More than 75% of babies will get infant formula in the first year. Choosing a formula can feel overwhelming, with countless brands, ingredients, and claims competing for your attention. Find out how formulas differ in carbohydrates, proteins, and fats, and what role additives like DHA, probiotics, and nucleotides play. Learn how to identify allergies and sensitivities, and determine if your baby requires a specialized formula. Plus, shopping tips on how to read labels without getting lost in marketing buzzwords, strategies to save money, and what to do during shortages. By the end of this episode, you will have a clear framework for selecting a formula that best supports your baby’s health, your values, and your family’s budget.

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I support the decisions you make for you and your baby when it comes to feeding. My goal is to provide accurate, evidence-based information and support to help you succeed. You can find all the breastfeeding and bottle-feeding resources, episodes, and articles here.

Combining Infant Formula and Breastfeeding

Breast milk provides unique nutrition and immune protection that formula cannot fully replicate. For some parents, introducing formula is a choice, and for others, it is a necessity. Using formula does not mean you need to stop breastfeeding altogether. Any amount of breast milk your baby receives is valuable, even if it is not at every feeding. Keep in mind that your milk supply depends on demand and milk removal through breastfeeding or pumping. If you replace a feeding with formula and do not pump, your supply will gradually decrease.

History of Infant Formula

The world’s first commercial infant formula was developed in 1867. Before this time, if mothers could not breastfeed their babies, they employed a wet nurse. This was someone who was producing breastmilk and breastfed another mother’s baby. While this may seem socially unacceptable now, before the invention of breast pumps, there were limited options. In the 1920s and 1930s, evaporated milk formula was available. In the 1950s, companies introduced commercial formulas, and by the early 1970s, over 75% of parents fed their babies formula. Today, the vast majority of parents use infant formula. We do not have data on the exact number of babies that get formula. We have data to show that 3 out of 4 babies drink formula by six months, and this number continues to increase.

Infant Formula as a Global Industry

The global infant formula market was valued at $81.72 billion in 2024 and is projected to more than double by 2032. Formula manufacturers have enormous budgets for lobbying and marketing. While formula is a safe and regulated option, marketing sometimes makes it difficult for parents to distinguish between evidence-based health recommendations and business incentives. Understanding this context can help you make informed feeding decisions that are right for your baby, without being swayed by advertising.

Marketing and Regulation

One factor that influences our perception of formulas is the way companies market them. In 1981, the World Health Assembly adopted the International Code of Marketing of Breast-milk Substitutes. This code establishes guidelines for how manufacturers promote formulas to support and promote breastfeeding. For example, it discourages direct advertising of formula to parents, including the distribution of free samples in hospitals, and using language that suggests formula is superior to breast milk. Many countries have adopted the code into law, but the United States has not. This means formula marketing here is largely unregulated, and companies can advertise directly to families. Aggressive marketing campaigns have played a significant role in the historical spread of formula use, often framing it as more modern or even superior to breastfeeding.

Formula Types

When it comes to choosing an infant formula, there are several options. Most formulas come in powdered form that you mix with water. There are also ready-to-feed formulas that you can pour directly into a bottle, as well as liquid concentrate formulas that require dilution before use. Each type has pros and cons. Powder is the most affordable and widely available, while ready-to-feed is the most convenient but also the most expensive. Concentrate falls somewhere in between. Regardless of the type you use, it is crucial to follow the instructions on the package carefully and never add extra water, as this can dilute nutrients and be unsafe for your baby.

Homemade Formulas

Making your own formula at home is not recommended. Manufacturers carefully develop infant formula with precise quantities of dozens of nutrients to meet your baby’s needs. It would be nearly impossible to include all the right ingredients in the right amounts in a homemade version. Do not add extra ingredients to a commercial formula unless your pediatrician specifically recommends it. This includes additives like vitamins, cereal, fatty acids, oils, or animal milk. The safest option is to use formula exactly as it is manufactured and follow the instructions on the package.

Formula Ingredients and Nutrition

Since the inception of infant formula, manufacturers have heavily invested capital and resources to mimic breast milk as closely as possible. All the ingredients that go into formula are, in one way or another, mimicking what is actually in breastmilk, but they are not identical. The formula today is the best we have ever had available, and it continues to improve over time.

Although different types and brands of formula vary in their ingredients, all formulas share a foundation of nutrients designed to support your baby’s growth. Every formula must contain the same basic building blocks: carbohydrates, protein, fat, vitamins, and minerals. These are the core nutrients that all babies need, and they make up the majority of what’s in every formula on the market.

