April 2021 Issue
Infant Nutrition: New Infant Formula Innovations
By Diana K. Rice, RD, LD, CLEC
Vol. 23, No. 4, P. 16
Companies are meeting consumer demand for more healthful ingredients and ‘cleaner’ formulations.
While it’s widely recognized that breastmilk is the ideal food for infants, more than 80% of infants will receive some formula, either exclusively or in combination with breastmilk.1,2
Gone are the days of mixing evaporated milk and Karo syrup in home kitchens, a popular method of feeding babies in the 1950s. The American infant formula industry is regulated by the FDA, which sets standards for nutrient composition, allowable ingredients, and manufacturing processes for today’s commercially available formulas. Formulas must meet certain levels of each of the macro- and micronutrients deemed critical for infant nutrition. Standard formulas are made from nonfat cow’s milk with additional sources of fat and carbohydrates to closely mimic the nutrient composition of breastmilk.
Historically, consumers often frowned upon infant formulas, believing they were made with low-quality ingredients. But as consumer demand for food products made with higher-quality ingredients has soared over the past several years, manufacturers began producing a wider variety of infant formulas in various categories to meet the moment of greater health consciousness. Similac was the first mainstream company to introduce organic and GMO-free infant formulas in 2006 and 2015, respectively.3,4 Now, nearly every major infant formula maker offers these options. Other recent innovations include formulas made with A2 beta-casein and those that meet both the FDA’s and European Commission’s safety standards. And as consumers continued to meticulously read ingredient labels, boutique brands, such as Happy Baby and Bobbie, and the larger companies, Similac and Enfamil, began advertising what isn’t in their formulas, particularly palm oil and corn syrup solids.
These innovations have made it easier for families that can’t or don’t want to breast-feed to choose infant formula. “In the present moment, I think we’re finally seeing a push toward ‘informed is best,’ with families wanting to know and understand what the data really say about breast-feeding benefits and formula-feeding risks,” says Mallory Whitmore, MEd, certified infant feeding technician at The Formula Mom, LLC, in Franklin, Tennessee. “There’s both a growing sense of self-assuredness and bodily autonomy,” she says. “This is empowering families to make feeding choices based not on what’s recommended across the board but instead based on what makes sense for them.”
Still, many families that choose formula have the same high standards for the product as they do for other foods they consume, if not higher because formula is their infant’s sole nutrition source. And formula manufacturers are eagerly meeting these standards, especially for the segment of the population willing to spend sometimes as much as three times the cost of store-brand formulas for these benefits. What follows is a discussion on some of the latest infant formula product innovations in a variety of categories.
Organic and Non-GMO
Increased consumer demand for organic and GMO-free food products has spurred the organic and GMO-free infant formula segment—and the market is booming. The global organic infant formula market is projected to reach $7.75 billion by 2023.5 Demand for organic is so high that even Walmart’s Parent’s Choice and Amazon’s Mama Bear formulas have jumped into the game, competing with Similac’s two organic options. Specialty brands, including Happy Baby, Earth’s Best, and brand-new player Bobbie also tout organic infant formula products.
Any formula with a USDA Organic certification also must be free of GMO ingredients. But many formulas that lack the USDA Organic designation still prominently advertise their GMO-free status, including Similac’s Pro-Advance and Pro-Sensitive options as well as some of the nonorganic house brands from Walmart, Target, Amazon, and Costco’s Kirkland line.
Despite these claims, the question is, “Are these formulas any more healthful for babies?” According to Crystal Karges, MS, RDN, IBCLC, maternal child health specialist at Crystal Karges Nutrition in San Diego, “Organic formula may be a more appropriate option for babies with compromised immune systems or underlying health conditions, as it can help decrease [health risks] that may be associated with pesticide exposure. But this doesn’t make organic formula nutritionally superior to standard infant formula.”
As for GMOs, the USDA maintains that GMO foods are just as safe and healthful as their non-GMO counterparts. Consumer opinions vary concerning this, so having a variety of options on the market to meet consumer preferences is beneficial.
European Style Formula
Over the past several years, a strong trend emerged involving the importation of infant formulas produced in Europe. European formula brands such as HiPP, Holle, and Lebenswert aren’t selling their products in the United States, but individual Americans and third-party vendors are going to great lengths to procure it for infants in the United States.
