From the Guidelines
It typically takes an infant about 1-2 weeks to adjust to a new formula, with a gradual transition recommended to minimize digestive discomfort. During this transition period, babies may experience some digestive changes like gas, fussiness, or changes in stool consistency and frequency. If you're switching formulas, consider doing so gradually by mixing the old and new formulas, starting with a 3:1 ratio and gradually increasing the proportion of new formula over several days. This approach is supported by guidelines that emphasize the importance of introducing changes in enteral feeding slowly and according to digestive tolerance 1.
When introducing a new formula, it's essential to monitor the baby's tolerance and adjust the feeding schedule accordingly. The ESPGHAN/ESPE/NESPGHAN guidelines recommend that only one change at a time be made to assess tolerance, and that feed volumes be increased slowly according to digestive tolerance 1.
Some key points to consider when transitioning an infant to a new formula include:
- Starting with a small amount of the new formula and gradually increasing the proportion over several days
- Monitoring the baby's digestive changes and adjusting the feeding schedule as needed
- Being aware of the signs of a true formula intolerance or allergy, such as excessive crying, vomiting, blood in stool, or rash, and seeking medical evaluation if these symptoms occur
- Considering the use of expressed breast milk or donor milk if available, as these may help optimize adaptation in newborn infants with short bowel syndrome 1.
It's also important to note that every baby is different, and some may adapt to a new formula more quickly than others. However, with a gradual and monitored approach, most infants can adjust to a new formula within 1-2 weeks. The American Academy of Pediatrics recommends exclusive breastfeeding for the first 4-6 months of life, unless contraindicated for medical reasons 1.
From the Research
Introduction to Infant Formula
- Infant formulas are designed to be used until 1 year of age, after which children are transitioned to non-infant formulas or cow's milk 2
- The transition to non-infant formulas or cow's milk depends on the child's weight and dietary intake
Factors Influencing Formula Feeding
- Sources of advice for formula feeding parents include the formula tin/packet, health professionals, and personal recommendations 3
- Health professional advice is widely received, but often not before starting formula 3
- Parents' choices of formula type/brand are influenced by personal recommendations and formula preparation 3
Preparation and Handling of Infant Formula
- Proper preparation and handling of infant formula are crucial to prevent health implications such as diarrhea 4
- Advice from health care professionals can improve formula-handling behaviors 4
- Common mistakes in formula preparation include mixing formula with warm tap water and heating bottles in a microwave oven 4
Nutritional Intervention in Acute Diarrhea
- Lactose-free formulas are not essential for nutritional intervention in acute diarrhea 5
- Continued breast feeding and/or use of lactose-containing formula during acute watery diarrhea can lead to significant reduction in stool output and weight gain 5