Milk for supplementing

What milk should I use to supplement my baby?

There are a number of recommended types of milk for supplementing babies or giving replacement feeds. The mother’s own milk is always preferred because of its many health benefits. If not available, some premature or ill babies are given pasteurized donor human milk. Some parents will use the milk of a family member or close friend. If human milk is not available, regular infant formula based on cow’s milk is usually appropriate. Some babies require a speciality infant formula. After one year of age, pasteurized whole cow’s milk can replace cow’s milk based-infant formula, but those babies receiving a speciality infant formula may not tolerate whole cow’s milk.

A) Appropriate milk choices for supplementing

Babies and children need to be given appropriate milk (supplemented) if not breastfeeding or breastfeeding effectively.  

1) Mother’s own milk

Because of the health benefits, the mother’s expressed milk or colostrum is the first choice when supplementing babies. It is important to ensure this milk has been safely expressed, stored and warmed.

2) Human milk

Milk banks prepare pasteurized donor human milk for hospitalized premature or sick babies when their mother’s own milk is not available. 

Some parents use human milk from a family member or close friend. This is called informal milk sharing.

3) Infant formula

Infant formula (formula) choices and recommendations vary among mothers, health-care providers, and even countries (Riikonen 2018).

Choices of infant formula include different:

  • Types which have very different ingredients.
  • Groups which can be liquid, concentrate, or powder.
  • Brands which can vary in price and ingredients.

a) Regular infant formula type based on cow’s milk

Most babies can tolerate regular formula based on cow’s milk.

b) Specialty infant formula type

Some babies need other types of formula if they are ill or cannot tolerate regular cow’s milk-based formula. These alternatives would be recommended by their health-care providers and include:

4) Cow’s milk

After one year of age, cow’s milk-based formula can be replaced with pasteurized whole cow’s milk.

Babies using specialty formula may not tolerate pasteurized whole cow’s milk. For example, babies who are allergic to cow’s milk protein should not be given cow’s milk. Please discuss this with your health-care provider.

References

Riikonen A, Hadley D, Uusitalo U, et al. Milk feeding and first complementary foods during the first year of life in the TEDDY study. Matern Child Nutr. 2018 Apr 25:e12611