How to choose the best baby food line:It's all in the extras...
Click for thatMy baby is just waking up from his nap... are you coming into work?”Summary here.
With or without DHA? Are prebiotics or probiotics better? What the heck is a nucleotide and why is it in my baby's formula? How can parents answer these questions if they don't understand these things? Well, I'm here to explain and decipher the appropriate ingredients on a nutrition label.
Most of these non-traditional, "non-nutritive" ingredients in the formula do not appear on the nutritional chart (where calories, fat, etc. are found). Here's another reason for the mantra...
Be sure to read the list of ingredients on the formula label!
All of these "designer" ingredients are listed with the vitamins and minerals after "contains less than 2% of:". I find it quite funny that the ingredients that make up less than 2% of your baby's formula are the source of 98% of formula marketing campaigns!
And I'll be honest with you: I've never recommended a family-specific formula for any of those psychic ingredients. You need to focus on finding the right mix of protein, carbs, and fat for your angel to digest happily. Then,E You can get something extra sexy in this mix, go for it! If you can't, forget it!
Below is a quick summary of the most common layout ingredients and the information you need to make a decision about giving them to your baby.
- DHA stands for docosahexaenoic acid - this is a fatty acid that is involved in many processes in the body and is required in large quantities for eye and brain development in babies. DHA is one of those "long-chain omega-3" fatty acids we hear all the time.
- ARA stands for arachidonic acid. This is also a fatty acid that is involved in generating many different signals in the body and plays a role in regulating inflammation. ARA is one of those "long-chain omega-6 fatty acids" you hear all the time.
Both DHA and ARA are not technically "essential" fatty acids (all necessary ingredients in the formula). This is because our bodies can make these fatty acids from shorter basic fatty acids. There are two arguments for adding them to infant formula: 1) the amount babies need may be greater than their ability to produce these long fatty acids, and 2) both fatty acids are found in breast milk, albeit in wildly different concentrations . (1).
A comprehensive review of many research studies on the subject found that adding these fatty acids to infant formula did not result in any significant improvement in vision, brain development, or overall growth in healthy, term babies (2). However, the addition of these fatty acids did not cause any adverse side effects either. Despite half-hearted research, adding these fatty acids to the formula has become popular. Since they are harmless and found in breast milk, I support starting with a formula that has DHA and ARA added; also because it's hard to find a formula that hasn't added them! Just know: it won't improve your baby's IQ.
|Ingredient label decoding:|
|Ingredients||What is it?||Look like this on the label:|
|DHA||Docosahexaenoic acid (DHA): a fatty acid that helps with brain and eye development||Mortierella Alpina Oil (in Enfamil® formulas) or M. Alpina Oil (in Similac® and Gerber® formulas)|
Schizotricium Oil (extracted with water)
Tuna Oil (in some European formulas)
|WE BUY||Arachidonic Acid (ARA) – a fatty acid that plays many roles in the baby's body||Crypthecodinium Cohni Oil (in Enfamil® formulas) or C. Cohni Oil (in Similac® and Gerber® formulas)|
This is its own article, so I'll keep it very short. ALL US formulas use the “single cell oils” listed above to provide DHA and ARA. A solvent called hexane is used in the extraction of DHA and ARA from these cells. Hexane itself is a foul substance and will poison you. Hexane is removed from extracted oils before those oils are added to the formula. However, the method itself remains controversial in many circles. It's not too hard to imagine why...
I did a whole happy hour and explained a lot more detail about the process and what I think you need to know to make your own decision. You can watch the video on the right if you want more details.
Since filming this video, many formulas have switched to a new source of DHA (Schizotricium Oil) without hexane extraction. However, they are still using a hexane extracted ARA source.
prebiotics and probiotics
Prebiotics and probiotics are all the rage these days, and baby food is no exception! Both are considered construction methodsthe baby's microbiome. This is a fancy word for all the healthy bugs that live in our gut. The healthy human gut is teeming with millions and millions of bacteria that help us digest our food and keep our immune system functioning properly.
