Healthiest Baby Formula: Other Things to Consider
When you’re searching for the healthiest baby formula for your infant, it’s easy to fall into a ton of different rabbit holes. You’re going to hear about things like whey/casein ratio and A2 milk. Let’s look at some of the factors worth considering when you’re looking at the best formula brands.
Whey/Casein Ratio
In an attempt to mimic real breast milk, formula manufacturers engineer their products to have a specific whey/casein ratio. Not sure what whey and protein are? Here’s the deal:
- Whey proteins stay in liquid form in the stomach (when exposed to stomach acid)—think the watery whey that separates in a container of natural yogurt–and exit the stomach more quickly. Whey proteins are therefore easier to digest and are rarely a source of allergies.
- Casein proteins form solids in the stomach (like cheese curds) and empty at a slower rate. They are more likely to cause digestive issues and be a source of allergies.
There is controversy over the optimal whey/casein ratio for a baby formula because the ratios found in breast milk change over time. Whey content is high in early lactation (with a ratio of about 90:10), and by late lactation, whey and casein protein amounts are roughly equal.
Goat milk and cow milk both have a whey to casein ratio of about 20:80. Manufacturers add whey protein to their formulas to adjust this ratio.
So what is the optimal whey/casein ratio? This depends on factors such as how old your baby is (in other words, how developed his/her digestion is), whether your baby has any digestive issues (like reflux, which may be a reaction to too much casein), and whether your baby is sensitive or allergic to casein.
We also don’t really know how much of the whey and casein added to formula actually ends up being assimilated. It’s definitely worth having a conversation with your pediatrician about which formula has the right ratio for your baby, although in many instances the whey/casein ratio isn’t an issue you need to worry about. Most babies do fine on standard formulas.
Bottom line: Because human milk is so rich in whey, we prefer formulas that add it. The best formula brands almost always do.
Prebiotics & Probiotics
Probiotics are beneficial bacteria, and prebiotics are food for probiotics. You probably already know that good gut bacteria is key to healthy immune function.
Breast milk has natural prebiotic properties, such as its oligosaccharide content. The act of breastfeeding also introduces lots of healthy bacteria to the breastfed infant’s microbiome. In an attempt to mimic human milk (and ride the wave of current health trends!), many formula manufacturers now add prebiotics and probiotics to their products.
There’s little research to suggest that this offers any real benefits, and the American Association of Pediatrics doesn’t officially recommend it. Still, the addition of pre- and probiotics are almost certainly not harmful to healthy babies.
Bottom line: Even though many of the healthiest baby formula contains pre- or probiotics, I probably wouldn’t rely on this as an effective supplement (mostly because of dosage and quality/viability of the organisms). Parents who are interested in supplementing with probiotics should choose a high-quality product like this one from Bobbie.
Aluminum in Infant Formulas
Unfortunately, it seems like high aluminum content in formulas is pretty much ubiquitous (studies confirm this in UK and Canadian markets, and there is no research done yet on formulas in U.S. market).
It’s not clear exactly why this is, but there are a variety of modes of potential contamination: raw materials (powdered milk may have aluminum added to prevent clumpiness, for instance), additives (like phosphorous), and manufacturing processes.
It’s important to note that a lot of healthful foods we eat contain more aluminum than any of the formulas in this study–including fish, spinach, and many types of tea. I’m not convinced that the amount in formula is something worth worrying about.
We also don’t know is how much of the aluminum that’s ingested ends up accumulating in the body of infants and toddlers. In adults, most aluminum is excreted, but what remains does accumulate and can cause problems in the long term.
There’s little that consumers can do about aluminum in formula, except for:
- Choosing breastmilk if possible.
- Avoiding soy-based formulas, as these tend to be highest in aluminum.
- Preparing powder formula with a silicon-rich mineral water—in the U.S., Volvic and Fiji water fit the bill. Experts believe that this could reduce the absorption of aluminum across the gut of the child and also potentially help the child to excrete aluminum in the body via the urine. However, these are areas which are also being researched.
A2 Milk
You will see that some of the best formula brands in our lists above contain “A2 milk.”