Where brands differ is in the details. They vary in the specific sources of carbohydrates or protein they use, as well as the optional ingredients or additives they choose to include. These differences are often what set one formula apart from another and what you see highlighted on the packaging.

Carbohydrate

The main carbohydrate in breast milk is lactose, and this is also the primary carbohydrate in most cow-milk-based formulas. Some formulas include a secondary carbohydrate source, such as corn maltodextrin. Lactose-free, soy-based, and certain specialty formulas use alternative carbohydrates. These can consist of sucrose, corn maltodextrin, modified cornstarch, or corn syrup solids. In organic formulas, you will often see brown rice syrup used instead. Breast milk is naturally sweet, and manufacturers choose these carbohydrate sources to mimic that sweetness while providing the energy babies need.

Protein

In breast milk, about 60 percent of the protein is whey and 40 percent is casein. Most formulas aim to achieve a similar balance or are made with 100% whey, although the ratio can vary from brand to brand.

Cow’s milk-based formulas use whey and casein as their protein sources. Most babies do well on cow’s milk formula, but some babies are allergic to these proteins and need alternatives.

Soy-based formulas are an option for families who wish to exclude animal proteins or for babies who cannot tolerate cow’s milk protein or lactose. These products utilize soy protein isolate, and some brands use partially hydrolyzed soy protein to make digestion easier.

Hydrolyzed formulas contain proteins that are broken down either partially or extensively. Extensively hydrolyzed formulas are hypoallergenic, since the proteins are broken down into amino acids, and are for babies with protein allergies who cannot tolerate cow’s milk or soy.

Goat’s milk-based formulas are gaining popularity, though they are not as widely available from large U.S. manufacturers. Proteins in goat’s milk are digested more easily, and the casein is more similar to human milk than cow’s milk. Goat’s milk also contains slightly less lactose than cow’s milk. While many parents find it works well for their babies, scientific studies have not shown a lower rate of allergy compared to cow’s milk.

Fat

Breast milk contains a mix of monounsaturated, polyunsaturated, and saturated fats. It is naturally high in fat to provide the energy babies need for rapid growth and brain development. Infant formulas use various plant oils to mimic the fat composition of breast milk. Common sources include soy oil, coconut oil, palm oil or palm olein oil, and high-oleic sunflower oil. These blends are designed to approximate the balance of fats found in human milk. Palm and palm olein oils are widely used; however, some research suggests that they may reduce fat and calcium absorption in infants. This is one reason why some parents seek formulas without palm oil, although many babies tolerate it just fine.

Vitamins and Nutrients

Formula labels can be intimidating, especially when you see long chemical names. Unless you are familiar with the technical terms, it may not be easy to recognize them as common vitamins and minerals. For example, ferrous sulfate is simply iron, and sodium ascorbate is vitamin C. The critical thing to remember is that all infant formulas are required to contain the essential vitamins and minerals your baby needs in specific amounts. These requirements are carefully regulated to ensure proper growth and development. If you are ever concerned that your baby may not be getting enough of a particular nutrient, talk with your pediatrician. They can help determine whether you should adjust your baby’s formula or feeding routine or test for a deficiency.

Iron

Iron is one of the most essential nutrients because it plays a key role in the blood’s ability to carry oxygen to body cells and is critical for brain development in the first year of life. Babies build up their iron stores during the third trimester of pregnancy, which means premature babies often need extra help getting enough. The American Academy of Pediatrics recommends that all healthy babies who are not exclusively breastfed receive iron-fortified formula until their first birthday.

The iron content of breast milk is much lower compared to formulas; however, the absorption rate is much higher. Breastfed infants absorb up to 50% of consumed iron, compared with 7-12% for formula-fed babies. Whether you are using formula exclusively, combining formula with breastfeeding, or breastfeeding alone, your baby is almost always getting the iron they need.

Additives and Extras

In addition to basic nutrients, formula companies often add other ingredients. Manufacturers add these extras to make the formula more similar to breast milk or to address specific issues. Let’s go over some of the common additives you’ll see on labels.

DHA & ARA

Many infant formulas include two long-chain polyunsaturated fatty acids: DHA and ARA. These are omega-3 fatty acids naturally present in breast milk and in foods like fish and eggs. They play an essential role in brain and eye development.

Nucleotides

Nucleotides are naturally present in breast milk and serve as the building blocks of DNA and RNA. They play several roles in the body and may help support the development of the immune system. Different formula brands add varying amounts of nucleotides. While early research suggests they may have benefits, further studies are needed to fully understand their role in infant development and the optimal levels of formula. The science of infant formula is constantly evolving, and nucleotides are one example of how manufacturers try to make formula more similar to breast milk.

