What are the types of formula milk?

Breast milk is the most precious gift a mother can give to her baby. However, many mothers have to supplement their breast milk with formula milk (based on cow's milk or other animal milk or plant ingredients, with appropriate nutrients added as a substitute for breast milk) when their breast milk is insufficient. When the baby is one year old and needs to switch to milk, how can new parents choose from the dazzling array of brands on the market? Or how can they choose the "right" milk powder? We invited pediatrician Dai Jishan, neonatologist Wu Jianyi and nutritionist Lin Minhua to explain.

How to choose milk powder for newborns

The government advocates breastfeeding, so it has set many thresholds for milk powder advertising. Milk powder manufacturers for children under one year old are strictly prohibited from advertising. If they do not do their homework beforehand, I believe many new mothers will have only a vague understanding of the selection of formula milk. In this regard, Wu Jianyi, deputy director of the Department of Children's Medicine at Kaohsiung E-Da Hospital, and Dai Jishan, attending physician of the pediatric department at Taipei Shutian Clinic, both believe that for newborn formula milk, "it is right to choose a big brand."

Strict milk powder inspection standards:

Dai Jishan explained that infant formula (0 to 12 months) that can be put on the shelves must meet the standards of the Food and Agriculture Organization of the United Nations and the World Health Organization: First, the basic ingredients must meet the standards, that is, from calories, protein, fat to carbohydrates, there are certain content standards. Some brands may focus on a certain ingredient. In other words, it just means that the content of this ingredient is higher but will not exceed the highest standard; secondly, nutrients cannot be added at will. Wu Jianyi emphasized that the content of milk powder is based on breast milk ingredients as the gold standard. Ingredients such as taurine, DHA, and beta-carotene are all found in breast milk. Although they can be added in appropriate amounts according to the ingredients in breast milk, you must never add nutrients at will.

Types of formula milk

Since there are certain standards and specifications, why are there still rumors about which brands will make children smarter and which brands will not cause allergies? Dai Jishan said that in fact, these are all manufacturers' promotion of the special ingredients of their own products. It mainly depends on the needs and acceptance of children.

From a medical point of view, milk powder can actually be roughly divided into general milk powder, hydrolyzed milk powder and special-purpose milk powder (such as lactose-free milk powder, special formula for premature babies, highly hydrolyzed protein formula, etc.). She suggested that if there is no family history of allergies or the baby has no special considerations such as atopic dermatitis, special liver and gallbladder intestinal diseases, or stubborn constipation, you can actually start with general milk powder.

General milk powder:

[Applicable to] Babies born at full term whose parents have no history of allergies.

[Applicable age] 0-12 months

Hydrolyzed milk powder:

[Applicable to] Those who want to prevent milk protein allergy, those whose parents have allergies or babies who already have atopic dermatitis.

[Reasons for application] Hydrolyzed protein uses heat processing or enzyme hydrolysis technology to change the arrangement and three-dimensional structure of proteins, breaking down large molecular proteins in milk into small molecular proteins. This can greatly reduce the allergenicity of milk protein, making the protein more suitable for the baby's immune system and easier to digest and absorb. But generally speaking, the taste is not as rich as ordinary milk powder and the price is slightly higher.

[Applicable age] 0-12 months

Discuss this with your pediatrician before purchasing.

Special purpose milk powder:

Including lactose-free milk powder, special formula for premature babies, highly hydrolyzed protein formula, etc.

【Applicable objects】

✔Lactose-free milk powder: for severe gastroenteritis.

✔Special formula for premature babies/low birth weight: for babies who are premature or very low birth weight.

✔Highly hydrolyzed protein formula: For children who still have allergic symptoms after using partially hydrolyzed milk powder or suffer from special liver, gallbladder and intestinal diseases.

【Reasons for application】

There is lactase on the baby's intestinal villi that can digest lactose. Once severe gastroenteritis occurs, the intestinal villi are damaged, resulting in a lack of lactase. Short-term lactose intolerance will occur, causing diarrhea, indigestion, bloating, etc. At this time, you can switch to lactose-free milk powder to alleviate diarrhea.

✔Special formula for premature babies: higher in calories and adjusted to the nutritional needs of premature babies after discharge from hospital.

✔Highly hydrolyzed protein formula: The protein is processed into extremely small molecules, and the other ingredients are also small molecules that are best absorbed, which will not cause liver, gallbladder and intestinal burden. However, the taste is poor and the cost is high.

You can ask a pediatrician to make a judgment before purchasing.

【Applicable age】

✔Lactose-free milk powder: Lactose is the source of sugar for babies, so if there is no lactose intolerance and severe gastroenteritis, the longest period of use should not exceed 2 weeks.

✔Special formula for premature babies: can be changed when the baby's weight reaches the normal standard.

✔Highly hydrolyzed protein formula: 0 to 12 months

Understanding the key nutrients in formula milk

Lin Minhua, director of the nutrition team at Yunlin Christian Hospital, explained that qualified formula milk must contain the five basic nutrients: carbohydrates (sugars), protein, fat, vitamins and mineral elements (such as iron, calcium, phosphorus, etc.), while commonly heard nucleotides, taurine, probiotics, prebiotics, etc. are additives.

You can find out the nutrients added to milk powder from the label on the packaging.

In terms of nutrients, most babies are deficient in vitamin D and iron. Babies who lack vitamin D have an increased risk of osteomalacia; iron deficiency will increase lead concentrations, which in turn increases the risk of long-term learning delays. As for additives, reports have shown that nucleotides can increase the ability to fight Staphylococcus aureus and Candida albicans, and increase the response to vaccine antigens; another commonly heard DHA is a long-chain polyunsaturated fatty acid that can be derived from essential fatty acids. Babies who are breastfed for a long time do not need to supplement fat or essential fatty acids. Its role is necessary for the development of the baby's retina and can also promote the development of the central nervous system.

It is definitely not the case that the more nutrients or additives the better. Each age group has a certain requirement, and too much will only increase the burden on the baby's kidneys.

Is it necessary to change milk at 1 year old?

Wu Jianyi explained that the biggest reason why babies need to change milk after one year old is that the protein content and nutrients required before and after one year old are different. In addition, they have been exposed to complementary foods, so there are more additives in the milk powder ingredients, such as prebiotics (which promote the production of intestinal probiotics) and probiotics (good bacteria that are beneficial to intestinal health). Therefore, you can make a choice based on the baby's condition. For example, children with weak gastrointestinal function can choose milk powder with added probiotics, and children who absorb poorly or who are less likely to grow meat can choose hydrolyzed or high-calorie types of milk powder.

Side dishes should be the staple food:

After the baby is 1 year old, most of the nutrition should be mainly supplementary food (referring to solid food), and the number of times of drinking milk can also be gradually changed from 5 to 6 times a day to 2 or 3 times a day. Dai Jishan said that the daily milk intake of babies over 1 year old is recommended to be 500 to 1,000 ml, and supplementary food should be the main food to avoid drinking too much milk and affecting the appetite of solid food. She pointed out that if you observe carefully, babies who mainly drink milk and supplementary food may have a slow growth rate. The American Academy of Pediatrics even proposed that children over 1 year old can start drinking fresh milk and do not necessarily need nutritional supplements from formula milk.

Babies aged 1 should mainly eat complementary foods (solid foods).