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And should you switch your baby??? Brand Whey to Casein Carbohydrate Fat Non-Required Extras Kabrita 50/50 100% Lactose 40% High 2-Palmitic Acid Oil, 27% Soybean oil, 19% Palm kernel oil, 14% Sunflower oil  DHA GOS* (a prebiotic) Holle Stage 1 20/80 52% Maltodextrin, 48% Lactose Goat Cream, Palm Oil, Rapeseed Oil, Sunflower Oil L-tryptophan, L-cystine, […]

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This article provides my detailed instructions about how I recommend introducing probiotics into your baby’s diet. I’ll try to keep it as brief and action-oriented as possible. If you haven’t read the first article in this series that gives you all the background you need to know about your baby’s microbiome (all those good bugs in her little intestines), I highly recommend you read that first.

Before I begin, I have to repeat my disclaimer: I am not your pediatrician! ALWAYS check with your doctor before adding any supplement to your infant’s diet. However, you can easily share this article with your doctor before trying it out for yourself.

And, let’s be honest, most docs are happy to let you experiment away in your own home.

If you both a prebiotic and a probiotic in your baby’s diet, I recommend choosing a prebiotic baby formula and then manually adding in a probiotic supplement. I like this combination for a few reasons. First, probiotic formulas are only available in powdered form so you have a little less flexibility at the store. Secondly, there is no prebiotic-only supplement currently marketed for infants that has been sufficiently tested for safety (that I know of!) There are plenty probiotic supplements that meet my safety criteria.

So, in order to get the benefits of both, choose a formula with prebiotics and add your own probiotic. For a list of the name-brand formulas that provide prebiotics, check out the previous article.

Remember, there are other more important things to look for in your baby formula, like hydrolyzed protein (if you need it), and lactose. If the decision comes down to prebiotic or hydrolyzed protein? Choose the hydrolyzed protein, add your own probiotic supplement, and don’t worry about the prebiotic. Your little warrior will still grow just fine!

What probiotic should I add, and how do I give it to my baby?

There are several different kinds of probiotics on the market that are designed for infants. The main brands that I am aware of are described in the table below. I give my opinion on each in the following paragraphs. I do recommend that you choose a brand marketed for infants because these are more likely to be the appropriate types of good bugs and give appropriate proper recommended dosage for babies. There are LOTS of other brands out there – if you find one that’s not on this list, ask your doctor what he/she thinks.

CFU stands for “colony forming unit” meaning a live bacteria that’s capable of growing if given good conditions (like an intestine!)

CompanyStrain(s)Dosage
Nutrikey Bifido powderBifidobacterium Lactis ¼ teaspoon = 7.5 billion CFU
Zarbee’s Natural Baby Probiotic SupplementLactobacillus rhamnosus (plus a PREbiotic)1 billion CFU per packet
Gerber Soothe Colic Drops Probiotic SupplementLactobacillus reuteri5 drops = 100 million CFU
BioGaia Protectis BabyLactobacillus reuteri5 drops = 100 million CFU
RenewLife Ultimate Flora FloraBabyBifidobacterium breve
Lactobacillus rhamnosus

Bifidobacterium bifidum

Bifidobacterium infantis

Bifidobacterium longum
1 scoop = 4 billion CFU
Klaire Labs Ther-Biotic InfantLactobacillus: rhamnosus, casei, paracasei, gasseri, salivarius &
Bifidobacterium: infantis, bifidum, longum, breve, lactis
1/4 teaspoon = 10 billion CFU
Culturelle Baby Grow and Thrive ProbioticsLactobacillus Rhamnosus GG
Bifidobacterius animalis subsp infantis
5 drops = 2.5 billion CFU
Udo’s Choice Infant & Toddler ProbioticLactobacillus: casei (35%) rhamnosus (25%) acidophilus (15%)
Bifidobacterium: infantis (15%) bifidum (5%) breve (5%)
1/2 teaspoon = 3 billion CFU
Here’s how the pricing for each breaks down:
CompanyPurchasing OptionServingsPrice
Nutrikey Bifido powderNutrikey website(100 ¼ tea. Serv’s per bottle)$29.95
$0.90/d
Zarbee’s Natural Baby Probiotic SupplementAmazon(1/day) 20 packets/box$18.41
$1.09/d
Gerber Soothe Colic Drops Probiotic SupplementAmazon25 servings/container = 25 days$24.86
$0.99/d
BioGaia Protectis BabyAmazon25 servings/container = 25 days$28.58
$1.14/d
RenewLife Ultimate Flora FloraBabyAmazon60 scoops/package; 1 scoop per day $21.79
$0.36/d
Klaire Labs Ther-Biotic InfantAmazon¼ tea per day; 60 days$42.00
$0.70/day
Culturelle Baby Grow and Thrive ProbioticsAmazon5 drops per day; 30 days$25.96
$0.87/day
Udo’s Choice Infant & Toddler ProbioticAmazon1/2 tea per day; 50 days$16.99
$0.34/day
Nutrikey-Bifido Powder:

This supplement is from a nutrition company that I trust. It only contains a single type of bacteria, but this is one of the main good bacteria that live in breastfed babies’ intestines. It comes in a powder form. The dosages on the label (above) are for adults and is also what is recommended by the company’s nutritionists for infants. I think this is too large of a dose for babies and think 1/2 a dose is a good amount.

Zarbee’s- Natural Baby Probiotic Supplement:

This company totally changed the probiotic over the last few years (for the better!). Now they use a very safe strain that has been well studied for safety and is even included in some formulas. It has a great storage life at room temperature too.

Bigger deal: This probiotic also contains a PREbiotic (fructooligosaccharides). They don’t tell you how much it contains, but it may be a great solution if you have a simple formula you love, but you want to add both a pre- and probiotic.

