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There's more to formula feeding than picking your favorite brand. From how it can affect your baby's poop to how much your baby will eat, we reveal a few surprises you may encounter when feeding your child.
1. Formula-fed babies have different poop
The contents of your baby's diaper are directly affected by what you feed her. And not only are "formula poops" different, but they can also be a bit shocking – particularly for parents who switch over from breastfeeding.
"Our baby went to formula at 5 weeks, and there was a drastic change in her poop," says one mom. "The smell, texture, consistency, amount, color, and frequency all changed!"
Why the difference? As pediatrician Margaret Morris explains, it's simply a matter of the body adapting to what it eats. "The flora of the gastrointestinal tract changes depending on what kind of food is running through it – and formula is a different food from breast milk," she says.
Many parents report that formula poop smells somewhat stronger, is darker in color, and is thicker than breast milk poop. If you want the nitty-gritty details, check out our poop slideshow (because when it comes to poop, a picture really is worth a thousand words).
2. Babies don't digest breast milk and formula at the same rate
Can formula-fed babies really go longer between feedings than breastfed babies? In a word, yes.
Here's why: Breast milk and most formulas contain the proteins whey and casein. Breast milk contains more whey, which is easier to digest (and therefore babies digest it faster) than casein. Formula contains more casein, which babies digest more slowly.
Before you get your hopes up for a good night's sleep, however, remember that every baby is different. Jatinder Bhatia, chief of neonatology at Georgia Health Sciences University and spokesperson for the American Academy of Pediatrics, explains that each baby has his own unique caloric needs, personality, and sleep patterns. As a result, some formula-fed babies feed – and wake – just as often as breastfed babies.
"My older son was exclusively formula-fed, and he woke up on the identical schedule that my exclusively breastfed baby did," says one our site mom.
Still, there's no doubt that formula takes longer to digest than breast milk. So if you seem to be feeding your baby a little less often than your breastfeeding friend feeds hers, don't worry.
3. Your baby can be allergic to formula
Most babies easily digest formula with sunny smiles and a few contented burps. But some have an allergic reaction to the cow's milk protein in the formula, making for a less sunny experience.
(Note: A milk protein intolerance is different than lactose intolerance, which is extremely rare in infants. Most people with lactose intolerance don't develop it until later in childhood or early adolescence.)
Your baby's bowel movements can serve as a major clue to how digestion is going, so if you're wondering whether your baby has a formula allergy, check things out down below. "Blood or mucus in the stool usually means the bowels are inflamed, which is a sign of a possible allergy," says Morris.
Other signs of a possible formula allergy include:
- Fussiness around feedings
- Skin rash
Constant discomfort can also be a symptom. Of course, as any parent of a colicky baby will tell you, continuous crying doesn't always mean a formula allergy. Still, as Morris puts it, "If a baby is persistently unhappy, there's probably a reason, and an allergy may very well be it. So it's important to check it out."
If your baby is allergic to milk-based formula, your doctor may recommend switching to a specialized formula such as an extensively hydrolyzed formula, in which the protein has been broken down into a more digestible form and processed to help prevent allergic reactions.
4. Different babies eat different amounts
While trading stories of sleep deprivation and spit-up explosions with your mommy group, you notice your friend's baby slowly sipping on 3 ounces of formula. Before he's halfway done, your baby has wolfed down 7 ounces! Have you birthed a glutton?
Nope. It's nothing more than a classic case of individual difference, says Morris. "Formula portions are not one size fits all," she explains. "Some babies need more calories than others, and what is sufficient for one child's growth may not be sufficient for another's."
In addition, your child's formula intake will vary from meal to meal – just as you may want a light salad for lunch but crave a more substantial dinner. "Don't be shocked if your baby takes 4 ounces at one feeding and 6 ounces at the next," says Morris. Let your baby's cues guide you.
Despite the variability, however, it's still important to follow some basic guidelines. Generally speaking, babies who are not yet on solids should get about 2.5 ounces of formula per pound of body weight in every 24-hour period. So if your baby weighs 6 pounds, you'll give her about 15 ounces of formula. If she weighs 10 pounds, she should drink about 25 ounces a day.
And don't forget to schedule regular visits with your baby's doctor to track her growth and ensure that everything is in order.
5. Most formula is basically the same
It's easy to feel overwhelmed by the sheer variety of formulas on the grocery store shelf. How do you choose the best one? Many parents are relieved to hear that when it comes to the most important nutrients, all formulas are created equal.
This is because formula is regulated by the Food and Drug Administration (FDA), which requires manufacturers to include 29 specific nutrients in each serving. While different brands have different names, packaging, and prices, none of them will short-change you on the required ingredients.
One ingredient that's not in all formulas is the fatty acid DHA, which some studies have shown can improve cognition and visual processing. It's included in many formulas these days, but not all, so you may want to look for a brand that includes it.
There are, however, many specialized formulas for specific situations:
- Formulas designed for premature and low-birth-weight babies contain more calories per ounce than the standard types.
- Formulas for babies with reflux have rice or other thickeners added to it.
- Formulas for infants with cow's milk allergy are extensively hydrolyzed to help prevent allergic reactions.
Parents who prefer to go the organic route can find formulas made with organic ingredients. Organic formulas are subject to the same FDA regulations as other formulas. In addition, they must be certified as organic by the U.S. Department of Agriculture.
Still feeling undecided? Your child's doctor can help you choose the formula that best fits your baby's needs. You can also compare notes with other parents in our formula-feeding community group.