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A podcast for parents regarding the health and wellness of their children.
The Formula of Infant Formula
No Description
I welcome Dr. Bridget Young, who has a PhD in nutrition and studies the composition of breastmilk and formula.
We discuss some of the most common questions I get asked about formulas:
00;00;06;23 – 00;00;37;13
Dr. Mona
Hey, everyone. Welcome to the PedsDocTalk podcast. I’m your host, Doctor Mona, where each week I hope to educate and inspire you in your journey through parenthood with information on your most common concerns as a parent and interviews with fellow parents and experts in the field. My hope is you leave each week feeling more educated, confident and empowered in the decisions you make for your child.
00;00;37;15 – 00;00;54;21
Dr. Mona
Hello and welcome to this week’s episode where I have Doctor Bridget Young, who is also known as Baby Formula Expert on Instagram, and she has a PhD in nutrition. And we are going to be talking all about formula. Welcome Doctor Young. Woo hoo!
00;00;54;23 – 00;00;57;02
Dr. Bridget Young
Thank you so much. I’m thrilled to be here.
00;00;57;04 – 00;01;15;22
Dr. Mona
I’m so excited I found you your website, which I’ll be attaching to the show notes as well as your Instagram is an amazing source of information. Formula selection is so confusing. So I took it upon myself to research more about formulas and guess where. Guess what website I found when I was doing my research?
00;01;15;24 – 00;01;17;26
Dr. Bridget Young
I was so honored.
00;01;17;28 – 00;01;29;15
Dr. Mona
Yeah. So I that’s how I found her in the first place. And then, you know, I read through it and then I’m like, let me see if I can contact her to get her on the podcast. And she agreed. So. Welcome, welcome, welcome.
00;01;29;17 – 00;01;30;25
Dr. Bridget Young
Oh thank you.
00;01;30;28 – 00;01;35;25
Dr. Mona
So tell me more about your background training. What brought you to becoming baby formula expert?
00;01;36;01 – 00;01;58;28
Dr. Bridget Young
Yes. Well, I’ve been working with moms and babies for more years than I would like to count right now. So I had my PhD in nutrition at Cornell, and I did a postdoctoral fellowship in pediatric nutrition, specifically at the University of Colorado, and then joined faculty there in pediatric nutrition for several years. And then currently I am pediatric faculty at the University of Rochester.
00;01;59;03 – 00;02;26;14
Dr. Bridget Young
So I have a PhD, which means I wear a huge nerd hat. Not socially cool like a pediatrician. And I run a research lab. So currently I study and have been for years studying breast milk composition, working with breastfed moms and babies. And I’m also a certified lactation counselor. So I actually got into formula. I’m trying to think how many, many, many years ago, through studying obviously breast milk composition informs formula formulation.
00;02;26;20 – 00;02;45;19
Dr. Bridget Young
And one of the things that I was very embarrassed about was when working with breastfeeding moms who occasionally would need to supplement for a number of reasons, and they would say, you know, we’ve reached this point. I need to supplement. What’s your recommendation for formula? I didn’t have one. And so, like, you knew not much about it, but and, you know, qualified enough to learn.
00;02;45;19 – 00;03;10;23
Dr. Bridget Young
And so I started diving into formula nutrition and understanding how you may try to make evidence based recommendations for one individual baby versus another. And that was over seven years ago. Might, you know, put that information on my first website. And then it’s just kind of grown from there. And so today, in addition to my research, I also work clinically with children and babies experiencing formula tolerance issues.
00;03;10;26 – 00;03;24;17
Dr. Bridget Young
And it’s a really wonderful way to kind of blend the two, to be in the the front edge of studying human milk composition and then understanding how that affects formula development, and then actually working with kiddos having issues with their formula. So it’s a lot of fun.
00;03;24;19 – 00;03;48;07
Dr. Mona
No, that’s great. And you definitely have so much information on your website. And what we’re going to be talking about in this episode is the main point of your website. Basically the main topics that when a parent goes to the store or decides, you know, what formula to get, we’re going to be going through how they can decide the terminology, I think is going to become really important when parents are looking, looking for a formula.
00;03;48;09 – 00;03;56;16
Dr. Mona
So we’ll get into all of that, some, some myths that happen with formula selection. But I am so excited. I think we have a great, great list of questions ready to go.
00;03;56;19 – 00;03;57;24
Dr. Bridget Young
Perfect. So let’s do it.
00;03;57;28 – 00;04;09;22
Dr. Mona
So the first question I have was about regulation in the United States. So people often feel that the United States doesn’t regulate formula. Well, what are your thoughts about the regulatory process in the States?
00;04;09;27 – 00;04;28;28
Dr. Bridget Young
It’s a great question, and it’s a really good point for parents to understand what is, quote unquote regulated versus not. So, I don’t have opinion on whether it’s good or bad. It is what it is. And if parents just understand what the FDA is, the regulatory body for formula and the United States, what they do, then you know what their job is and what they don’t regulate.
00;04;29;04 – 00;04;59;02
Dr. Bridget Young
So in the United States, the FDA’s job is to basically, regulate the safety of formulas in terms of contamination. And they also regulate the parameters, the nutritional parameters that a formula has to fall into. So you anybody can go to the FDA website and find the nutritional parameters for what an infant formula needs contain. You know, it’s a list of all the vitamins and minerals and nutrients and a range of minimums and maximums.
00;04;59;09 – 00;05;25;08
Dr. Bridget Young
And they also maintain, regulation on what types of ingredients can be used. So for example, you can’t just put olive oil in formula even though some people would like to. Every ingredient that is used in formula has gone through safety testing. Is research proven to be safe. For instance, for infants and so there’s a limited list. And so that’s what the FDA regulates what can go into formula and the range it can be in.
00;05;25;14 – 00;05;43;27
Dr. Bridget Young
And then they also play a very big role like I mentioned in safety. They inspect all formula manufacturers annually in the United States. They do batch testing. So you know, when you hear that scary recall, that’s the FDA. That’s their job. And they maintain records. So if there is, God forbid, a recall, the news is spread right away.
00;05;43;27 – 00;06;08;24
Dr. Bridget Young
People find out immediately. So that’s their job. So it’s not their job to, for example, talk about organic versus not organic. They don’t say this ingredient is probably a better choice than that ingredient that’s completely out of their purview. So when people I, you know, see a lot of conversation about people probably wishing the FDA did more, but they have a very specific purview and they do that purview very well.
00;06;08;24 – 00;06;38;17
Dr. Bridget Young
I feel very comfortable that infant formula is the safest food on the market. Nothing else gets safety tested like infant formula, as it should be. But they don’t do nutrition quality research or make any kind of statements along those lines. So I think that’s helpful for parents to understand starting off. And I’ll throw in one more thing that’s very interesting about the FDA and differs from Europe, is that the FDA regulates the term, quote unquote, infant formula.
00;06;38;20 – 00;07;08;03
Dr. Bridget Young
So anything marketed as an infant formula by law meets the needs of an infant from birth to 12 months. So when you see things like infant formula, stage one in the U.S. or stage two or infant formula for supplementing, that’s all marketing, maybe minute differences and a couple of the nutrients up or down a little bit. But for example, a baby whose exclusively formula fed can totally have a formula marketed as for supplementing.
00;07;08;10 – 00;07;29;28
Dr. Bridget Young
That’s by law. A baby who’s a newborn or for a better example, is a baby who’s seven months old can still drink stage one formula. By law, it will meet his needs. Europe regulates differently, but that’s a source of confusion for a lot of parents. And if they understand the FDA regulating, then then it just takes a load off your mind when looking at those different flashy labels.
00;07;30;00 – 00;07;48;07
Dr. Mona
Thank you so much for clarifying that, especially the newborn versus infant and the marketing behind it. People often ask that in my office, and I tell them I’m like, it’s actually, like you said, nutritionally or equivalent in terms of what it is. It’s just that they’re hoping that you see it as a next phase, and then maybe you’ll buy the next stage up.
00;07;48;09 – 00;08;06;00
Dr. Mona
So I completely agree with that. So would you say that the European formulas are quote unquote better? Because a lot there’s a lot of parents now who are interested. One of the the two main brands I hear is Holly and hip. Oh, yeah. I’m pro now. I’m probably pronouncing it wrong, but do you feel like they’re better, quote unquote.
00;08;06;00 – 00;08;10;18
Dr. Mona
Or are Americans formulas under the FDA regulation? Okay. To use?