Gerber – Soothe Colic Drops Probiotic and BioGaia Protectis Baby Supplement:

I wrote a bit about this strain of bacteria above. It has been shown to be safe for babies and may even help reduce the severity of colicky babies. It comes as a handy liquid with a dropper (similar to lots of vitamin D drops). You give baby 5 drops per day.

Gerber and BioGaia seem strikingly similar, don’t they…. Get whichever is most convenient, and you can feel OK switching back and forth between the brands if you need to.

RenewLife Ultimate Flora – FloraBaby:

This supplement is a powder that comes with a pre-measured scoop. It is different from the above options because it actually provides several (5 to be exact) different types of bacteria at once. All 5 types are found in large amounts in breastfed babies’ intestines, and are considered safe as probiotics for infants.

Klaire Labs Ther-Biotic Infant

I was introduced to this supplement from a well-known acupuncturist that I respect, Chris Kresser. I like it because it provides 10 (wow!) different types of bacteria, all of which are OK for babies. Plus, the price is great! The only downside is the powder is extremely concentrated so ¼ teaspoon is a full day’s dose for baby. This makes it hard to “ramp up” to a full dose as it can be difficult to measure out one quarter of ¼ teaspoon.

So if your baby is very sensitive, or a newborn freshling I recommend starting slowly and working up to this brand and dosage.

Culturelle Baby Grow + Thrive Probiotic

This is a great probiotic and a brand known by most pediatricians. It is a blend of 2 “powerhouse” (well studied) infant strains. If your little one needs a probiotic and you want a little more than the single strain/lower dosage in Gerber Soothe, but aren’t ready for the larger mix of strains in some of the other blends, this is a perfect middle-ground choice.

Also, Culturelle has a few varieties – some come with vitamin D, and some come with chamomile for calming.

Udo’s Choice Infant & Toddler Probiotic

This is another good company and this multi-strain blend is a great option for a baby that can tolerate more than one strain. I consider it similar to the Klaire labs in that is has many strains. I like the 3 billion dosage better for babies than the 10 billion in Klaire labs but both of these are easily adjustable at home.

Another big win for this probiotic – it is available in lots of health food stores (including Sprouts, Sunflower, Whole Foods and more), so you can purchase it right out of a refrigerator and know that it has been properly stored.

General rules for giving your baby a probiotic:
  1. Tell your doctor what your plan is before you start.
  2. Ramp up the dosage slowly.
  3. Spread the dose out throughout the day.
  4. Add one supplement at a time.
  5. Monitor closely.
  6. Be consistent.
Choosing the probiotic(s) that will be best for your baby:

Which brand is the best? The answer is: it depends on your baby. (Obviously – you know I can never just give a simple answer…. I’m an academic! We have to discuss it to death!!)

In general, I would prefer to see a nice mix of several known good bacteria. This will help baby’s intestines to look more like a breastfed baby’s. However, every baby is different. Some are very sensitize to small dosages, and others don’t seem to notice at all. So, how you ramp up to a blend of many probiotics, and which you start first should look different for every baby. I am giving four categories of infants below. Pick which fits you best and then follow those instructions.

If your baby is colicky:
I suggest starting with Gerber Soothe drops. It may help with the colic, and it only has 1 strain of bacteria to not overwhelm your little one!

  • If your baby is under 3 months old, work your way up to the full dose (5 drops per day) over the course of 2 weeks.
  • If your baby is over 3 months old, work your way up to the full dose (5 drops per day) over the course of 1 week.
  • Monitor for signs of intolerance or intestinal distress each day.
  • Be sure you are splitting up the supplement throughout the day, not all in one bottle. This will more closely resemble breastfeeding and provide a nice constant stream of probiotics to the intestine.

Once you have made it to the full dose and haven’t experienced any negative side effects, stay at this dosage for about 10 days to 2 weeks. Then add in the NutriKey bifido powder or Culturelle in the following manner.

  • If your baby is under 3 months old, work your way up to the full dose (three ¼ teaspoon servings per day) over the course of 2 weeks.
  • If your baby is over 3 months old, work your way up to the full dose (three ¼ teaspoon servings per day) over the course of 1 week.
  • Monitor for signs of intolerance or intestinal distress each day.
  • Be sure you are splitting up the supplement throughout the day, not all in one bottle. This will more closely resemble breastfeeding and provide a nice constant stream of probiotics to the intestine. You can provide both supplements at once.

Once you are up to the full dose on this second supplement, stay here. This will provide baby with 1 good strain of Lactobacillus and Bifidobacterium. Consistency is key and providing these supplements every day will provide great support for digestion and is more likely to result in stable changes in the microbiome.

I have generated a dosing worksheet to help introducing a probiotic. Put it on your fridge and monitor your little one’s progress every day.

I have generated a dosing worksheet to help introducing a probiotic.
Put it on your fridge and monitor your little one’s progress every day.

Download it here

If your baby is slightly colicky or just “sensitive” and may be easily irritated:
I still suggest starting with Gerber Soothe drops. It may help with the colic, and it only has 1 strain of bacteria to not overwhelm your little one!

  • If your baby is under 3 months old, work your way up to the full dose (5 drops per day) over the course of 2 weeks.
  • If your baby is over 3 months old, work your way up to the full dose (5 drops per day) over the course of 1 week.
  • Monitor for signs of intolerance or intestinal distress each day.
  • Be sure you are splitting up the supplement throughout the day, not all in one bottle. This will more closely resemble breastfeeding and provide a nice constant stream of probiotics to the intestine.

Once you have made it to the full dose and haven’t experienced any negative side effects, stay at this dosage for about 10 days to 2 weeks. Then add in the RenewLife– FloraBaby or Udo’s Choice in the following manner.

  • If your baby is under 3 months old, work your way up to the full dose over the course of 2 weeks.
  • If your baby is over 3 months old, work your way up to the full dose over the course of 1 week.
  • Monitor for signs of intolerance or intestinal distress each day.
  • Be sure you are splitting up the supplement throughout the day, not all in one bottle. This will more closely resemble..
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I have previously written a little bit about prebiotics and probiotics in baby formula in the series about how to choose a baby formula.  However, I get so many questions about this, and it’s such a hot topic these days that I wanted to make you all experts. 

