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
Nicole
Hi im wondering what your thoughts on similac pure bliss are? I am hoping to use natures only but am waiting to see the pediatrician next. Im looking for a second option if that one does not work out for us.
Malorie
Any updates on safe formulas yet?
Maia James
Hi Lily-
Would you consider goat milk? Otherwise, I am sorry to say that I don’t really feel comfortable dispensing anything that might be considered medical advice—I’m not an MD or a nutritionist. I can tell you, however, that my first-born had pretty much zero interest in solid foods until he was 18 months old (although he was still nursing), and I never really found a way to get him to eat. I wish I had just chilled out about it rather than stressing so much! Overall, I think you would benefit most from a holistically-minded pediatrician you trust.
Maia James
Hi Ashley-
Kabrita doesn’t: https://goo.gl/BdNLir
Ashley
7 month old with allergy to coconut oil…. do you know of a formula that does not have coconut oil? Thank you so much!!!
Lily
Hi there,
I’ve been and continue to primarily nurse my daughter but when my production has occasionally dipped, I’ve had my daughter’s daycare or partner try to feed her Baby’s Only dairy (DHA & ARA free) formula but she’s never accepted it, preferring instead to hold out until I arrive. Now that she’s just over one years old, we want to consider opting out of dairy milk as we have our misgivings about her drinking animal milk. Any good resources for ensuring she gets proper nutrition while consuming plant based milk? And other things we should concern ourselves with that she doesn’t over-consume from plant milk (such as estrogen)? I have limited bandwidth for very academic materials but would appreciate any sound practical advice or other educational resources. Also, she hasn’t really taken to really solid foods yet (prefers mainly pureed food or breast milk) so any tips on encouraging consumption of solids would be great. Thanks!Maia James
I think Plum looks like Good Stuff:)
Jaclyn
Can any of these brands be made ahead of time and stored for up to 24 hours? The organic munchkins site implies that this is not possible in its instructions section. Also, any thoughts about using Baby’s Only for an 8 month old? It only has FDA approval for toddlers.
Maria
What are your thoughts on Plum Organics infant formula?
Rachel post
Would you maybe think about doing a review for Australian products ? My son is breast-fed but I’m looking to wean him , I would appreciate any suggestions .thanks
Laura
I did some research and Baby’s Only is not FDA approved as an infant formula, it’s a much more rigorous process which includes numerous checks on their facilities. If you google Natures One Baby’s Only FDA you will come up with a link on the FDA site showing where they were warned because they had been marketing it otherwise. Saying that it’s because mothers should breastfeed for the first year is a marketing ploy. We have been using Baby’s Only Whey but recently switched to Lebenswert when I found that out. Our daughter didn’t seem to like the taste at all which helped make that decision even greater. Google what I mentioned earlier and you will see. You can also google FDA infant formula and see what the requirements are.
Sophia Nguyen
Baby’s Only Organic Formula was great. Due to some milk supply issues, I started supplementing formula when my daughter was about 4 months old. After doing quite a bit of research, my top choice was the HIPP brand, which I had my family bring over for me when they could (they live in Europe, and it is ridiculously cheap to buy off the shelf there compared to the $40 a box it costs to import it). When that wasn’t possible, Baby’s Only was the only other brand I would give me daughter. It has the best ingredients and was rated the highest, and I thought the price was quite reasonable
Malorie
Out of both whey baby only formulas, would you personally go with the option with added DHA/ARA or without? Thanks!
Patricia
What do you know about ordering Holle from Beyondorganic.com. I am recently needing to supplement and ordered a box to see how my son does. I am still breastfeeding morning and night.
Thank you and by the way your thread is incredibly helpful as a first time mom!Worried Mom
Hi! I know you are updating all the details in March but I really need to know now to make the decision for my baby…. please help!!! If it was for your baby, out of all the current formulas here in the US, which one would you pick? Thank you soooo much!!!!! <333
georgesmaa
Hello! I second the question about Enfamil’s new lactose only Enspire formula. Looking forward to your updated guide in March.
sarah hansen
babys only jet.com info listed ~Not intended for infants under 1-year of age unless specified by a healthcare professional
sarah hansen
babys organic jet.com info listed ~Not intended for infants under 1-year of age unless specified by a healthcare professional
sarah hansen
formula will cause these digestive issues in a baby that is only breastfed. pump pump pump if you cannot nurse. it can help your supply. and now the aap recommends not offering anything besides breastmilk until 6 months of age. good idea. many women think they arent producing enough milk but the more suckling or pumping you do the more you will.
Maia James
Yes I am so happy to see the changes Earth’s Best has made! Will include a more thorough investigation when we update this guide (in early March).