00;08;10;25 – 00;08;32;00
Dr. Bridget Young
Oh, American formulas are absolutely okay. It’s very, very safe. I feel very comfortable recommending them all day, every day. So they’re they’re just different. So I would never say one is better than the other. I think we’ll get into this. Every baby is different. Just like every person is different. For an adult. You would never say all adults are going to thrive on the exact same diet.
00;08;32;02 – 00;08;53;21
Dr. Bridget Young
And I think babies that my opinion babies are the same. So there’s going to be a different formulation that’s going to help one baby really thrive and digest comfortably than another baby. And so finding the ingredients that match your baby’s biology, that’s what my website’s all about. That’s my big mantra. So that conversation in my mind completely supersedes European versus American.
00;08;53;28 – 00;09;15;06
Dr. Bridget Young
So I can very briefly say European formulas are regulated by the European Commission. Kind of like their version of the FDA. So they’re regulated by a different body. And the European Commission does kind of take on a bigger job than the FDA. They have they have more parameters and more requirements that they put on formula, which makes some people find them desirable.
00;09;15;06 – 00;09;37;18
Dr. Bridget Young
For example, they do have requirements about detectable levels of pesticides in all of their formulas, and they have, more strict criteria about exactly what types of ingredients can be used. So that makes some people feel more comfortable that you can find formulas in the U.S that meet all those criteria. So it’s not like one is universally better than the other.
00;09;37;18 – 00;09;54;05
Dr. Bridget Young
It’s honestly it’s understanding a lot of difference in regulation, which is very boring to discuss and not what I think I’m an expert in. But the nutrition and the ingredients I always think are the number one priority in finding the new ingredient blend that matches your baby’s biology.
00;09;54;08 – 00;10;12;18
Dr. Mona
I knew we would get along because this is so important for people to hear. And, you know, it is a modern parenting thing where this whole, you know, European formula, like all my a lot of my patients and Instagram followers who are in the States, you know, they DM me and they ask and they’re like, hey, I want to get a European formula, where do I buy it from?
00;10;12;18 – 00;10;33;29
Dr. Mona
And I say, I’m not against it. Like you said, I think it’s great if you can find it from a reputable place, but the American formulas are perfectly fine. And like you beautifully said, as long as you find the right one for your baby, if there’s some issues talking to your pediatrician, obviously doing your own research is going to be the best thing, but you don’t necessarily have to go overseas.
00;10;33;29 – 00;10;57;01
Dr. Mona
It’s an important concept, because what I think happens then is that, you know, in mommy groups or whatever it is, a mom is using an American formula and she finds out, oh, well, this Holly was better. And she’s like, well, this one was working for my kid. Should I switch? No, not necessarily. So I don’t want people to feel guilty that they’re not doing the best thing for their child when there’s so many formulas in the United States also.
00;10;57;06 – 00;11;17;01
Dr. Bridget Young
Yeah, yeah. And I love that New York pediatrician. Whenever people are considering European formulas, I have the same opinion. But my number one thing is you must involve your pediatrician. There are minor differences in regulation that your pediatrician will know about that that do make a big difference, and getting the formula from a reputable source, you know, it hasn’t sat in the sun.
00;11;17;01 – 00;11;34;17
Dr. Bridget Young
It’s not past the expiration date. You know, things that can make it go very bad very quickly are all things you have to take into account when you’re using a European formula that just you can take for granted in the US, that it’s safe. It’s within the expiration date. You’ll hear about a recall. So it’s a little bit of a risk benefit discussion that you have to have with your pediatrician.
00;11;34;19 – 00;11;54;13
Dr. Mona
Now we’re going to go into talking about the composite version of formula, which I think is really important. And I again your website had everything detailed. We’re taking the big the big points, for this conversation. But first let’s talk about the protein source and formula. What is it. What is it composed of and how does it differ than breast milk.
00;11;54;15 – 00;12;19;28
Dr. Bridget Young
Right. This is my favorite topic because it’s not talked about very much. And in my opinion, this is all mums ears are going to perk up. This is the biggest factor in terms of baby comfort when digesting a formula. So if we’re talking about dairy based formulas, which is most formula and most standard formulas, protein, either from a human breast or cow comes in two components whey and casein.
00;12;19;28 – 00;12;37;16
Dr. Bridget Young
So these are categories of protein, just like trees are either deciduous or coniferous, all proteins in mammals, milk are either way proteins or casein proteins. And they behave differently. So casein proteins tell you thank you in part to remember a little Miss Muffet. A little Miss Muffet sat on her tuffet eating her curds. And her way, way.
00;12;37;17 – 00;12;56;24
Dr. Bridget Young
So curds are casein. That’s what makes them casein. If you drop a protein into an esthetic environment, like a tummy, if it curdles, it’s casein. If it remains liquid, it’s way like that’s the only difference. So like when your baby’s spit up on you, the part that soaks right through your shirt and gets your skin wet is liquid.
00;12;56;24 – 00;13;21;11
Dr. Bridget Young
That’s way the little tiny white chunk that you have, just like, smear all over your shirt. And don’t come up. That’s casein. So the reason it’s important to think about them when picking a formula, or especially if you’re switching a formula, is to think about how they behave in the stomach. So human breast milk different between moms, but it’s roughly 60% whey, 40% casein.
00;13;21;11 – 00;13;50;21
Dr. Bridget Young
So more weight than casein. Cow’s milk protein is the other way around. It’s roughly 80% casein, 20% way. So much more curdle, much less liquid when it’s in the stomach. I want to be clear. It’s not exactly the same thing. So cows milk, casein proteins, there’s a lot of different proteins that are in the casing category. They might not be exactly the same as proteins in the breast milk casein category.
00;13;50;21 – 00;14;15;16
Dr. Bridget Young
So it’s not as easy as just add more whey. And we’ve got breast milk. We’re still working on that from a research standpoint. But it’s important for parents to just understand going in that there’s going to be a lot more casein in a cow’s milk protein, so a lot of formulas will add extra way back to try to bring that ratio up to be more like breast milk and have it predominantly way, some formulas though do not.
00;14;15;19 – 00;14;54;03
Dr. Bridget Young
And that’s a really big difference. So it’s not like one is better and one is worse. They’re just really different. So in general, way empty stomach faster because it’s liquid. So that’s something to keep in mind when you’re choosing. So if you have a baby who’s on a formula and you have regurgitated issues, so a lot of spit up, maybe reflux projectile, spit up anything where you would be really interested in getting that formula into their intestines and out of their stomach more quickly, then choosing a formula or moving to a formula that has more whey and less casein might be a really good option for you.
00;14;54;05 – 00;15;13;26
Dr. Bridget Young
And vice versa. If you’re on a formula that has a lot of that extra whey added back in, but your baby is just not doing well, you’re, you know, they’re not digesting well. Something is, you know, they’re healthy, but something’s just doesn’t seem to be sitting right with them in their digestion. Then maybe trying a formula with more casein and less way.
00;15;13;29 – 00;15;35;18
Dr. Bridget Young
So it’s a little bit different sometimes that makes a difference in helping them. So just switching to either more predominantly casein versus more predominantly whey. The kicker is you basically need a PhD to figure it out on the label. I mean, I exaggerate, you don’t. I’ll break it down for you, but it’s not like the front of the can says this is a predominantly casein formula.
00;15;35;18 – 00;16;05;05
Dr. Bridget Young
I really wish it did. But the way that you find out if it’s way your casein, you could go to my website and look at the charts I have there, but you have to flip over the can and look at the list of ingredients. If you see way there, then, you know, they added way back. And so it’s going to be a predominantly whey formula if you just the skim milk or nonfat milk protein, they just kind of expect that you have this knowledge that skim milk is predominantly casein.
00;16;05;07 – 00;16;29;11
Dr. Bridget Young
And so then, you know, okay, I’m feeding a formula where the protein is predominantly casein. Again, one is not better than the other, but they do behave very differently in the mechanics of digestion, which naturally makes sense is going to jive with some babies versus not with other babies. And so it’s a really good I described as kind of like a lever that you can pull when you switch formulas, trying to address what’s making your baby uncomfortable.
00;16;29;11 – 00;16;31;25
Dr. Bridget Young
If they’re having discomfort digesting.
00;16;31;27 – 00;16;48;11
Dr. Mona
I have seen those labels and I agree with you. You need a more than a PhD, an MD or whatever. It is very complicated. And I you know, I actually learned that tip from your website about how to read the labels, which that’s why I’m so happy that you’re joining me. And about, you know, what you just mentioned is such a good pearl.