The microbiome is the hottest new thing in medicine.  It is all the rage in the research world and is now thought to be responsible for practically everything.  Yes, just like fashion, trends come and go in medical research as well.  Right now, the microbiome is hotter than the lumberjack hipster look in Denver!

The intestinal microbiome is a term for all the bacteria that live in our intestine (mostly our colon).  And this is a lot of bugs!  Your colon is home to roughly 10 times more bacteria than you have cells in your entire body; Roughly 60% of your stool is actually made up of bacterial cells … that is cray! Your microbiome plays several major roles in the human body and new roles are being discovered every day.  Currently we know that these good bugs are critical for our immune system and our weight regulation, and this is the case for infants too.

Babies are actively “growing” their microbiome which starts to develop even before birth.  Whether your baby was born vaginally or via c-section plays an enormous role in what his/her microbiome will look like.  But hey, the hell of delivery is behind you now so let’s not dwell on it!  Let’s focus on what we can do with nutrition after birth to give baby the best chance of growing a healthy microbiome.

The infant microbiome of breastfed babies is very different than the microbiome of formula fed infants.  There are lots of reasons for this.  The first is that breast milk itself contains probiotic bacteria.

Probiotics are actual live bacteria that are considered “healthy”.  These are the good guys.

The amount of probiotics in breast milk is very small, but is still thought to play a role in developing the infant

microbiome.  Additionally, breast milk provides a large variety of probiotics that change over the course of lactation, and differ between moms.  That makes it very hard to replicate.

Even more importantly, breast milk also contains a whopping load of prebiotics.

Prebiotics are food sources for healthy bacteria.

The prebiotics in breast milk are called human milk oligosaccharides (or HMO’s).  These are chains of carbohydrate that baby is not capable of digesting, so they make it all the way to the large intestine where they serve as food for the good healthy bacteria there.  The amount and variety of HMO’s in breast milk is literally astounding and is unique to every mom.   All that prebiotic provides fuel for a very special kind of bacteria that we want to grow in baby’s gut.  HMO’s also help protect the baby from infection, and help the immune system develop. These HMO’s, combined with the live bugs themselves creates a perfect recipe for the ideal infant microbiome.

The complexity of the prebiotics and probiotics in breast milk make it impossible to duplicate in formula.  However, it is still worth trying to get our formula-fed babies’ microbiomes to look more like breastfed babies because of all the benefits we know this has!  So far, the baby formula industry has thought of 2 ways to try to do this: 1) by adding prebiotics to formula, or 2) by adding probiotics to formula

What do probiotics look like in baby formula:

There are a few different types of probiotics that are added to some baby formulas.  These good bacteria are chosen because they are either found in breastmilk and/or because they grow abundantly in breastfed babies’ guts.  The two most common seem to be Lactobacillus Reuteri and Bifidobacterium Lactis (often just L. Reuteri  or B. lactis on a label).  Both of these probiotics have been researched to show that they are safe for even young infants to consume  (1).

L. Reuteri is unique because there has been a lot of research done on this little bug, all focusing on infant colic.  There are some pretty convincing studies that show that providing L. Reuteri to colicky babies results in less crying bouts and less total minutes of crying compared to either a placebo or gas drops (2)(3)(4).  Hey now!  If anyone reading this has ever had a truly colicky baby, we all agree that we have tried some much crazier things to get that baby to calm down (cue endless hours of swinging baby in the carseat, running the dryer with nothing in it, or walking up and down the stairs…).  Providing a probiotic in a bottle that may help after just 7 days is one of the more logical things to try.  If the colic is due to some underlying gastrointestinal discomfort, the probiotic may help to soothe this.  However, the horrible thing about colic is we don’t know what causes it, so we can’t predict what babies will respond well to L. Reuteri.  But it won’t hurt baby to try.  Gerber makes a supplement that is pretty cheap, and ready for the correct dosages for babies.

L. Reuteri is also the probiotic in Gerber Good Start Soothe (see the chart below).

B. Lactis is one of the common bacteria found in breastfed babies’ intestines, and it is the one in Gerber Good Start Gentle.  Gerber claims that it will help with babies’ immune development.  Although, this is a bit funny to me, since one of the major roles of the microbiome as a whole is to aid in proper immune function…. But that’s marketing.

While I do think it is worthwhile to provide your formula fed baby with a probiotic (especially if you’ve got a colicky little angel on your hands), I want you to understand exactly what that means in biological terms.  The microbiome is incredibly enormous in terms of the number and types of bacteria.

Here’s an analogy: Imagine your microbiome is like an outdoor in-ground swimming pool (deep-end and all) which is filled with colored balls from a playground ball pit.  If this represents your baby’s microbiome, then each ball would be a different bacteria.  There would be about 300 different colors of balls.  Now roughly 80% of the balls would be 10 colors, but there would be 300 different colors represented.  B. Lactis may be red.  It’s one of those 10 common colors/bugs.

Providing a probiotic at the recommended dosage is like throwing ONE red ball into that swimming pool of balls.  Wait, it’s not even that much.  Some of the bugs will no longer be alive/active in the supplement, and some will not survive the acidity of stomach … so it’s more like throwing half of a red ball into the swimming pool.  With this in mind, it seems insane that there are any studies at all that show benefit!

I give you this analogy to be sure you understand the context of what a probiotic may or may not do in the gut.  If you understand this, you likely understand that you will see benefits only after prolonged (7 days at the very least!) and consistent (daily!) use.  Still worth trying, especially since there’s no risk to your little one.

What do prebiotics look like in baby formula:

Adding a prebiotic to a baby formula is similar in context to adding a probiotic.  There is an enormous variety of prebiotic glycans in breast milk.  “Glycans” is just a super fancy science word for the chemical structure of the prebioitics – use it in order to show off to friends. Prebiotics in formula come in 2 general categories these days.

