Formula Milk 101 : Singapore Formula Milk, Baby Bottles and Breastpump Guide 2024

 I. Formula Milk



1. Baby Nutrition Guide

a. 0-6 months - Stage 1 Formula Milk

Newborns should either breast milk or infant formula on demand.


Breast Milk
For new-born babies, WHO advices to solely breastfeed for the first 6 months and then continue with additional nutritious foods up to 2 years old, based on you and your baby's needs. Source

Breastfeeding is usually the better option compared to formula milk because it..
- Adapts to the baby's changing requirements
- Provides babies with all of the vital nutrition and hydration they need
- Helps protect against infection and to build a healthy immune system
- Is a cheap and convenient to feed your babies wherever and whenever they need to.


Infant Formula Milk
In case breastfeeding doesn’t work or you choose not to breastfeed, infant formula is the only suitable alternative. It should be your baby’s only source of nutrition for the first 6 months. A formula-fed infant will drink every 3 - 4 hours and will increase as your baby grows.

According to NHS guidelines, cow’s milk and other substitutes should not be introduced as a main drink until after 1 year. Never start solids before 4 months. Source

Always seek medical advice before buying infant formula.


4-6 Months Old
Most babies are ready to start solids around 5 - 6 months old.
Some signs that show they are ready include..
- Mastering the grabbing skill
- Developing head and neck control
- Losing the tongue-thrust mechanism that automatically pushes food out of their mouth. N

Aim to feed about 1-2 tablespoons of food twice a day to your baby. Solid food shouldn't replace milk as the main source of nutrients.

Here are some infant formulas you can find in Singapore..

- Dumex Dulac Stage 1



- Dumex Mamil Gold Stage 1



- Similac® Stage 1 Baby Milk Powder Formula 2'-FL  



- Nestle NAN Optipro H.A. Infant Formula Stage 1

b. 6-12 months - Stage 2 Formula Milk

At 6 months, parents will usually introduce more foods into their baby’s diet, so the amount of milk they will need will gradually decrease. For both formula-fed and breastfed babies, the amount of milk they drink should naturally adjust according to how much food they have eaten.

However, for babies 6 to 9 months old, most of their calories should still come from breast milk or formula. Don’t stress about getting them to eat bite after bite of solid food. Feed up to two meals daily (or once every couple of days for some babies), with each meal 2 to 4 tablespoons.

Suitable baby foods include iron-fortified single-grain baby cereal along with pureed vegetables, fruits, and meats. You can also try offering finger foods like cut vegetables, fruit, yogurt and cheese. However, try not to introduce more than one food at a time to identify possible allergies or digestive problems.

If they seem to have an endless appetite or don’t seem to be eating enough, contact your child specialist.

Here are some Stage 2 formulas you can find in Singapore..

- Enfamil A+ Stage 2 Follow On Milk Formula



- Dumex Mamil Gold Stage 2 Follow On Baby Milk Formula



- Frisolac Gold Stage 2



- Hipp Organic Combiotic Follow-on Milk 2



9-12 Months Old
At this age, about half of your baby’s calories may usually come from food and the other half from breast milk or formula.

Babies these age are usually interested in trying new foods, so you can try to give them small pieces of your own meals. If they want more, give them more, but if they push it away, maybe that item is just not their one of their favourites.

Babies like to play with their food, so you can try using yogurt, cheese or oats as a sauce for vegetables or whole-grain crackers. Just remember to cut the foods properly and to avoid hard pieces to prevent choking.



c. 12 months onwards - Stage 3 / Stage 4 Formula Milk

Read More : Best Milk Formula for Toddlers Singapore
Summary : Feed breast milk, dairy milk (cow / goat / etc), alternative plant based milk (soy), more soft / semi solid foods. Seek medical advice before feeding non breast milk alternatives.

Children will usually start to eat larger, more regular meals and get most of their nutrition from foods other than milk. WHO recommends that babies continue to be breast fed up to 2 years and beyond, but they may begin to need less breast milk as they eat more food. Source

After 12 months, your baby may not need formula milk anymore as they can start drinking cow’s milk and other alternatives more regularly.

Below are some of the main types of milk that may be given at this stage.

Cow’s Milk - For children under 2, choose full-fat cow’s milk. Semi-skimmed doesn’t have the same nutrient profile in terms of vitamins and minerals and has less energy.

Goat’s / Sheep’s Milk - Their nutrient profiles are similar to cow’s milk so as long as they’re pasteurized, they’re alright to offer.

Soya Drinks & Other Milk Alternatives - As part of a healthy, balanced diet, soya, oat, almond and other vegetable based milks can be offered or used in cooking. However, they are usually not as nutritionally comparable to cow’s milk. Furthermore, not all brands fortify with the same nutrients so they shouldn’t replace cow’s milk.

2 years and above
Summary : Feed cow's milk or alternative, and a balanced diet. Formula milk as an addition if the child is not receiving enough nutrients.

Children will start to eat a more varied, balanced diet and may rely less on milk. You may adjust how much milk you give them based on their diet throughout the week. If your child's diet doesn’t include dairy, you should consider how you can replace any nutrients they might be missing out on, such as formula milk or alternative foods.


