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Breastfeeding: The best start into life

The WHO recommends exclusive breastfeeding during the first six months followed by breastfeeding in combination with complementary feeding for as long as mother and child desire it.

Milk formulae: Composition and classification

Legal classification: Food intended for infants
The composition is regulated by the EC Regulation 609/2013. All products must comply with the legal requirements concerning the energy and nutrient content. There are, however, greater variations in composition when it comes to optional ingredients such as LCPs or pre- and probiotics, which are not regulated by law.

Legal classification of formulae according to feeding stages:

  • Infant formulae: For exclusive feeding from birth.
  • Follow-on formulae: For complementary feeding after 6 months – not suitable for  exclusive feeding. Follow-on formulae are tailored to the needs of older infants. This particularly shows with the minerals iron and calcium, as their concentration can be considerably higher than in infant formulae. Furthermore, follow-on formulae have an adapted casein-whey ratio, which promotes improved satiety.

The table below illustrates the characteristics of breast milk, infant and follow-on formulae as well as cow’s milk. The energy and protein content of infant and follow-on formulae differ only slightly. However, follow-on formulae may contain other carbohydrates besides starch such as saccharose or fructose. Additionally, flavourings may be added as well. HiPP, however, chooses not to use any such ingredients so as not to adversely affect an infant’s development of taste.

Differences: Breast milk – milk formulae – cow’s milk

(Example with no claim to completeness)

Breast milk (BM) Infant formula Follow-on formula Cow’s milk
Energy (kcal/100ml) 66-69 (mature BM) 60-70 60-70 66
Protein ratio (casein : whey) approx. 40 : 60 approx. 40 : 60 approx. 60 : 40 approx. 80 : 20
Carbohydrates Lactose Lactose & optionally up to 2g/100ml of starch Lactose & optionally up to 2g/100ml of starch or other carbs Lactose
Feed from when From birth From birth as exclusive food From 6 months in combination with weaning food From 1 year
Drinking amount As required As required Babies need approx. 5 meals a day; every newly introduced weaning meal replaces one milk feed Approx. 300 ml/day. During the first year it is acceptable to use 200ml for the preparation of a meal – do not give as a drink

What else is important in the preparation?

Suitable water: Fresh tap water may be used for the preparation of formula feed, provided that it is of drinking water quality. Warning! Tap water is not suitable, in case of: lead pipes, regions with increased levels of uranium (>10 or 15 µg/l), unchecked domestic wells, water filters or household boilers. If necessary, parents should inquire the water quality at the local waterworks and if there’s a doubt, a sample should be analyzed.

Alternatives to tap water are bottled still water or special baby spring water with the words "suitable for the preparation of milk formulae" written on the container.

Preparation according to the instructions: Always prepare freshly, portion precisely by using the enclosed measuring spoon, feed immediately and dispose of leftovers.

Functional Ingredients

Apart from the obligatory ingredients, premium brands often also add optional functional ingredients. These include, for example, long-chain polyunsaturated fatty acids (LCPs) as well as pre- and probiotics. These ingredients can also be found in breast milk, which is why they may also be used in modern milk formulae provided that the safety and benefit of these ingredients was scientifically proven. The ESPGHAN, for instance, demands such proof for pre- and/or probiotics.

Pre- and probiotics have a positive influence on the gut flora. A healthy gut flora in turn supports the not yet fully developed immune system of the young infant.
Experts also recommend the use of LCPs in infant formula as they support a child’s cognitive as well as visual development.

HiPP, with their brand COMBIOTIC®, uses the probiotic culture L. fermentum®, which was originally isolated from breast milk, and the prebiotic galacto-oligosaccharides (GOS), which are derived from lactose. The combination of both ingredients was investigated by two separate studies and both their safety and their benefit were confirmed. The proven benefit of infant as well as follow-on formulae was the significant reduction of gastrointestinal infections when compared to the control group.

1 Braegger et al. JPGN 2011; 52: 238-50 (ESPGHAN= European Society for Pediatric  Gastroenterology, Hepatology and Nutrition).
2 Koletzko et al. J Perinat Med 2008; 36: 5-14.
3 Maldonado et al. JPGN 2012; 54: 55-61; Gil-Campos et al Pharm Res 2012; 65: 231-238.

No experiments with baby’s diet!

Plant-based milk alternatives (e.g. cereal-based beverages) or milks from other animals are not suitable for infants.

  • The high protein content of animal milks puts a strain on an infant’s still immature kidneys.
  • Plant-based "milks" have an unbalanced nutrient content.

Contrary to numerous claims, goat milk does not prevent cow’s milk protein allergy in cases of an increased risk of allergies nor is it a suitable treatment for cases of cow’s milk protein allergy. This is due to the fact that goat’s milk and cow’s milk have a similar allergenic potential or, more specifically, there exists a high cross-reactivity between the two.

The only scientifically proven alternative for non-breastfed infants considered at increased risk for the development of allergies are hypoallergenic (HA) infant formulae.

Why feed follow-on formulae?

Follow-on formulae are adapted to the nutritional requirements of infants of weaning age:

  • Needs-oriented energy content – Follow-on formulae in accordance with EU regulations have to comply with the same statutory requirement as infant formulae, which is 60-70 kcal/100ml.
  • Follow-on formulae are the main iron source during the second 6 months of life / second half of the first year of life.
  • A newborn’s iron reserves are used up during the first six months.
  • An infant has to take in more iron in the second half of the first year than during the first half.

HiPP follow-on formulae contain twice as much iron than HiPP 1 formulae.

  • Iron supply is particularly critical for infants in their second six months of life.
  • Follow-on formulae contribute substantially to the calcium intake during weaning age.

HiPP follow-on formulae contain approx. 40% more calcium than HiPP infant formulae.