00;16;48;11 – 00;17;08;22
Dr. Mona
And I think that’s going to help so many families when they’re standing in that aisle wondering where to even begin. The other component of formula is carbohydrates. So obviously we know that they have carbohydrates. And one of the most common one is corn sirup. A lot of parents are have corn sirup phobia. What are your thoughts about corn sirup and formula?
00;17;08;23 – 00;17;12;11
Dr. Mona
Is it okay? Is it safe? More about the composition of that.
00;17;12;13 – 00;17;33;02
Dr. Bridget Young
Yes. I’m so glad you asked this because I get this question all the time too. And like I said, I have a PhD in nutrition, so I get the corn sirup phobia, I totally understand. The thing to remember is that babies are not just tiny adults in terms of their intestines, so they have a very limited repertoire of ingredients that they can digest.
00;17;33;02 – 00;17;53;25
Dr. Bridget Young
Obviously, from an evolutionary perspective, they’re made to only drink breast milk for the first, you know, 4 to 6 months. So if they’re not getting breast milk, then they have to have other inputs that they can digest. So the predominant or really the only carbohydrate in breast milk is lactose. That’s also the carbohydrate in cows milk. So most formulas have some amount of lactose.
00;17;54;02 – 00;18;20;26
Dr. Bridget Young
But if a baby’s not if the baby formula does not have lactose, there’s very few carbohydrates we can use as a replacement, because babies don’t express all the enzymes that older kids and adults do like. You can’t just feed. We know there’s a baby oat fiber. They won’t be able to break it down. So they have to have these very simple sugars, sugar as a carbohydrate in order for them to get the energy that they need from their carbohydrates.
00;18;20;29 – 00;18;47;29
Dr. Bridget Young
So if it’s not lactose, which you will see on most formula labels, corn sirup is one of the most common substitutes for lactose. You may also see sucrose, which is table sugar, which I know is really scary to parents. But again, if it’s not lactose, it has to be basically either, corn sirup or sugar. There’s a lot of other words that formula companies are wising up for.
00;18;47;29 – 00;19;08;27
Dr. Bridget Young
Instead of saying just corn sirup or but or using other ingredients that all digest the same thing. So brown rice sirup, corn sirup, solids, glucose sirup, those maltodextrin, they all metabolize into plain glucose, which probably sounds familiar. That’s the that’s the sugar that you have going around in your blood that keeps your body, that keeps your body functioning.
00;19;08;29 – 00;19;32;17
Dr. Bridget Young
So those all break down for glucose very quickly so that the baby can actually harvest that energy. So it’s not super scary to see most, but I will say most babies completely thrive on 100% lactose. So if you if you’re it feels not just sitting well with your intuition to have your baby on a formula that has corn sirup in it, then choose a formula to start with that has lactose in it.
00;19;32;20 – 00;19;56;22
Dr. Bridget Young
But I don’t want parents to ever be fearful of seeing those words on the label. And you said this earlier and I applauded in my head, if you’re my number one rule is if your baby is thriving, you have found the perfect formula for your family. So if your baby is thriving and then you just happen to realize that there’s corn sirup or corn sirup solids in there, I personally would not tell you to change formulas.
00;19;56;22 – 00;20;03;01
Dr. Bridget Young
I would say you found the perfect formula for your baby. Look how well they’re doing. Stick with it, mama. You’re doing a great job.
00;20;03;03 – 00;20;14;05
Dr. Mona
I love that tip. And I think that is so important because why? Why fix what’s not broken? That’s like the the parenting motto with everything and like yes, exactly. So I, I’m like, well.
00;20;14;12 – 00;20;18;27
Dr. Bridget Young
Save the worry for potty training. Yikes. Other things to worry about.
00;20;19;00 – 00;20;31;23
Dr. Mona
Yes. Oh, I love that. And the next thing about formula was the addition of prebiotics and probiotics in formula. What are they beneficial? What’s the difference between prebiotics and probiotics?
00;20;31;23 – 00;20;51;10
Dr. Bridget Young
Yeah. I love this question. I’m totally gonna answer it. No, I’m gonna answer a different question first, and then I promise I will get back to it because there’s something new all the time. Like we just have now, milk that globule membrane and lactoferrin, and now we have HMO. So I call these these sexy extra. So prebiotics and probiotics.
00;20;51;12 – 00;21;13;22
Dr. Bridget Young
From a research standpoint, they’re all super fun to talk about. But I will just say the number one factor for your baby’s comfort is going to be those major ingredients, the protein, the carbohydrate in the fat. So adding a prebiotic is not going to make a difference. If your baby can’t digest the protein well, you know it’s not going to magically cure them.
00;21;13;25 – 00;21;32;15
Dr. Bridget Young
So I view all those extras as like icing on top of the cake. But I always ask parents to focus if they’re trying to fix the problem. Focus on those main big ingredients that make up the 98% of the formula first, and then worry about all the sexy stuff. So with that in mind, prebiotics and probiotics are totally a sexy topic right now.
00;21;32;15 – 00;21;54;20
Dr. Bridget Young
They’re the source of a lot of marketing, which can be really confusing. But here’s the different prebiotics are food for healthy bacteria. So pre always means like it comes first. So they are the food for the healthy bacteria in the baby’s gut that the baby’s growing very rapidly. Babies are born without very much. And they have tons of healthy bugs move in especially over the first six months.
00;21;54;22 – 00;22;21;24
Dr. Bridget Young
Probiotics are healthy bacteria themselves. So probiotics are live, quote unquote good bugs that are either included or formula. There’s a lot of supplements that parents can buy, too. There’s a bunch of different kinds. I mean, we could have a whole episode going over the different types. I don’t have a universal recommendation of one versus the other. I don’t think we know enough yet to be able to make that kind of universal recommendation.
00;22;22;00 – 00;22;45;26
Dr. Bridget Young
I think they can be really helpful for some babies. But again, if I have a if I’m working with a baby who’s really having what we consider a formula talented, she was really uncomfortable. A prebiotic and probiotic is never the first thing I consider. It’s always those major nailing down those major ingredients that jibe with that baby’s intestines first, and then maybe adding a prebiotic or a probiotic.
00;22;45;26 – 00;22;47;01
Dr. Bridget Young
Once we get that figure it out.
00;22;47;03 – 00;23;07;26
Dr. Mona
So you said it. In clinical practice, you work with a lot of families who are whose children are on formulas and see if you need to change things around, correct? Yes. So what are in your opinion, obviously, I’m a physician and you’re a PhD who does this on a daily basis. What would be signs that a family would say, hey, maybe I need to talk to my doctor or a specialist about switching formulas?
00;23;07;26 – 00;23;08;27
Dr. Mona
Yeah.
00;23;08;29 – 00;23;27;28
Dr. Bridget Young
That’s a great question. So I kind of think about this in tears, tears of how quickly you need to call your doctor. First of all, I would say if you have a question at all, call your doctor. I’m sure you agree. Like, even if you’re just curious about something, if you want to change a formula, but even just for a small problem, still to always call your pediatrician, they know your baby’s medical history.
00;23;28;05 – 00;23;51;09
Dr. Bridget Young
All pediatricians are nice people. That’s why they’re in pediatrics. They’re happy to talk to you. But things to look for if you to change formula immediately. I think parents know that if you see blood in the stool, if your baby’s having any kind of congestion, lots of nasal dripping, mucus either in there, you know, coughing or a lot of clumps of mucus in their stool.
00;23;51;11 – 00;24;14;00
Dr. Bridget Young
Full body rashes, like, those are big reasons to call your pediatrician right away. And your pediatrician definitely wants to hear about that. I think probably everybody knows that other things, that I think are probably more common that I probably all parents deal about, but that can sometimes be fixed with formula. Not all the time. Gas is a big one.
00;24;14;02 – 00;24;36;06
Dr. Bridget Young
Every baby has gas. Breastfed babies have gas. Yes, that baby’s got it all babies have gas. Now there are some things in formula that can make some babies gas worse. So some. And you know we’re I’m happy to talk about those. So sometimes an ingredient switching formula can help with gas. It will never eliminate gas, but it can help.
00;24;36;08 – 00;24;55;28
Dr. Bridget Young
Some formulas have really been shown to be very helpful with eczema. So if eczema is something your baby’s suffering from, I’m sure you’re discussing it with your pediatrician to begin with, but talking about what formula they’re on and a switch could help. Definitely. Anything that you know is in the intestines. So, excessive spit up or reflux, you know, formula.