Sources
https://www.srnutrition.co.uk/2019/08/milk-recommendations-for-infants-toddlers/
https://www.aptaclub.de/en/baby/which-milk-should-i-use-and-when.html
https://www.who.int/nutrition/topics/infantfeeding_recommendation/en/
https://www.nhs.uk/conditions/baby/weaning-and-feeding/drinks-and-cups-for-babies-and-young-children/


2. Difference between Newborn vs Infant vs Toddler Formula


a. Difference Between Infant Formula and Stage 1 Formula Milk

- Infant formula resembles breast milk more

- Infant formula's only form of carbohydrate is lactose 
- Stage 1 formula contains starch in addition to lactose

- Infant formula is usually watery, has less protein content, and is easier for babies to digest
- Stage 1 formula is creamier than infant milk and will keep your baby full longer

- Both formulas can be used from birth onwards.
- Both formulas can be used until the baby stops bottle feeding.



b. Difference Between Stage 1 and Stage 2 Formula Milk

- Stage 1 and Stage 2 formula milk have similar nutrients. The main difference is the ratio of casein and whey proteins, which are both derived from milk.

- Stage 1 formulas are whey dominant just like breast milk which has a whey to casein ratio of about 60:40. Whey digests quickly compared to casein.

Stage 2 formulas are similar to Stage 1 formulas but has more casein, with a whey to casein ratio of 20:80. Casein digests slower, keeping babies full for longer.

- Stage 2 formulas are often creamier than Stage 1 formula and has more energy, making it more satiating for babies older than 6 months.

Stage 2 formula is mainly appropriate when your child starts eating baby food. It can be used to supplement baby food if your baby is still hungry after drinking Stage 1 milk. 

- Stage 2 formula can be used starting from month 7 (earliest) until the baby stops bottle feeding. 



c. Difference Between Stage 2 and Stage 3 / Stage 4 Formula Milk

- Stage 3 formula usually has more starch and energy contents than Stage 2 formula, making babies full for longer.

- Stage 3 formula is usually not as micro and macronutrient dense as Stage 1 or Stage 2 formula milk, as it is considered as a weaning formula.


About Stage 3 Formula Milk
Stage 3 formula is appropriate for toddlers 12 months or older. 

It shouldn't be used as a substitute for a healthy diet with fruits, vegetables, and proteins. This formula milk should be a part of your baby's diet, and shouldn't replace solid foods.

It may not be necessary for toddlers who are already eating a lot of healthy foods. However, if the child cannot consume enough normal food, stage 3 formula could be useful. 

As always, consult a child specialist for specific nutrition advice.



3. Breastfeeding vs Formula - Advantages and Disadvantages


a. Advantages of Breastfeeding

- Breastfed babies are generally healthier and have a reduced chance of suffering from many types of diseases. This is because breastmilk helps protect against infection and to build a healthy immune system.
- Breastmilk is more easily digested by babies, reducing the likelihood of digestive diseases such as diarrhea or constipation.

- Breastmilk adapts to the baby's changing requirements

- Breastmilk provides babies with all of the vital nutrition and hydration they need
- Breastmilk is cheap and convenient to feed your babies wherever and whenever they need to.


b. Advantages of Breastfeeding for Mothers

- Breastfeeding promotes faster weight loss after birth as it burns calories and helps shrink the uterus.
- Breastfeeding helps lower the risk of breast cancer, uterine cancer, ovarian cancer, high blood pressure, anemia, diabetes, and cardiovascular disease.
- Breastfeeding reduces the risk of postpartum depression
- Breastfeeding promotes skin to skin contact which can enhance the emotional connection between the mother and the baby.
- Breastfeeding produces oxytocin and prolactin that naturally soothes the mother. They also promote stress reduction and positive feelings in the nursing mother.


c. Disadvantages of Breastfeeding

- Breastfeeding may be uncomfortable at first, especially to new mothers. It is common to get sore breasts or nipples during the first month of breastfeeding.
- Breastfeeding can be time consuming for the mother.
- If the breastfeeding mother consumes alcohol, her breastmilk may affect the baby.
- The breastfeeding mother's health conditions may affect the baby.
- Breastfeeding can be difficult to carry out in public.


d. Advantages of Formula Feeding

- Formula feeding is convenient. Formula-fed babies can be fed by anyone at any time.

- It's flexible. Breastfeeding can be difficult for mothers who are working or studying.

- Your partner can help out with nighttime feedings and share that bonding experience with your baby.

- Scheduling feedings may be easier. Formula isn't digested as quickly as breast milk, so formula-fed babies don't need to eat as often, especially in the first few months.

- You don't have to worry about what you eat. Moms who breastfeed may have to avoid certain foods that their baby can't tolerate.

- You can have a glass of wine or a cocktail once in a while. Alcohol is a no-no for women who breastfeed because they pass on tiny amounts of it to their babies.

- Formula feeding mothers can measure how much milk their babies are drinking.


e. Disadvantages of Formula Feeding

- Formula milk is generally not as nutritious as breastmilk. Thus, the baby's immune system may not be as strong compared to if they were breastfed.

- Formula fed babies have a higher chance of suffering from digestive issues like diarrhea, vomiting and constipation.

- Formula feeding mothers have to be wary of where they purchase their formula from as they may come across fake or expired milk.

For infants, not being breastfed is associated with an increased incidence of infectious morbidity, including otitis media, gastroenteritis, and pneumonia, as well as elevated risks of childhood obesity, type 1 and type 2 diabetes, leukemia, and sudden infant death syndrome (SIDS).


