infants.

Formulas are divided into three main groups: milk-based, soy-based, or specialty formulas. An infant is usually started on a milk-based formula. If there are issues with digestion, such as fussiness or gas, there are partially hydrolyzed milk-based formulas with pre-processed smaller proteins, which are easier to digest. Specialty formulas are used for infants with formula intolerance.

If you are considering switching to formula feeding due to difficulty with breastfeeding, consult with your pediatric healthcare provider and an IBCLC (International Board of Certified Lactation Consultants) lactation specialist (connect.ilca.org). If you choose to formula feed or are unable to breast feed, your pediatric healthcare provider will advise a suitable formula. Store-brand formulas are much less expensive than comparable brand-name formulas and must maintain the same standards. This can be a significant cost savings. Always consult with your pediatric healthcare provider prior to switching formulas.

There are recipes for “homemade formulas” on the internet; however, it is not safe to do so. There are risks for malnutrition, contamination, and even health consequences by using such products. Do not use raw milk or regular milk products. They do not have the nutrients that babies need. Do not purchase imported formula. Only breast milk or commercial formula that meets FDA requirements is safe for infants.

Be sure to wash your hands and sanitize the bottles and workspace before preparing formula. Bottles can be sanitized in the dishwasher or by hand. If hand washing, rinse before and after cleansing with soapy water and allow to air dry. You can sanitize the items by boiling them for 5 minutes. Mix the formula precisely according to the package directions. Never dilute formula to “make it stretch” as this can result inadequate nutrition.

Formula should not be warmed in a microwave, as it can heat unevenly causing a burn. Instead, place the bottle in warm water. Test the milk temperature by dripping it on your skin. Use formula within 2 hours or store it in the fridge for up to 24 hours.

It is crucial for parents of infants to provide either breastmilk or formula until 12 months of age. As someone who needed to utilize formula, I am thankful that there are nutritionally balanced formulas available that are safe for infants. Breast is best; however, formula is a safe, nutritionally balanced alternative.