00;24;55;28 – 00;25;16;03
Dr. Bridget Young
If you’re babies on formula, that will be part of the conversation with your pediatrician. Constipation for sure. Like that’s obviously something that’s not moving in the intestines. Sometimes changing certain ingredients in formula can help with those things. So things directly in the intestines like gas, constipation, and regurgitation, are often things that I deal with and, more minor immune related symptoms.
00;25;16;03 – 00;25;18;11
Dr. Bridget Young
The classic one is eczema.
00;25;18;13 – 00;25;46;24
Dr. Mona
So one of the one of the most common things that I hear. And maybe again, this is not a GI talk, but it is important because it’s the infant gut and formula is heavily involved. Is a lot of parents think that their child is lactose intolerant in newborn period or infancy. So I want to clarify because again, we’re going to I’m going to do a whole other episode about cow milks, protein allergy and lactose intolerance, which lactose intolerance is very, very rare in infancy.
00;25;46;27 – 00;25;50;29
Dr. Mona
It’s usually something that you that present much later. But have you heard that as well?
00;25;51;00 – 00;26;16;09
Dr. Bridget Young
Oh, yeah. All the time. All the time. So yes, I always tell parents a true lactose intolerance in an infant is very rare. It’s tested for, like, you would know. Now. So my thoughts on lactose when babies have issues that normal symptoms that are associated with lactose intolerance in adults, like gas, bloating, cramping, I always say like, hey, I see why you would think this might be a lactose problem.
00;26;16;12 – 00;26;36;27
Dr. Bridget Young
I would bet my bottom dollar it’s a protein problem in a baby because they’re designed to digest lactose. So, now some babies do seem to do better on a little bit of a lactose reduced formula, which we described earlier. If you take lactose out, you have to add corn sirup or something similar back in. So to get rid of the lactose, you have to add something back in.
00;26;37;01 – 00;27;01;05
Dr. Bridget Young
Some babies really do seem to do better on a little bit of a lactose reduction, but in general, if I see things like that cramping, really big bloating, you know, or the baby’s so distended after having a bottle. I usually think about assessing the protein. The vast majority of formula tolerance issues or digestive discomfort issues are with the protein, not the lactose.
00;27;01;05 – 00;27;09;21
Dr. Bridget Young
So I always start there and then, you know, we can consider the lactose separately afterwards. But start with the protein first.
00;27;09;23 – 00;27;26;12
Dr. Mona
And what Bridget was saying, you know, in terms of having a true lactose intolerance or lactose allergy, there is a screening test done in the hospital. And in those situations, like the only formula that is pretty much for true lactose intolerance, if that is happening and it is rare, is a soy formula.
00;27;26;15 – 00;27;41;05
Dr. Bridget Young
Yes. Because and it’s not because of the soy, it’s because all soy formulas in the US are 100% lactose free because they have no milk, there’s no risk of a little bit of contaminating lactose from that milk. And so thank God we had those formulas for those babies. It’s life saving for them.
00;27;41;05 – 00;27;56;04
Dr. Mona
And that brings me to my next question, and I’ll tell you why. It brings me to this in a bit. But hydrolyzed formulas. So that is a term that I don’t know if everyone listening will understand, but what is an example of hydrolyzed formula? What does it mean in terms of the science?
00;27;56;09 – 00;28;16;15
Dr. Bridget Young
Yes. Oh, I’m so glad you asked. So hydrolyzed formula is a way or hydrolyzed itself. The word comes from hydrolysis, which just means to break apart. I always joke that, like in medicine, we have to have fancy words for things that we can sound very elites. But if you hear hydrolyzed or hydrolysis just being broken apart, so a partially hydrolyzed formula is a partially broken down formula.
00;28;16;17 – 00;28;37;23
Dr. Bridget Young
So that’s a way of categorizing proteins. So you could have a partially hydrolyzed whey formula. You could have a partially hydrolyzed soy formula. So it just means we’ve taken the proteins. And you can think of like breaking them in half. And so they’re they’re pre digested basically. So we do have several options on the market of partially hydrolyzed formulas.
00;28;37;23 – 00;28;57;16
Dr. Bridget Young
And this just means the proteins themselves have been broken down a little bit inside. The reason historically formula companies started making these is because cows milk proteins. You think about the molecularly they’re bigger in size and breast milk proteins. So baby cows drink bigger proteins than baby humans. It turns out they’re very different. Animals need very different needs.
00;28;57;16 – 00;29;20;15
Dr. Bridget Young
So that kind of makes sense. So the formula companies said, well, maybe we should break these down and see if that helps some of our more sensitive kids or kids who are having trouble growing, if that helps them. And there’s no research to say that that obviously one is universally better or we would universally recommend them. But I do personally think it is a great it’s just a great option to have if that is your baby.
00;29;20;15 – 00;29;42;29
Dr. Bridget Young
So if you know this is a conversation you definitely have with your pediatrician, but if your baby definitely they’re having trouble growing, or if they’re having trouble, you think that they’re having trouble digesting their protein. Moving or trying a partially hydrolyzed formula can help. So basically some of the work is already done for them. For digesting protein. And protein is one of the hardest components of a formula to digest.
00;29;43;02 – 00;30;08;22
Dr. Bridget Young
So examples of those are both Gerber Gentle and Gerber Smooth are partially hydrolyzed whey formulas. They have no casein at all, and for milk has both gentle ease and regulation. And those are partially hydrolyzed formulas that are a blend of whey in casein and then partially hydrolyzed. Similac has total comfort, which is a partially hydrolyzed way, so you can see how what protein you kind of have.
00;30;08;22 – 00;30;28;11
Dr. Bridget Young
Two levers you can pull. You can tweak the way in casein ratio, and you can also tweak the protein size by moving from a standard to a partially hydrolyzed formula. So it’s very overwhelming to see all the cans in the formula aisle. But once you know what you’re looking for, you can see how you can get so many options pretty quickly.
00;30;28;18 – 00;30;56;16
Dr. Bridget Young
But I do think having a partially hydrolyzed formula is very helpful for kids who are really having a hard time digesting the other thing. And sometimes when kids after they’ve been sick or if they’ve had a hard time digesting, they can have minor inflammation in their intestines just temporarily. They’re totally going to be fine and outgrow it. But sometimes in the meantime, when you’re trying to help them get back on their feet, to use a phrase, having a partially hydrolyzed protein can kind of help them by doing a little bit of that work for them.
00;30;56;18 – 00;31;17;00
Dr. Mona
And two comments. One is that this is not sponsored by any of those companies. I have to say that I forgot to I could be at the beginning. So I’m pretty sure my, my, my listeners, station, my listeners know that I make that clear if I am being for sponsoring something. But now, but it’s funny, I actually I personally formula feed my son and we do Gerber soothe.
00;31;17;05 – 00;31;35;09
Dr. Mona
It’s just what I thought also from my research and from what I knew. So I’m loving hearing that you also agree that it’s it’s a good partially hydrolyzed formula. What are extensively hydrolyzed formulas? And again, I know a lot of my listeners may not ever have to get to these formulas, but what are some examples of this? When would a child need these formulas?
00;31;35;14 – 00;31;59;27
Dr. Bridget Young
Yes. Great question. So you start off with standard formulas. You can break down the proteins to be partially hydrolyzed like we just discussed. And then you can break down the proteins even more to be fully hydrolyzed. And you’ll see that phrasing on the ingredients. In the United States, fully hydrolyzed formulas are also hypoallergenic. So an allergy is the body’s immune system reacting to a protein.
00;32;00;02 – 00;32;23;08
Dr. Bridget Young
So a hypoallergenic formula, we’ve hydrolyzed or broken down the proteins into such small, tiny pieces that the immune system doesn’t even recognize them anymore. So a fully hydrolyzed formula is a hypoallergenic formula. So if your baby has been diagnosed with a cow’s milk allergy, then they need a formula that the protein is so small that that allergy isn’t triggered by their formula, obviously.
00;32;23;10 – 00;32;51;12
Dr. Bridget Young
So hypoallergenic formulas and fully hydrolyzed formulas are synonyms in the US. It’s different phrasing in Europe. So in the US you’ve only got three options for a hypoallergenic formula. So you have Similac, element. You have Gerber HRA which stands for hypoallergenic. And then you have neutral again. So those three are hypoallergenic formulas and that’s it. So you have much more limited options.
