Pediatric Nutrition in Practice

2 Nutrition of Healthy Infants, Children and Adolescents

Key Words

Infant formula · Follow-up formula · Soy protein

formula · Protein hydrolysate formula · Thickened

formula

Key Messages

• Infant formula is required as a substitute for breast
  milk for infants who are not fully breastfed


• Infant formula must satisfy all the nutritional needs
  of an infant from one food product and needs to
  meet high quality and safety standards


• The suitability of infant formula should be deter-
  mined by comparing its effects on outcomes with
  those in healthy, exclusively breastfed infants


• Powdered formula is not a sterile product and may
  contain pathogenic bacteria (e.g. Cronobacter spp.).
  Powdered formula should always be freshly pre-
  pared prior to feeding © 2015 S. Karger AG, Basel

Infant Formula

Breastfeeding is the best choice for infant feeding
and provides multiple benefits for children’s
health [1]. Therefore, breastfeeding should be ac-
tively promoted, protected and supported. In-
fants who cannot be breastfed (or should not re-
ceive breast milk, or for whom breast milk is not
available) should receive an infant formula with a

composition based on current scientific knowl-

edge [2, 3]. Infant formula must satisfy all the nu-

tritional needs of an infant from one food prod-

uct, and it provides a high intake per kilogram

body weight during a very sensitive period of life.

Therefore, particularly high quality and safety

standards are applied to infant formulae [4]. The

composition of infant formulae should serve to

meet the particular nutritional requirements, and

promote the normal growth and development, of

healthy infants. While the composition of human

milk of well-nourished women provides some

guidance for the composition of infant formulae,

gross compositional similarity is not an adequate

determinant or indicator of the safety and nutri-

tional adequacy of infant formulae [3]. Rather,

the suitability of infant formula should be deter-

mined by a comparison of its effects on physio-

logical (e.g. growth patterns), biochemical (e.g.

plasma markers) and functional outcomes (e.g.

immune responses) in formula-fed infants with

those found in populations of healthy, exclusively

breastfed infants [3].

Revised global recommendations on the com-

position of infant formulae have been adopted in

the Codex Alimentarius of the Food and Agricul-

ture Organization of the United Nations (FAO)

and the WHO [5] , which to a large extent fol-

lowed recommendations by an International Ex-

Koletzko B, et al. (eds): Pediatric Nutrition in Practice. World Rev Nutr Diet. Basel, Karger, 2015, vol 113, pp 97–103
DOI: 10.1159/000375271

2.2 Formula Feeding

Berthold Koletzko

2