For mothers, failure to breastfeed is associated with an increased incidence of premenopausal breast cancer, ovarian cancer, retained gestational weight gain, type 2 diabetes, and the metabolic syndrome.


f. Scholarly Articles on Breastfeeding vs Bottle-Feeding

Effect of breastfeeding compared with formula feeding on infant body composition: a systematic review and meta-analysis

Review of Infant Feeding: Key Features of Breast Milk and Infant Formula

Growth performance comparison of exclusively breastfed infants with partially breastfed and formula fed infants

Growth patterns of breast fed and formula fed infants in the first 12 months of life: an Italian study

Breastfeeding and Child Cognitive Development

The Risks of Not Breastfeeding for Mothers and Infants

Breastfeeding and the risk for diarrhea morbidity and mortality

Efficiency of Breastfeeding as Compared to Bottle-Feeding in Very Low Birth Weight (VLBW, <1.5 kg) Infants



4. What are the different forms of formula?

Formulas come in three forms: ready-to-use, liquid concentrate, and powdered. Source

a. Ready-to-use formula

This is definitely the most convenient formula type – no mixing or measuring required. Just open and serve. It's the kind of formula that hospitals often give to newborns. It's hygienic and especially helpful when you don't know whether you'll have access to safe water.

The convenience of ready-to-use formula comes at a price – it costs about 20 percent more per ounce than powdered formula. The containers also take up more storage space in your cupboard and more space in the landfill (unless you can recycle the containers).

Once opened, ready-to-use formula has a short lifespan – it must be used within 48 hours. Also, because liquid formula is often darker than powdered formula, many moms complain that it's more likely to stain clothes.


b. Liquid concentrate formula

This type requires mixing equal parts of water and formula concentrate. Compared to ready-to-use formula, concentrate is less expensive and takes up less storage space. Compared to powdered formula, it's a little easier to prepare but more expensive.


c. Powdered formula

As the most economical and the most environmentally friendly formula option, powdered formula takes up the least amount of space in transport, in your pantry, and in your trash can.
Powdered formula takes more time to prepare than other types of formula, and you must follow the directions exactly, but it has a one-month shelf life after the container has been opened. As with liquid concentrate formula, you can mix up just the right amount – as much or as little as you want – whenever you need it. This is especially helpful if you're a breastfeeding mom who may only need a supplemental bottle occasionally.




5. What are the different types of formula?

a. Cow's-milk-based formula


Most formula available today has cow's milk as the main ingredient. The overwhelming majority of formula-fed and formula-supplemented babies do best with this type of formula because it has just the right balance of protein, carbohydrate, and fat.

The milk protein in formula is significantly altered to make it easier to digest. Your baby won't be able to digest regular cow's milk until after his first birthday.

b. Partially and extensively hydrolyzed formulas

In these formulas, the protein is broken down into small parts (partially hydrolyzed) or even smaller parts (extensively hydrolyzed) that are easier for your baby to digest than larger protein molecules.
The proteins in extensively hydrolyzed formulas are completely broken down into their building blocks (amino acids), which allow them to be easily absorbed. Extensively hydrolyzed formulas are considered hypoallergenic and are used for babies who have a cow's milk protein allergy.

Partially hydrolyzed formulas are not hypoallergenic, so don't use one if your baby has a milk protein allergy or if you suspect she may have one. The pediatrician might recommend trying this type of formula if, for example, your baby always seems fussy after feedings – which might indicate trouble digesting standard cow's milk formula.

Hydrolyzed formulas are also recommended when a baby has trouble absorbing nutrients (a common problem for preemies).

c. Soy-based formula


These formulas are made with a plant protein that, like the protein in cow's milk, is modified for easy digestion. Although soy-based formulas are a good option for vegan families, they're not recommended for preterm infants weighing less than 1,800 grams (about 4 pounds), and there are only a few medical reasons for using them. These include:
  • Transient lactose deficiency: a temporary lactose intolerance caused by a gastrointestinal infection
  • Immunoglobulin E (IgE)-associated allergy to cow's milk: an allergy to cow's milk protein that causes immediate symptoms, including wheezing, runny nose, hives, and rashes; however, many babies with IgE-associated milk allergy are also allergic to soy protein, so don't give soy formulas to your child unless your doctor recommends it
  • Galactosemia: a rare inherited disorder in which the body is unable to break down a milk sugar (galactose) to produce energy; most states test for galactosemia during newborn screening tests
  • Congenital lactase deficiency: an extremely rare inherited disorder in which a baby is born with very little or none of the enzyme that breaks down the sugar lactose found in milk, causing life-threatening lactose intolerance symptoms
Note: Research suggests that certain compounds in soy can act like the hormone estrogen in the body. In animal studies, eating a lot of soy was linked to early onset of puberty in females and changes in the development of breast tissue. If your baby drinks only soy formulas, talk with your doctor about whether it could affect your baby's development.


d. Lactose-free formula

Lactose intolerance or an inability to digest lactose – the sugar naturally found in milk – is rare in infants. If your baby is lactose intolerant, his doctor may recommend a soy formula or another formula in which the lactose is replaced with a different sugar, such as corn syrup.

Formula for premature and low-birth-weight babies: These formulas often contain more calories and protein, as well as a more easily absorbed type of fat called medium-chain triglycerides (MCT). How much MCT is in these formulas varies by brand. Your baby's doctor will help you select the one that will help your baby gain just the right amount of weight.


e. Human milk fortifier

This product is used to enrich the nutrition of breastfed babies who have special needs. It's designed to be mixed with breast milk and should not be fed as a stand-alone formula.


f. Metabolic formula

If your baby has a disease that requires very specific nutrition, he may need one of the specially developed metabolic formulas.


g. Organic formula

This type of formula allows parents to limit their baby's exposure to herbicides, pesticides, and other chemicals. Formulas labeled "organic" must be certified by the U.S. Department of Agriculture.