Why would they do this when plenty of safe, FDA-approved formulas are available in the United States? “Parents are drawn to European formulas because they perceive them to be higher-quality or ‘cleaner’ than formulas available in the US,” Whitmore says. “The European Commission has stricter guidelines than the FDA, including prohibitions on the use of corn syrup, corn syrup solids, and GMOs, and specific guidelines and limits for the use of sucrose. For some parents, the benefits of these stricter regulations, requirements, and allowances outweigh the risks of importing.”
However, importing and selling European formula in the United States is illegal. Another risk is that the foreign instruction labels can lead to parents improperly mixing the formula, which can present a danger to infants.
Bobbie Organic Infant Formula, a product that launched in the United States in January 2021, aims to meet the demand for European formula while also safely meeting FDA standards. “We couldn’t understand why, as modern working mothers who wanted the best for our babies, we were turning to a black market of European formula to feel okay about our feeding choices,” says Sarah Hardy, chief operating officer and cofounder of Bobbie.
Currently, Bobbie is the only FDA-approved formula that also meets the nutrition standards of the European Commission, but Similac’s Pure Bliss cites “European crafted nutrition” in its marketing messages, a reference to the product’s grass-fed milk and DHA content, which are more common in European products.
In the past 12 months, Similac, Gerber, and Enfamil each introduced infant formulas made with only A2 beta-casein. These three products are the first of their kind to hit the American market and are an extension of the larger trend of consumers seeking A2 milk products as a way to enjoy cow’s milk without gastrointestinal distress.
Research suggests that of the two types of beta-casein present in cow’s milk, A1 and A2, the A1 protein may be responsible for symptoms such as gas and constipation in children and adults. Notably, A2-based products (including but not limited to infant formulas) are more popular in Europe and Australia than they are in the United States, although the primary manufacturer of A2 milk in the United States, The a2 Milk Company, recently has enjoyed a 91% jump in US revenue from 2019 to 2020, demonstrating a growing US interest in these products.6
To date, infants suffering from gastrointestinal distress usually are given formulas free of lactose or those made with hydrolyzed proteins, so the addition of A2 formulas to the American market theoretically gives parents of infants with tummy troubles another option. Technically, however, no research has evaluated the effect of A2-based formulas on digestive distress in infants, although studies to do so currently are underway.
Free From Corn Syrup and Palm Oil
In keeping with the trend toward “clean” ingredients, consumers also are increasingly seeking infant formulas that don’t contain palm oil as a fat source or corn syrup solids as a carbohydrate source.
Many parents want to avoid palm oil because of concerns over deforestation related to palm oil’s production.7 They question whether palm oil is a healthful choice for infants and take issue with palm olein oil, the form used in infant formulas that may lead to constipation.8 Other research suggests it inhibits calcium absorption in infants’ intestines.9,10 For these reasons, Similac and Bobbie don’t use palm oil in any of their products, and instead use safflower, soy, or coconut oil.
With regard to corn syrup, it’s important to know that corn syrup solids aren’t the same as high-fructose corn syrup (HFCS), an ingredient that many consumers avoid. Corn syrup is derived from corn and composed of long chains of glucose linked together. “This provides necessary carbohydrate energy for the infant,” says Brian Liddell, DO, FAAP, a board-certified pediatrician with The Doctor and The Dietitian, a Boise, Idaho–based company that offers feeding advice to families. “HFCS is different,” he continues. “It has been processed such that some of the glucose has been converted to fructose.” But HFCS isn’t an ingredient used in any infant formula.
Still, consumers see the words “corn syrup” on an ingredient label and are more likely to put the product back on the shelf. Brown rice syrup also is falling out of favor among consumers due to concerns it may contain unsafe levels of arsenic. Maltodextrin has a reputation for being highly processed, which leaves lactose as the preferred “clean” carbohydrate source in infant formulas. One hundred percent lactose-based formulas are more common in Europe, but FDA-approved options that exclusively rely on lactose include Bobbie, Enfamil’s Enspire, Similac’s Pure Bliss, and Happy Baby’s nonsensitive options.
Soy formulas can’t rely on lactose as their carbohydrate source, so sweeteners often are added—which sometimes are off-putting to parents. “One of the big questions I get about soy formulas is why they contain added sweeteners, like corn and brown rice syrup,” says Alex Caspero, MA, RD, cofounder of Plant-Based Juniors in St. Louis. “Many of my parents are hoping to find a formula that doesn’t contain these, but the reality is that soy formulas must contain added sweeteners so they’re closer to [the nutritional composition of] human milk. Soy doesn’t contain enough carbohydrate or fat and therefore must be supplemented with additional sweeteners and oils.”