- Probiotics are actually living bacteria! These are "good" bugs that are added to the formula in hopes that they will find their way into the baby's intestines. The most common type of probiotic for children that you have probably heard of is calledbifidobacteria.
- Prebiotics are indigestible fibers that promote the growth of good bacteria in the gut. In other words, prebiotics are food for probiotics.
Both live good bacteria and food for these bacteria (prebiotics) are found in breast milk. In fact, breast milk is high in prebiotics (called human milk oligosaccharides (HMOs)... say THAT five times faster!) and many researchers are studying this fiber so we can try to replicate its many benefits in milk. Formula. It really is all the rage in searches these days.
The oligosaccharides in breast milk really help the breastfed baby a lot. Not only do HMOs feed the right types of microbes in the gut, they protect the baby from infection AND help the baby's immune system develop so it can protect itself (3). The trick is that there are over 100 types of HMOs and every mother puts a different HMO cocktail in her breast milk, so it's hard to replicate. The good news is that we have been researching how to add these HMOs to infant formula for years and several companies are now adding 1-5 HMOs to their formulas! The most commonly used HMO is called 2'-Fucosylctose (2-FL for short) and is found in Similac 'Pro' formulas, Gerber 'Pro' formulas and some branded generic formulas (yes!). I did a Happy Hour on Similac Pro Formulas so you can get a lot more details by watching this video. This is a very active area of research, so I look forward to more updates in the future!
Adding other prebiotics not found in breast milk to healthy formulas helps make the bacteria in your gut more similar to those of breastfed babies... a very good thing (4)! The most common type of these other prebiotics are:
- Galactooligosaccharide (GOS)
- Fructooligosaccharide (FOS)
While these prebiotics definitely help our favorite bacteria grow, they don't provide the immune benefits that some of the HMO prebiotics do (5). As I just said, this is the fastest growing area of research and I expect that we will see new ingredients on the market in the near future.
There are also many live bacteria in breast milk. Crazy, right?! A super recent study just showed that about 30% of a breastfed newborn's microbiome comes from breast milk (6). That's crazy.
Research has shown that probiotics may be helpful in preventing and treating atopic dermatitis, or eczema, in healthy, term babies who are at risk (7), and probiotics may help improve the immune response in healthy, term babies (8 ) and even help with colic (9).
There are currently many different types of probiotics available in formulas (see below) and even more are available as dietary supplements. If you are considering adding a probiotic supplement, I suggest you click below and download my probiotics protocol (free) for instructions on how to choose a good brand and safely add it to your baby's diet.
All of this research is very promising, but we urgently need more studies, especially long-term studies that follow babies over several years. Overall, though, I'm pretty supportive of prebiotics and probiotics in infant formula. If I had to choose one, I would recommend prebiotics since there are so many more in breast milk. Plus, it's much easier to add a probiotic supplement (rather than a prebiotic) to your baby's diet if you feel he needs it. Finally, probiotic baby food only comes in powder form, giving you more flexibility when choosing a prebiotic formula.
|Ingredient label decoding:|
|Ingredients||What is it?||Look like this on the label:|
|Präbiotics||Food for the good bacteria that help them grow in the baby's intestines.||Galactooligosaccharide (GOS) Fructooligosaccharide (FOS) Polydextrose|
HMO: 2'-Fucosylactose, Lacto-N-tetraose, 3-Fucosylactose, 6'-Sialylactose, 3'-Sialylactose
|Probiotics||Good live bacteria that help the baby's intestines function||Lactobacillus Reuteri(L.Reuteri)(Gerber® Soothe)Bifidobacterium Lactis (B. lactis) (Gerber® Gentle)|
Nucleotides are actually the building blocks of your DNA and RNA: adenine, guanine, cytosine, uracil, and thymine, to which a sugar molecule is attached. In addition to building DNA, they serve many other functions in the body. Knowing how useful these molecules are, it is not surprising that they are also found in relatively high concentrations in human breast milk. Some research on very young babies suggested that feeding them nucleotides helped these babies develop an appropriate immune response. They are considered very safe for babies. However, we still don't understand why nucleotides might be useful in infant formula or what long-term effects they have on healthy babies born at term. Because the nucleotides are in breast milk infant formula, companies have been adding them to infant formula since the 1990s.