But according to the American Academy of Pediatrics (AAP), no research to date has proven organic milk to be healthier for children than regular milk. Parents may want to consider whether organic formula is worth the higher price.


h. Other specialty formulas

New formulas come out all the time that claim to relieve problems such as colic or acid reflux. These formulas have a protein ratio similar to breast milk and vary slightly in composition from regular formula, but some experts say they may not be any better.

"More often than not, specialty formulas are substantially more expensive and not significantly different in key nutritional value," says KT Park, a pediatric gastroenterologist at Stanford's Lucile Packard Children's Hospital. "Babies undergo tremendous adaptation of their gastrointestinal tract during the first six months of life, which is normal. There are very few scenarios in which infants would require the more expensive formulas."

If you think your child might benefit from a specialty formula, ask your child's doctor about it before you stock up.



6. What are the main ingredients in infant formula?

There are five main components to formula: carbohydrate, protein, fat, vitamins, and minerals. 

What makes one brand of formula different from the next are the specific carbohydrates and proteins (as well as any additional nutrients in smaller quantities). For example, casein and whey are two kinds of cow's milk proteins found in various proportions in different brands of cow's-milk-based formula.
It's very easy to get confused by all of the items listed on the ingredient label. 

Here's how to decipher the maze of ingredients and a comparison to the ones found in breast milk..

a. Carbohydrate

Lactose is the main carbohydrate in both breast milk and formulas made from cow's milk. Corn maltodextrin is sometimes used as a secondary source of carbohydrate in formula. Lactose-free, soy, and special formulas contain one or more of the following carbohydrates: sucrose, corn maltodextrin, modified cornstarch, or corn syrup solids.


b. Protein

Breast milk contains about 60 percent whey and 40 percent casein. Most formulas have similar protein ratio. Others contain 100 percent whey.

Soy formulas contain soy protein isolate – a processed soybean ingredient that is almost pure protein (at least 90 percent). Some brands use partially hydrolyzed soy protein (protein that is partially broken down) to allow for easier digestion.


c. Fat

Breast milk contains a blend of monounsaturated, polyunsaturated, and saturated fat. Formulas use a variety of oils to match the fat makeup of breast milk. They include soy oil, coconut oil, palm or palm olein oil, and high oleic sunflower oil.

Although palm and palm olein oil are widely used, research has shown that these fats can reduce absorption of fat and calcium. This would mean that your baby would not absorb as much fat and calcium as she would from a formula that doesn't contain this oil.

Medium-chain triglycerides are a form of fat that require less effort to digest and are more easily absorbed. They're used in special formulas for premature infants and for infants who have trouble digesting or absorbing nutrients.

The US Food and Drug Administration (FDA) has approved the addition of two long-chain fatty acids to formula: DHA (docosahexaenoic acid) and ARA (arachidonic acid), which are now standard ingredients in formula. Both of these substances are found in breast milk when the mother's diet is adequate, and both are important for brain and vision development.

Babies get DHA and ARA from their mother during the third trimester, but the transfer is cut short when a baby is born prematurely. All babies need a steady supply of both substances throughout their first year.

Numerous studies support the supplementation of formula with DHA and ARA. While there aren't any long-term studies confirming the safety of these substances, there's no evidence suggesting that these additives are harmful to babies, either.

The AAP hasn't taken a position on whether DHA and ARA should be added to formula, but the organization does point out that they're believed to be important in brain and eye development.



d. Vitamins and minerals

Most words on the ingredient label describe vitamins and minerals. These words can be hard to figure out – for example, ferrous sulfate is iron, sodium ascorbate is vitamin C, and calcium pantothenate is vitamin B5.

The AAP recommends that all healthy babies who aren't breastfed exclusively be given iron-fortified formula until their first birthday. It's important that babies receive the minimum recommended amount of iron (0.27 mg daily for infants 0 to 6 months; 11 mg daily for babies 7 to 12 months) to prevent iron-deficiency anemia.

Iron is vital to the blood's ability to circulate oxygen, which all of the body's cells need to function properly. Studies have shown that getting enough iron in the first year of life is important for brain development. A baby's iron stores are established in the third trimester, so premature babies need extra help in getting plenty of iron.

Most formulas contain at least 4 mg of iron per liter, although "low-iron" formulas are still on the shelves. These were developed years ago in response to the misconception that the iron in formula causes constipation. But the dose of iron in formula is too small to cause constipation. The AAP would like these low-iron formulas to be discontinued or labeled as nutritionally inadequate.


e. Nucleotides

These are the building blocks of DNA and RNA, naturally present in breast milk. They have several functions and may aid in immune system development. Different brands of formula have different amounts of nucleotides added.


f. Rice starch

Rice starch is added to "anti-regurgitation" formulas. Your doctor may recommend this type of formula to alleviate your baby's acid reflux.


g. Dietary fiber

Soy fiber is added to soy formula for the temporary treatment of diarrhea in babies who are older than 6 months and in toddlers. The only formula available containing fiber is Similac Expert Care for Diarrhea, which is clinically shown to reduce the duration of diarrhea.


h. Amino acids

Amino acids such as taurine, methionine, and carnitine are added to soy formulas, and sometimes to cow's-milk formulas, to match the amino acids in breast milk.


i. Probiotics and Prebiotics

Probiotics are a type of live, "friendly" bacteria that may help prevent intestinal infections, inflammation, and diarrhea that can occur with the use of antibiotics. Prebiotics are oligosaccharides (carbohydrates found in human milk) that help boost the numbers of probiotic bacteria in the gut.