Prebiotics and Probiotics

Prebiotics are indigestible carbohydrates that act as food for probiotics, which are the beneficial bacteria that live in the gut. Together, they can help support a healthy digestive system and immune function. Research on the addition of prebiotics and probiotics to infant formula is still in development, and formulas vary in whether they include these ingredients and in the amounts used.

Dietary Fiber

Some manufacturers include dietary fiber to provide digestive benefits. Research suggests they may help promote softer stools, reduce constipation, and support healthy gut bacteria. Some studies also indicate that they may help prevent diarrhea, although the evidence remains limited.

Amino Acids

Amino acids are the building blocks of protein, and they are naturally present in breast milk. In formulas, manufacturers may add specific amino acids to better match the composition of breast milk or to make proteins more easily digestible.

Reading a Formula Label

Formula labels can be confusing, with long lists of ingredients and bold marketing claims on the front of the package. The most important thing to know is that every formula sold in the United States must meet strict FDA requirements for essential nutrients. That means the basics are covered, no matter which brand you choose.

Where formulas differ is in the details. First, pay attention to the protein and carbohydrate sources. Additives like DHA, ARA, nucleotides, or probiotics may or may not matter to you. The key is to focus on the big picture. All formulas contain the required nutrients, with the main differences being in the protein and carbohydrate sources, as well as optional extras.

Brand Name vs. Generic Formula

One decision you may face is whether to buy a brand-name formula, a store-brand, or a generic version. All infant formulas must meet the same FDA standards, which means the basic nutrients your baby needs are guaranteed, regardless of which option you choose. The most significant difference is usually the price. Generic or store-brand formulas can be significantly less expensive, which makes a big difference over the first year.

There are several reasons why some parents prefer brand-name formulas. Brand names often include additional ingredients, such as specific probiotic blends or branded versions of DHA and ARA, that generics may not contain. Specialty formulas, like extensively hydrolyzed, hypoallergenic, or anti-reflux options, are also more widely available in brand-name lines. Some parents also feel more confident with a long-established brand they know and trust, or a brand recommended by their pediatrician. Both options are safe and nutritionally complete. For many families, it comes down to cost and personal preference.

Organic Formula

Organic infant formulas have grown in popularity alongside the broader organic food movement. For a formula to have an organic label in the United States, at least 95% of its ingredients must come from certified organic sources. This means producers cannot grow crops with conventional pesticides, synthetic fertilizers, or genetic modification (non-GMO). For animal-based ingredients, such as milk, farmers cannot use antibiotics or growth hormones.

Nutritionally, organic formulas must still meet the exact FDA requirements as conventional formulas. The main differences are how the manufacturers produce ingredients and whether avoiding pesticides, hormones, or GMOs is a priority for your family. Additionally, organic formulas are typically more expensive, which may be a factor to consider.

Many formulas contain ingredients derived from corn or soy, such as corn syrup solids, maltodextrin, or soy protein isolate. In the United States, over 90% of corn and soy crops are genetically modified (GMO). If you would like to avoid GMOs, you can choose to buy organic or look for a formula labeled non-GMO.

Shopping for Formula

You may need to try a few different types or brands before finding one your baby tolerates well. As tempting as it may be, do not stock up before your baby is born or before you identify a favorite brand. Once you know what works, buying larger quantities can save you money and reduce stress. Whether you are trying to find the right formula for your baby or looking for ways to make it more affordable, here are some practical tips for shopping.

Saving Money

Formula can be expensive, but remember this is a temporary expense. You can phase it out after your baby’s first birthday. Buying in bulk at warehouse stores like Costco or taking advantage of sales can significantly reduce costs. Major retailers, such as Walmart, Target, and Costco, often offer lower prices than smaller grocery stores. Many formula brands also offer coupons, rewards programs, or discounts if you sign up on their websites or join their email lists. Some pediatricians’ offices may also provide samples or coupons.

Safety When Buying Formula

Always purchase formula from trusted retailers. Imported or overseas formulas may not meet FDA requirements, and you may find counterfeit or expired products on unverified online marketplaces. For your baby’s safety, stick with established stores and reputable online retailers where you can be confident the product is authentic and properly stored.

Shortages and Supply Concerns

The 2022 U.S. formula shortage highlighted how stressful it can be when your brand of formula is difficult to find. Supply disruptions can happen with any brand, but smaller brands may be more vulnerable because they typically have fewer manufacturing facilities and less shelf space in major stores. This means that even a minor recall or shipping issue can temporarily make them harder to find.

If your baby’s usual formula is out of stock, it is important not to dilute formula, stretch bottles, or attempt homemade recipes, since these can put your baby at serious risk of malnutrition. Instead, check with trusted retailers, try a comparable formula type or brand, and talk to your pediatrician about safe alternatives.

