Breastmilk is always the recommended first feeding choice for babies and exclusive breastfeeding is recommended up until 6 months of age.
When exclusive breastfeeding is not possible or has stopped before a baby reaches 12 months of age, commercial infant formula is the only safe alternative.
It is important to follow the instructions on the tin when preparing formula. The volumes on the tin are a guide only and babies will drink varying amounts.
There is a wide range of brands and types of infant formula in Australia which can make choosing a formula confusing. Frequent formula changes between brands is not recommended.
Infant formula products are regulated under the Australia and New Zealand Food Standards. There are three types of products covered by this standard:
- infant formula (suitable for infants aged 0 - <12 months)
- follow-on formula (suitable for infants aged from 6 - <12 months)
- infant formula suitable for special dietary use
A standard formula will meet all the nutritional needs of babies in their first year of life. Solids should be introduced at approx. 6 months of age with milk feeding (breastfeeding or formula) continuing until 12 months of age.
Categories for standard formula
Step one, starter, newborn, or 0-6 months
Safely use from birth to 12 months
Step 2 or follow on
For babies over 6 months
Note: Step 3 or toddler formula is available for toddlers over 12 months of age. A healthy toddler should not need formula and can be encouraged to drink regular milk or breastfeed as part of their daily dairy serves. Step 3 formula should not be given to babies under 12 months.
Cow’s milk formula
Cow’s milk based formula is the most common type of infant formula used. Modified cow’s milk formula aims to resemble breast milk as closely as possible. It contains lactose which is the sugar found in breast milk and cow’s milk.
Some brands offer “gold” or “optimum” varieties and claim to be superior in nutritional value compared to standard formulas. A standard formula is entirely adequate.
A2 formula is based on cow’s milk which contains the A2 protein, which is claimed to be less associated with digestive associated with digestive discomfort, however the evidence for this is limited.
Organic infant formula is made from organic certified ingredients (such as milk that comes from cows not given growth hormones and which graze on grass not treated with synthetic fertilisers or pesticides).
Goat’s milk based
Goat’s milk based formula contains goat’s milk protein. Goat’s milk formula contains lactose. Goat’s milk formula is not suitable for babies who have an allergy to cow’s milk as the proteins in goat’s milk are very similar to cow’s milk.
Soy based infant formula is a vegan alternative to cow’s or goat’s milk based formulas, and does not contain any animal products. Soy based formula is also lactose free. Soy based formula should not be used for allergy prevention. Babies who have an allergy or intolerance to cow’s milk proteins may also be allergic or intolerant to soy proteins.
Soy based formula is not recommended for infants under 6 months.
Infant formula for special dietary use
Some formula brands have developed a range of products to address specific concerns/needs or requirements.
We recommended that you speak to a health professional if considering the use of one of these formulas
Rice based or plant based formula
Rice based formulas are made from rice protein and available without a prescription, over-the-counter. They may be a suitable alternative for infants with allergies over extensively hydrolysed formula or soy based formula. A health professional should always provide direction as to when this type of formula should be used.
Lactose free formulas are rarely required as lactose intolerance in infants is rare. Specific medical conditions may require a lactose free formula, however this should always be guided by a health professional.
AR or anti-regurgitation
AR (anti-regurgitation) formulas are thickened formulas thought to reduce reflux in babies. Reflux is common in infants and typically resolves with time. It does not require treatment unless the baby also has poor weight gain or significant discomfort. AR formulas may reduce the volume or frequency of vomiting and discomfort after feeds.
Thickened feeds are another strategy utilised to manage reflux in infants prone to frequent spit ups. Unlike AR formula, commercially available thickeners can help allow for greater control over the desired consistency or thickness of the formula. Thickener can also be used with breast milk.
The food thickener used must be suitable for infants.
Hydrolysed formula can be partially hydrolysed or extensively hydrolysed. This means that the proteins in the formula have been broken down into smaller pieces.
We recommend that hydrolysed formula be commenced under the guidance of a health professional.
There are 3 types of hydrolysed formulas:
- Partially hydrolysed – the proteins are partially broken down. Partially hydrolysed formulas can be advertised as being gentler on the stomach or for constipation and colic, however evidence regarding this is limited. It is not suitable for infants with a cow’s milk protein allergy. Partially hydrolysed formula is usually more expensive than other types of formula.
- Extensively hydrolysed – the protein is broken down into small pieces called peptides. These formulas are used for diagnosed medical conditions including allergies and intolerances.
- Amino-acid based – also known as elemental formula. These contain no large or small protein particles as the protein is broken down into its basic building blocks, called amino acids.
Extensively hydrolysed and amino-acid based formulas are only available on prescription for infants with specific medical concerns that cannot tolerate commercially available formula, due to the allergies or intolerances. These formulas should only be used under the guidance of a health professional.
Always speak to your health professional for information tailored to your baby (GP, Child and Family Health Nurse, Paediatrician).
Raising Children Network
Department of Health and Aging
- Breast milk is the recommended first choice for all infants. When exclusive breastfeeding is not possible, infant formula is the only safe alternative.
- A standard formula is entirely adequate to meet all the nutritional needs of babies in their first year of life.
- Prepare the formula according to the exact directions on the tin. Always supervise your baby during feeding.
- There is no benefit in changing from one formula to another unless medically indicated. If you feel your baby is not tolerating a formula, speak to your health professional for advice.
- The volume your baby drinks will vary. The feeding amounts specified on the tin should be used as a guide only.