The AAP says some studies show that probiotics and prebiotics can play a role in keeping your child's digestive system healthy. But they can also be unsafe for babies with compromised immune systems and certain other medical conditions, so it's best to check with your baby's doctor before using these formulas. Any benefit from probiotics and prebiotics goes away once your baby stops using them.



7. Formula Milk for Babies with Milk Allergies

a. Milk Allergy vs Lactose Intolerance

For milk allergies, the baby’s immune system reacts negatively to the proteins in cow’s milk. Breastfed babies are reacting to the dairy his mother has eaten (the milk proteins pass through breast milk), while formula-fed babies are reacting to the cow’s milk proteins in the formula. In either case, a baby's immune system sees the cow’s milk proteins as foreign substances.

Milk intolerance, on the other hand, has nothing to do with cow’s milk proteins or the immune system, and instead has to do with the digestive system. Your child might have loose stools or blood in stool hours or days later.


B. How Do I Know if My Baby Needs Hypoallergenic Formula?

These are 6 signs your baby need hypoallergenic formula. 

a. Extreme Irritability
If your baby cries for long periods of time and/or seems unconsolable, it may be a good idea to discuss this with your doctor. He can evaluate your baby further and help diagnose a cow’s milk allergy. In this case, switching to a hypoallergenic baby formula may help your baby’s symptoms.

b. Family History of Food Allergies
If you or a member of your family has a history of food allergies, your baby is more likely to have one as well. An extensive French study done in 2019 showed a strong genetic link in cow’s milk protein allergies (CMPA).

c. Constant diarrhea / vomiting

d. Your baby has acid reflux (GERD)
Acid reflux is what happens when stomach contents and acid flow back up into the throat. This is a common problem in infants, especially those below 3 months old. Hypoallergenic formula may help reduce the symptoms.

e. Eczema
Your baby’s skin is sensitive, which can make it difficult to tell the difference between dry skin and eczema. Eczema is extreme dry skin that is red, inflamed, itchy, and often cracked. Babies with eczema are more likely to develop food allergies and oftentimes will develop skin symptoms before other food allergy symptoms appear. (Source)

f. Respiratory Issues
If your baby is wheezing or experiencing other respiratory issues, your baby may need immediate medical attention. See a doctor as quickly as possible.

Above all, if you're unsure, best consult a doctor for determining the best formula for your baby.


c. Lactose-free Milk vs Regular Milk

a. Contains the Same Nutrients as Regular Milk
Even though lactose-free milk is added lactase, lactose-free milk remains as nutritious as regular milk. Both are a good source of protein, calcium, phosphorus, vitamin B12, riboflavin and vitamin D.

b. Flavor
Lactose-free milk may seem sweeter than regular milk because it is added with enzyme (lactase), which breaks lactose down into two simple sugars: glucose and galactose. Simple sugars taste sweeter than complex sugars, that’s the reason why lactose-free milk has a sweeter flavor than regular milk.



d. Soy Milk Pros & Cons

1. Soy for Lactose Intolerance 
For babies with lactose sensitivity, soy formulas are frequently advised. Lactose intolerance happens when your baby is unable to digest naturally occurring sugars in cow’s milk that might cause extreme irritability and gastrointestinal side effects such as diarrhea.

2. Nutrients in Soy Milk 
Soy milk is fortified with some of the same micronutrients found in cow's milk - such as calcium, vitamin D, riboflavin, phosphorous, vitamin A, and vitamin B-12. Soy milk also has comparable amount of protein as cow's milk, but with very little saturated fat and no cholesterol.

3. Soy for Cow's Milk Allergy 
Soy-protein formulas are widely used for feeding children with CMA. Cow's milk allergy is an adverse immune response associated with a clinical reaction due to the binding of specific immunoglobulin (IgE) to antigens/proteins in cow's milk (IgE), which could induce an allergic reaction in sensitized individuals. It is the most common type of food allergy, affecting <2% of children under 4 years of age (Source

However, best consult a doctor first before taking soy formula because some infants with cow’s milk allergy also react to soy.

4. Long-Term Health Considerations
Although a few studies on the safety of soy in young children have been conducted, but long-term safety data are very limited. Furthermore, the protein may cause stomach pain, diarrhea, and a lack of bowel motions, among other things.

Because of the safety concerns around soy, pediatricians usually only recommend it for babies with medical issue or for cultural / religious reasons.



8. How often do I need to feed infant formula?

You can start by offering your baby 1 to 2 ounces of infant formula every 2 to 3 hours during their first days of life. This is if your baby is only getting infant formula and no breast milk. Give your baby more if he or she is showing signs of hunger.

Most infant formula-fed newborns will feed 8 to 12 times in 24 hours. Talk with your child’s doctor or nurse about how much infant formula is right for your baby. (Source)



9. How do you know if your baby needs a different formula?

- Excessive Spit Up
- Extra Fussiness Following Feedings
- Bloody Stool
- Severe Constipation
- Allergy Symptoms. They can show symptoms either immediately following feeding or up to 10 days later. For instance: eczema or skin rashes, loose stools (which may contain blood), vomiting or gagging, refusing bottles, wheezing, swelling, hives.