Here’s the deal: Cow milk has two primary types of proteins–A1 and A2 beta-casein. More studies are needed, but there is some evidence to suggeste that A2 milk is easier to digest and less likely to cause inflammation than is A1 milk. The strongest evidence is around lactose intolerance–studies suggest that milk with A2 protein is much less likely to cause gastrointestional distress.
Among the healthiest baby formula brands, four contain A2 milk: Aussie Bubs, Baby’s Only, Serenity, and Holle. Also, goat milk contains that A2 protein, so this is part of the reason it may be more digestible.
Bottom line: We think A2 is probably better than A1 milk for babies, and some–but not all–of the best baby formula brands include it.
DHA/ARA
DHA and ARA are long chain fatty acids found naturally in human breast milk, which make up the major long chain fats in baby’s brain and nerve tissue.
We know that naturally occurring oils from food, food-based oils, and mom’s diet (in breast milk) is highly beneficial. However, it’s not clear that these benefits are enjoyed when DHA and ARA are added to formula. Still, most formulas now boast the addition of essential fatty acids DHA and ARA.
The most common types of DHA and ARA extracted by the solvent hexane, a known neurotoxin, although the hexane is removed from the formula after it’s been processed. There are other methods for extraction, but these are relatively new and the jury is out on whether they are harmful, beneficial, or of no consequence at all.
If you choose a formula without DHA added, but want to supplement on your own, this is the brand we like.
Note that all European formulas are now required to contain DHA, and that organic oils in European formula cannot be hexane-extracted.
Bottom line: We think there’s no downside to the addition of DHA/ARA in formula, and most of the best formula brands have choses to add it.
BPA in Formula Cans
Good news: there is one thing you no longer have to worry about when buying formula, and it’s BPA. The FDA has finally gotten with the program and banned BPA from formula container linings. Of course, I worry about what’s being used in place of BPA, but still this is a small victory!
Healthiest Baby Formula FAQs
What is the closest formula to breast milk?
Needless to say, I’m pro-breastfeeding. I have only two kids, but I breastfed for a total of 7 years, so you can do the math. But of course I also know amazing parents who formula feed their (very healthy!) children.
Every formula brand claims that their nutrient blend most closely mimics breast milk. Based on our research process, we think that ByHeart and Kabrita get the closest.
What’s the best hypoallergenic baby formula?
Some babies, like those with milk protein allergies, need a hypoallergenic formula. Sometimes called “gentle,” these formulas contain hydrolyzed proteins, which means that they are broken down and more digestible.
Many pediatricians recommend Pregestimil or Nutramigen (both by Enfamil) or Alimentum (by Similac). If forced to choose between these, I would go for the Alimentum since it skips the carrageenan and corn syrup. But I can’t call any of these Good Stuff since all three contain ingredients of concern and none is organic. Nutramigen is probably the very worst of these, comprised of 48% corn syrup solids!!
If it were my baby, I would choose HiPP HA organic baby formula, which contains no sugar, corn syrup, or maltodextrin, and is full of good prebiotics. You also might want to try HiPP Anti-Reflux formula if your baby has a sensitive stomach. It’s made with 100% whey and no casein to prevent reflux.
If you want an American brand, Bobbie Organic Gentle is the only one that is sweetened with just lactose.
Please check with your pediatrician first if you suspect an intolerance or allergy.
Can you give an infant a “toddler” formula?
I know many parents who have chosen to feed their infants a “toddler” formula. Most toddler formulas contain the 29 key nutrients that are required by the FDA for infant formula. Some of these are the best formula brands out there but are not marketed as infant formula because the brands haven’t completed the infant feeding studies. A few notes on this country’s formula rules and regulations, by the way:
- The recipe requirements are from the Infant Formula Act of 1980 (which I believe is in desperate need of an update!).
- Infant formula certification requires multi-year and multi-million dollar feeding studies.
- Thus, there is a huge barrier to entry for innovative companies or smaller brands. ByHeart is one of the few brands who did their own study. (More on them in this post.)
- In early 2022, the FDA recalled brands (e.g., Similac, Alimentum and EleCare) after babies drinking these formulas became ill. This was nearly 6 months after the FDA found out but failed to act on the information. In March of 2022, the FDA finally shut down the facility producing these formulas, which lead to a formula shortage.
