Parents should start their babies on a standard milk-based formula unless they have a medical condition, such as an allergy to cow’s milk, that warrants the use of a specialized variety, says Jessica Gust, a pediatric dietitian and founder of Element Nutrition Co. for Kids in Arroyo Grande, California.
If their baby isn’t tolerating a standard formula, the best formula to change to depends on the symptoms, she says. There are several potential signs a baby isn’t tolerating their current formula well.
Excessive Spit Up
All babies spit up due to their underdeveloped digestive systems. As long as your infant is steadily gaining weight—about 6 ounces a week—and wetting diapers at least once every six hours, there’s often little to worry about. But when spit up amounts to more than 2 tablespoons at each feeding, it could be a sign of a formula intolerance.
Very Slow Weight Gain
Tracking weight gain and diaper output can be useful in gauging a baby’s overall well-being. When infants are gaining weight properly, parents may note the following:
- Babies reach their birth weight again 10 to 14 days after birth.
- Between birth and 3 months of age, they gain about 1 ounce a day.
- By the time they reach 6 months, babies gain .67 ounces a day.
If your baby doesn’t gain weight as expected, discuss it with your child’s pediatrician.
Extra Fussiness Following Feedings
There are countless reasons a baby might spiral into a crying fit, but when your child is inconsolable during or following a feeding, formula intolerance may be the culprit. A study of 256 babies between 1 and 3 months old who were prone to excessive crying and fussiness reported a “substantial decrease” in symptoms following a 14-day switch from a standard milk-based formula to a partially hydrolyzed 100% whey or whey-enriched protein formula.
There’s no way around it—finding blood in your baby’s diaper can be a scary sight. While there are several reasons for bloody stools—all of which necessitate a call to your pediatrician—one culprit may be an allergy to cow’s milk, which is the protein source for standard baby formulas.
Formula-fed babies generally have at least one bowel movement a day, though going up to two days without one is no cause for concern.
However, if your baby is straining, producing hard, small stools, or suffering from painful stomach cramps, it’s likely they’re constipated. A diet change could provide some relief. Babies who use a formula without palm oil may have softer stools.
Be aware that switching to a low-iron formula in an effort to ease constipation isn’t recommended. Infants require iron intake for proper growth and development, and the amount present in baby formulas shouldn’t cause constipation.
An estimated 2% to 3% of babies develop a milk allergy within their first few months (though most outgrow it). They can show symptoms either immediately following a feeding or up to 10 days later. These symptoms include:
- Eczema or skin rashes
- Loose stools (which may contain blood)
- Vomiting or gagging
- Refusing bottles
- Anaphylactic shock (though more common with other food allergies)
If your baby experiences any of these symptoms of an allergic reaction, contact your pediatrician.