In addition to the new innovations in infant formulas, parents are turning to beverages marketed as toddler formulas for their infants. Technically, toddler formulas are products marketed for children aged nine months or older, and they don’t meet the FDA’s standards for infant formulas intended for babies aged 0 through 9 months. They’re marketed as a nutritional stepping stone for children who may not be ready for cow’s or plant-based milk, but most experts agree that while they’re safe for toddlers to consume, they aren’t necessary. “An otherwise healthy child does not need or benefit from the consumption of a toddler formula,” Liddell says. “Because toddler formulas tend to contain more sodium, fat, and sugar than infant formulas, they should not be given to infants under 9 months old. In addition, infant formulas are strictly regulated by the FDA, but the same requirements do not apply to toddler formulas. So often, their composition varies greatly from product to product.”
Ultimately, the growing number of FDA-approved infant formulas is a benefit to American families. But it’s important to help parents differentiate between what’s trendy and what will benefit their infant’s health and to steer them away from questionable products such as imported European formulas and toddler formulas for infants.
Of course, the right option among the various FDA-approved formulas for infants will vary from baby to baby. “Whenever I’m asked about my favorite formula, my response is always, ‘whatever your baby accepts and that is accessible and affordable for you,’” Caspero says. “There are plenty of options out there, and I think the biggest thing to focus on is access and what’s best for the baby.”
— Diana K. Rice, RD, LD, CLEC, is known as The Baby Steps Dietitian and is the founder of Diana K. Rice Nutrition, LLC, where she works with families to eat well and reduce the stress surrounding their food choices. She specializes in pediatric nutrition and intuitive eating and is the host of The Messy Intersection, a podcast to help women navigate their early childrearing years.
1. Talbot K. Bobbie is the infant formula these founders wish they had when breastfeeding failed them. Forbes website. https://www.forbes.com/sites/katetalbot/2021/01/05/bobbie-is-the-infant-formula-these-founders-wish-they-had-when-breastfeeding-failed-them/?sh=2163a7d177c3. Published January 5, 2021.
2. Centers for Disease Control and Prevention. Breastfeeding report card United States, 2020. https://www.cdc.gov/breastfeeding/pdf/2020-Breastfeeding-Report-Card-H.pdf
3. Similac Organic, the first organic infant formula from Abbott. Food Ingredients 1st website. https://www.foodingredientsfirst.com/news/similac-organic-the-first-organic-infant-formula-from-abbott.html. Published October 17, 2006.
4. Strom S. Similac Advance infant formula to be offered G.M.O.-free. The New York Times. May 25, 2015. https://www.nytimes.com/2015/05/26/business/similac-advance-infant-formula-to-be-offered-gmo-free.html
5. Global organic infant formula market research report: information by product type (starting milk formula, follow-on milk formula, special milk formula and others), formulation (powdered formula, concentrated liquid formula, ready to feed formula and others), distribution channel (store-based and non-store-based) and region (North America, Europe, Asia-Pacific and rest of the world) - forecast till 2023. Market Research Future website. https://www.marketresearchfuture.com/reports/organic-infant-formula-market-2807. Published August 2019.
6. Enfamil launches infant formula containing A2 milk proteins. Ingredients Network website. https://www.ingredientsnetwork.com/enfamil-launches-infant-formula-containing-a2-news084818.html. Published September 14, 2020.
7. Palm oil. World Wildlife Fund website. https://www.worldwildlife.org/industries/palm-oil
8. Lasekan JB, Hustead DS, Masor M, Murray R. Impact of palm olein in infant formulas on stool consistency and frequency: a meta-analysis of randomized clinical trials. Food Nutr Res. 2017;61(1):1330104.
9. de Souza CO, Leite MEQ, Lasekan J, et al. Milk protein-based formulas containing different oils affect fatty acids balance in term infants: a randomized blinded crossover clinical trial. Lipids Health Dis. 2017;16(1):78.
10. What’s in Similac formula? Baby formula ingredients & nutrition. Similac website. https://www.similac.com/baby-formula-ingredients.html