Editing Infant formula (section)

==Preparation and content==

===Variations===
Infant formulas come in powder, liquid concentrate, and ready-to-feed forms. They are designed to be prepared by the parent or caregiver in small batches and fed to the infant, usually with either a cup or a [[baby bottle]].<ref name="WHO"/>

Infant formulas come in a variety of types:
*Cow's milk formula is the most commonly used type. The milk has been altered to resemble breast milk. 
*[[Soy-based infant formula|Soy protein based formulas]] are frequently used for infants allergic to cow's milk or lactose. Soy-based formulas can also be useful if the parent wants to exclude animal proteins from the child's diet.
*Protein hydrolysate formulas contain protein that's been broken down into smaller sizes than are those in cow's milk and soy-based formulas. Protein hydrolysate formulas are meant for babies who do not tolerate cow's milk or soy-based formulas. 
*Specialized formulas are also available for premature infants and those with specific medical conditions.<ref name="Mayo Clinic">{{cite web | url=https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/infant-formula/art-20045782 | title=Infant formula: Your questions answered | publisher=Mayo Clinic | access-date=7 October 2015 | author=Mayo Clinic staff}}</ref>

Manufacturers and health officials advise it is very important to measure powders or concentrates accurately to achieve the intended final product concentration; otherwise, the child will be malnourished. It is advisable that all equipment that comes into contact with the infant formula be cleaned and sterilized before each use. Proper [[refrigeration]] is essential for any infant formula which is prepared in advance.

In developing countries, formula is frequently prepared improperly, resulting in high infant mortality due to [[malnutrition]] and diseases such as [[diarrhea]] and [[pneumonia]]. This is due to lack of clean water, lack of sterile conditions, lack of refrigeration, illiteracy (so written instructions cannot be followed), poverty (diluting formula so that it lasts longer), and lack of education of mothers by formula distributors. These problems and resulting disease and death are a key factor in opposition to the marketing and distribution of infant formula in developing countries by numerous [[public health]] agencies and NGOs (discussed in more detail at [[Nestlé boycott]] and [[International Code of Marketing of Breast-milk Substitutes]]).

===Nutritional content===
Besides breast milk, infant formula is the only other milk product which the medical community considers nutritionally acceptable for infants under the age of one year (as opposed to cow's milk, goat's milk, or follow-on formula). Supplementing with [[baby food|solid food]] in addition to breast milk or formula begins during [[weaning]], and most babies begin supplementing about the time their first teeth appear, usually around the age of six months.

Although cow's milk is the basis of almost all infant formula, plain cow's milk is unsuited for infants because of its high [[casein]] content and low [[whey]] content, and untreated cow's milk is not recommended before the age of 12 months. The infant intestine is not properly equipped to digest non-human milk, and this may often result in diarrhea, intestinal bleeding and malnutrition.<ref>{{cite journal | vauthors = Jiang T, Jeter JM, Nelson SE, Ziegler EE | title = Intestinal blood loss during cow milk feeding in older infants: quantitative measurements | journal = Archives of Pediatrics & Adolescent Medicine | volume = 154 | issue = 7 | pages = 673–678 | date = July 2000 | pmid = 10891018 | doi = 10.1001/archpedi.154.7.673 | doi-access = free }}</ref> To reduce the negative effect on the infant's digestive system, cow's milk used for formula undergoes processing to be made into infant formula. This includes steps to make protein more easily digestible and alter the [[whey]]-to-[[casein]] protein balance to one closer to human milk, the addition of several essential ingredients (often called "fortification", see below), the partial or total replacement of dairy fat with fats of vegetable or marine origin, etc.

Carbohydrates are an important source of energy for growing infants, as they account for 35 to 42% of their daily energy intake. In most cow's milk-based formulas, [[lactose]] is the main source of carbohydrates present, but lactose is not present in cow's milk-based lactose-free formulas nor specialized non-milk protein formulas or [[hydrolyzed protein]] formulas for infants with milk protein sensitivity. Lactose is also not present in soy-based formulas. Therefore, those formulas without lactose will use other sources of carbohydrates, such as sucrose and [[glucose]], dextrins, and natural and modified [[starch]]es. Lactose is not only a good source of energy, it also aids in the absorption of the minerals magnesium, calcium, zinc and iron.<ref name="carb">Schmidl, M.K., Labuza, T.P. (2000).[https://books.google.com/books?id=Yp44IzX8hVAC&pg=PP1 "Infant formula and Medical Foods. In Essential of Functional Foods".] Aspen Publishers. pp.&nbsp;137–164. Google Book Search. Retrieved on November 7, 2009.</ref>