00;32;51;12 – 00;33;19;00
Dr. Bridget Young
So a lot of babies who are really having a hard time growing or they have an allergy end up on a hypoallergenic formula. I always say, if you’re in a store and you’re holding one of those cans in your hand, don’t buy it without talking to your pediatrician. Like if you get that far down, that is definitely a conversation you want your pediatrician involved in because, you know, there’s just so many other things you would want your baby assessed for at that stage, and you definitely want your pediatrician involved.
00;33;19;06 – 00;33;42;17
Dr. Mona
I am so happy you said that, because what I see a lot of is, for example, just using gas as a symptom. The baby has gas alone and the parents are jumping from formula to formula. Going on what, you know, what a friend said online or a friend that they know of that work for their baby. But it’s really important that whoever’s listening you talk to the pediatrician in terms of the symptoms so they can direct you.
00;33;42;17 – 00;33;57;08
Dr. Mona
Do you need maybe a partially hydrolyzed? Do you need extensively hydrolyzed? The thing about these are, fully hydrolyzed formula is like an element. From a pediatrician standpoint, they’re very expensive and they actually don’t taste that great compared to the other formulas. Oh.
00;33;57;08 – 00;33;58;16
Dr. Bridget Young
They’re nasty.
00;33;58;18 – 00;34;01;25
Dr. Mona
Yeah. In residency, we had to do a taste test of them.
00;34;01;26 – 00;34;02;23
Dr. Bridget Young
Yes.
00;34;02;26 – 00;34;31;20
Dr. Mona
And it tastes. I mean, of course, if a baby needs them, we have to give it. So I don’t want you to feel that way. But if we don’t have to give it to them, we don’t want to, because maybe there’s other formulas that we can use for price also. And that also brings me to another comment, which is what I was saying earlier about a mother who came into my office once and her child was on a trampoline, and she was so upset because she said, well, my child has a milk protein allergy, but nitrogen has lactose in it.
00;34;31;26 – 00;34;52;16
Dr. Mona
And I was so confused because I looked at the label and it says it has lactose. And I’m like, I don’t understand what you’re saying. And she’s like, my I’m supposed to be on a formula for my child’s milk protein allergy. I’m like, you are neutral again. And I it’s an important clarification that we also said briefly earlier that lactose is a sugar and milk protein is a protein.
00;34;52;16 – 00;34;58;02
Dr. Mona
And so even these fully hydrolyzed formulas contain lactose, right. Some of them.
00;34;58;05 – 00;35;10;07
Dr. Bridget Young
So well, some of them can have trace lactose because yes have. So they don’t they’re not contributing a lot of the calories is lactose. But they can have trace lactose because they use cows milk based ingredient.
00;35;10;10 – 00;35;14;05
Dr. Mona
That’s good to know. And again it’s it’s that’s why it’s so complicated reading those labels.
00;35;14;05 – 00;35;27;21
Dr. Bridget Young
Yeah I know when you to different. So like that kind of difference is only relative to those babies with that rare genetic disorder. Yeah. That’s the kind of language that gets people really confused. Understandably.
00;35;27;23 – 00;35;56;12
Dr. Mona
And like she was saying, the fully hydrolyzed formula is like, elemental, neutral. Again, these are formulas that we as pediatricians sometimes put our children on for camel cow milk protein allergy, which she mentioned, and also for reflux sometimes because sometimes calma protein allergy can present as reflux. So again, that’s another reason why Bridget said beautifully talk to your pediatrician because based on the weight, your child’s, the symptoms your child’s having, they will dictate.
00;35;56;12 – 00;36;15;03
Dr. Mona
Okay, let’s try this. The number one thing. And I’m going to reiterate it again. When you start to switch formulas, especially to these hydrolyzed formulas too soon, you may have just jumped the gun when you didn’t really need to. And then it kind of can confound some of the picture of the, you know, what’s going on clinically. So it’s really important to speak to your doctor.
00;36;15;07 – 00;36;17;03
Dr. Mona
I’m so glad you said that. Bridget.
00;36;17;10 – 00;36;24;12
Dr. Bridget Young
And I always say things are so nice, like they’re always happy to chat. They would always rather hear from you first before making these decisions anyway.
00;36;24;14 – 00;36;44;09
Dr. Mona
Absolutely. And that’s our job. And you know, we so what we know as pediatricians, we know all the basic categories. Right. Like I know first line what I like if I’m going to a more partially hydrolyzed it’s extensively hydrolyzed. Obviously, if I need to do a soy formula, you and your website is a wealth of information for all those nitty gritty things.
00;36;44;09 – 00;37;03;07
Dr. Mona
And that’s why I think it’s so great that we’re talking, because I even think that if my fellow colleagues listen to this, they may not know about the details, or they may have forgotten from their training about the way in question, about the carbohydrates, about the fats and all these things that you’re discussing. So your pediatrician is a good starting point.
00;37;03;09 – 00;37;25;06
Dr. Mona
I don’t think any Patricia’s going to get upset at you for doing your own research, but obviously, remember, it is so catered to patient to patient, which is why you need to talk to your doctor too. So you mentioned earlier about reading labels and you talked about, whey and how you can kind of figure that out. Is there anything else a parent should think about when they’re approaching a label and how to read it?
00;37;25;08 – 00;37;43;19
Dr. Bridget Young
Yeah. Number one is remember you have a baby. Thus you are already a rock star. Do not be. Did you like you guys have brought a baby into this world. That is the hardest job. Don’t let this label get the better of you. So if I had my perfect world, all formulas would just be in silver cans with the ingredients.
00;37;43;19 – 00;38;00;05
Dr. Bridget Young
That’s it. There would be no marketing. There definitely be no glitter font because all of that is really just confusing. So when you’re looking at a formula, I would say ignore the front pick, turn it over and look at the back. There’s two sections to the nutrition label. There’s the nutrition label that we usually look at first when we’re adults.
00;38;00;05 – 00;38;18;00
Dr. Bridget Young
It has like how many calories? For me, those comes from fat. You can pretty much completely ignore that on an infant formula label, because that’s what the FDA regulates. The FDA says to be an infant formula, you have to have this much protein, this much fat, you know, this many milligrams of vitamin C. So that’s very tightly regulated.
00;38;18;00 – 00;38;41;01
Dr. Bridget Young
There’s many differences between formulas, but honestly, not enough that I ever really make my decision based on that. The only thing you should look at is the actual list of ingredients, and then you could do a lot of detective work by looking at the list. So infant formula ingredients have to follow the same regulation as adult ingredients. So the number one ingredient that you see is the most quantity.
00;38;41;01 – 00;39;03;01
Dr. Bridget Young
So they’re order of quantity. So you can get a little gauge. For example if your formula has both lactose and corn maltodextrin for example. Well which one of those comes on the label first. That’s the one that there’s more of. So you can read a little nuance into it that way. And then also, you know, like we mentioned before, it is nonfat milk.
00;39;03;01 – 00;39;21;03
Dr. Bridget Young
The first ingredient, as it often is great. Is there way farther down on the list of ingredients? If yes, well, then they you have a way predominant formula because they added more way back. If it’s missing, then you have a cuisine predominant formula. So you have a list of ingredients. And then every formula will have the first the fat, the carbohydrate and the protein.
00;39;21;08 – 00;39;43;18
Dr. Bridget Young
And then you’ll see a little label less than 1% or less than 2%. And then you have all the vitamins and minerals that need to be added in and whatever the ingredients are also added. So it speaks volumes to me. And I always encourage parents, parents, if it’s less than 1% or less than 2%, it’s probably not the source of your baby’s constipation or reflux or, you know, whatever is bothering your family.
00;39;43;20 – 00;40;14;11
Dr. Bridget Young
So focus on the list of ingredients. Focus on those first, anywhere between like five and ten ingredients that make up the 98% of your formula. And then once you have that dialed in, if you have options for the extras within your blend that you’ve got dialed in, fabulous. Explore them if your budget allows, but focusing on those first ingredients on the list is really where you’re going to learn so much about your baby’s biology and what really keeps them the most comfortable.
00;40;14;13 – 00;40;34;18
Dr. Mona
That is such a great tip, especially because they don’t always say the amount of all these things. So the fact that you’re you’re explaining it like whatever comes in order, obviously that’s the most that’s actually really helpful. And I think that’ll help a lot of parents when they have the the label phobia, because it is hard. And it’s also hard whenever you’re giving something to your baby to see the long list of ingredients.