Help with Formula Costs

There are resources available if you need assistance providing your baby with formula. In the United States, the Special Supplemental Nutrition Program for Women, Infants, and Children provides formula support for eligible families. Local community organizations may also offer resources or discounts. If costs are a concern, consult with your pediatrician or local health department to explore the available options in your area. Some health insurance plans will cover specialty or medically necessary formulas with a doctor’s prescription. If you’re outside the U.S., check your local health system or community programs, as many countries offer support for formula costs.

Finding the Right Formula

Every baby is different, and finding the right formula can take some trial and error. If your baby rejects a specific formula, it doesn’t always mean there’s something wrong. Sometimes it takes a little time for your baby to adjust to the taste and texture. In most cases, you should give a new formula at least a few days to a week before deciding to switch. If your baby seems uncomfortable, gassy, or fussy after feedings, you can try a different brand or type. Remember that not every symptom is caused by formula. Babies spit up, cry, and have irregular bowel movements for many reasons.

Allergies and Sensitivities

Sometimes, difficulty finding the right formula isn’t just about preference or digestion, and it may be due to an actual allergy or sensitivity. Digestive problems include diarrhea, vomiting, frequent spitting up, or the presence of mucus or blood in the stool. Skin reactions may appear like rash, eczema, or hives. Respiratory symptoms can include a stuffy or runny nose or a persistent cough. If you notice any of these changes after starting or switching formulas, please bring them to your pediatrician’s attention. They may recommend trying a different formula type or brand. Keep in mind that even after changing, it can take several days for allergy or sensitivity symptoms to resolve.

Specialized Formulas

Some babies require specialized formula due to an allergy or other medical or dietary need. These formulas can make a significant difference for babies with special health concerns, but they should not be tried casually. Always check with your pediatrician before switching to a specialty formula.

Lactose-free and reduced-lactose formulas are available for babies who cannot tolerate lactose, the natural sugar in milk. True lactose intolerance in infants is rare, but some babies may benefit from reduced-lactose formulas if they have temporary digestive issues.

Manufacturers thicken anti-reflux (AR) formulas with rice starch or other ingredients to help babies with frequent spit-up or reflux. While these can reduce regurgitation, they are not for every baby. If you consider an AR formula, consult your pediatrician first to ensure that reflux is not associated with another underlying issue.

Preemie formulas are for premature babies who require additional calories, protein, vitamins, and minerals to support growth and catch-up development. These often contain medium-chain triglycerides (MCTs), which babies more easily digest and absorb.

Doctors prescribe metabolic disorder formulas for rare conditions like PKU (phenylketonuria), where a baby cannot process specific proteins. You should only use these highly specialized formulas used under medical supervision.

How to Choose the Right Formula

With so many options available, selecting a formula can be overwhelming. The good news is that all formulas sold in the United States are safe, regulated, and designed to support your baby’s growth. Let’s go through a simple framework to guide your choice.

1. Start with a standard cow’s milk-based formula unless your pediatrician advises otherwise or your family is vegan. Most babies do well with this type of formula. Examine the protein and carbohydrate sources listed on the label. These are the most significant differences from one brand to another.
2. Determine whether extras, such as DHA, probiotics, or organic certification, matter to you. These are optional, not essential. Some families prioritize them while others don’t.
3. Factor in cost and availability. Formula is a daily expense, so choose something you can afford and reliably find in stores near you.
4. Watch how your baby responds. Fussiness, spit-up, or digestive issues don’t always mean the formula is the cause, but if you notice persistent problems, bring them to your pediatrician’s attention before switching.

The bottom line is that there isn’t one “best” formula for every baby. The best formula is the one your baby tolerates, that meets their nutritional needs, and that works for your family’s values and budget.

Transitioning Off Formula

Breastmilk or formula is your baby’s sole source of nutrition for the first six months. At that point, you will introduce solid foods and continue breastfeeding or bottle feeding. While the official recommendation on breastfeeding is up to two years and beyond, you can transition your baby off formula after their first birthday.

Talk to Your Pediatrician

Feeding your baby is a crucial part of caring for them, and the options and nuances can be overwhelming. If you have any questions about feeding your baby or using infant formula, please consult your pediatrician.

Formula Storage, Preparation, and Safety

I covered formula preparation and safety in depth in the complete guide to bottle feeding episode. If you have not listened to that yet, I highly recommend checking it out for step-by-step details on mixing formula, using safe water, and proper storage. The short version is always follow the instructions on the package and do not add or dilute anything unless your pediatrician recommends it.

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