10. Do Toddlers Really Need Stage 3 and Stage 4 Formula Milk?


The nutrients found in toddler formula milk can usually be found in everyday food. After the age of one year old, cow's milk and a healthy diet should be enough to provide for your toddler's dietary needs. 

For DHA, taurine and choline which are prominently promoted on milk tins, pediatric dietitian Meave Graham from Child Nutrition Singapore said: “These nutrients are found in breast milk and in normal balanced diets. Children do not need special supplements of these nutrients.”



If a toddler is having problems adjusting to a normal meal because they are a picky eater, milk formula for toddlers may make the situation worse. Formula milk has a higher sugar content and can be very filling, reducing interest in trying other foods. This may make the child overly dependent on milk, making it even harder to adjust to eating normal meals.

If your child is having any dietary issues, always consult your pediatrician before switching to any milk formulas.



11. What formula is good for constipation and gas?

a. Protein Hydrolysate Formula

In all standard formulations, the protein is not processed at all. They’re exactly the same size as when they first came from the cow which may cause constipation in some babies.

Protein hydrolysate formulas are meant for babies who don't tolerate cow's milk or soy-based formulas.

This type of formula are nutritionally the same as standard formula milk, but it contains protein that's been broken down (hydrolyzed) — partially or extensively — into smaller sizes than are those in cow's milk.


b. A2 Milk Formula 

Researchers believe that A2 is the more natural variant of beta casein. Some studies found that people who only drank milk from cows that produce A2 milk had less bloating and indigestion, leading some to believe that A2 milk is a healthier alternative to regular milk.


c. Goat Milk Formula

Goat Milk formula may be a better formula for children with constipation; this is because goat formula contains high levels of prebiotic oligosaccharides. 

Moreover, It’s possible that goat milk is easier on the stomach. This is because goat milk has fewer micro-proteins than cow milk, which makes it easier for certain people to digest. 

Parents can change their child’s formula from cow’s milk to goat’s milk, however, during the transition, your child may experience certain side effects. And if your children have just stopped breastfeeding and you choose to give them goat’s milk, best to do it under doctor’s supervision.



12. What are the causes of constipation in children?

Constipation may be caused by..
- Ignoring the urge to use the toilet
- Not eating enough fiber
- Not drinking enough fluids
- Switching to solid foods or from breast milk to formula (infants)
- Changes in situation, such as travel, starting school, or stressful events

Medical causes of constipation may include..
- Diseases of the bowel, such as those that affect the bowel muscles or nerves
- Other medical conditions that affect the bowel
- Use of certain medicines




13. What to do after your baby throws up

- Rest their stomach. Keep your baby from eating or drinking for 30 to 60 minutes after vomiting so that their stomach has time to recover.

- Give them fluids. after 3o minutes, start by giving your baby small amounts (0.5 oz or less) of fluid every 5 to 10 minutes. If your baby vomits the fluid out, wait another 30 minutes. Then start again with small amounts of fluid every 5 to 10 minutes. Use water, breast milk or a clear, noncarbonated liquid.

- Medicines. If your child has a fever, ask your pediatrician for the appropriate medication.




14. How can I treat my baby's reflux naturally?

- Avoid overfeeding. If the baby's stomach is too full, some of the contents might be pushed back out. To reduce overfeeding, feed your baby smaller amounts more frequently.

- Burp your baby frequently. Extra gas in the stomach causes gas bubbles to escape, which has a tendency to bring the rest of the stomach's contents up as well. Burp after and during meals.

- Limit active play after meals

- Hold your baby upright. Pressing on a baby's belly right after feeding may push their stomach contents out.

- Consider the formula. Frequent vomiting may serve as one of several signs that it's time to consider alternative formulas with your pediatrician.

- Give oatmeal. Only recommended for babies after 6 months old. Babies with reflux may need thicker food to order to swallow safely or reduce reflux.

- Avoid tight diapers or clothing




15. Milk Brands in Shopee Singapore

All Infant Formulas 

All Milk Formulas for 1 Year Old and Above


Anmum / Materna for pregnant mums, Lacta for breastfeeding mums, Essential Stage 3 and 4 Toddler Formula

Bellamy's Milk Formula Singapore / Organic, Stage 1 to 4, Pregnancy Milk

Bubs Organic Milk Formula Singapore / Organic, Grass fed or goat milk options, Stage 1 to 3

- Gentlease for digestion problems / Post discharge for newborns 
- Enfamil AR (anti regurgitation) for acid reflux and spit up
-  Lactofree lactose free / Nutramigen hypoallergenic lactose free

Enfagrow Milk Formula Singapore / Stage 3 to Stage 5, Has Gentlease Option


Dutch Lady / 123, 456, Maxgro

- Comfort Next for constipation / AR thickened formula to reduce spit up 
- HA hydrolyzed formula for cow's milk protein allergy / Has Frisomum pregnancy and lactation formula

Holle Milk Formula Singapore / Organic + Organic Goat Milk Option, Stage 1 to 3

HIPP Milk Formula Singapore / Organic, Combiotik option has prebiotics, Stage 1 to 4

Isomil Milk Formula Singapore / Soy Formula, Stage 1 and Stage 3

Karihome Milk Formula Singapore / Goat milk, Stage 1 to 4 

Kendamil Milk Formula Singapore / Organic + Goat Milk Option, Stage 1 to 3



Nature One Dairy Milk Formula Singapore / Standard, Premium (More DHA, ARA, GOS, Lutein) and Organic Formulas, Stage 1 to 4, + Pregnancy formula