1 – Specialty formulas (like Similac PRO, and Gerber HMO) have a prebiotic that is actually found in breast milk: 2-fucosyl-lactose (or 2FL). This HMO helps the healthy bacteria grow and may have some immune benefits too (5)! However, remember that breast milk is full all kinds of different HMO’s.  While 2FL is one of the most common, there is a large percentage of Moms that don’t put ANY 2FL into their breast milk (6).  So, while having a breast milk-derived prebiotic is certainly appealing and likely helpful for many babies, I don’t think we haven enough research to universally recommend it.  If you want to learn more about this HMO in formula, I’ve got this video for you!

2 – More traditional prebioitc fibers have been added to formulas for years.  All of the breast milk prebiotic glycans (or HMO’s) are built off of the main sugar in breast milk – lactose.  The alternative prebioitic glycans added to baby formula are built off of different sugars, either galactose or fructose.  That’s why you see them on the list of ingredients as “galacto-oligosachharides” or “fructo-oligosaccharides”. Another one is “polydextrose”  These different prebioicts are lab derived substitutes.  While they DO serve as food for good bacteria, they don’t provide immune protection, and are not something that we find in breast milk.

You know what else in breast milk is a prebiotic?  Lactose!  Yup, some of that lactose in breast milk is not digested and makes it all the way down to the large intestine where it is “eaten” by good bacteria.  The same thing will happen with baby formulas that contain lactose.  This is another reason I recommend starting with a formula that has some lactose in it.

To summarize prebiotics, here’s an analogy.  The prebiotics in breast milk are like providing the bacteria with every dish imaginable on tables that fill a banquet hall.  A single galacto- or fructo-oligosaccharide offers the bacteria a single cup of broccoli.  Like the probiotics, I still think it’s worthwhile to provide prebiotics to formula fed babies!  Better to give broccoli than nothing!  I just want you to know what you’re giving, and why you are giving it.

So how do I translate this new knowledge into real life purchasing decisions?

Now that you have all this rockstar scientist knowledge, how does it affect your purchasing decisions?  First, you now know what you are looking for on the label, and how to not fall victim to simple marketing.  To help you out, I have provided a list below of all the main name-brand formulas for healthy term infants that contain either pre- or pro-biotics.  Plenty of other generic brands will have some of these ingredients as well, you just have to look on the list of ingredients to find them.

Formula Pre or Probiotic What Type Marketing Claim
Gerber Gentle Prebiotic & Probiotic 2′-Fucosyllactose (2FL) & B. Lactis Closest to breast milk
Gerber Soothe Prebiotic & Probiotic 2′-Fucosyllactose (2FL) & L. Reuteri For excessive crying, colic, fussiness, and gas
Gerber Gentle for Supplementing Probiotic B. Lactis Nutrition to complement breast milk
Gerber Natura Prebiotic Galactooligosaccharides Organic
Enfamil Infant (Original, Premium & NeuroPro) Prebiotic Galacto-Oligosaccharides, Polydextrose Supports older milestones like grasping
Enfamil Newborn Prebiotic Galacto-Oligosaccharides, Polydextrose Tailored for early milestones like focus
Enfamil Gentlease (Original, Premium & NeuroPro) None Eases Fussiness, Gas and Crying
Enfamil Reguline  Prebiotic Polydextrose, Galacto-Oligosaccharides Support digestive health and promote soft stools
Enfamil Enspire  Prebiotic Galacto-Oligosaccharides, Polydextrose Cognitive and Immune Benefits
Enfamil AR  Prebiotic Galacto-Oligosaccharides, Polydextrose #1 selling brand for spit up
Similac Advance  Prebiotic Galacto-oligosaccharides Closer than ever to breast milk
Similac Pro-Advance  Prebiotic 2′-Fucosyllactose (2FL) & Fructooligosaccharides Immune Support
Similac Pro-Total Comfort  Prebiotic 2′-Fucosyllactose (2FL) & Fructooligosaccharides Easy to digest and Immune Support
Similac Sensitive  Prebiotic Galacto-oligosaccharides For fussiness and gas due to lactose insensitivity
Similac Organic  Prebiotic  Fructo-oligosaccharides Organic
Similac Pure Bliss  Prebiotic  Galacto-oligosaccharides Starts with fresh milk from grass fed cows
Similac for Supplementing  Prebiotic  Galacto-oligosaccharides For Breastfeeding moms
Similac for Spit Up  Prebiotic  Galacto-oligosaccharides Help Reduce Frequent Spit Up

If you are interested in my professional opinion, I am going to dedicate the entire next article to tell you how I recommend integrating pre- and probiotics into your baby’s diet.  Please note: I am not your pediatrician!  ALWAYS check with your doctor before adding any supplement to your infant’s diet.  However, I will give you my professional opinion and step-by-step instructions that you can easily share with your doctor before trying it out for yourself.

Did you find it helpful to add a pre- or probiotic to your infant’s diet? Or have you found a baby formula you love with a pre- or probiotic that isn’t listed above?  I’d love to hear about it! We all learn from each other’s experiences.  Tell us all about it in the comments below.

xo, Bridget

References:

