!7# The Nutritional Value and Essence of Different Milk Formula Substitutes

!±8± The Nutritional Value and Essence of Different Milk Formula Substitutes

Last 50 years have brought about the most substantial progress in improving the composition of mother's milk substitutes ever made in history. In this 21st century, infant formula manufacturers have continued to carry out efforts to develop better breast milk than ever before. Efforts to identify and replicate helpful trace elements, and to conduct important research regarding the addition of immune active ingredients and enzymes that will make formula products even better, are currently under way. But for the main time, here are some already existent formulas which have good nutritive values.

Cow Milk Based Formulas
Characteristics

• Standard formula used when breast feeding is not adopted or is stopped before one year of age.
• Designed to mimic breast milk composition. Breast milk is approximately 60% whey and 40% casein, Cow's milk is 8% casein and 20% whey.
• Formulas contain at least 50% more protein/dL than breast milk (1.5g/100cc).
• Formulas provide appropriate intake of essential nutrients: iron and linoleic acid.
• Carnitine and taurine are added to most standard formulas
• Nucleotides are added to Enfamil and Similac.

Cow-Milk Based Composition
• 20 calories/ounce standard dilution
• Protein is ideally whey-predominantly (similar to breast milk).
• Carbohydrate is lactose (except in Lacto-free Formula).
• Fat is a mixture of vegetable Oil (LCT)
• Approximately 32 ounces of standard formula per day will meet 100% of RDA for vitamins and minerals for term infants.
• If Infants are only fed ready to feed dormula, fluoride supplement of 0.25mg/day is necessary to meet the RDA based on American Academy of Pediatric guidelines.

Available Brands of Cow Milk Based Formulas
• Enfamil with Iron (or low-iron) (Mead Johnsom)
• Similac with Iron (or low-iron) (Ross)
• Gerber
• Good start (Carnation formula with 100% whey as protein).
• Similac PM 60/40 (has decreased calcium, phosphorus and potassium content: Often used in renal patients). (Ross).
• Lactose-free (Mead Johnson) Cow-Milk protein, but lactose-free.

Soy-Based Formulas
Indication for use
• Vegetarians
• IgE mediated reaction to cow's milk protein
• Lactose Intolerance or Galactosemia
• Refeeding after chronic diarrhea (lactose-free)

Characteristics:
• Increased proteins content than cow milk based formulas, since using plant source for protein (2.2g/dL).
• Increased vitamin and mineral content to compensate for mineral antagonists, such as phytates.
• Additional methionine added to formula to ensure a "complete" protein.
• Taurine and cystein added.
• Sweeter taste than cow-milk based and lower cost.

Composition
• 20 calories/ounce standard dilution
• Protein: soy protein with added methionine
• Carbohydrate:Sucrose, corn syrup solids, tapioca starch
• Fat: Blend of vegetable oils

Available Brands of Soy Formulas
• Prosobee
• Isomil
• Isoyalac

Casein Hydrolysate Formulas
Indication for use
• Milk protein or soy protein allergy
• Complicated gastrointestinal disorders
• Colic
• Feeding intolerance to cow milk or soy formulas

Characteristics
• Poor taste and expensive
• Not recommended for long term use in preterm infants due to inadequate vitamin and mineral content and protein source may be difficult to metabolize
• Alimentum is only available in ready to feed.
• Pregestimil is only available as a powder for the sonsumer, but is available in some hospitals as 20 X 24 calorie/oz ready to feed.
• Nutramigen is available in liquid concentrate and powder to the consumer, but is available as ready to feed in the hospital setting.

Available Brands
• Nutramigen
• Pregestimil
• Alimentum

Composition
• Protein: Casein hydrolysate (small peptide considered to be hypoallergenic)
• Carbohydrate: Modified tapioca starch and glucose Oligosaccharides.
• Fat: approximately 50% of fat is MCT oil in Alimantum and pregestimil, and 100% of fat is corn oil in Nutramigen.