Shannon
Hi! I just found your site, and I’m loving it. Thank you! I wanted to check about Earths best – it looks like they don’t have corn syrup solids anymore. Do you think this is ok now?
April
Hi there,
Thanks so much for this! I’ve read through all the comments but still have one question. What two/three formulas would you recommend trying for a baby that has reflux and one wanting to avoid constipation? We are looking for the purest, cleanest, safest formula too. Thanks so much!!Maia James
Yes the ingredients in Sammy’s are great, but my understanding is that there was a recall and it’s no longer available except as a toddler formula (so check with your pedi). We wrote about Goat Milk formula here: https://gimmethegoodstuff.com/is-goat-milk-formula-healthier/
Michelle
Maia,
Thanks for a very insightful article. I am due in July with twins and know that I will have to use formula. I had a very difficult time with my now 3 year old and could only breast feed from one side. After a month of a lot of discomfort and not providing enough milk for him I made the switch to baby’s only. With twins my fear is now doubled! I was going to use baby’s only again and found an article online about Sammy’s milk. Have you heard of it? Any thoughts? You input would be greatly appreciated! Thank you! sammysmilk.comMaia James
Hi! Thanks so much for the kind words. I wish I could help with this question, but since I am not a medical professional, I feel like I need to defer to your pediatrician on the specific nutritional needs of your child at various ages.Â
Maia James
I will look into this one when we update our formula guide! Thanks for the suggestion!
Maia James
Yes, we are on it! There will be an updated Safe Formula Guide coming out this month.
Dereniz
Hello I wanted to know your thoughts about Plum Organics? Would you rather go with Best Organic Formula?
Cindy
What do you think of Enfamil’s newest formula Enspire?
Jared
Roughly when in February? We are due the day before yesterday and trying to choose a safe formula. :-D
We like the baby’s only stuff, but my only concern is that our pediatrician recommended the first ingredient on any formula be milk/lactose. The only one for which that is true is the Whey protein formula for sensitive stomachs. The standard Non GMO and DHA/ARA both start with BRown Rice Syrup. Nonfat milk is second.Casey
Hi there! Apologies if this has already been mentioned in one of the
comments, but I just got back from buying Baby’s Only based on
your review, but then looking at the FAQ on their own website they
discourage use for infants whereas you mention they said that
because they believe in breastfeeding. Now we aren’t sure if we
should return it and go for Earth’s Best which seems to have been
the next best formula that was relatively easy to find…
https://naturesone.zendesk.com/hc/en-us/articles/201491456-Infant-use-Baby-s-Only-Organic-toddler-formula-
Lauren
Hi and I also missed out on thanking you in my below comment as well, so sorry! I have loved your site (and you for the conscientiousness and care you put into keeping everything on it [and us] updated)! I have revised it a number of times. I’m curious, following up this thread comment if you might elaborate on what you think might be best for what age ranges? We were using Plum Organics but I’d like to skip the DHA and soy. Even so, if there is something I’m missing on the suitability of these for various ages then I would like to know your thoughts, and if you know there is a suitable version (at least without soy for each stage?). Again, I just truly want to thank you so much for everything you do! You’re amazing!
Natalia
What are your thoughts on Target’s Up & Up? It isn’t organic, which is not ideal, but it doesn’t appear to have some of your major no-nos like corn syrup.
Maia James
We are working on an updated Safe Formula Guide and it will include this one. It should be live in February!
Lauren
I saw that too! Unfortunately it still has the DHA and soy, for one thing. It looks like it’s pretty similar to Plum Organic formula (can find it at Buy Buy Baby and Babies R Us) now, which I have been using but I’m definitely heading to a Whole Foods to pick up some of the Nature’s One Baby’S Only formula instead now. I don’t want my little boy to have hormonal issues due to soy and I partially breastfeed so I can probably pass along some natural DHA, if just a little. I am also curious if the DHA supplement made by the Honest Company or any others can be recommended. And though it’s kind of unrelated, the Honest Company also sells a probiotic my pediatrician said she would recommend (baby experiencing intermittent bloody stool) because she said that the bacteria (lactobacilli) is one of the few strains that has been vigorously tested on infants. I would like to know if there is any information on what probiotics are recommended now. Thanks so much!!
Ali
Hello,
Earth’s Best Organic Formula has recently removed the corn syrup solids, when you are able to, can you take a look at it again and possibly update the review of it? Many Thanks, AliKerry
Hi – I am interested in your thoughts/review on the Similac Pure Bliss Infant formula. Is it better/worse than the regular Similac Advanced Non-GMO? Trying to get an idea of which category you think it falls into. Thanks!
