The Guide to Infant Formulas: Part 2. The Similac choices

The Pediatric Insider

© 2013 Roy Benaroch, MD

Last time, in Part 1, we talked about the ingredients in infant formulas. Despite the advertising, they’re all much more similar to each other than you’d think. This time I’ll go through the products from the major companies. Infant formulas have complicated and overlapping names—what’s really the differences, and how should you choose?

First, Abbots’ Similac family of products. Get it, “Similac”? Lac, referring to milk; simil, like similar? I like the name! So what have they got in their stable?

Their flagship product for “routine feeding” is “Similac Advance,” a cow’s milk based product that has as much good stuff as any other formula. It’s got the DHA. It’s got the lutein. It’s got a nice baby-blue package. They also market for “routine feeding” Similac Advance Organic, in a green package (green = natural and organic!), which has the same stuff, though a “unique Lutein and DHA blend.” Does unique mean better? Who knows. What it does have as a carbohydrate source is organic cane sugar, which probably makes Similac Organic taste sweeter than human milk or other formulas. I’m not sure that’s a good thing, to get baby used to sweeter tastes, but it might not matter one way or the other. Still, if you’re choosing Similac Organic, you’re choosing the sweet stuff.

On a separate page, Abbott has a number of formulas “for sensitive tummies.” I guess Sim Advance is for those tougher babies! The “for sensitive tummies” choices include Similac Sensitive, which is essentially the same as Similac Advance, but without lactose. Now, lactose intolerance is just about unseen—ever—in human babies, so there is really isn’t any biologic basis for this product to be any better for any babies than Similac Advance. It does come in a soothing orange package. There’s also “Similac Total Comfort”, which has milk-based proteins that are broken down to some degree, “for easier digestion.” In a way, this is their version of Carnation’s “Good Start”—more about that later. There’s no good independent evidence that breaking down these proteins aids in digestion, and it certainly won’t help treat protein allergy. The package is a lightish purple, and reassuringly says it’s FOR DISCOMFORT, then in smaller type “due to persistent feeding issues.” If discomfort is from other things, I suppose the purple packaging won’t help much.

Similac has two more “sensitive tummy” formulas. One is “Similac Soy Isomil” (or what used to be just “Isomil”) which uses soy rather than milk protein. The AAP recommends soy formulas for very few babies—including those from families who wish to avoid cow products, and for the very rare babies with hereditary inabilities to digest certain sugars. For almost all babies, soy is not necessary, and it’s certainly not more digestible than cow’s milk base formulas. The last “sensitive tummy” formula is “Similac for Spit Up” which adds rice starch to thicken the formula, especially once it’s in the low-pH environment of the stomach. They claim it reduces “frequent spit up” by 54%, a nice science-sounding number, based on “data on file”. That means they did the study and haven’t published the result.

There’s also a “Similac for supplementation” formula, designed they say “for breastfeeding moms who choose to introduce formula.” My read of the ingredients shows it’s almost entirely identical to ordinary Similac. It comes in a green container, though a slightly different shade of green than Similac Organic. They claim that by tinkering with the prebiotics, this product may lead to softer stools, though there’s no clinical evidence to support that. I can’t imagine why there needs to be a different formula for supplementing breastfeeding than for routine feeding, but then again I’m not in marketing.

Similac also has an “expert care” area, including Alimentum (genuinely hydrolyzed proteins for the relatively rare babies with real protein allergies), Neosure (for preemies), and Similac Expert Care for diarrhea. I won’t spend much time on these, but they really are for use only when recommended by a physician for specific medical reasons.

Whew. A lot of formulas to choose from! So many colors!

Next: The Enfamil line. Can’t wait!

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Tags: bottle feeding, infant formula

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