The nutrient content of infant formula for sale in the United States is regulated by the [[Food and Drug Administration]] (FDA) based on recommendations by the [[American Academy of Pediatrics]] Committee on Nutrition. The following must be included in all formulas produced in the U.S.:<ref name=21cfr107.100>{{CodeFedReg |21|107|100|accessdate=September 29, 2024}}</ref>
*[[Protein]]
*[[Fat]]
*[[Linoleic acid]]
*[[Vitamin]]s: [[vitamin A|A]], [[vitamin C|C]], [[vitamin D|D]], [[vitamin E|E]], [[vitamin K|K]], [[thiamin]] (B<sub>1</sub>), [[riboflavin]] (B<sub>2</sub>), [[vitamin B6|B<sub>6</sub>]], [[vitamin B12|B<sub>12</sub>]], [[Niacin (nutrient)|niacin]], [[folic acid]], [[pantothenic acid]]
*[[Mineral (nutrient)|Mineral]]s: [[calcium]], [[magnesium]], [[iron]], [[zinc]], [[manganese]], [[copper]], [[iodine]], [[selenium]], [[sodium]], [[potassium]], [[chloride]]

Non-milk-based formulas must also add the vitamins [[biotin]], [[choline]] and [[inositol]].

Additionally, manufacturers may choose to add additional ingredients to their formulas. These additional ingredients are often used to differentiate their products in the market, as the nutrient composition of formulas is otherwise highly similar between products.<ref name="c891">{{cite web | title=Baby & toddler, Feeding articles & support | website=NCT (National Childbirth Trust) | date=2011-05-28 | url=https://www.nct.org.uk/baby-toddler/feeding/early-days/whats-best-kind-formula-milk | access-date=2024-09-29}}</ref> Not all additives are clearly beneficial according to current studies, either because no benefit has actually been demonstrated, or because the additives are too new to have received significant scientific scrutiny.

*[[Omega-3 fatty acid]]s
**Omega-3 fatty acids, such as [[docosahexaenoic acid|DHA]], are often added to infant formula, purportedly to support brain development, although studies have generally failed to find a significant effect on neurodevelopmental outcomes.<ref name="j166">{{cite journal | last1=Jasani | first1=Bonny | last2=Simmer | first2=Karen | last3=Patole | first3=Sanjay K | last4=Rao | first4=Shripada C | title=Long chain polyunsaturated fatty acid supplementation in infants born at term | journal=Cochrane Database of Systematic Reviews | publisher=Wiley | volume=2017 | issue=3 | date=2017-03-10 | pages=CD000376 | issn=1465-1858 | doi=10.1002/14651858.cd000376.pub4 | doi-access=free | pmid=28281303 | pmc=6464574 }}</ref> Infants can synthesize DHA and other fatty acids from the linoleic acid in formula. As formula additives, these fatty acids are often derived from [[fish oil]] or similar sources.

*[[Human milk oligosaccharide]]s (HMOs)
**HMOs are naturally occurring sugars found in human breast milk, and may work to improve the immune system and act as nutrients for beneficial gut bacteria.<ref>{{cite journal | vauthors = Bode L | title = Human milk oligosaccharides: every baby needs a sugar mama | journal = Glycobiology | volume = 22 | issue = 9 | pages = 1147–1162 | date = September 2012 | pmid = 22513036 | pmc = 3406618 | doi = 10.1093/glycob/cws074 }}</ref> However, while human breastmilk contains dozens of different types of HMOs, commercial infant formula usually only includes a few of the more common types.

*[[Nucleotides]]
** Nucleotides are compounds found naturally in human breast milk. They are involved in critical metabolic processes, such as energy metabolism and enzymatic reactions. Also, as the building blocks of deoxyribonucleic acid (DNA) and ribonucleic acid (RNA), they are essential for normal body functions. Compared to human breast milk, cow's milk has lower levels of the nucleotides uridine, inosine, and cytidine. Therefore, several companies that produce infant formula have added nucleotides to their infant formulas.<ref name=carb/>

Other commonly used ingredients:
*[[Emulsifiers]] and [[stabilizer (food)|stabilizer]]s: Ingredients added to prevent the separation of the oil from the water (and its soluble components) in the infant formula. Some commonly used emulsifiers include monoglycerides, diglycerides, and gums.<ref name=two>Blachford, Ed. Cengage, G. [http://www.enotes.com/how-products-encyclopedia/baby-formula “Baby Formula”] {{Webarchive|url=https://web.archive.org/web/20111030020841/http://www.enotes.com/how-products-encyclopedia/baby-formula |date=October 30, 2011 }}, eNotes.com, November 3, 2009 <!--accessed Nov,16, 2009--></ref>
*[[Diluent]]s: [[Skimmed milk|Skim milk]] is commonly used as the primary diluent in milk-based liquid formula to provide the bulk of the volume. In contrast, purified water is the most commonly used diluent in milk-free formulations.<ref name="two" />