Nestle Nan / Optipro, Supremepro, HA (Hypoallergenic), Sensitive, Lactose free

Pediasure Milk Formula Singapore / For children 1-12 years old, Has sucrose free option

Wyeth S26 Milk Formula Singapore / Stage 1 to 4, Ascenda for growth (1 to 7 years old)

Similac Milk Formula Singapore / Total Comfort for sensitive stomachs, RS for anti regurgitation, Neosure for premature babies, Has organic option, Stage 1 to 4





II. Baby Bottles

best baby bottle singapore



1. How to choose a baby bottle

a. It should be easy to assemble and fill

You should be able to easily put the pieces of the bottle together, which usually means popping in a nipple and screwing on the top. The bottle should also have a mouth that’s wide enough to pour milk into without dumping it onto the counter. Or, if you’re using powdered formula, the bottle should allow for easy stirring. (Pro tip: We like to use a chopstick.)


b. It should be easy to wash

When choosing a bottle, look for a shape that makes it easy to clean. Sour milk or extra formula powder can get stuck in the cracks and corners, which can lead to bad smells and make the bottle unsafe for a baby to use. Most bottles can be put in a dishwasher, but we prioritized bottles with a wider-neck shape, which made them easier to clean with a good bottle brush.


c. It needs to be leak-free

There’s nothing worse than discovering a puddle of breastmilk on the floor of the car next to a tipped-over bottle. Thus, we searched for bottles that sealed tightly and didn’t leak, even after being shaken up or dropped. Most came with lids, and we made sure that they sealed well and didn’t fall off in transit.


d. It needs to be durable

You’ll be using these bottles for at least a few months, if not for a full year, so we looked for bottles that could handle being used daily for many months without picking up nasty smells or cracking.


e. There are options for materials

Many bottles are made from a lightweight and durable plastic. However, there has been increased concern from parents over the chemicals that can be leached from plastic food or beverage containers which is why you'll see mentions of BPA or phthalate-free plastics. Some parents will opt to use glass bottles instead, and popular brands like Dr. Brown's often offer a glass version of their products. However, glass comes with its own trade-offs: it's easier to crack or break, and it's much heavier.


f. Your baby needs to like it

Most babies have varying nipple preferences, based on the shape of their mother’s breast, so this measure is a bit subjective. But based on online reviews and our personal experiences, we noticed that certain nipple shapes were easier for most babies to latch onto. Wider, shallower-shaped nipples with a skinnier teat made for an easier experience, especially if the bottle's nipple had a little bit of give, just like a mother’s breast might.


g. You might need colic-free technology

Some bottles, Dr. Brown’s in particular, are made with anti-colic vents, which limits the amount of milk your baby can take in and helps to reduce gas or air bubbles in their stomach. Other bottles, like our Best Anti-colic pick the MAM Easy-Start, use other methods to control milk flow and also allow you to 'graduate' to larger nipple sizes as your baby grows. While this isn’t necessary for older babies, pediatricians often recommend this option for infants under the age of 6 months, and especially for babies born prematurely.


2. Types of Baby Bottles


Glass bottles are thermal shock resistant, so they can go from freezers to boiling water without breaking. They are also dishwasher safe and they wont absorb colors or odors like silicone and plastic bottles. However, they are heavier to hold and are usually more expensive compared to plastic or silicone bottles.

Plastic bottles are affordable, light, easy to hold and won't break easily when dropped. There are many options in the market for plastic bottles. However, some plastic bottles may have BPA, which is bad for health. They may not be safe to put in the microwave or dishwashers. Lastly, some brands may have many parts which may be troublesome to clean.

Silicone bottles are soft and most closely resemble a breast, making it easier for babies to accept. They’re unbreakable and free of many chemicals usually found in plastic bottles. They are dishwasher safe and easier to clean as they usually have less parts than plastic bottles. However, silicone bottles are usually the most expensive and there are not as many options in the market. There is a risk of them leaching at very high temperatures, and they can also discolor and absorb odors over time.



3. Why should baby bottles be BPA-free?

When babies use bottle which isn’t BPA free, their body can absorb the BPA molecules. The issue is that BPA acts as an artificial hormone, disrupting a baby’s hormonal development and potentially leading to major health issues later in life.



4. When is the best time to introduce a bottle?

Although there is no ideal timing, lactation consultants generally advise waiting until the breast milk supply is established and breastfeeding is going well. An ideal time for introducing a bottle is between 2-4 weeks.



5. How to clean baby bottles

- Be sure to wash your hands before handling your baby's bottles for cleaning and drying.

- Baby bottles must be cleaned with soap, not just rinsed, after every use.

- At room temperature, expressed breastmilk or formula is safe for only two hours. If you come across a bottle that's been sitting out for that long or longer, you need to toss the milk or formula that's inside and clean the bottle thoroughly.

- Feeding items should be sanitized once a day if your infant is younger than 2 months, a preemie or health-compromised. As your baby grows older, a regular cleaning after each use is enough, with occasional sanitizing for peace of mind.

- The easiest way to clean any baby bottle is in the top rack of the dishwasher. It helps to have a dishwasher basket to hold small parts, like bottle nipples. The CDC says that if you use a sanitizing cycle and heated dry cycle, you’ve effectively sanitized everything. If you wash baby bottles on a normal, quick or eco cycle and opt to air dry, you’ll want to occasionally sterilize in addition to using the dishwasher.