  1. Weizman, Z., and Alsheikh, A. (2006) Safety and tolerance of a probiotic formula in early infancy comparing two probiotic agents: a pilot study. J. Am. Coll. Nutr. 25, 415-419
  2. Savino, F., Cordisco, L., Tarasco, V., Palumeri, E., Calabrese, R., Oggero, R., Roos, S., and Matteuzzi, D. (2010) Lactobacillus reuteri DSM 17938 in infantile colic: a randomized, double-blind, placebo-controlled trial. Pediatrics 126, e526-533
  3. Savino, F., Pelle, E., Palumeri, E., Oggero, R., and Miniero, R. (2007) Lactobacillus reuteri (American Type Culture Collection Strain 55730) versus simethicone in the treatment of infantile colic: a prospective randomized study. Pediatrics 119, e124-130
  4. Szajewska, H., Gyrczuk, E., and Horvath, A. (2013) Lactobacillus reuteri DSM 17938 for the management of infantile colic in breastfed infants: a randomized, double-blind, placebo-controlled trial. J. Pediatr. 162, 257-262.
  5. Goehring, K., Marriage, B., Oliver, J., Wilder, J., Barrett, E. and Buck, R. (2016) Similar to Those Who Are Breastfed, Infants Fed a Formula Containing 2′-Fucosullactose Have Lower INflammatory Cytokines in a Randomized Controlled Trial. J. Nutrition. 146, 2559-2566.
  6. McGuire, M., Meehan, C., McGuire M., Williams J., Foster J., Sellen D., et al. (2017) What’s Normal? Oligosaccharide concentrations and profiles in milk produced by healthy women vary geographically. Am J Clin Nutr. 105 (5), 1086-1100.

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Babies are amazing aren’t they!   

They also cray. And their little intestines are seriously the topic of 90% of new parents’ conversations. Did you ever thing the first question upon seeing your partner at the end of the day would be “How were our toots and poops today?”  You know you’ve been there! 

As a side note spoiler for you – it doesn’t actually ever end.  You just switch from asking your partner to asking the toddler himself endless questions about his excretions… 

“Do you have to go potty?”   

“Why is there a crayon in your poop?”  

“Why did you poop in that hat?”  

“Are you going potty RIGHT NOW?!”  

(Yes, all phrases I have sadly said…. multiple times)

To get back on track – when your baby has been having intestinal issue, it is often recommended that you try a partially hydrolyzed formula.  I am actually a huge fan of these formulas for babies experiencing digestive distress, and for newborns who aren’t getting breast milk.

Partially hydrolyzed formulas have had their proteins pre-processed a bit so the size of the proteins is smaller than the original (intact) cow’s milk proteins, and are closer in size to human breast milk proteins.  I’ve got a whole article on these proteins, so this article is a bit more practical and aims to help you choose between the individual formulas that fit into this category. 

The good news is – you have lots of options if you decide your baby needs a partially hydrolyzed formula.  Gerber has 3 options, Enfamil has 2 options, and Similac has one.  The European company, HiPP also has it’s own partially hydrolyzed formula that comes in two varieties (one made in the UK, one made in Germany). 

There’s not one BEST choice.  It depends on what your little one’s needs are.  Are you looking for a lot, or a little lactose? Are you looking for a probiotic or a prebiotic? These answers will all lead you to different choices.  

The biggest choice to me is: what starting protein do you want?

The term “partially hydrolyzed” simply refers to the size of the proteins.  So you can have a whey and casein blend that is partially hydrolyzed (like Enfmail’s options) and you can have 100% whey that is partially hydrolyzed (like Similac and Gerber’s options).  Here there is no right choice either. I just encourage you to think about the decision strategically.  If your baby has a sensitivity to a casein protein or a whey protein, then avoiding large doses of those proteins may help.

The only way to know if this is the case, is to know what you are feeding her and observe how she reacts.  And that’s why it’s great that we have so many options.

So here’s the master chart that compares the differences in partially hydrolyzed options for you. This should help you make an informed choice.

Brand Protein Carb Fat Pre & Probiotics Non-required Extras $ per oz

Enfamil Gentlease

Partially  Hydrolyzed Nonfat Milk + Whey 

(60:40 whey:casein ratio)  

80% Corn Syrup Solids , 20% lactose Palm oil (45%), Coconut  oil (20%), Soy oil  (20%),  High Oleic Sunflower oil  (15%)  No Carnitine, Taurine $1.25

Enfamil Reguline

Partially  Hydrolyzed Nonfat Milk + Whey 

(60:40 whey:casein ratio)  

50% Corn Syrup Solids , 50% lactose Palm oil (45%), Coconut  oil (20%), Soy oil  (20%),  High Oleic Sunflower oil  (15%) Polydextrose,  Galacto-oligosaccharides 

(prebiotics)

Carnitine, Taurine $1.32
Similac Total Comfort Partially Hydrolyzed Whey Protein   80% Corn Syrup Solids, 20% Sugar High Oleic Safflower oil (40%), Soy oil (30%), Coconut oil (30%)   Galacto-oligosaccharides (a prebiotic) Carnitine, Taurine, Nucleotides, Lutein & Lycopene $1.73

Gerber Gentle

Partially Hydrolyzed Whey Protein   70% lactose, 30% maltodextrin Palm olein oil (47%), Soy oil (27%), 20% Coconut oil (20%), High Oleic safflower or sunflower oil (6%) Galacto-oligosaccharides (a prebiotic)  

Bifidobacterium Lactis (a probiotic)  

Carnitine, Taurine, Nucleotides $1.05

Gerber Soothe

Partially Hydrolyzed Whey Protein   70% maltodextrin, 30% lactose Palm olein oil (47%), Soy oil (27%), 20% Coconut oil (20%), High Oleic safflower or sunflower oil (6%) Lactobacillus Reuteri

(a probiotic)

Carnitine, Taurine, Nucleotides $1.09

Gerber For Supplementing

Partially Hydrolyzed Whey Protein   70% lactose, 30% maltodextrin Palm olein oil (47%), Soy oil (27%), 20% Coconut oil (20%), High Oleic safflower or sunflower oil (6%) Bifidobacterium Lactis

(a probiotic; 8x the concentration of Gentle)  

Carnitine, Taurine, Nucleotides $1.03

HiPP Comfort – UK

Partially Hydrolyzed Whey Protein   maltodextrin, lactose, starch  Vegetable oils with beta palmitate (palm kernel oil, palm oil, rapeseed oil, sunflower oil) Galacto-oligosaccharides (a prebiotic)   L-tyrosine, L-phenylalanine,  taurine, L-tryptophan, L-Carnitine $1.66

HiPP Comfort – German

Partially Hydrolyzed Whey Protein   maltodextrin, lactose, starch Vegetable oils with beta palmitate (palm kernel oil, palm oil, rapeseed oil, sunflower oil) Galacto-oligosaccharides (a prebiotic)  

Lactobacillus fermentum hereditum 

(a probiotic)

L-tyrosine, Carnitine, Taurine $2.21

I want to mention a few things before closing.   