Again, ask your pediatrician to review the nutrition label on any formula you’re considering.
Where is American baby formula made?
Almost all infant formula sold in this country is produced by just four manufacturers:
- Mead Johnson (Enfamil)
- Abbott Nutrition (Similac)
- Nestlé (Gerber)
- Perrigo (Bobbie, Earth’s Best, generic formulas for many grocery chains)
ByHeart is made in the U.S. in its own factory.
Should you use filtered water for baby formula?
Yes! Tap water may be contaminated with chlorine byproducts, weed killers, insecticides, solvents, lead, BPA, phthalates, PFAS…the list goes on. Fluoride is present in infant formula, and when combined with fluoridated tap water, infant exposure levels can exceed safe amounts. I think everyone should invest in a good water filter, but especially if you have a formula-fed baby in your home.
What is the safest baby bottle?
Here is a cheat sheet to help you choose the safest bottle for your baby, whether you are breast- or formula-feeding!
Should I consider a goat milk formula?
Yes! Goat milk may be more similar to human milk because it contains A2 beta-casein protein. For an in-depth look at the pros and cons, check out our post about goat milk formulas.
659 comments
Maia James
Yes, this new one from Plum looks better than Honest or Earth’s Best. Also check out Sammy’s Milk.
Ivy
hi maia,
what are your thoughts on this article about the aluminum level concern on hipp baby formula? http://hippformulausa.com/hipp-formula-aluminum-study/
please advise, thanks.
very respectfully,
ivy
Alan
Thank you! I’ve looked up both, it seems sammys does not contain any soy. Unfortunately his pediatrician says enfamil is fine and shouldnt be changed. I will look into some customer reviews in regards to sammys, if there is any.
maia
Hi Alan-
I’m about to publish a review of goat milk formula and have been very impressed with Sammy’s Milk. Plum Organics also came out with a new formula that looks promising. I’d suggest you run these two options by your pediatrician!
Alan
I’m so confused on what to get my 2 month old son. My wife is not producing much breast milk anymore, and I am furious over feeding him enfamil. She works as well, so holle and hipp are out of the question due to heating water pre-feed. I’m thinking of getting baby’s only whey formula with no brown rice. Any thoughts?
Alyssa
What about Kirklands infant formula? I know it isn’t organic but I don’t see and palm oil or corn syrup. Is plum also good stuff?
Rita
Also, would this formula be considered good stuff…
http://www.plumorganics.com/formula
Linda
Hi-
I’ve been feeding my LO Lebenswert stage 1 (& Holle stage 1 when there’s a shortage on Lebenswert stage 1 lol) Looking at stage 2 formulas now and wondering which would you recommend Holle stage 2 or Lebenswert stage 2? Also would you say Holle jarred food is good stuff?
Rita
Spoke to my pediatrician who does not recommend the baby’s only formula, she recommended similac organic which is on your no no list. With that said it looks like I will have to choose between honest co or earths best, which would you go with? My 2 month old has had terrible gas problems on enfamil newborn and I am just now starting to investigate the ingredients.
Bell
Matt,
https://gimmethegoodstuff.com/best-multivitaminsMaia states “Nordic Naturals Baby’s DHA is a good one, as are the Nordic Naturals supplements for adults.”
Maia James
Hi Erica-
Wow I didn’t know about Plum’s formula, but I just did a quick look and it’s definitely promising! Will do some more digging. Thanks!
Erica
Hi Maia,
Asking for a friend of mine who is concerned about the calcium levels in the Baby’s Only Whey for her infant and is not interested in HiPP or Holle despite telling her about how much we love HiPP and ordering from LWO (after your recommendation). Needless to say, she’s on the hunt. What do you think about Plum’s new formula? Thanks! EricaMaia
Yes, I would look in Baby’s Only Soy for sure (ask your pediatrician first, of course)—sounds like your daughter is truly dairy intolerance, so thank goodness for soy formulas!
