Formula and complementary feeding

Some mothers are unable, or choose not, to breastfeed; bottle-feeding carries certain risks that can be minimized by following simple rules. Formula must satisfy all the nutritional needs of an infant and recommendations for the composition of infant formula have been adopted in the Codex Alimentarius. The two main types of formula differ in protein composition (whey or casein predominant). Follow-on formula are designed for infants from 6–12 months of age. Soy protein is an alternative to cow milk protein, but because of its high phytoestrogen content, should not be used before 6 months. Unmodified cow’s milk as the main drink before 12 months of age is associated with iron deficiency. ‘Complementary feeding’ embraces all solid and liquid feeds other than breast milk and infant formula. There is considerable international variation in practice with regard to introduction of complementary feeds, but in general this should not be before 17 weeks, and not after 26 weeks.