  1. All these formulas have DHA and ARA The HiPP formulas have a combo of fish oil and hexane extracted oils. So all the formulas use hexane extracted sources of DHA and ARA.  HiPP comfort just uses a bit less.
  2. HiPP Comfort uses a special type of palm oil that avoids all the potential issues related to palm oil. (Awesome!).  Check out this article and video to get all the biochemical details about what makes “beta” palm oil special. 
  3. Remember that all US formulas HAVE to meet the needs of babies between 0 – 12 months of age. So …. even if a formula is marketed as “for supplementing” or for babies with constipation, that doesn’t mean you can’t use it if you want.  That is JUST marketing!  In fact, I have had great success with clients using Reguline  and Gerber for Supplementing when the baby was not suffering from constipation or being breastfed at all.  It’s all about the ingredients, and only the ingredients!
  4. Lastly, HiPP Comfort is a great formula and obviously has some desirable characteristics for a partially hydrolyzed formula (hello no palm oil calcium soaps and biodynamic farms).  BUT, please read my article about US vs European formulas first if you are thinking of using an EU formula.  I’m not trying to scare you at all, I just want you to be totally aware for the differences and pros and cons – like with any other important choice you make, that’s all.

I hope that’s helpful!

Remember, all babies grow out of their little tummy issues.  All babies eventually learn to toot on their own (I promise!).  All babies stop spitting up eventually.

You’ll get through this! And now you can feel really confident that you are making your formula choice from a place of empowerment and not desperation.   

You got this!
xo, Dr Young

P.S. Some of the links above are affiliate links.  This means, if you end up buying the formula, I get a tiny kickback – at no cost to you.  I only use these links for products that I have used successfully with clients before.  Mama’s gotta pay those website hosting fees!  This is how I can keep putting this free info out there. Thanks!

The post How to Choose the Best Partially Hydrolyzed (Gentle) Formula For your Baby appeared first on Baby Formula Expert.

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“There’s no use crying over spilled milk”
– Said some man who never used a breast pump.

If you are a pumping Mom, you work HARD for that milk and want to save every last drop! No one needs (or deserves) a cocktail more than Moms with a new baby. For reals.

The decision to drink while nursing is a personal one. It’s between you and your doctorl I have pretty liberal opinions about indulging while nursing/pumping. I wrote an article explaining why here.

This bonus article shares my personal hack for saving milk that I pump after having a few cocktails. I work so hard for that milk … I never pump and dump!

Why I Never Pump and Dump - Happy Hour w/ Dr Young - YouTube

If you have a few cocktails while still nursing …. You’re supposed to pump and dump your milk. God, there is nothing more painful than dumping milk. Here’s what I do instead:

  • Enjoy a well-earned night out with my husband (the best part!)
  • Come home and pump (uggghh).
  • Freeze the boozy milk in a bag labeled with a skull and cross-bones
  • Save it in the back of the freezer until your baby is at least 6 months (so not a newborn).
  • Dilute the boozy milk with at least 4 parts sober milk before feeding to baby!

When my baby goes to daycare, I bring 3 pre-made bottles. So, I’ll thaw out a boozy milk bag and then spread it out over 2-3 days, which is 6-9 bottles! This way, he only gets at most 1 ounce of boozy milk at a time mixed with at least 4 ounces of sober milk. I only do this if he is healthy at the time (no colds or flu). Since he’s a healthy 8 month old at this point – this is NO problem for him. He doesn’t even notice. Try it out with your kid and see how he/she does. Dilute it even more if you make lots of bottles at a time.

But seriously, you must tell your doctor first! This is how I roll – because it works for my individual family, and my pediatrician is fine with it. You’ve got to clear with your own doc.

That’s it! Please use this suggestion wisely and not as an excuse to go all Lindsey Lohan on your breastfed infant. I wrote this article with the hope that it provide some of you who are very cautious with permission to enjoy a glass of wine or two. Our culture dramatically underestimates how important Mom’s mental health is to her baby’s health. I hope this hack helps you give yourself the break you deserve.

Cheers Mama!

xo Dr. Bridget

The post Good to the last drop …. Why I never pump and dump breast milk appeared first on Baby Formula Expert.

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What every new mother looks like. Ha!

Have you ever heard the term “self-care”? Well it’s actually pretty obvious what it means – taking time to appropriately care for yourself. No advanced degree needed there…

Well 2 years ago – I had never heard this term before. Now it seems to be the focus of every other post on my Facebook feed. This is partly because I had kids myself, so became much more involved in parenting feeds on social media. But part of it is – “self-care” is a trendy topic in the Mom-opshere! #SelfCare #TreatYoself

I totally agree with the principle! We all know we are better, more patient, more intuitive, more (insert favorite mothering buzzword) when we are well-rested vs. the stressed-zombie version of ourselves. But, if I hear one more podcast give the example of the public service announcement on the plane that says “put on your mask before you help others”, I may barf.

But on a less-sarcastic, and deeper level – it is very common and normal to feel like you have lost your personal identity to motherhood. This is one of the biggest reasons that it’s important to make time to enjoy activities that feed your soul and rejuvenate your zest for life … and for your offspring.

But did you notice I used the “T” word there? Time. Taking Time. But I have NO time!

If you’ve got a baby in your house – your time is not your own. And “self-care” becomes a sickening joke. I have listened to countless podcasts (I am obviously a bit of a podcast junkie) that tout the benefits of maternal self-care and give the classic examples of: manicure, spa-day, massage, or even a 24-hour mom-cation in a hotel. When you have a baby (or 2), these suggestions can seem so ludicrous, it makes you want to evil-witch-laugh at the speaker … and then run away to ugly-cry in the bathroom.

