All Your Baby Formula Questions—Answered

The reasons families choose to formula-feed are about as varied as babies’ sleep habits (read: all over the place). But whether it’s a medical need, a mental health choice or simply what feels right for your family, we know that formula-feeding can come with a lot of questions. That’s why we asked Jacqueline Winkelmann, MD, a board-certified pediatrician hospital and medical advisor to Bobbie—the European-style, organic baby formula—for her expertise on this topic. Read on for her advice on formula nutrition, supplementing, bottle-feeding and more.

What should I keep in mind when deciding on a formula?

With so many different formula options available, Dr. Winkelmann encourages parents to consider the most important factors to them as a guide. What matters most to you? Is it saving money? Quality of ingredients? Low pesticide levels? Ease of purchase? Do you want it ready-made? Is it environmentally conscious? “There are no right or wrong answers, but the answers to these questions will point you in the right direction for you and your family,” she notes.

What are some of the most important ingredients to look for in a formula? What should be avoided?

According to Dr. Winkelmann, the ideal formula is one that most closely mimics breast milk. For example, she explains that in breast milk, the main carbohydrate source is lactose, not corn syrup. Additionally, she notes that the ratio of whey to casein (a protein component) in breast milk is 60:40, so a choice like Bobbie organic infant formula, that features a 60:40 whey:casein ratio, is easy on babies’ stomachs . “Whey is easier to digest than casein, which means this formula is easy for babies to digest,” she says. And as far as what you should avoid when choosing a formula, Dr. Winkelmann advises parents to steer clear of added sugars and palm oil. In some recent studies, palm oil has been associated with harder stools in some young infants, which could cause constipation. It’s also helpful to not focus too much on any one ingredient or even an “organic” status. “Not all organic formulas are created equal, so educate yourself as a parent and look for a formula that comes close to breast milk,” she points out.

What is different about European-style formulas (as compared to US formulas)?

If you’ve seen an uptick in European baby formulas, you may be wondering what all the hype is about. Dr. Winkelmann explains that there is more demand for European formulas recently, because parents are aware that the European Union (EU) updates their guidelines more frequently than the US does. “This allows for new scientific evidence to be incorporated in the regulations for infant formula,” she explains. In addition, many parents view EU formulas as “cleaner” or “healthier” because of some of the regulations set for European formulas, such as the fact that all formulas in the EU must be organic and contain DHA, a fatty acid shown to be important for infant brain and eye development. (The US does not have these regulatory mandates in place, although most brands voluntarily incorporate DHA.)

How can I know if supplementing with formula is right for us?

First things, first: Know that using formula in some form is extremely common. In fact, 83 percent of families will turn to formula at some point during baby’s first year of life. And the beauty of formula-feeding is that it can be used alongside breast milk—you don’t have to choose one or the other. Some families may use a combination of breast milk and formula, while others may need temporary supplementation to support baby’s growth and development. “This is the reality for the majority of parents,” observes Dr. Winkelmann. “In my mind, it’s the best of both worlds! Mom and baby get the benefits of breast milk but use some formula to supplement whenever desired/needed.” If formula-feeding—no matter how that looks—becomes part of your family’s feeding journey, Dr. Winkelmann reminds parents not to stress about making the switch. In fact, adapting is part of being a parent. “Parenthood is all about trial and error, and it’s 100 percent OK to change your mind!” she points out. “Your baby will be just fine, and if it feels right for you and your family, then it’s the right choice for your baby.”

What are some tips to start combo feeding?

If you do choose some form of combo feeding, Dr. Winkelmann encourages you to try these tips to make it work:

  1. Don’t wait too long to introduce a bottle. Once breastfeeding is established (there’s no hard-and-fast rule here, but La Leche League recommends at around 4 weeks), start introducing a bottle of pumped breast milk or formula. And whatever you do, do not wait until the end of maternity leave to introduce a bottle, or it could be a very stressful first few days back to work!
  2. Try having your partner or another caregiver give the first few bottles of formula. “Baby is more likely to accept the bottle from someone other than Mom,” says Dr. Winkelmann.
  3. Switch up the temperature. If baby doesn’t take to the formula easily, try a different temperature. Breast milk is body temperature, so try to warm up baby formula before offering the bottle again.
  4. Be patient. “Sometimes it takes time and commitment, but you’ll get there!” she adds.

If I want to switch, how should I introduce a new formula?

If you decide to switch baby’s formula, Dr. Winkelmann suggests being patient with the process. A large factor in how well your baby accepts a new type of formula could be their own preference and how old they are when it’s introduced (such as 8 weeks old vs. 8 months). She advises taking the following steps:

  • Switch out one bottle per day with the new formula, and add more daily as baby adjusts. Start slow, and give yourself some time.
  • Have someone else give the first few bottles. Just like when you first introduce a bottle, baby may be more likely to accept switching to something new from someone other than the primary caregiver.
  • Introduce a new type of formula when baby is hungry.
  • Instead, start with a bottle in the middle of the day when your baby is rested and calm.

Are there changes to baby’s poop when you switch to formula?

Dr. Winkelmann notes it might take some time for baby’s digestive system to adjust to the switch. Things that can happen with a baby’s body that are all normal when introducing formula: poop that is brown, green or even orange; seizure; looser stools; more spit-up. However, she adds, you should always consult your health-care provider if baby develops hives, has blood in their poop, experiences sustained vomiting or has any other symptoms that concern you.

What are some strategies I can use if my baby refuses formula?

There are two important things. Winkelmann says parents need to remember when offering a baby a bottle for the first time: 1) If the baby refuses the bottle, try a different brand and/or nipple with different flow rates. “Babies can get frustrated if the flow isn’t right for them,” she explains. 2) It can take up to two weeks for baby’s system to adjust to any formula, so patience is key. “Introduce it slowly and advance as baby tolerates the formula,” she suggests. Additionally, warming formula so it’s closer to the temperature of breast milk can help. And last, but not least: “Don’t give up!” says Dr. Winkelmann.

What’s the most important thing parents should know about formula-feeding?

Dr. Winkelmann wants families to know that there should be absolutely no guilt about using formula to nourish your baby. “Infant formula is one of the most highly regulated food products in the US,” she explains. “Formula is safe and will help your baby grow and develop and thrive.” Choosing a high-quality, organic formula modeled off of breast milk like Bobbie organic infant formula can help families feel confident in their decision to turn to formula. And as Dr. Winkelmann points out, it’s also important to remember that while breastfeeding or feeding breast milk certainly has desirable qualities and outcomes for parent and baby, formula-fed babies thrive, grow and develop well, too.

Did you know 83 percent of parents in the US will turn to formula at some point in their feeding journey? Bobbie is a new European-style organic infant formula, sourced with purpose and designed to be easy on baby’s tummy. Learn more at Bobbie.com.

About the expert:

Dr. Jacqueline Winkelmann is a Board-Certified Pediatrician and Bobbie Medical Advisor. She received her degree from the University of Illinois College of Medicine and completed her Residency in Pediatrics at Hope Children’s Hospital in Chicago. She has been on staff at CHOC Children’s and CHOC Children’s at Mission Hospital since 2001, where she also served as Chief-of-Staff. Her young patients know her better as Dr. Jacq, because: “both Jacqueline and Winkelmann are both too long for a little kid to pronounce!”

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.

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