00;40;34;18 – 00;40;54;20
Dr. Bridget Young
Oh yeah. Yeah. All antibiotics, food. And you know, it’s hard to look at. But remembering that babies are not just tiny adults, you know, we can’t just give them vegetables and meat. They have to have something. And you can’t just give them cows milk. Need all those vitamins and minerals. And so try not to be intimidated by all the scary words.
00;40;54;26 – 00;41;13;23
Dr. Mona
I agree, and it’s funny, the first time I ever looked at one I was like, wow. Because again, I also was like, how am I supposed to read this? And then I did my own investigation. And obviously through my training and thanks to your website, I got more insight. It is very daunting if you’re not, especially if you’re not in the medical field and you’re already having anxiety over picking a formula.
00;41;13;23 – 00;41;40;17
Dr. Mona
Or maybe it’s not what you expected to do, right? Meaning some families or some mothers were deciding on breastfeeding and then now they’re being, you know, told that they have a supplement or they’re going down the formula route and they already have the guilt associated with not breastfeeding. And they’re like, why am I giving all these ingredients? As a mother who is formula feeding her son, I want to really reassure you guys that it is, like Bridget said, regulated all the ingredients in there, are safe in the combination that they’re, you know, being put into that formula.
00;41;40;17 – 00;41;44;21
Dr. Mona
So there it may be hard to read and maybe, well, a long list, but it all makes sense.
00;41;44;26 – 00;41;45;20
Dr. Bridget Young
Yes.
00;41;45;23 – 00;42;02;09
Dr. Mona
So what? What would be? I know this is a hard question because there’s probably so many, but if a parent is going to the store and you know, they’re deciding, obviously they may breastfeed, but they want to have another formula or they’re making the choice to fully formula feed. What would be your top five favorite formulas to start out with?
00;42;02;16 – 00;42;03;06
Dr. Mona
Oh.
00;42;03;09 – 00;42;32;13
Dr. Bridget Young
That is a hard question. Well, I mean, I start by saying there’s not a single terrible formula out there. I think I have probably worked with babies thriving now on every single formula made. So like, there’s no formula. I’m like, never feed that formula. You know, it’s really just, really just independent. So it depends. Choosing a formula depends on where you’re where who is your baby?
00;42;32;16 – 00;42;52;13
Dr. Bridget Young
So are they a freshly baby who just came out of the womb, and they seem to be really having a hard time digesting. I would start them on a partially hydrolyzed formula. Are they nine months old, killing solid foods and, you know, just supplementing on top of breast milk? Well, start that kid on an on a standard formula with lactose and full size protein.
00;42;52;13 – 00;43;17;09
Dr. Bridget Young
They’re going to be fine, you know. So it’s really depends on the individual baby. So I can I think what I’ll say instead is I have a couple formulas that I think are really underutilized. Or under really under marketed. Because so much of so there’s so much marketing and formula, it’s so sad. But there’s a couple that I often find are helpful, for considering.
00;43;17;09 – 00;43;38;24
Dr. Bridget Young
So one is actually, again, I’ve no affiliation with these companies and the milk regulation. So it’s regular and is being marketed for constipation. So it’s kind of got that regular word in there. But it’s a great formula for a lot other things than constipation. So it does have prebiotic in it, which is like to me. But what’s kind of cool about it is it’s a partially hydrolyzed formula.
00;43;38;26 – 00;44;05;27
Dr. Bridget Young
It’s a mixture of whey and casein. And it has a so that’s the protein. And the carbohydrate is 50% lactose, 50% corn sirup solids. So it’s reduce. But there’s still a good amount of lactose in there. So if you know your baby needs to be in the partially hydrolyzed category. So take your baby for example. Perfect. You started off on Gerber, which is partially hydrolyzed and 100% way.
00;44;06;00 – 00;44;26;19
Dr. Bridget Young
So say he’s doing really well, but like there’s still he’s still having some discomfort, nowhere near enough where you’re considering a fully hydrolyzed formula, but you still think like there’s still something in here that’s not really that’s still upsetting him, or he’s still having a difficult time with digesting, then it’s really nice to have a partially hydrolyzed option that’s a mixture of way in casein.
00;44;26;19 – 00;44;47;04
Dr. Bridget Young
So if he’s having a hard time with so much way, well, that other formula, from a reckoning, will have less weight because it will have some partially hydrolyzed casein. And then and then those other partially hydrolyzed formulas generally. And that’s kind of the standard one. They market is partially hydrolyzed. And that’s only 20% lactose. So just in my experience, usually 50% lactose.
00;44;47;04 – 00;45;05;18
Dr. Bridget Young
If your baby’s going to do better on electricity, like that’s plenty. So it’s nice that they still kind of get a good amount of lactose. So I like that formula, for a lot of other reasons than constipation too, that some on one, the other one that, I often find is really helpful for parents who are drawn to European formulas.
00;45;05;18 – 00;45;33;22
Dr. Bridget Young
But, having a hard time getting around, wrapping their head around different regulations, finding an importer, or maybe a pediatrician. Some patricians are very comfortable, uncomfortable with European formulas. We do have only one in the United States. One formula that is grass fed and that’s Similac. Pure bliss. So it’s a grass fed formula. It’s a great starter formula because it’s super standard, meaning 100% lactose, full size proteins or just normal size protein.
00;45;33;28 – 00;46;01;25
Dr. Bridget Young
It’s a way casein blend about 5050 whey, 50 casein carbohydrates, 100% lactose and is grass fed. So that’s a really nice compromise for a lot of families who want something like grass that in there are way more grass fed formulas available in Europe. But if they’re a little wary of facing all the regulations importing, or if their pediatrician is uncomfortable with, that’s a really nice compromise between the two that, it’s just really helpful for a lot of families that we have at least one option.
00;46;01;25 – 00;46;19;04
Dr. Mona
And thank you so much for saying that there is no bad formula, because again, this kind of goes back to what I was saying earlier about that guilt that people get. And I hear it often, especially in the social media world, that, oh, well, you’re giving your child that one. That’s not the best one. It’s like, well, we said earlier multiple times, it may be the best one for your baby.
00;46;19;04 – 00;46;38;01
Dr. Mona
Just going standard, standard formula. You walk in the aisle, you just grab what’s there. Maybe the one that works for your baby. You never know. And I love the way you approach it. And again, you said this earlier, but how? It is a trick question. That question I just ask you because you can’t. It’s the favorite could be very baby to be so and maybe your favorite.
00;46;38;01 – 00;46;57;23
Dr. Mona
But you have to kind of see well what is going on with the baby. And I love this conversation so much because you kind of broken down, okay. That example you gave with my son Ryan, if things weren’t working well, where could you go next? And I think that’s important that parents understand that just like everything we do with our children, there may be you may have a plan and you may need to change that a little bit.
00;46;57;23 – 00;47;08;23
Dr. Mona
So I appreciate that. Now, in terms of the organic formula industry, I’m sure this is more relatively new. Is it perceived as better or is this just personal preference?
00;47;08;25 – 00;47;30;08
Dr. Bridget Young
I to answer so the short answer is no, it’s not better from. So I do research. So if there is not a single research study suggesting that organic formula provides any definitely not nutritional benefit like organic vitamin C is still vitamin C versus not. So there’s no studies suggesting that organic formula provides benefit. Now there’s very few studies at all.
00;47;30;11 – 00;47;50;23
Dr. Bridget Young
But it’s it’s completely it’s kind of completely irrelevant also in terms of your baby’s digestion. So what I mean by that is we don’t have we do have organic formulas. Absolutely. But the we have a limited option of organic formulas. So in the United States, all of the organic formula options are standard formulas meaning full size protein.
00;47;51;00 – 00;47;57;04
Dr. Bridget Young
So if your baby needs a partially hydrolyzed formula, organic is not better for you because.
00;47;57;09 – 00;47;57;21
Dr. Mona
Again.
00;47;57;26 – 00;48;20;15
Dr. Bridget Young
You’ll be getting a totally different protein source. I’ve actually worked with a lot of families who, who, who, who introduced a new formula without knowing it because they wanted to switch to organic, which, yeah, that’s no family fault. It’s really difficult to understand the label, but there’s not much variation on the organic formulas in the US market.
00;48;20;15 – 00;48;45;25
Dr. Bridget Young
They’re all standard, intact or full sized proteins, and they all have, 100% lactose or mostly lactose. Some of them are lactose reduced. So if you need some kind of other protein source or larger lactose reduction, then organic would definitely be a worse choice for you. So I always say I kind of view organic as a sexy extra.