- Look for them in the ingredients list as: "Nucleotides (long list of formal chemical names)."
- Here is a word-for-word example: "...nucleotides (adenosine 5'-monophosphate, cytidine 5'-monophosphate, guanosine disodium 5'-monophosphate, uridine disodium 5'-monophosphate)..."
To be honest, I don't really care if this ingredient is a "must have" for healthy term babies.
Lactoferrin and milk fat globule membrane
OK - This article is getting longer as new formulas are released! The final 2 attractive breast milk ingredients to add to the formula are: lactoferrin and milk fat globule membrane (MFGM). These two ingredients first appeared (last year) in Enfamil's Enspire formula. and MFGM is the special ingredient in Enfamil's "NeuroPro" formulas
(VERY) in summary: these proteins are found in fairly high concentrations in breast milk. When we add them to formula, babies get less sick (especially fewer ear infections) and develop higher IQs (10, 11). If you want a good (but very geek dense) overview of these proteins in the formula, here's a good reference (12). For a friendlier breakdown of these ingredients, check out my happy hours on each topic.
Wassup, which one do you choose?!?!?
I know that's the question you're really asking. That's impossible to answer as it's literally like comparing apples to oranges. Also, the different benefits may be more pronounced for some babies. This video walks you through the things to consider about your unique baby to help you decide which of these special ingredients might be most beneficial for your little angel:
FINALLY! Purchase summary:
Here is a brief summary of branded formulas for healthy term babies that contain the "designer" ingredients listed above.
|Formula||DHA and ARA||Präbiotics||Probiotics||nucleotide||other Extras|
|To calm oneself down||Sim||2FL||L.Reuters||Sim||–|
|Newborn||Sim||GOS and polydextrose||–||Sim||–|
|NeuroPro Newborn||Sim||GOS and polydextrose||–||Sim||MFGM|
|Young||Sim||Polydextrose and GOS||–||Sim||–|
|InfantilNeuroPro||Sim||Polydextrose and GOS||–||Sim||MFGM|
|Standards||Sim||Polydextrose and GOS||–||NO||–|
|ARKANSAS.||Sim||GOS and polydextrose||–||NO||–|
|To inspire||Sim||GOS and polydextrose||–||Sim||lactoferrin and MFGM|
|Organic||Sim||FOS||–||Sim||lutein and lycopene|
|Advance payment||Sim||WE ARE||–||Sim||lutein and lycopene|
|Pro progress||Sim||2-FL and FOS||–||Sim||lutein and lycopene|
|sensitive||Sim||WE ARE||–||Sim||lutein and lycopene|
|pro-sensitive||Sim||2-FL and FOS||–||Sim||lutein and lycopene|
|pure happiness||Sim||WE ARE||–||Sim||Grass Fed and Lutein|
|absolute comfort||Sim||WE ARE||–||Sim||lutein and lycopene|
|Pro Absolute comfort||Sim||2-FL & GOS||–||Sim||lutein and lycopene|
|spit||Sim||WE ARE||–||Sim||lutein and lycopene|
|I am Isomil||Sim||FOS||–||NO||lutein and lycopene|
Messages to take away:
- DHA and ARA are not essential fatty acids but are found in breast milk. They're added to almost every formula these days, which is awesome!
- Probiotics are good, live bacteria that we hope will choose to make their way into your gut. Prebiotics are food for good bacteria. Both are found in breast milk.
- Prebiotics are found in very large amounts in breast milk (so-called HMOs). The non-human prebiotics in the formula help the good bacteria grow, but they probably don't regulate the immune system the way HMOs do. This is a really active area of research!
- You can choose a formula that contains prebiotics and/or probiotics. I like both, but I would choose prebiotics over probiotics if I had to choose between one.