Betsy
Our daughter is almost 5-months old and has an extreme intolerance to Dairy. I’ve been on a strict diet and exclusively pumping, but need an option to supplement as I have to travel for work. I tried Nutramagin and she had a horrible reaction, so I was preparing to try Soy until finding this post. The only other alternative I have discussed with my doctors is Elecare that is a completely broken down amino acid based formula but it smells like vomit and I’m certain she isn’t going to drink it. The GI specialists have said the food intolerance is usually the casein protein and not lactose, so a lactose free or Goat option wouldn’t help. If Soy is our only option, what is the best Soy option? Baby’s Only? Help please- after reading this I’m feeling horrible about the idea of using Soy at all, but making our own formula is just not realistic for our working family.
Maia
Hi Julie-
Here’s some info on water filters (including Brita): https://gimmethegoodstuff.com/water-water-everywhere-nor-any-drop-to-drink/ And here’s some on milk/almond milk: https://gimmethegoodstuff.com/easy-almond-milk-recipeEarth’s Best did improve their formula, but the third ingredient is corn syrup, so I can’t really call this Good Stuff:/. Baby’s Only with Whey or the European formulas (Lebenswert, Holle, HiPP) would be better, in my opinion.
Maia
Hi Karisa-
Yes, Baby’s Only with Whey seems really promising…I really apologize to everyone for the delay in an official recommendation and comparison to the European brands, but I promise it’s coming!
karisa
Would you say Baby’s only whey is better or just as good as HIPP that it now doesn’t have brown rice syrup and also no nucleotides? I am on HIPP ,but would like to try it considering it’s easier to get .
karisa
I am currently using hipp first infant milk, I love it . I have tried lebenswerts and hipp (Germany) but baby spit up horribly. I was wondering when you would be doing a full review on baby’s only whey ? Since it’s a lot more easy to get .
Julie
Hi Maia (Love your name by the way!), thank you for writing such a informative article!.
I have a 10 month old that I have been able to provide breast milk so far but my supply is dwindling. I looked at the options under “The Good Stuff” Tab and noticed that you didn’t include Earths Best Formula here but you added it under the “Sneaky Stuff” Tab. It seems to be ok considering it has lactose in it as the first ingredient? Am I missing something else that deems it not so good? What is your take on Earths Best Organic Formula and comparison to the other formulas you mentioned under the “the Good Stuff” tab? In your opinion is Earths Best good or not so good? I also noticed that you recommend filtering water to make formula safer for infants. I have a plain Brita filter and was wondering if that would be just fine? I noticed in the store that they offer “Nursery Water”. Is that what can be used? Whats the difference between filtered water and nursery water? also, it seems like the only brand that does not include palm oil is Baby’s Only. Is there a way of determining the amount of palm oil added to the various organic formula brands? Since my daughter will be on formula for a very short amount of time, I was wondering what are your thoughts on transitioning to milk (whole milk vs coconut milk vs almond milk vs rice milk, etc.)? Thank you once again for writing such a great article!Matt
Is there a good DHA supplement to add to formula? We use the Holle formula stage 1 but have heard we may need to supplement with DHA since Holle doesn’t contain any. We heard that the brand Nordic Naturals is good because its derived from fish oil rather than hexane. Just wanted to see what youo’ve heard? Thanks!
Bell
Andrea,
I hope this helps… I purchased a “Tommee Tippee Closer to Nature Perfect Prep Formula Machineâ€. When you add the predetermined amount of formula to the bottle, the machine will initially shoot a burst of boiling water to kill any bacteria that may be present in the formula. The next step would be to cover and shake the bottle until mixed. The bottle is placed back to the machine and you hit the button again to complete the process resulting in the perfect temperature to feed the baby. It takes less than a minute and can make various sized bottles. When I go out I pre make a bottle and place it in an insulated bottle bag. I haven’t been out too often with the baby, but when I do go out, it’s to my mom’s. She lives 45 min away so the pre-made bottle is usually consumed within one hour and thirty minutes or stored in the refrigerator for later use. Below is a link to the machine I use.
http://www.tommeetippee.us/product/perfect-prep-machine/
Bell
Thank you for answering my question.