00;48;45;28 – 00;49;06;18
Dr. Bridget Young
So find the perfect ingredient blend that works for your baby. And then if you can get that blend in organic, totally go for it. I do, I wish all of our infant formulas were organic. Yeah, I do, you know, like I’m biased. And I think babies are our best patients and we they should have the best ingredients. But that’s not that’s just not the case with what we have available right now.
00;49;06;20 – 00;49;23;10
Dr. Bridget Young
So are there’s no research proven benefit to having an organic formula. And in fact, it could be a detriment to you if your baby needs to be on one of these more specialized protein blends or carbohydrate plants that aren’t available in an organic source.
00;49;23;13 – 00;49;49;03
Dr. Mona
Great point. And you know, I want to add that one thing I commonly see with organic formulas. And there’s there are many, but, Earth’s best is one of the most common one that I hear. A lot of families or a lot of the patients had more fit up with this formula than. And it could be case by case, but I just found that I don’t personally promote a lot of organic formulas, because I know that there are a lot of non-organic formulas that may be better tolerated.
00;49;49;05 – 00;50;05;06
Dr. Mona
So this is just something in my last five years that I’ve gotten kind of turned off of the organic formulas because, again, it could just be the all the ones using that, or there’s a bunch of other ones, but there are some good ones that I’m sure are out there. But again, everyone listening. It doesn’t mean you have to do organic.
00;50;05;06 – 00;50;26;16
Dr. Mona
If your friend said that, that’s what they do because like we said, it could not work for your baby. And then I don’t want you to live in this sort of worry that, well, why did I switch to this formula? And it’s getting worse because that’s what I see a lot of. Also going back to the the switching when babies gassy or spitting up is that parents are switching to a formula with the expectation that, oh this is going to change.
00;50;26;16 – 00;50;31;20
Dr. Mona
And then when it doesn’t, they feel scared or they get worried or stressed understandably.
00;50;31;23 – 00;50;52;27
Dr. Bridget Young
Do you want a clinical tidbit? You want to know why? I personally think that happens with organic formulas. Yeah, yeah. So all not all, but the vast majority of organic formulas are casein predominant. So most formulas do not add way back in. And that’s because organic was very expensive. So if they just use organic nonfat milk then that’s still organic.
00;50;52;27 – 00;51;11;28
Dr. Bridget Young
But then it’s a very it’s usually 80% or 70% casein and casein as we just discussed, curdles. And it moves out of the stomach slower. So it actually makes a lot of sense that the baby spits up more because there’s just the milk is hanging around a lot longer, and casein can be kind of agitating for a baby, especially if they’re moving from a formula.
00;51;11;28 – 00;51;34;10
Dr. Bridget Young
That was mostly way. So I’ve actually observed that many times myself as well. I was like, oh, it’s because you move to organic and like, God bless you. How are you supposed to know you were moving to a casein predominant formula? That’s right. Nowhere. You’re just expected to look at the label and have all this knowledge. So there’s a lot going into those those choices and those, formulation decisions that that companies make.
00;51;34;12 – 00;51;36;19
Dr. Mona
Well, I am just so happy that my clinical.
00;51;36;21 – 00;51;37;18
Dr. Bridget Young
Yes, I know.
00;51;37;20 – 00;51;55;20
Dr. Mona
Advisement is matching with the science. That’s awesome. Because I thank you because I was seeing that. And now that makes complete sense. Especially obviously talking about the proteins in milk. So the last two questions I have are more just safety concerns. So one of them was parents asked, can I make formula at home? What are your thoughts?
00;51;55;22 – 00;52;15;14
Dr. Bridget Young
Please don’t. Yeah. It’s okay, don’t I? And I know, like, don’t get me wrong, I’m like a barefoot hippie myself in the kitchen. I, I get the draw. And if you go on YouTube, there’s a million recipes. But there’s two really big reasons not to. One is if your baby’s exclusively formula fed, they’re only drinking formula.
00;52;15;17 – 00;52;41;10
Dr. Bridget Young
So the recipe has to be like literally perfect. There’s no room for error because, if you put a little too little of something in on accident, your baby will develop a deficiency very quickly or a toxicity very quickly because it’s all they’re eating. The other thing is there’s just so much out of your control. So even if you are a registered dietitian with a PhD, like you can make a perfect recipe.
00;52;41;13 – 00;53;01;02
Dr. Bridget Young
There’s no way that you can guarantee that you can implement it. Meaning every formula recipe has to use a supplement like that. Usually there has to be at least a B vitamins supplement with all those other vitamins and minerals, cause it has to provide every single vitamin and mineral you have to rely on. Some degree of supplements and supplements are not regulated by the FDA.
00;53;01;05 – 00;53;26;13
Dr. Bridget Young
So even when you buy a supplement and it says, for example, this has 200mg of vitamin C, you don’t really know that it has 200mg. The average batch may, but that 1st May have 100, the next 1st May have 500. And they can use fillers that they don’t have to put on the label. So you don’t know if you’re feeding your baby gluten, sawdust, potato starch, all these other things that come in supplements that don’t even need to be listed on the label.
00;53;26;15 – 00;53;52;16
Dr. Bridget Young
And that’s just very scary. So babies can develop toxicities or deficiencies of nutrients very quickly, but they can also be exposed to all these other, potentially really dangerous ingredients. And there’s just so even if you’re the perfect parent and nobody is, we’re all sleep deprived and just doing our best. But even if you were, there’s so many of those other factors out of your control that babies can get really sick really fast.
00;53;52;16 – 00;53;55;21
Dr. Bridget Young
And so it’s just never worth the risk.
00;53;55;23 – 00;54;13;11
Dr. Mona
And we’re recording this during the pandemic for Covid 19. So if you’re listening to this now, you know, that’s great. If you’re listening two years from now, remember the timing right now. There was a lot of push on social media from oh, we can’t leave. So let’s just make our own formula at home. And all of the pediatricians were like, what is going on?
00;54;13;18 – 00;54;34;15
Dr. Mona
No, no, no, I agree with you completely. Do not make your own formula. It’s just too risky. And it’s not the composition that’s needed to be safe for your baby. So I agree with you completely. The last one I have was powder versus readymade. Is, the difference? Is it okay to do powder? Of course. For everyone who’s not familiar, powder tends to be more affordable.
00;54;34;15 – 00;54;36;08
Dr. Mona
So what’s the difference for those two?
00;54;36;12 – 00;54;55;21
Dr. Bridget Young
Unless your pediatrician has told you you specifically need to be using ready to feed, then totally. You can use powder. So if your baby is immunocompromised or premature, like there’s there’s very specific criteria where your people may tell you that they want you to use ready to feed, go for powder or feel free to switch back and forth.
00;54;55;24 – 00;55;17;21
Dr. Bridget Young
So ready to feed formulas are sterile, meaning that you can kind of think of things when they’re boiled or sterile. So there’s absolutely no living bugs. The baby cannot get contaminated sick from, ready to feed liquid formula powder. There’s always a potential tip for that because you’re mixing it with water. You know, your dirty hands, that kind of a thing.
00;55;17;24 – 00;55;38;13
Dr. Bridget Young
But so few babies need that extra, extra protection of ready to feed. That powder is perfectly fine. Perfectly safe. We have very clean water here in the US. We’re very blessed. And so that’s, you know, not a concern. There are usually a couple differences between powder and ready to feed that sometimes affect baby’s comfort. So I get this question all the time.
00;55;38;13 – 00;55;57;26
Dr. Bridget Young
Like I’m trying to transition my baby from ready to be to powder, and he won’t take it or it gives him gas. And like, I’m so tired of spending the money with help. So usually the recipes are the same with a few exceptions, because ready to feed or liquid concentrate is sterile. It can’t have probiotics. The probiotics are killed.
00;55;57;26 – 00;56;13;06
Dr. Bridget Young
Yeah, because they are bacteria. Another good bacteria. They would be killed. So again, your baby’s a perfect example. So he’s on food if you’re making it with powder since getting a probiotic every single day, if you say you’re going to go on a trip, things switch to ready to feed for a week. And he does great and come back home.
00;56;13;11 – 00;56;31;01
Dr. Bridget Young
Let’s go back to the powder. And he’s gassy as all heck. You’re like, what is happening? Well, it’s probably because he stopped having a probiotic for a week. And then if you switch just cold turkey, it’s like whole hog full dose probiotic, which if you do too much probiotic too fast, you usually end up with gas. So that’s something to be aware of.