Hand-washing a baby bottle and its parts also works and is necessary if you don't own a dishwasher, and it's bound to happen when your dishes get backup up. The CDC suggests you put the parts in a large, clean bowl and add soap and water before scrubbing, rather than letting parts fall into the sink, in case the sink harbors germs. There are many bottle brushes you can use and any dish soap is good, though there are some brands such as Dapple Baby Bottle Soap that specifically target fatty milk residue to help remove stubborn stains.



6. How long to sterilize baby bottles in boiling water

5 minutes. Make sure all air bubbles are out of the bottles and that they are fully submerged under the water. Bring the water to the boil. Boil for 5 minutes. Let the feeding equipment cool in the saucepan before taking it out.



7. What to do with old baby bottles?

  • Recycle them.
  • Use them as traveling snack containers.
  • Turn them into art supply containers or for rinsing out paintbrushes.
  • Donate them to a local animal shelter, hospital or zoo. I think they're probably less picky about the condition.
  • Give them to the kids to use with dolls.
  • Use them as measuring cups for liquids.

Baby Milk Bottles Buying Guide


Baby Bottle Brands on Lazada

















III. Breastpumps




1. What is the Difference Between Breast Pumps?

  • Double-electric breast pumps: These powerful electric models let you pump both breasts at once, important if speed is a concern.
  • Single-electric breast pumps: You’ll only be able to pump one breast at a time, which can take longer. On the plus side, these cost less than a double-electric pump.
  • Battery-operated breast pumps: These can be slower and run through batteries pretty quickly. The advantage of a battery-operated pump is that they're portable and helpful if you don’t have access to an electrical outlet (such as when you’re commuting to work or traveling).
  • Manual breast pumps: These are lightweight, portable and inexpensive. The downside? You'll be doing a lot of the work yourself and you may not get as much milk as a result.


2. How to Use an Electric Breast Pump

Before starting to pump, ensure that all breast pump components are spotless and sterilized before use. Next, read the manual to become familiar with the procedure. When you are ready to pump, locate an isolated spot with an electrical outlet, if necessary. Some electric pumps may be battery-operated.

Then, adhere to these general procedures.

- Handwashing ensures that your hands are sanitary. Assemble the breast pump, breast shield, milk container, and tubing.
- Place the breast shield over your breast. It should be snug and painless. The tunnel size should be three to four millimeters larger than your nipple. It must be centered and gently pressed to create a solid seal.
- Consider your child for triggering the let-down reflex. Start the pump with a moderate intensity level. You can gradually increase the intensity if it is not excruciating. Continue adjusting until milk begins to flow.
- After each use, thoroughly sanitize the breast shield and any components in contact with breast milk. According to the manual, each breast pump will have specific cleaning instructions. Follow these instructions attentively. 



3. How to Choose an Electric Breast Pump

It's not always easy to find your way around breast pumps. Various options are available, and it can be challenging to determine which is ideal for you. If you're in the market for an electric breast pump, here are a few things to keep in mind..

a. Budget 
Electric breast pump price varies greatly. Determine your spending limit and double-check if everything you need comes with the pump. Ensure you have everything you need before hitting that "BUY" button.

b. Suction strength and modes
The level of suction strength and several settings available on different electric breast pumps varies significantly. Look for a pump with hospital-grade suction or at least an efficient suction and various expression and massage settings for the best pumping experience.

c. Noise Level 
Unfortunately, not all electric pumps are as quiet as others. Find a model with low noise output. It'll be a lot less of a hassle to pump in the evenings or at the office when you have a discreet breast pump.

d. Portability 
Regular pump users likely won't appreciate toting around a device that looks like a brick when they're on the go. A lightweight pump that is easy to carry around will be a huge help in many situations.

e. Reviews
Do your research on best electric breast pump Singapore reviews and ratings. There you will see the first-hand experience of new users to guide you more on choosing the right electric breast pump for you. By then, you will know the good and bad experiences of the users.


4. Best Electric Breast Pump Brands in Singapore

In Singapore, there are several well-regarded electric breast pump brands known for their quality, efficiency, and user-friendly features. 

Here are some of the best electric breast pump brands..

a. Medela

Medela is a globally recognized brand that offers a wide range of electric breast pumps. They are known for their innovative technology, comfortable pumping experience, and extensive product options to suit different needs.


b. Spectra

Spectra is a popular brand that specializes in electric breast pumps. They are known for their quiet operation, efficient suction, customizable settings, and hospital-grade performance. Spectra pumps are well-regarded for their comfort and ease of use.



c. Philips Avent

Philips Avent is a trusted brand that offers a variety of electric breast pumps. They are known for their reliable performance, user-friendly features, and compatibility with other Avent products such as bottles and storage containers.



d. Lansinoh

Lansinoh is a reputable brand that produces electric breast pumps known for their effectiveness and affordability. They offer a range of models designed for different needs and provide features like adjustable suction levels and portability.



e. Ardo

Ardo is a respected brand known for its high-quality electric breast pumps. They prioritize user comfort and offer pumps with gentle, efficient suction. Ardo pumps are often lauded for their durability and ease of use.



f. Tommee Tippee

Tommee Tippee is a well-known brand that offers electric breast pumps suitable for both occasional and regular use. Their pumps feature adjustable suction levels, compact designs, and ease of assembly.




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