Health Canada recommends that, for the nutrition, immunologic protection, growth, and development of infants and toddlers, you breastfeed exclusively for the first six months, and continue for up to two years or longer with appropriate complementary feeding.
If you need help breastfeeding, healthcare professionals and family and friends can often provide support, encouragement, and advice during this period of learning to feed your new baby.
Here’s some help understanding why some families choose to supplement breast milk with formula and how to choose the best formula for you and your baby.
Why some families choose to supplement breast milk with formula
There are a variety of reasons families choose to supplement breast milk with formula, such as:
- Mom’s breast milk is taking time to come in
- Baby isn’t gaining weight as doctors would expect
- For flexibility or to let another caregiver be part of feeding time
- Mom’s returning to work and/or can’t pump breast milk
- Rarely, due to health concerns, mom’s been advised to avoid providing breast milk to baby
Things to consider when deciding to introduce formula
- Unlike regular cow’s milk, infant formulas contain the recommended amounts of protein, carbohydrate, fat, vitamins and minerals required for baby’s healthy growth & development.
- Cow’s milk-based, commercial iron-fortified formula is the most appropriate alternative for healthy infants who aren’t exclusively fed their mom’s breast milk
- All infant formulas in Canada meet strict nutritional standards, but not all formulas are the same.
- All breastfed and partially breastfed infants in Canada should receive a daily vitamin D supplement of 10ug (400 IU).
How to choose the right baby formula
When deciding which formula to choose for your baby, there are a few things to consider – nutrients, format, and the type of protein the formula consists of.
1. Benefits for baby
Scientific advancements have made infant formulas better than ever—consider choosing a formula that contains:
The following probiotics may be beneficial for your little one;
- Probiotic B. lactis: Probiotics are part of what gives breast milk its natural protective qualities. Probiotic B. lactis contributes to baby’s healthy gut microbiota and helps support their developing immune system.
- Probiotic L. reuteri: Probiotic L. reuteri contributes to baby’s healthy gut microbiota and helps to reduce fussiness and mild spit-ups.+ Learn more about the benefits of probiotics here.
- 2’-FL: 2’-FL is a type of prebiotic that is naturally found in breast milk^ and supports your little one’s digestive health and developing immune system.
- DHA is an Omega-3 fatty acid that contributes to your baby’s normal physical brain and eye development.
Another consideration for the type of formula you choose is the format. Infant formula comes in three different formats and you can choose one, two or use all three formats for your baby—whatever your daily routine can handle! These are the three formats of baby formula and their features:
- Easy-to-use format made for convenience
- Comes in ready-to-feed sterile nurser form (Just attach nipple, warmǂ, and feed!)
- Do not mix with additional water§
- "Just Add Water" concentrated liquid infant formula is easy-to-use and prepare
- Requires additional amount of sterilized water§
- Mixes easily (No clumps or scoops!)
- Great value!
- Requires powder be added to measured amount of sterilized water§
3. Types of protein
Intact Protein Formula
Most routine formulas for healthy term infants contain intact cow’s milk protein. This means there are full-size proteins and the formula provides complete nutrition* for baby. You’ll see ingredients such as skim milk, nonfat milk, whey protein concentrate, and milk protein isolate. In dairy-free soy formulas, you’ll see soy protein isolate in the ingredient list.
Extensively Hydrolyzed Protein Formula
These are hypoallergenic formulas designed for babies with cow's milk protein allergies. The milk protein has been broken down into small pieces (extensively hydrolyzed) in a way that makes it unlikely to cause an allergic reaction. These formulas are for babies with allergy, and you’ll see hydrolyzed casein in the ingredient list.
Partially Hydrolyzed Protein Formula
Partially hydrolyzed protein formulas have milk protein that has been broken down into smaller pieces, but not as small as extensively hydrolyzed formula. These proteins are not for babies with true cow’s milk allergy, but they are tummy friendly and easy to digest*. You’ll see ‘partially hydrolyzed’ beside the milk ingredient in the ingredients list. 100% whey protein, partially hydrolyzed formulas have been shown to promote softer poops.ǁ
How to introduce infant formula to your baby
Follow these simple instructions to supplement breastfeeding with formula or to transition fully to formula feeding:
- Substitute one mid-day breastfeeding with a bottle-feeding. Relieve your breasts between feedings by expressing small amounts of milk (as necessary).
- Talk soothingly when you offer the bottle to your baby and give extra loving attention.
- Substitute another breastfeeding with a bottle-feeding every 2-3 days until you reach your desired balance between breastfeeding and bottle-feeding.
Some additional thoughts on transitioning to formula
- Do not replace two consecutive feedings on the same day when you first begin weaning.
- If you continue with breastfeeding in the morning and evening, or leave them as your last substitutions, you will have greater flexibility to return to work or share daytime feedings with others
- The transition to formula may happen smoothly, but sometimes it takes a little longer. Be patient.
All babies and parents are different, so whichever formula you choose and introduce to your baby, try to be patient, relax, and enjoy your time together.
† In breastfed babies.
^ Not derived from human milk.
ǂ Do not use a microwave oven to warm formula, as it can produce hot spots in the bottle that can burn your baby.
§ Your baby’s health depends on carefully following the label directions for preparation and use.
* Like all infant formulas
ǁ Compared to intact protein formulas.
Joint statement of Health Canada, Canadian Paediatric Society, Dietitians of Canada, and Breastfeeding Committee for Canada. Nutrition for Healthy Term Infants: Recommendations from Birth to Six Months. 2012. Nutrition for Healthy Term Infants: Recommendations from Birth to Six Months - Canada.ca
Holscher H, et al. JPEN. 2013;36(1):106S-116S.
Chau K, et al. J Pediatr. 2015;166(1):74-78.
Czerkies L, et al. J Pediatr Health Nutr. 2019;1(1):19-26.
Garofoli F, et al. Int J Food Sci Nutr. 2014;65(5):646-648.
Bode L, et al. Glycobiology. 2012;22(2):1147-1162.
Goehring K, et al. PLoS One. 2016;146(12):2559-2566.
Storm H, et al. Global Pediatric Health. 2019;6:1-10.
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