00;56;31;03 – 00;56;50;04
Dr. Bridget Young
Probiotics can only be in powdered formula. They can they literally just can’t be in liquid formula. The other thing that sometimes makes a difference is powdered formula. You obviously have to shake or stir or do something with to get it to go into a liquid form. So often it gets more bubbles in it, by getting it to go into liquid.
00;56;50;09 – 00;57;08;17
Dr. Bridget Young
And so sometimes, especially if you’re rushing like the baby screaming, you’re trying to make that bottle so fast you can inadvertently have your baby swallow more air, drinking a powdered formula than a liquid formula because of all those air bubbles which can could some in some babies. Not all babies contribute to more gas. So those are things you can keep in mind and address.
00;57;08;17 – 00;57;22;18
Dr. Bridget Young
Like you can make your formula ahead of time so it can sit in the fridge for a couple of hours before you use it, which will help the foam to settle or, you know, just be aware of those differences will help you assess if that’s what’s causing your baby to seem to prefer one versus the other.
00;57;22;21 – 00;57;48;20
Dr. Mona
These are great tips, and I think I actually spoke about that in my My Fussy Newborn episode that you listen to also. Yeah. Because about yes about maybe the obviously the air bubbles and whatnot. And yes, I agree with the ready made and powdered formula comment. Your pediatrician would talk to you, but typically if a baby’s premature, so before 37 weeks, or if the baby has any sort of medical condition, just run it by the pediatrician.
00;57;48;25 – 00;58;07;09
Dr. Mona
And usually under the age of six weeks, we say just do ready made. And then and then you can start to do powdered after that, but run it by your doctor just to make sure. We actually started out with Gentiles at the hospital. And then it was ready made. And then we transitioned to, the probiotic one, because that’s what I had preferred.
00;58;07;11 – 00;58;18;20
Dr. Mona
And, you know, it just worked better for Ryan when Gentiles could work for many other families and babies. So it’s exactly what you said. Oh, Bridget, I could talk to you about formula for the rest of the night.
00;58;18;20 – 00;58;19;26
Dr. Bridget Young
But, yeah.
00;58;19;28 – 00;58;40;20
Dr. Mona
I, I love this. I, I think this was an amazing summary of the bare bones of formula. Obviously, there’s way more that goes into way, way more, no pun intended. There’s, there’s way more that goes into, formula than what we talked about. But what would be your final message for everyone listening?
00;58;40;22 – 00;59;01;27
Dr. Bridget Young
Oh, you know what? It wouldn’t be about formula, would I mean, definitely educate yourself, get yourself over to my website, talk to your pediatrician. But my final message would be, especially if I could speak to the moms in particular, who had hoped to exclusively breastfeed and are may now be facing supplementation or a switch to formula. It’s so emotional.
00;59;01;28 – 00;59;24;26
Dr. Bridget Young
The on top of hormones. You may already be feeling, I would say take a deep breath. You’re doing a great job and trust your intuition, so you’ll have to make a choice. Educate yourself for sure, but then you’re the expert on your own baby. So get the knowledge and then trust your intuition when you’re making a choice. Because your baby is your baby and you are the expert on that sweet little thing.
00;59;24;26 – 00;59;28;14
Dr. Bridget Young
And they were meant to be with you. So you’re doing a wonderful job.
00;59;28;16 – 00;59;48;19
Dr. Mona
Oh, I love it. And I cannot express that enough as well that if you are living with that guilt and you’re listening to this episode because you and again, you wanted to breastfeed and that wasn’t this isn’t what you wanted to ever do for your baby. You never thought you’d listen to a podcast episode about formula. I, I want to personally tell you a little story just briefly before we go.
00;59;48;26 – 01;00;10;14
Dr. Mona
I, I’m a pediatrician, I thought I would breastfeed. We actually get formula samples in our office. So one of the formula reps came by and she said, Doctor Amin, what formula are you going to give your baby? And I said, I’m going to breastfeed. And it was so nonchalant, right? I said, I’m going to breastfeed. And I had some formulas in mind in case I needed to supplement or in case I needed to go the formula route.
01;00;10;21 – 01;00;27;25
Dr. Mona
And lo and behold, I ended up needing to do formula. And, you know, it’s it’s one of those things that I, you know, you dealt with it for one day. I was very upset about it for one day. And then I realized just how beneficial it was for me and my recovery and how, you know, eight months later, Ryan is thriving.
01;00;27;29 – 01;00;47;23
Dr. Mona
And so the amazing thing about formula and I want to that’s my final message, is that there is so much research that goes behind it. We are lucky that we have that option. I describe it to some of my moms that, you know, some people in the world, they can’t, for whatever reason, breastfed their babies and they don’t have access to, you know, sterile formula or formula in general.
01;00;47;23 – 01;01;07;07
Dr. Mona
And so we’re lucky that if that’s what needs to happen, there are alternatives. And I agree, I do not want a mother to feel guilty. I wish I could just leap out of this episode and hug every mom who’s making that decision, because it is a really hard decision when you had breastfeeding in your plan, and then now you’re having to research this kind of last minute.
01;01;07;14 – 01;01;25;22
Dr. Mona
So I hope a lot of the people listening to this or maybe expect in parents, because it’s just nice to know what your options are in the chance, doesn’t mean that your breastfeeding is not going to be successful, but in the chance that you have to go that route. So you’re not, you know, at 2:00 am trying to figure out, well, what formula do I have to go get now?
01;01;25;27 – 01;01;33;15
Dr. Mona
And it’s something that just keeps you a little bit prepared and not panicked, because it can just help you with those stressful, stressful nights of that fourth trimester.
01;01;33;18 – 01;01;35;27
Dr. Bridget Young
Yes, yes. Amen.
01;01;36;00 – 01;01;45;15
Dr. Mona
And I’m going to be adding, Bridget’s website to to my shownotes as well as her Instagram page. And Bridget, you also have a course that you do.
01;01;45;17 – 01;02;07;21
Dr. Bridget Young
Yes. So we actually my team and I just recently released, a Baby Formula E course for parents. So if you are in that situation where you are realizing you’re going to need to be choosing a formula for the first time, or even worse, if you’re using formula and you know you need to switch but are feeling very overwhelmed about how to go about making that decision, that’s to our E courses for.
01;02;07;21 – 01;02;37;20
Dr. Bridget Young
So it’s going to take the topics we started to cover here and really go down into more detail and walk you through my step by step method for deciding what ingredients you want to target for your unique baby, and helping you choose so that you’re making an evidence based choice based on science and not marketing, so that if you interested in that, go over to Best Baby formula.com and join me there and then my website is Baby Formula expert.com where there’s all kinds of resources and if you are a nerd like me, it’s going to be your heaven.
01;02;37;20 – 01;02;44;00
Dr. Bridget Young
You can find out anything you want to know about all the other aspects of formula. And I’d be happy to chat with anybody over there.
01;02;44;03 – 01;02;48;02
Dr. Mona
Thank you so much. And I think you will be able to probably do a promo code.
01;02;48;05 – 01;03;01;17
Dr. Bridget Young
Yes. Oh thank you. Yeah, I have a promo code for your audience. Thank you for reminding me. So for those of you who are interested in the course, you can use the code doctor talk ten. So do all caps pedes doc talk ten and that will get you $10 off the course.
01;03;01;24 – 01;03;18;22
Dr. Mona
Thank you so much for the code for your obviously your training and education to be able to provide this much needed resource. So I again am so grateful to you. I’m so grateful for your content on your on your website as well as on your Instagram. But also for joining me today.
01;03;18;25 – 01;03;23;01
Dr. Bridget Young
Yes, you’re wonderful too. I feel the same exact way about you. Thank you for everything you do for parents.
01;03;23;08 – 01;03;42;25
Dr. Mona
Thank you for tuning in for this week’s episode. I hope you guys enjoyed it. As always, please leave a review, share it with a friend, comment on my social media and if you’re not already, follow me at PedsDocTalk on Instagram. Love doing this for all of you. Have a great rest of your week. Take care. Talk to you soon!
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All information presented on this blog, my Instagram, and my podcast is for educational purposes and should not be taken as personal medical advice. These platforms are to educate and should not replace the medical judgment of a licensed healthcare provider who is evaluating a patient.
It is the responsibility of the guardian to seek appropriate medical attention when they are concerned about their child.
All opinions are my own and do not reflect the opinions of my employer or hospitals I may be affiliated with.
