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
Laura
Maia,
Thank you so much for all your product guides! I cannot tell you how much you have helped me in choosing everything from nipple balm, to dish-soap, to our family’s first crib mattress. I just have a couple of questions regarding the hypoallergenic Hipp formula: -You mentioned that the powdered form of Hipp contains high levels of aluminum; does that mean you would not recommend using Hipp HA in its powdered form (I ask because it is proving VERY difficult to purchase the liquid form from here in the US)? -What are your thoughts on the different Hipp HA formulas: PRE HA, HA 1, and HA 2? My daughter, Willow, is now 7 months old, and I’m just not sure what the best option is for her. What is up with the starch, for instance? Thank you in advance for any response you might have! Laura Sarasota, FL.Cecile Vaughan
Another important factor to consider is grans of protein per 100mls. To mimic breastmilk it needs to be quite low. However a formula such as bellamy’s has 1.7gm per 100mls which is significantly higher than most conventional brands. I wonder if you looked at this and considered it in your recomm./findings.
Layla
Hi! Would you recommend baby’s only or plums organic? If you had to choose a formula sold in US. Or is there a better formula sold in stores in most US stores? Also was wondering you had a review on bottle sterilization machines on which one is best? Thanks so much, I’m due in Jan so just want to get everything ready. So thankful for you and your blog. It helps moms like you don’t even know (:
Erin
I typically respect your work as it is very difficult navigating what is truly safe and healthy for our families and I appreciate anyone who is truly trying to help others in the journey. However your comments regarding the ‘precautionary principal’ have me confused on your actual views, and make me question if I should continue to trust the information you provide. For reference, this is the passage I find bothersome:
“To gain deeper insight into the formula manufacturing industry, check out an article written by Charlotte Vallaeys, who is the Director of Farm and Food Policy at The Cornucopia Institute. Her article was immensely helpful as we worked on this Guide. And while I really trust and respect her work, the tenor of her perspective tends to be more alarmist and she is more heavily on the “precautionary principle†side of the spectrum (versus “ingredient is innocent until proven guilty†approach), which isn’t always practical.” I do not know Ms. Vallaeye ,however you seemsto insinuate that you do not agree with the precautionary principal, which she apparently follows. And you claim is is not ‘always practical’. To say something isn’t (always) practical gives the impression you think someone who does it is foolish. I believe a more appropriate term is “inconvenient” because it is never impractical to do your best to protect yourself and your family from potential threats. However poor US regulations certainly have made it inconvenient for an American to simply try and be healthy and raise healthy family. And yes there are times- as an individual having to live within our means- we have to ‘give in’ and say, let our children be exposed to plastics at public schools. Or maybe we can’t afford to buy ALL our food organic but we get as much as we can and maybe give that to our kids while we eat conventional. Maybe I’m misunderstanding what it means to actually practice the ‘precautionary principal’ but I thought it was about practicing it to the best of your ability, which may not be perfect but it certainly isn’t foolish or impractical. And it does surprise me that you would have that view (if you do) because it seems to completely go against the point of your website. I stopped following another healthy living blogger because she made the ignorant comment that “humans are always more important than nature” when humans- like all lifeforms-are a PART of nature, so it’s only logical (not even mentioning the moral side of it) to keep our planet healthy if we want to be healthy. It was really disappointed she turned out to be like that and again I had to navigate the web trying to find people and information that went with my principals and I could truly trust, because it’s difficult enough navigating food labels and finding ingredients in non food items. I know we are all responsible for our own education and choices, but that is exactly what I am trying to do-find credible information to help me make the best choices I can for myself and future children.So if you could clarify your position on the precautionary principal I would appreciate it, so I can decide if your website is a good fit for me. Thank you in advance for reading my comments and concerns.Lori
In regards to taking DHA supplements when pregnant or nursing, what is the best kind to take? Should I avoid ones that say “algal oil?”
Precious
I was breastfeeding until my baby was 6 months because it was tough for me to pump every hour and a half at work (I work in retail). It broke my heart to put her on formula but this article and the constant updates made me feel a little bit better. I decided to put her on plum organics formula even though you hadn’t reviewed it at the time because you encouraged me to read the labels. It was the best one I could afford (my family is on food stamps). It was available locally, and sometimes Target would give you a gift card for purchasing multiples. It’s still a little pricier than most commercial formulas in the US, but it was a sacrifice I was willing to make to ensure the baby was receiving the best. We just scrimped on other items to be able to afford it. She’s now 16 months old and has never had any stomach issues (like my older one did on multiple commercial formulas), and is a happy, healthy baby. Thank you so much for all the awesome information.
Ursula Overstreet
Re: Bimbosan Organic Infant Formula
Hi All, My name is Ursula Overstreet. I am happy to let everyone know that I live in Switzerland and therefore have a direct access to Bimbosan formula. I’ve been sending it to Chicago to a friend of mine Alicja and her baby son Jake for about 6 months. I buy the formula at the local pharmacy and send it by Swiss post. After trying many formulas, both Alicja and Jake are happy with Bimbosan, and I decided to open an Internet shop featuring Bimbosan and other European brands. My website is currently under construction and will be operating soon.The Bimbosan brand is a well known and respected brand here in Switzerland next to Holle which is also Swiss, not German as most people seem to believe. The Bimbosan company was established in the 1930s as a family business and has been running ever since. Beside traditional powdered milk the Bimbosan brand offers options like AR and HA, a variety of paps for different conditions i.e. loose or hard stools, hearty appetite, etc. It is well worth checking their website. The website is available in English http://bimbosan.ch/en/home/. It provides detailed product information plus there is a hotline number also available in English. A friend of mine used the number and was happy with the service. They don’t deliver to the USA. I have also written to Maia with the request to verify me as a vendor. I hope this can happen soon. UrsulaThis Swiss brand of formula looks similar to the other European brands. I love the lack of maltodextrin, palm oil, corn syrup, and sugar! Bimbosan doesn’t include DHA/ARA. Unfortunately, I can’t find any vendors selling this formula. Please comment below if you know of a reliable source to purchase Bimbosan.
Roxanne
Thank you for updating this guide!! It’s really so helpful.
Alicja Bochenek
Hello,
My son, Jacob has been on Bimbosan Swiss formula since he was about two months old. He’s nine months now. Jacob was born at 35 weeks and weighed 3 lbs 11.7 oz. At first, not knowing any better, I gave him enfamil gentle ease as per my pediatrician because he had a terrible acid reflux. As a first time mom, unable to breastfeed ( I only breastfed Jacob for two weeks while he was in the hospital) I was completely devastated and felt incredibly guilty. I wanted my baby to have the best, most natural formula. My friend, Urszula, who lives in Switzerland started sending me Bimbosan formula and my son has been thriving on it. He’s 9 months now and weighs 14 lbs. My pediatrician is amazed each time we go for a visit. I did show her the formula and honestly, she told me whatever I’m feeding him, it works because he’s doing great. I feel at ease, knowing that even though I’m unable to breastfeed, my baby is getting the best possible formula and he’s thriving on it. My friend will be selling bimbosan and holle. Her website is currently under construction. Also, bimbosan recently released acid reflux specific formula. Currently, my son is on bimbosan paps. They have paps for evening and morning, for loose stool and constipated babies. I love all of their paps and formulas. I am happy to have found it through my friend. I wish more mothers educate themselves about this wonderful, family owned Swiss company. AlicjaKelsey
I sifted through some comments to make sure I wasn’t duplicating. I see your updated list, but curious about your thoughts on the Munchkin Grassfed formulas. Currently only stage 2 for toddlers is on market but supposedly stage 1 (newborn to 1) out soon.