- Nucleotides have been added to the formula for decades. These are safe and found in large amounts in breast milk. Not all formulas contain nucleotides.
- Lactoferrin and the milk fat globule membrane are proteins found in breast milk that contribute to some of the benefits of breastfeeding. These are new to the formula market, but there is plenty of research backing their benefits.
I'm sure that as a parent of a newborn, you have plenty of free time to read all of my in-depth articles. However, if you don't have all that much free time, click the button below for a nice summary of the key points in this series of flagship articles. I would like to help!
Get the summary now
1. Stam, J., Sauer, P.J., and Boehm, G. (2013) Can we determine a baby's needs based on the composition of breast milk?I am. J.Clin. Nourishment 98, 521S-528S
2.Simmer, K., Patole, S.K. & Rao, SC. (2011) Dietary supplementation of long-chain polyunsaturated fatty acids in term infants.The Cochrane database of systematic reviews, CD000376
3. Donovan, S., Comstock, S. Human milk oligosaccharides affect neonatal mucosa and systemic immunity.Ana Nutr. Metab.2016; 69 (Supplement 2): 42-51.
4.Thomas, D.W., Greer, F.R., Committee of the American Academy of Pediatrics, N., Section of Gastroenterology, H. and Nutrition, American Academy of Pediatrics. (2010) Probiotics and Prebiotics in Paediatrics.paediatrics 126, 1217-1231
5. Comstock S.S., Li M., Wang M., Monaco MH., Kuhlenschmidt T.B., Donovan S.D. Dietary oligosaccharides from human milk, but not prebiotic oligosaccharides, increase circulating populations of natural killer cells and mesenteric lymph node memory T cells in uninfected individuals
and newborn piglets infected with rotavirus.J Nutr.2017; May 10 doi:10.3945/jn.116.243774. [Epub before printing].
6. Pannaraj P, Li F, Cerini C, Bender J, Yang S, Rollie A, Adisetiyo H, Zabih S, Lincez P, Bittinger K ., Bailey A., Bushman F., Sleasman J., Aldrovandi G. Association between bacterial communities in breast milk and the establishment and development of the infant gut microbiome.JAMA Pediatrics.2017;doi:10.1001/jamapediatrics.2017.0378. [Epub before printing].
7. Foolad, N., Brezinski, E.A., Chase, E.P., & Armstrong, AW. (2013) Effect of nutritional supplementation on atopic dermatitis in children: a systematic review of probiotics, prebiotics, formulas and fatty acids.JAMA Dermatology 149, 350-355
8. Holscher H.D., Czerkies L.A., Cekola P., Litov R., Benbow M., Santema S., Alexander D.D., Perez V., Sun S., Saavedra JM, and Tappenden, K.A. (2012) Bifidobacterium lactis Bb12 enhances intestinal antibody response in formula-fed infants: a randomized, double-blind, controlled study.JPEN J.Parenter. enteral nutrition. 36, 106S-117S.
9. Savino F, Cordisco L, Tarasco V, Palumeri E, Calabrese R, Oggero R, Roos S, and Matteuzzi D. Lactobacillus reuteri DSM 17938 in infant colic: a randomized, double-blind, placebo-controlled trial.paediatrics. 2010; 126, e526-533
10. Timby, N., Domello¨f, E., Hernell, O., Lönnerdal, B., Domello¨f, M. Neurodevelopment, nutrition, and growth up to 12 months of age in animals fed low-level infant energy foods were fed low protein supplementation with bovine milk fat globule membranes: A randomized controlled trial.I am. J.Clin. Nourishment2014; 99: 860-868.
11. Timby N, Hernell O, Vaarala O, Melin M, Lonnerdal B, Domellof M. Infections in formula-fed infants supplemented with milk fat globule membranes.JPEG2015;60: 384–389.
12. Lönnerdal, B. Infant formula and infant formula: bioactive proteins in human milk and implications for infant formula composition.I am. J.Clin. Nourishment2014; 99(3):712S-7S.