Well, first-off, take heart! The infant phase is temporary and you WILL eventually have time to pee alone, and even go to the gym again! I see the light at the end of my tunnel, and you will too!!! But in the meantime, we can’t just give up on caring for our bodies and our souls, because our babies deserve that better-version of us.

Here’s my real world self-care solution for parents in the baby-stage: It’s the 5-20-1 rule.

Each partner writes down 5 activities, that each take 20 minutes or less, that are truly restful and/or enjoyable to the soul. You put your lists on the refrigerator and each do 1 of these activities a week. That’s it. 20 minutes a week. Schedule it! On Tuesdays at 6:30 – daddy takes baby for a 20 minute walk and Mommy gets her time.

That is manageable!

 
You totally have my permission to do more than once a week! But honestly, planning for 1 activity is realistic enough to stick to, and is likely way more than you’re getting now. And 20 minutes is that sweet-spot of enough time. It’s enough time to really relax, but not so much time that the other care-giver feels overwhelmed.

I encourage partners to gift each other additional sessions as a gesture of love. That’s why you each have a list! If you notice your partner is particularly frazzled – take the baby and suggest an activity on the list. Here are some suggestions for activities that might inspire you as you make your list.

    • Gentle Yoga or stretching
    • A walk outside (alone!)
    • Reading your favorite book
    • Reading your favorite blog (NOT a baby or mommy blog)
    • Painting your nails (top on my list because it reminds me I am a woman.)
    • A bath or shower
    • Dance party to your favorite music
    • Adult coloring book
    • Quick baking project (one of my favs IF you can be alone in the kitchen!!)
    • Making a cup of hot chocolate in your favorite mug
    • A 20-minute Netflix show! I think it’s important this be upbeat – no depressing downers. Some of my favorites are: The Office; Parks & Rec; American Housewife (hilarious!!)
    • Tabata or HIIT workout (those very short but intense workouts)
    • Meditation
    • Call with a good girlfriend
    • A glass of nice wine (depending on the time of day)

Have another activity I should add? I’d LOVE to hear it! Tell me in the comments!

Self-care is important! But unrealistic expectations can do harm. I suggest acknowledging that the infant phase is going to be hard – but it’s temporary!

Making a plan to care for YOU (that person who existed before you birthed a baby) is important. Making that plan realistic – is crucial. I find the 5-20-1 rule can work wonders. Share it with your partner and let me know how it goes.

xo Dr Young

The post A Realistic Plan to get Me-time when you have a Newborn – the 5-20-1 Rule appeared first on Baby Formula Expert.

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When I was pregnant – I thought it was so ironic (and cruel) that I never needed a glass of wine more in my life…

Then I actually had the baby and thought …. No. NOW I’ve never needed a glass of wine more in my life!

Then, I had a second baby and thought …. No. NOW …

You get it…

Here’s the point – if you are nursing your precious angel from heaven, you of course worry about doing anything that could possibly harm your baby. We all do! Lots of Moms worry so much about alcohol getting into their breast milk that they choose to avoid alcohol altogether for the duration of their breastfeeding journey. If that makes you happy – then do it!! But, I find that lots of Moms make this decision from a place of fear. And that is never the right place from which to make a decision. I’m here to provide you with all the nerd biological facts so you and your doctor can make an informed decision that’s right for your family. Whatever you do decide – you need to clear it with your doctor.

Obviously, since I do a “Happy Hour” every week (and apparently will never be done nursing), I have chosen to consume alcohol occasionally. Here’s all the facts that made me comfortable with this choice. I talked about this topic in one of my videos, so if you would rather watch – here it is:

When to Pump and Dump? - Happy Hour w/ Dr Young - YouTube

Alcohol Transfer into Breast Milk

For my fellow chemistry nerds out there – you know that alcohol is chemically ethanol, and has an –OH moiety on the end of the molecule allowing it to pass freely through membranes. (If you don’t know that that means, you are probably cooler than I am – and don’t worry about it). This means that alcohol enters the bloodstream rapidly. We know this because you start to feel buzzed pretty quickly after drinking alcohol. For a breastfeeding Mom, alcohol also passes freely across the mammary epithelial cells both INTO and OUT OF her breast milk. This transfer will be concentration driven. Translation: The alcohol content of her breast milk will be the same as the alcohol content of her blood, in real-time. The alcohol in the milk in her breasts will increase in real-time as she consumes more, and will decrease as her liver processes the alcohol and she starts to “sober up”.

Biological Impact of Alcohol Consumption on Breastfeeding

Alcohol consumption may decrease breast milk production while your body is still processing the alcohol (1). This is because alcohol affects affects both oxytocin and prolactin concentrations (the 2 master hormones that control breastmilk production). The affect is complicated and not completely understood, but the general consensus (from real old research) is that alcohol consumption results in reduced letdown/milk ejection, which probably explains the lower production (2-5). However, this effect is really variable between women, and seems limited to the time of alcohol consumption.

Infant Exposure

So, what you really want to know is – what’s the effect on my baby!? Well, let’s do some math (yay!). Remember, as per nerd language above, the alcohol content of your breast milk is the exact same as the alcohol content of your blood, or your BAC (Blood alcohol content; it’s a percentage). Here’s some relevant numbers

  • The legal limit for driving is a BAC of 0.08%. I consider this very intoxicated, especially for a woman who just came off of 9 months of pregnant sobriety.
  • Beer = 2-12% alcohol; liquor = 40% alcohol; orange juice = 0.5% alcohol (from the natural fermentation of the sugar in juice)
  • A 160 pound woman who drinks 2 glasses of wine in 1 hour has a BAC of roughly 0.040%.
  • A 140 pound woman who drinks 2 glasses of wine in 1 hour has a BAC of roughly = 0.048%
  • A 120 pound woman (I wish!) who drinks 2 glasses of wine in 1 hour has a BAC of roughly = 0.059%

So, for the 140 pound woman – If she nurses her baby 1 hour after 2 drinks, her baby drinks milk that has 0.048% alcohol in it. That’s 10 times lower than the amount of alcohol naturally in orange juice! So, the alcohol exposure to the breastfed baby is super minimal. In fact, a nice short review on the topic stated that, “Even in a theoretical case of binge drinking, the [child] would not be subjected to clinically relevant amounts of alcohol.” (6). That certainly made me feel better!

