Infant formula

If the baby is not breastfeeding or requires more milk than breastmilk, the baby must be given infant formula. Infant formula can be given from birth and for the duration of the first year of life.

What is infant formula?

Infant formula is an industrially manufactured milk substitute that can be given to infants as a replacement for breastmilk. Infant formula is available from grocery stores and pharmacies in powder form and ready-to-drink in cartons or packaging. Infant formula has been created to resemble breastmilk as closely as possible. Infant formula has a very similar nutrient content to breastmilk, but lacks some of the substances in breastmilk that are beneficial to the baby’s development and immune system.

Babies who receive infant formula will grow and develop normally.

Different types of infant formula

The most commonly used types of infant formula are made from cow’s milk, but there are also infant formulas available that are made from soy and goat’s milk. Different types of infant formula are available, for example for babies with allergies. All infant formula available on the Norwegian market must comply with the Norwegian Food Safety Authority’s regulations.

If you have a vegan or vegetarian diet and want your baby to have the same, you can choose to use a soy-based infant formula. Such infant formula must not be given to premature babies. If soy-based infant formula is not available when the baby needs it, you need to give your baby infant formula made from cow’s milk.

Never make your own infant formula at home.

You must never make infant formula at home from ordinary milk, goat’s milk, protein shakes or similar. This is because it is not possible to create the right composition of nutrients. The wrong composition can harm the baby’s kidneys or prevent the baby from growing properly. Infants must not be given soy milk, oat milk, almond milk, rice milk or other plant-based drinks.

If infants are given such drinks instead of breastmilk or infant formula, the baby could become severely malnourished, become very ill or die.

When should I give infant formula?

There can be several reasons why a baby needs infant formula instead of or in addition to breastmilk. During the first four months of life, the baby should be given only breastmilk or infant formula or a combination of breastmilk and infant formula. If possible, it is a good idea to give the baby some breastmilk alongside infant formula.

When the baby does not get enough breastmilk

One reason to give infant formula is when the baby does not get enough breastmilk.

It is common to worry about whether your baby is getting enough breastmilk. Most babies lose some weight during the first few days after birth. Healthy babies who are born at term have nutrient reserves that allow them to handle this. The baby’s weight should start to increase over time.

Your baby will be weighed when you attend check-ups at the health centre. The baby is getting enough breastmilk if they gain weight as normal, feed at least 8-10 times per day and have plenty of wet nappies and regular bowel movements.

See text and film: How do I know that I am producing enough milk?

If the baby does not follow their growth chart, healthcare professionals will examine whether it is because the baby is not suckling effectively at the breast or whether there are other reasons for the limited growth. You will get help with breastfeeding and the baby will be monitored through additional weight checks.

If the baby’s growth still does not increase as normal, you may need to give infant formula in addition to breastmilk. Speak with your healthcare provider if you have any doubts.

Frustration relating to breastfeeding

Many people experience a pressure of expectation relating to breastfeeding, not least an expectation of their own performance as a breastfeeding mother. For this reason, it is not uncommon to feel disappointment and frustration if breastfeeding is not working as intended.

If you experience difficulties breastfeeding, you can ask for help from the maternity ward or health centre or contact Ammehjelpen. Most breastfeeding issues can be solved through proper guidance. On the NIPH website, you can find a checklist for whether breastfeeding is going well (PDF, in Norwegian)

In order for your baby to thrive, you need to feel good too. Please ask for support and guidance if you feel depressed or find breastfeeding stressful and difficult. Sometimes, the right decision can be to stop breastfeeding. The most important thing is the care and love you can give to your baby, with attention to your baby’s cues and plenty of skin-to-skin contact.

When not to breastfeed

A small number of women are unable to or should not breastfeed and should give their baby infant formula instead. In some cases, this can be true from birth. This could be because you are HIV-positive, have tuberculosis or certain other conditions. It can also be because you have to take certain medications that cannot be used while breastfeeding.

Ask your GP or pharmacist or check Tryggmammamedisin.no (in Norwegian) to find out whether you can breastfeed safely on your medication.

Mixed feeding or infant formula only?

There can be many reasons for breastfeeding not working so that you need to supplement or replace breastmilk with infant formula. All breastfeeding, including mixed feeding, is beneficial both for you and your baby, so please continue to breastfeed as much as you can.

If you mix-feed, you can increase and maintain milk production by breastfeeding from both breasts before giving infant formula.

See videos and read more about mixed feeding here:

Mixed feeding - why?

Mixed feeding - how to maintain milk production?

If you decide to use infant formula, it can be difficult to go back to only breastfeeding again. This is because milk production will decrease when you breastfeed less often.

In the event of allergies or intolerance

You do not need to prevent allergies

Children that do not receive breastmilk can have regular infant formula even if there are allergies in the family.

Partially or completely hydrolysed infant formula (special nutrition with split proteins) is not recommended to prevent allergies, including for babies at high risk of developing allergies.

There is no reason to start solid food earlier than recommended for the purpose of preventing allergies.

In the event of diagnosed allergy or intolerance

In the event of a diagnosed cow’s milk protein allergy, completely hydrolysed infant formula from the pharmacy is recommended, but talk to your GP first. Hydrolysed infant formula can also be used in cooking after the baby has started solids.

Lactose intolerance is very uncommon in babies under the age of one year, even in children with parents from countries where lactose intolerance is common. Babies with a high probability of developing lactose intolerance can be given normal infant formula.

Hygiene and preparation

Good hygiene and correct preparation are necessary to prevent the baby from becoming ill. Disease-causing bacteria can be found in the infant formula powder or can be transferred to the infant formula from the person preparing the infant formula, as well as from the environment or equipment used to prepare and feed.

Thorough cleaning of dummies and bottles, hygienic preparation and using warm water when mixing the powder (minimum 70 degrees) can prevent the baby from becoming ill. In order for the temperature to be high enough, all water should be at a high temperature when being mixed with the powder.

See videos and read more about how to prepare infant formula:

How to feed the baby infant formula?

You can feed your baby using a bottle, spoon, cup or lactation aid. Your baby should be able to decide when to feed. You therefore need to pay attention to your baby’s cues. See videos and read more about feeding methods:

See text and film: How do I know if my baby is hungry?

See text and film: How to plan mealtimes when babies are bottle-fed?

See text and film: How to give a bottle?

Hay G, Fadnes LT, Meltzer HM, Arnesen E, Henriksen C. (2022) Oppfølging av gravide, ammende og spedbarn med vegetarisk eller vegansk kosthold. Tilgjengelig fra: https://tidsskriftet.no/2022/04/fra-fagmiljoene/oppfolging-av-gravide-ammende-og-spedbarn-med-vegetarisk-eller-vegansk.

Helsedirektoratet (2021) Vegetar- og vegankost – ekspertuttalelse fra Nasjonalt råd for ernæring. Tilgjengelig fra: https://www.helsedirektoratet.no/rapporter/vegetar-og-vegankost-ekspertuttalelse-fra-nasjonalt-rad-for-ernaering

World Health Organization (2012). Safe preparation, storage and handling of powdered infant formula: guidelines. Tilgjengelig fra: https://www.who.int/publications/i/item/9789241595414

Content provided by The Norwegian Directorate of Health

The Norwegian Directorate of Health. Infant formula. [Internet]. Oslo: The Norwegian Directorate of Health; updated Tuesday, June 14, 2022 [retrieved Sunday, April 21, 2024]. Available from: https://www.helsenorge.no/en/spedbarn/infant-food-and-breastfeeding/infant-formula/

Last updated Tuesday, June 14, 2022