If your baby is experiencing difficulties adapting to a different infant formula, here's a guide on making the switch.
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Examine the primary ingredient
Infant formula typically consists of four main base ingredients:
Cow’s milk: Widely used for most babies, this formula closely resembles breast milk. Examples include Enfamil NeuroPro and Similac Pro Advance.
Soy: Suitable for infants unable to tolerate lactose, soy formulas use soy instead of milk proteins. Some families opt for soy due to dietary preferences. Major brands offering soy formula include Earth’s Best Non-GMO Plant Based Soy and Gerber Good Start Gentle Soy.
Hydrolysed proteins: Recommended when a baby has difficulty digesting dairy or has a general food allergy. This formula is made from cow’s milk, but the casein and whey proteins are broken down into smaller pieces, making it hypoallergenic. Examples include Enfamil Gentlease and Gerber Good Start Gentle.
Amino Acids: Nonallergic formulas for extreme cases where a baby cannot tolerate cow’s milk or hydrolyzed proteins. Neocate Infant is a common brand.
For most infants, cow’s milk formulas are suitable. Some families may choose soy formula for dietary reasons or based on their beliefs. Babies on formulas with hydrolysed proteins or amino acids typically have been prescribed due to a cow’s milk allergy.
The American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP) recommend hypoallergenic formulas made with hydrolyzed proteins for many children with a milk allergy. In rare cases, a nonallergenic formula made with amino acids, such as those by Neocate and Nestle’s Alfamino Infant, may be necessary.
Jessica Gust, a nutritionist and pediatric dietitian at Element Nutrition Kids, advises against buying hypoallergenic formula if not needed, as it can lead to shortages for babies who require it.
If your usual baby formula is unavailable, consider another brand with the same base ingredient. Opting for a store brand or 'off-label' in the same category can often be successful. Many parents have found alternatives at stores like Costco, CVS, Walgreens, Amazon, Walmart, or Target, using their store brands.
If your child is on a soy or hydrolysed formula due to a food-related allergy, consult their doctor before switching formula categories. While some children may easily transition from milk to soy, finding an alternative with the same base ingredient is crucial. If you can't find the specific formula addressing issues like spitting up or gassiness, rest assured, as these concerns often diminish as babies grow older.
Switching to breast milk
If your baby's regular formula is unavailable and you can breastfeed, follow the same steps for introducing new formula as you would for breast milk. If you're new to breastfeeding, you can find a consultant near you through the International Lactation Consultant Association. If breastfeeding is not an option, but you're considering sourcing breast milk elsewhere, ensure it comes from a legitimate breast milk bank to guarantee proper storage and vetting.
"Obtain it from a reliable source," advises Dr. Regan. "Look for a certified human milk bank to ensure it's human milk that has been properly vetted." The Human Milk Banking Association of America offers a search feature to locate a bank in your area.
Switching baby formula
Introduce the new formula gradually if possible. Dr. Regan recommends mixing the new formula with your current brand over about a week. Start with a bottle that's one-quarter new formula and three-quarters existing formula, then move to a half-and-half mixture, and so on until you can entirely switch to the new formula.
"Some babies are picky about the taste, so if you can gradually switch, it will help," notes Dr. Regan.
If your usual brand is not available during the transition, you can also introduce the new formula all at once. It's possible your child may feel uncomfortable during the change. Dr. Kadaj mentions that gastrointestinal and dermatologic side effects are common when switching formulas, leading to symptoms like spitting up, gas, bloating, diarrhea, constipation, vomiting, and skin rash.
However, if these symptoms occur, there's no need to panic. Gust emphasizes that they usually resolve quickly, and not every baby experiences significant discomfort. "I have had some clients who I've had to switch three plus times with minimum discomfort and others who have had more significant symptoms," Gust says. "Most standard tummy troubles from switching formulas resolve fairly quickly."
If symptoms persist or become severe, it's crucial to contact your doctor. "If babies have severe symptoms, excessive crying, blood in the stool, etc., those are red flags and should be reviewed by their doctor right away," Gust advises.
The change can be temporary, and once your preferred baby formula brand is back in stock, it's okay to switch back, according to Dr. Regan.