Now, before you rush for a glass of Pinot – it’s important to note that newborn babies’ livers are immature, so they don’t process alcohol as quickly as adults’. In fact, they process at about half the rate. So, even though the exposure seems trivial, it’s higher for infants than adults. However, at a responsible consumption rate for mothers, this is not considered a risk to healthy infants.

There have been some studies of infant effects of consuming breast milk with alcohol in it. To be honest, the results are (to me) so minor and conflicting that I don’t want to list them all here (6). The funniest to me is that – when offered “sober” breast milk, and breast milk pumped after Mom had had a few (referred to as “happy milk” in my house) – the babies actually preferred the “happy milk”! (7). Hilarious.

Another super recent study looked at infant outcomes and compared breastfed babies whose mothers did and did not drink. They reported that alcohol consumption was unrelated to breastfeeding duration (phew!) (8). They only found one difference in infant outcomes between groups – The infants whose mothers consumed alcohol at 8 weeks actually scored higher for personal-social development at 12 months (8). Now that doesn’t mean that drinking made the infants do better. There are a LOT of complexities that go into interpreting an observational study like this. But it certainly does make me feel better that the alcohol group was certainly not worse off.

All the research (which is limited) has been done with healthy term infants, so that’s the only scenario this information applies to. If your baby is at all ill, or may have an even more immature liver – due to prematurity, illness, or any abnormality – that is a completely different story, and you’ve got to talk to your doctor.

Taking steps to further minimize risk

Since alcohol leaves the breast milk as quickly as it enters, we can take advantage of timing to even further minimize any infant exposure. Your BAC (and thus your milk alcohol) is highest 30 – 90 after drinking. So, time your nursing sessions accordingly. For example, my boys were/are both “all business” nursers – our average breastfeeding session is 10-15 minutes total (don’t hate – I’m just lucky!). Thus, my favorite time to drink was during nursing! This way they were exposed to very minimal alcohol and then I had at least 3 hours before their next feed, which is plenty of time to process 1 glass of wine. Take into account your baby’s average nursing time, and normal feeding schedule to time your drinking so that you are nursing when your BAC (and thus milk alcohol) are likely to be lowest.

With all that science in mind – the infant alcohol exposure itself is rarely a concern for me. To me, the more likely dangers of drinking while breastfeeding are related to the care-giver! We all know that alcohol effects us in lots of ways – you have worse balance, slower reflexes, are less likely to wake up easily, etc. None of that matters when you are 22 and have no responsibilities (ahhh…. Taylor Swift, your life looks so fun!). But now you have a baby. I suggest you make some rules with your partner to be sure you take responsible precaution when drinking at all. Here are suggested rules that have worked for my hubby and me:

  • I (the Mama) never drink alone when I am the sole care-giver. Let’s be honest, never drinking alone is probably a good rule for everyone.
  • We have a designated “care-giver” so that there is always someone who can drive, and walk around safely with the baby if he is fussy (it’s like having a DD for parenthood).
  • NO CO-SLEEPING! I really mean it. Even if this is your normal sleeping arrangement. Please don’t bring the baby into the bed at all if you have had any alcohol. It’s just not worth the risk.

These rules made me feel even better about being able to indulge every now and then without guilt (and without pumping-and-dumping – which is just so painful)! You know yourself best. Find rules that work for your own family within your own limits.

Then clear it with your doctor.

Motherhood today is high-pressure and hard! Taking a moment to enjoy and care for yourself is actually helpful to your baby – because it allows the best version of you to show up to motherhood. I hope that enjoying an occasional and responsible glass of wine, ideally with good friends, helps give you the perspective you need. You are doing a great job!

Cheers!

xo Dr Young

References:

  1. Mennella JA. Short-term effects of maternal alcohol consumption on lactational performance. Alcohol Clin Exp Res. 1998;22(7):1389-92.
  2. Chien YC, Huang YJ, Hsu CS, Chao JC, Liu JF. Maternal lactation characteristics after consumption of an alcoholic soup during the postpartum ‘doing-the-month’ ritual. Public Health Nutr. 2009;12(3):382-8.
  3. Cobo E. Effect of different doses of ethanol on the milk-ejecting reflex in lactating women. Am J Obstet Gynecol. 1973;115(6):817-21.
  4. Cobo E, Quintero CA. Milk-ejecting and antidiuretic activities under neurohypophyseal inhibition with alcohol and water overload. Am J Obstet Gynecol. 1969;105(6):877-87.
  5. Mennella JA, Pepino MY, Teff KL. Acute alcohol consumption disrupts the hormonal milieu of lactating women. J Clin Endocrinol Metab. 2005;90(4):1979-85.
  6. Haastrup MB, Pottegard A, Damkier P. Alcohol and breastfeeding. Basic Clin Pharmacol Toxicol. 2014;114(2):168-73.
  7. Mennella JA. Infants’ suckling responses to the flavor of alcohol in mothers’ milk. Alcohol Clin Exp Res. 1997;21(4):581-5.
  8. Tay RY, Wilson J, McCormack C, Allsop S, Najman JM, Burns L, et al. Alcohol consumption by breastfeeding mothers: Frequency, correlates and infant outcomes. Drug Alcohol Rev. 2017.

The post Drinking and Breastfeeding – When to Pump and Dump (Or Not…) appeared first on Baby Formula Expert.

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