In this article

Breastfeeding When not to breastfeed Types of breastmilk

Mother's diet Foods to avoid Bottle-feeding

Soya formulas Possible feeding problems

Using formula milk is sometimes necessary and may be the preferred option for some mothers. While formula milk can't match the important immunological benefits of breastmilk, its nutritional composition is as close to breastmilk as possible.

There are two types of formula milk: whey-dominant and casein-dominant. Both are based on cow's milk. Whey-dominant milks are the most highly modified and closest to breastmilk, so are considered to be the most suitable for babies from birth onwards. Casein-dominant feeds are marketed as more suitable for older or hungrier babies. Although they have the same nutritional composition, it has been suggested that the type of curds formed in the stomach from casein take longer to digest, leaving the baby feeling fuller for longer - but no hard evidence exists to support this.

These should be used with caution for children who are sensitive to cow's milk protein. For infants under the age of six months, they should be avoided if at all possible. Speak to your health visitor or midwife about suitable alternatives if you suspect your baby might be sensitive to cow's milk.

Diarrhoea and vomiting

These are potentially serious problems that can cause life-threatening dehydration and an electrolyte imbalance. A combination of vomiting and diarrhoea is more serious than diarrhoea alone.

Many babies regurgitate small amounts of milk at the end of a feed. This is completely normal. However, projectile vomiting, vomiting both after and between feeds, or blood- or bile-stained vomit must be reported immediately to your doctor. Feeding should be stopped and replacement fluids may be recommended. Feeds should then be reintroduced gradually until symptoms disappear. With bottle-fed babies, your midwife may suggest that you reintroduce the milk at a reduced strength, gradually building up to full strength.

Poor weight gain

A slow rate of growth isn't necessarily a cause for concern. Your midwife and health visitor will monitor your baby's weight gain and offer appropriate advice if necessary. Typical causes of poor weight gain include: inadequate nutrient intake due to poor breastfeeding technique, incorrect formula, inadequate milk supply or a baby's inability to feed properly (such as poor suckling position), and inadequate absorption due to food intolerance or intestinal disturbances.

Excessive weight gain

This is rare in babies who are breastfed exclusively. Bottle-fed babies often grow at a more rapid pace and, if weight gain is excessive, your health visitor or midwife should check the amount of formula and its dilution.

This article was last medically reviewed by the MRC Human Nutrition Research in July 2008.
First published in March 2001.