Homemade infant formula is not a good idea

The Pediatric Insider

© 2014 Roy Benaroch, MD

Miranda wrote in with a topic suggestion—she wanted to know about homemade infant formula. She had noticed a lot of people suggesting it. What’s the deal?

Speaking about nutrition and human babies, it makes sense to start with this: human breast milk, from mom, is the best food for babies. But even that is an over-simplification. It turns out that in the modern world, human breast milk is often deficient in vitamin D, and maybe iron, too. I know I’m going to get some heat over this, but it’s true: even human breast milk isn’t “perfect.” It’s close, but if we’re going to be honest, even straight-up mom’s milk isn’t “ideal” for babies.

So what’s the best alternative? The contestants: human breast milk, which we’ll just call “human milk.” Commercial infant formula, which we’ll call “science milk.” This is the stuff that’s been studied for years, and is lab-designed to give babies the exact nutrition they need to thrive. Then there’s home-mixed infant formula, which we’ll call “homemade milk”, usually prepared based on an internet recipe.  What kind of “grade” should we give our three competitors, based on an objective assessment of their composition?

The number one “ingredient”, so to speak, is water. Clean, pure, safe water. Human milk, fresh from the breast, is free of harmful contaminants and infectious germs. Science milk is made under sterile conditions, and the liquid versions are pasteurized—as long as they’re stored correctly, there’s essentially no risk of infections spreading. Homemade milk? Who knows. I doubt anyone at home is sterilizing all of their surfaces to the extent done in a commercial lab. And some of the homemade milk recipes call for unpasteurized, “raw” milk—which can be loaded with animal colon bacteria as has been linked to all sorts of colorful infections. Winners: human milk and science milk (tie); loser: homemade milk.

Then there’s protein. There’s too much protein of the wrong kind in most mammal milks (including cow and goat), so science milk relies on modified mammal milk or soy to get the right amounts of the right kind of proteins. The wrong proteins can cause intestinal and kidney damage. One homemade milk recipe I found used blenderized livers as a protein source, which is even more dangerous. Human milk, protein-wise, is perfect. Winner: human milk, with science milk a close second. Loser: homemade milk.

The carbohydrate in all mammal’s milks is mostly lactose. Goats, humans, cows—our milk is all lactose-based. Science formulas sometimes substitute other carbs, largely to take advantage of the fear of lactose intolerance (which doesn’t occur in human newborns.) There’s no known downside to this, though it’s kind of silly. Winner: tie! Lipids (fats) are pretty much the same across the board, or near-enough so.

Sodium: ordinary milk from other mammals (goats and cows and presumably kangaroos, though I honestly don’t know about them) has far, far too much sodium. To properly reduce this, homemade formulas have to dilute that out somehow. Winners: human and science formulas.

Other micronutrients: there are a lot of these, of course—iodine and vitamin C and vitamin D and iron. And these really are important. Iron deficiency in infancy can contribute to permanent cognitive problems. You really do want to make sure that Junior is getting all of these vitamins and minerals in the exact proportions needed. The micronutrient content of human milk has been extensively studied, and science formula does a great job in either copying that, or even improving on that (re: iron and vitamin D.) Winner, science formula, by a nose; human milk is a very close second. Homemade formula are based on dozens or maybe hundreds of recipes, and no one has systematically figured out which if any actually deliver the micronutrients that are needed.

 Here’s a funny, true story from my residency: an 8 month old baby was admitted to the pediatric intensive care unit, near death. (Wait, it gets funnier.) He was very, very anemic—I remember noticing when drawing blood from his nearly lifeless body that the blood itself was kind of watery and runny. He also had neurologic problems and his vital organs had shut down. It turns out that his father was traveling hours a day, back and forth, to a farm to pick up fresh goat’s milk to feed him (because his parents had heard that goat’s milk was healthy!) Since goat’s milk is entirely deficient in one of the B vitamins (folate), the child’s blood marrow pretty much shut down. And there were a whole bunch of other health consequences related to other nutrient deficiencies and protein overload. After a few weeks in the ICU the baby survived. Isn’t that a funny story? No, of course it isn’t. It isn’t funny at all.

Ease of use and preparation: human milk wins, here, of course—though it has to be said, not always. Some women really do have a hard time nursing. It’s not always the easiest choice. Fortunately, we have another reasonably easy alternative: science milk. Mix the powder with water in the right proportion, and you’ve got pretty much exactly what your baby needs. The worst choice, here, would be homemade milk: it’s complicated and fiddly, has a lot of ingredients to get wrong, and it still may not even provide the nutrition your baby needs.

Homemade infant formula is a terrible idea. There is no way for parents to make something as pure and complete as either human milk or commercial infant formula (science milk.) There’s no evidence whatsoever that it even might be safer or better in any tangible way. This is one case where homemade is not the way to go. If you’re not breastfeeding, you should use commercial infant formula. Do not trust your baby’s health on your chemistry skills and recipes from the internet.

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10 Comments on “Homemade infant formula is not a good idea”

  1. Scientist Mom Says:

    Many pediatricians recommend breast milk plus special vitamin drops as the perfect infant food.

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  2. Pablo Says:

    I always find it interesting that formula (“science milk”) was not invented as an alternative to breast milk, but as an alternative to the crap that people were using instead of breastfeeding. Things very similar to the “homemade” recipes that are being tossed around these days – the raw goat’s milk thickened with corn starch with ground up liver formulas.

    IOW, women weren’t breastfeeding but were giving their babies crap. Therefore, pediatricians worked to create something better, so that if they weren’t breastfeeding, at least they’d have something decent. That’s how we got “science milk.”

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  3. Dr.M Says:

    I cannot believe people actually make their own formula. It’s bad enough when they do it to their animal (making a homemade unbalanced diet). It should be criminal if they do it to a baby.

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  4. Ocuinn Says:

    Go to Canada’s north and you will see that homemade milk is still extremely prevalent.

    Carnation evaporated milk + corn syrup + water.

    There is also a large number of obese babies and children.

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  5. Diane Says:

    Have you read the label on “store bought” formula? Basically enriched liquid twinkie. There are ways to make homemade formulas that are nutritionally complete. (Nutritionists have these magic things called “recipes” that can easily be handed to parents) The caring Dr. would make sure that if a parent was set on making the formula homemade to educate the parent on the necessary components to keep their baby healthy rather then shame a parent for caring enough to want to avoid toxins,chemicals, colors, excess corn syrup in a processed can at the mini market. Your choice- you can use the opportunity to recognize a parent is committed to do their very best to provide the safest foods for their baby and help them do it safely- or call them fools and tell them to get in line and buy the canned stuff that we are being told is over processed and not good for babies. I know the type of Dr. I would want. Also, if you actually read the USDA findings, there are fewer documented illnesses to “raw” milk then the zapped, manipulated, destroyed and rebuilt stuff they call “milk” on the shelf at the grocery. Eating a salad has a 100 percent higher risk of food borne illness then raw milk. I also suggest you go visit both a raw milk farm and a commercial dairy. Just the cleanliness alone will make you rethink the white stuff in a carton at the grocery. