What is the best infant formula for your baby?

The best milk for your baby is breast milk. When formula is needed, whether on your paediatrician's advice or by the family's choice, the first thing to know is that the World Health Organization (WHO) does not recommend any brand: all formulas sold in the European Union must meet the same composition standard. That is why there is no single "best infant formula" for every baby, only the one that suits their age and, if there is a problem, the one their paediatrician recommends. Our midwives explain the types available and what to look for.

Types of infant formula and when they are used

Type of milk	From what age	Is it needed?
First infant formula (1)	From birth	This is the reference formula if the baby is not breastfed or breastfeeding is not enough. It can be used throughout the whole first year.
Follow-on formula (2)	From 6 months	Not essential: according to the WHO, you can stay on first infant formula until 12 months.
Growing-up milk (3)	From 12 months	Not necessary: from one year old, a healthy child with a varied diet can drink whole cow's milk.
Special formulas (lactose-free, hydrolysed, anti-reflux…)	Depending on the case	Only on your paediatrician's advice. We cover them in anti-colic, anti-reflux and anti-constipation formulas and in hydrolysed formula.

What to look for when choosing an infant formula

• It must be infant formula suitable for your baby's age. Plant-based drinks (oat, almond, supermarket soya), cow's milk before 12 months or homemade formulas are not suitable for feeding a baby.
• Make it up exactly as the packaging says, without making it stronger or more diluted. We explain it step by step in how to make up a formula bottle.
• The packaging should be sealed and within its use-by date, and stored as the manufacturer indicates.
• Don't switch milk without a reason. If you think it doesn't agree with your baby (vomiting, diarrhoea, blood in the stools, a lot of crying or poor weight gain), check with your paediatrician first.
• No added sugar: first infant formulas contain lactose, which is the natural sugar in milk. You should not add sugar or anything else to the milk.

What is the best infant formula according to the World Health Organization?

The WHO emphasises that the best way to feed a baby during the first six months is exclusive breastfeeding. It provides all the nutrients needed for growth and protects against common illnesses such as diarrhoea and pneumonia. From six months, other foods are added and breastfeeding is recommended until two years or beyond (WHO, exclusive breastfeeding).

When breastfeeding is not possible or not enough, the WHO advises using a suitable and safe infant formula, prepared correctly and on the advice of a healthcare professional. There is no "best" brand recommended by the WHO: what matters is that the formula meets composition and safety standards and suits your baby's age and needs (WHO, 2011).

Composition of breast milk

Breast milk is the model on which all formulas are based. In this table you can see its energy and nutrient composition compared with the average of first infant formulas and with cow's milk.

Which infant formula is most similar to breast milk?

None. Breast milk has something no formula can copy: living cells, antibodies, digestive enzymes and growth factors, and it also changes over the course of a feed, the day and the months according to what your baby needs. Formulas try to come close to its composition and bioavailability, and all those sold in the EU have energy, protein, fat, vitamins and minerals within the limits set by law.

Since 2020, for example, all first infant and follow-on formulas have to contain DHA (an omega-3 fatty acid). Some brands also add oligosaccharides similar to those in breast milk (HMOs), probiotics or partially hydrolysed protein. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) considers that it has not been clearly shown that these additions make a formula better for a healthy baby. So, unless your paediatrician recommends a specific milk for a particular reason, any first infant formula suitable for your baby's age will feed them well.

Who regulates the composition of milk?

Across the European Union, the composition and labelling of first infant and follow-on formulas are set by Delegated Regulation (EU) 2016/127, which has applied since 22 February 2020 (since 2021 for formulas made from protein hydrolysates). It replaces the former Directive 2006/141/EC, which was applied in Spain through Royal Decree 867/2008.

This regulation sets the minimum and maximum values for each nutrient, based on scientific studies in babies and using breast milk as the reference. Growing-up milks do not have their own composition standard, and manufacturers usually follow the one for follow-on formulas.

Is it necessary to switch from first infant formula to follow-on formula?

No, it isn't. The WHO considers follow-on formulas unnecessary, and the American Academy of Pediatrics recommends giving babies who are not breastfed the same first infant formula throughout the whole first year. Follow-on formula has more energy and some nutrients than first infant formula, but that does not make it better for a baby over 6 months, who already gets those nutrients from other foods. If you have any doubts, talk to your paediatrician.

Do these milks cover my baby's needs?

Yes, if they are made up correctly and your baby takes the amount they need for their age and weight. To find out how much they should take, see our table of milk quantity in a bottle by age. The most reliable way to know whether your baby is eating enough is their weight curve at check-ups and regular wet nappies.

Conclusion: what is the best infant formula?

Breast milk is the best option for feeding your baby. If you need formula, no brand is better than the others: they all meet the same European standard. Choose a first infant formula suited to your baby's age with your paediatrician, always make it up as the packaging says and seek advice if you notice it doesn't agree with your baby. Every baby is unique and, as with everything to do with parenting, your paediatrician and your midwife are best placed to guide you in your particular case.

Sources

• World Health Organization (WHO). Exclusive breastfeeding (e-Library of Evidence for Nutrition Actions) and press release of 15-01-2011.
• WHO. Information concerning the use and marketing of follow-up formula, 2013.
• Commission Delegated Regulation (EU) 2016/127 on the specific compositional and information requirements for infant formula and follow-on formula.
• ESPGHAN Committee on Nutrition. Position papers on infant formulas with added ingredients.
• Asociación Española de Pediatría (AEP), En Familia. Alimentación del lactante con fórmula.