Neonatal-Perinatal Medicine Specialist Questions Baby Formula

My baby is unable to digest formula milk. Is it normal?

I have a baby who is now 1 month old. Since the past month he was only on breast milk. However since he is always hungry I started to give him formula since I wasn't sure about how much he was getting fro me. But he keeps spitting it up, and I can see powder substances that seem like the formula in his poop. It is also making him constipated. Can you suggest a lighter formula for him?

2 Answers

Im not sure what signs of non digestion your baby is having? Vomiting, weight loss? Discuss with your pediatrician and she should be able to find another formula to try Michael L Spear, MD, MSEdl Faculty Advisor, Honor Board Professor of Pediatrics Drexel University College of Medicine
Breast milk is the easiest milk to digest, and includes protective elements that are not present in formula milk, like lactoferrin, and especially maternal antibodies that no formula can give. It recommended to give strictly breastmilk up to 4 and 1/2 months, then to introduce progressively other nutriments. Make sure to sleep enough, exercise regularly, that you drink a lot and eat enough of a well balanced diet, and that your baby goes to the breast every 3 hours, up to 4 hours at night. Your baby should settle after the feed and sleep for 2-3 hours in-between feeds if well fed. Fennel tea, almonds and other natural food are good to stimulate lactation and your doctor can give you more advice if your milk production does not increase with those. If you eat/drink lots of dairies, you may also consider cutting a bit on those. You can also try to express your milk manually or with a pump that you will find in pharmacies - this will inform you on how much milk you produce, and will also stimulate your production if you do it every 3-4 hours for 5 minutes each side after your baby has gone to the breast - your brain will interpret that your baby needs more food and increase the production of lactation hormones. Usually breast milk production does self-regulate according to the baby's demand, but this may be impaired, especially in case of previous surgery on the breast, and few women just don't get enough milk despite trying. Formula milk is based on cow milk, and the casein in the cow milk is known to create intolerance, with the most severe form being cow milk protein allergy (CMPA), which usually presents with increased spits-ups, loose stools (but not always), possibly blood in the stools, poor weight gain and abdominal discomfort. If your baby presents poor weight gain and bloody stools, I recommend that you consult your doctor to rule out other causes of intolerance. There is unfortunately no specific test to confirm CMPA and exclusion of cow milk proteins is sometimes needed to document improvement, which can take up to 2 weeks to happen. If your baby has spits up and constipation, it can also just be that formula milk is more difficult to digest and is known to make more solid stools. Every regular cow-milk-based formula contains casein. Make sure you put the right proportion of formula powder in the preparation, as if it is too concentrated, it is even more difficult to digest and makes more constipation. Sometimes changing the milk to a lactose-free formula may help. if your baby has real CMPA, you would need to go on a dairy-free diet, or he/she will need a special formula like Alimentum or Neocate, in which casein is hydrolyzed, or even more elemental formula. Those are much more expensive though and are often not available in pharmacies.
Again, I can only encourage you to keep breastfeeding, as it is simply the best food for your baby.
Best luck with your breastfeeding!