Bell
Andrea,
I hope this helps… I purchased a “Tommee Tippee Closer to Nature Perfect Prep Formula Machine”. When you add the predetermined amount of formula to the bottle, the machine will initially shoot a burst of boiling water to kill any bacteria that may be present in the formula. The next step would be to cover and shake the bottle until mixed. The bottle is placed back to the machine and you hit the button again to complete the process resulting in the perfect temperature to feed the baby. It takes less than a minute and can make various sized bottles. When I go out I pre make a bottle and place it in an insulated bottle bag. I haven’t been out too often with the baby, but when I do go out, it’s to my mom’s. She lives 45 min away so the pre-made bottle is usually consumed within one hour and thirty minutes or stored in the refrigerator for later use. Below is a link to the machine I use.
http://www.tommeetippee.us/product/perfect-prep-machine/
Maia
We are in the process of writing a blog about goat milk formula that will be published in the next few weeks!
Erica
Hi Maia,
We just starting researching Sammy’s Milk after reading about it on another blog. Any thoughts? Thanks!Maia James
So glad you had good experiences with those vendors. Definitely #3 in for the Baby’s Only. For other readers, that’s this one: http://amzn.to/1LXfDxQ
Bell
Hello,
P.S. As a 1st time mom your website has been very helpful and I’m very thankful for the time you dedicate to educating us Moms on safety issues.My daughter is 9 weeks old, and I’m not producing enough BM to keep up with her needs. Thus leading me down the path of researching formulas. After extensive reading we decided to go with Holle Stage 1 since Lebenswert was not available at the time (BTW I’ve ordered from both Little World Organics & Organic Munchkin : they’re both GREAT…excellent customer service & quick turnaround!!). However, I’ve recently been looking into Baby’s Only since it’s available at my local market. My question is out of the 3 which would you say is the best???
1. Baby’s Only Organic® Dairy Toddler Formula
2. Baby’s Only Organic® Dairy with DHA & ARA Toddler Formula 3. Baby’s Only Organic® Dairy with Whey Protein Toddler Formula
Maia James
Hi there-
My research has led me to believe that no, there is not a risk from the radiation.
http://www.npr.org/blogs/thesalt/2012/01/12/145107755/why-x-rayed-food-isnt-radioactive-and-other-puzzles
Cristina
Hi Maia,
How do I know for sure if there is any irradiation done on the formula that has been shipped to me? I ordered off of a website that ships from Germany. I’m using Lebenswert.
Thanks,
Cristina
Maia James
Goats milk formula review coming in March:)
jim
This may be a repeat of my prior reply but I do not see it listed so I will try again just to be sure. I apologize in advance if that is the case.
I have not heard of HiPP HA but I did look it up and I think it may work. Given that this does not come in liquid form, will this product also be plagued by excessive aluminum like its sister product? BTW, thank you for the extremely prompt response to my original post!!GayDad
Any reviews of Sammy’s milk ? I just started supplementing with Lebenswert Bio Stage 1 but just noticed Sammy’s available in my local health market.
Maia James
Have you heard of HiPP HA?
Jim
Hi Maia,
We have been using Lebenswert 1 for our 7 week old pretty much from the start. We were concerned that she was spiting up a lot so the doctor recommended Enfamil AR. Do you know if there is an equivalent organic version of this that you would recommend (extra points for German brand)? Thank you for all your research and support – you are truly my go to source on nutrition.
Maia James
Hi CJ-
Great question:). One big issue with Enfamil is there is no organic option. And as you said, the palm and soy oil aren’t great. Soy lecithin is also bad, especially when not organic (extracted with hexane). However, as you said—-the fact that it is mostly milk and doesn’t contain sugar or corn syrup is actually better than most formulas. If it were organic, I dare say it might be Good Stuff;). Oh, except for the fact that it was found to have high levels of perchlorate (rocket fuel): http://www.motherjones.com/blue-marble/2009/04/rocket-fuel-found-infant-formula
Maia James
Hi Darcy-
My advice is to bring the ingredients/nutritional info to the attention of your pediatrician and get his/her advice.
