Special formulas are those in which one of the basic nutrients (usually the protein and/or carbohydrate) has been changed to an alternative nutrient that an individual baby may better tolerate. When formula shopping, be sure not to make a change to these specialty formulas without your doctor’s advice. Specialty formulas:
- are usually much more expensive
- usually taste bitter to downright bad because the technology required to predigest (hydrolyze) the protein into more easily-digestible units results in a more bitter-tasting protein
- The nutritional quality of the changed or absent nutrient may be less than in standard formulas.
- Less is known about the long-term effects of feeding babies these special formulas. In other words, all formulas are experimental, but some are more experimental than others.
The following are the most popular specialty formulas at this writing: Lactose-free formulas (e.g., Lacto-free, Mead Johnson) are an example of new formula products that are driven more by market demand than scientific sense. Many formula-fed babies (and breastfed babies, too) get fussy, resulting in what we call the formula parade: switching from one formula to another until either something works or the baby’s intestines mature and he outgrows the problem. Whatever formula you’re using at the time gets the credit. The fact is that oftentimes baby’s fussiness is not due to the formula, but to other unrelated causes. Nevertheless, formula gets the blame, so factories step up with new varieties to keep up with the demand. Hence lactose- free formulas.
Lactose-intolerance is over-diagnosed in babies (as it is in adults). It’s easy to blame formula, and therefore lactose, for baby’s fussiness. Think for a moment. If so many babies are lactose-intolerant, why would lactose be the sugar in human milk? True, human milk also contains the enzyme lactase that helps babies absorb the lactose, whereas formula does not, but milk lactase doesn’t do the whole job. It does seem that nature would provide the intestines of nearly all babies with enough lactose to get through at least a year or so of milk-feeding (lactose is only present in dairy products and not other foods).
The main difference in lactose-free formula is that the lactose sugar has been replaced by other sugars, usually corn syrup and sucrose (table sugar). The protein and fat blend is the same as in cow’s milk-based formulas. The biochemist who dreams up the formula believes that sugar is sugar, and substituting corn syrup and sucrose for lactose is no big deal. Lactose is eventually broken down into glucose, as are corn syrup and sucrose, so it shouldn’t matter. Actually, the intestines break the lactose down into two sugars – galactose and glucose. Both of these sugars are absorbed into the bloodstream. No one really knows what galactose does or why it’s beneficial, just as no one knows the whole story about how the body reacts to sugars from corn syrup and sucrose. So, we’re back to the non-science of common sense. If the human baby (like all mammals) didn’t do better with galactose, it wouldn’t be there in the first place. The milk sugar would have been pure glucose. Like so many other nutrients in formula, there is one big WE DON’T KNOW about lactose-free formulas.
We also know that lactose does more than just supply energy. The lactose that doesn’t get digested in the upper intestine contributes to what is called the friendly ecology of the gut. Lactose helps healthful bacteria thrive. Lactose- free formulas not only deprive baby of lactose, they also deprive those trillions of friendly bugs that live in the intestines and do good things for the body. Lactose also facilitates calcium absorption in the gut, so that babies on lactose-free formulas may run the risk of not getting enough calcium.
Lactose-free formulas (including soy formulas) are often tried when a baby has symptoms of lactose intolerance, such as excessive bloating, gas, diarrhea, a red burn-like rash around the anus, and abdominal cramping. They are useful in babies who have rare metabolic diseases in which they are missing the enzyme that metabolize lactose. (This only occurs in around one of 65,000 babies.) Lactose-free formulas can also be tried in babies recovering from a diarrhea- producing illness and who suffer from a temporary lactase-deficiency while the intestinal lining is healing.