Maia James
Hi there and thanks so much for your kind words! I know people who do both successfully—-switch to Stage 2 or stay with Stage 1 because of that vexing maltodextrin. I don’t feel qualified to answer questions about specific nutritional needs of babies, so I suggest you run it by your pediatrician. As for the lavender issue—my understanding is that only at very high levels would this be a concern, but I do think it’s worth being aware of when choosing products.
Maia James
If it were my baby, I would prefer BO to EB.
Maia James
You’re right! This version is sweetened with lactose, which is awesome! Thanks for bringing to my attention.Â
Maia James
Hi there! Unfortunately, I don’t feel qualified to answer this kind of nutritional question, and would have to defer to your pediatrician. Congrats on your babies and best of luck!
Maia James
I think this is Okay Stuff based on my cursory research. I will address this more when I update the Safe Formula Guide soon!
Christen Rivas
Maia, do you recommend switching to Stage 2 or 3 as babies get older? Do they have different nutrition levels that are more appropriate for babies nearing 1 year? I have been giving my daughter Lebenswert Stage 1 since she was 2 months and we have absolutely loved it. She is now 9 months and I was just about to place my usual reorder and noticed that on Organic Munchkin the description of Lebenswert Stage 1 recommends using it till 6 months and then switching to stage 2. But I see Stage 2 has maltodextrin instead of lactose… what are your thoughts on that?
P.S. at her recent 9 month appointment with pediatrician he said her health and growth rates are absolutely perfect, and to “keep doing what you’re doing!” Which was so encouraging and I feel like that is largely thanks to YOU!!! I just love how hard you work at helping us mamas do the best we can for our babes. <3 Also he mentioned recent research showing baby skin care products (or breathe-easy rubs like Maty's and The Honest Company's) containing lavender are raising estrogen levels in babies. Yikes!!! Guessing you already know that but it was a shock to me, considering how many products out there for babies contain it for calmness and to help them sleep.Donna
Hi there!
Our pediatric chiropractor talked to us about my daughters gas abd constipation and mentioned he used baby’s only lacto relief with his son and had success, I also bought earths best sensitive but noticed it had soy…egatvare your thoughts?
Emily
HELP!!! My daughter drinks Holle level one, she is with her grandparents this weekend a I forgot to pack them a scoop. If anyone out there uses this too, what is the volume of that scoop? For now grandma is using a level table spoon.
Patrick
Hi,
Looking thru the ingredients list, it doesn’t seem to contain any cane sugar, like mentioned here on this page. Is there something we are missing?We are using Similac Advance sold in Canada:
https://www.amazon.ca/Similac-Omega-Powder-Step-658g/dp/B00MSRB2DM/ref=cm_cr_arp_d_product_top?ie=UTF8
Maia James
Unfortunately I’m not a medical professional and can’t provide any specific. I would recommend you see your pediatrician to find out what would be best for your baby.
Janel
Maia, thank you so much for doing the research and saving me so much time. I’m not sure if you can help further but it would be amazing if you could. What do you know about hemp milk? My supply is starting to slow down and my husband wants to supplement with hemp milk and switch to hemp milk completely when I can no longer produce. Can hemp milk be used in place of formula?
We have preemie twins that are now 5 months old.
Susanne
what are your thoughts on Similac’s Pure Bliss?
Mariya
Please Help! So I needed formula as an emergency and I know Holle is one of the best but I would need to order online (which I will ) but I needed formula now and so I ended up getting Baby’s Only since it was your next on the list that’s located here in the US. The only thing is that the one I got says “whey protein” under the word organic (on the front of the label). When I read the back it says " when transitioning from breastmilk to a formula, a child may experience stooling issues. The use of whey as an additional protein may aid digestion and often results in softer stools". So seems like it’s even better than the regular one that you have picture of since I heard some babies get very bad constipation with regular one..But my question is, is this type of formula safe for my 3 month old??? She was always breastfed and never had formula and neither did any of my other 4 children (they all were only breastfed) and when I got sick my milk dried up so now I had to get formula for my 5th baby and I know nothing about formulas at all! This is all brand new to me and a whole new other world! So I went online to check which one is best and when I stummbled upon ur website I saw all the bad stuff in formulas I’m now freaked out and scared to give the stuff to my baby but know I have no other choice :(. So is this formula safe for my 3 month old? (with the whey protein). Or would yourecommend goats milk instead? I heard it’s the next closest to breast milk and some moms give it to their babies but I dont know like I said this is all new to me since all the other ones and her to this min were only breastfed.. I’m so scared!! I dont know what to do :(