Nina
Hi Maia,
I am currently importing Holle Stage 1 and 2 and selling it on my site www.naturalbabyorganics.com I was wondering how to go about getting on your recommended list of vendors. I am open to any vetting process that you may have.
Darcy
If I am breastfeeding my 3 wk old; and feel the need to supplement with baby’s only- dairy toddler formula is it safe??
ws
The article complains about algae based DHA oil being extracted using hexane.
The author is quite misinformed. Pretty much the entirety of edible oil industry uses hexane as extraction solvent. Ranging from vegetable oil to fish oil, it is industry standard to process the oil using hexane.Maia James
Yes, if you are looking for a formula that contains no soy, Holle or Lebenswert would be the way to go.
Maia James
Hi Andrea!
I’m so glad this guide has been helpful! I am hoping some readers will chime in here with some tips, but have you considered HiPP ready-made formula?
Maia James
Thanks for the feedback, Sarah! We will definitely be including Kabrita when we research goat milk formulas:).
Sarah
We’ve been using Kabrita formula and really love it. After reading the amazon.com reviews we tried it for my son with reflux, after 1 day we saw major changes and he is now happy and spit up free. I like their Non-GMO and European sourcing, it’s not organic but seems like it is pretty close and from family farms.
Andrea
Maia- thanks so much for this article and for answering questions! this guide has become like a bible for me. I am very happy with 3 boxes of Lebenswert 1 I ordered from LWO before they run out of it. However, I don’t manage to find a way to feed my 3MO with this formula while on the go (because of the warm water/cooling process) or when he wakes up crying in the middle of the night due to the time it takes to prepare it (with warm water ready in a thermos). I’ve been using plain old Enfamil for those occasions (bought baby’s only but I’m terrified with those constipation comments).
I’m wondering if your or any other user have tips and tricks on how to use Lebenswert while on the go or for quick midnight feedings. Thanks!Greg D
Hi – Thank you for putting up such a useful source for concerned parents! I have a question regarding the amount of soy in these forumulas. Is there one that contains no soy? From reading it seems that Holle would be the best option.
Thanks for any inputCJ
Great information! I am currently comparing Enfamil and Baby’s Only (which is obviously the one you recommend!), but my question is:
Baby’s Only’s first ingredient is the brown rice syrup, meaning it has more of that than milk. Enfamil’s first ingredient is milk, and it’s sweetener is lactose (which is agreed that that is better than syrups). Is there that much “bad stuff” in Enfamil that those first two main ingredients are negated? I realize the big issue is the palm oil, but palm oil seems to be pretty consistent in all organic formulas (the exception being Baby’s Only.) Just some thoughts I noticed and would love your feedback about the true evils of Enfamil :DMaia James
Hi Erin-
At this point, the only two companies I feel comfortable recommending are LWO and OM. This definitely doesn’t mean that other importers (or the German company you mentioned) are doing anything shady, but I just haven’t been able to vet them.
Erin MacDougall
Thank you so much for this article. The information in it has been extremely helpful to me making a decision for my baby and I have shared it with other moms I know. I did want to ask if you’ve had any experience with purchasing Lebenswert or Holle from the Biolagisch site in Germany (http://www.biologisch24.com)? Because LWO has been sold out for a while (and it is so hard to nab from them in the few minutes the site has the order form open), I really need some other options. I tried Organic Munchkin – the box was totally damaged but the inside bag seemed ok but I didn’t like that ideally it may have been thrown around a lot. Your thoughts would be welcomed on ordering from Germany. Thank you for all you do!
Dwayne Johnson
Hi Maia,
Do you know of a healthier option we can look into? Thank youThank you for this article. I have been a concern dad worrying if our baby is getting enough and worrying if my wife can make it through a year with his healthy appetite.
We have recently found out that our bay has a milk allergy, our very good hearted, paediatrician has given us ‘Enfamil Nutramigen’ in a means to top our boy up without the ill effects of milk based formulas due to his allergy.
As you can figure we definitely do not want to use it and we would like to stay clear of the soy as well.
teresa
I found a website that carries all Holle/Hipp/Lebenswert formulas, including their goat milk formula. It’s called beyondorganicbaby.com Are you familiar with them, and if so, are they a reliable source?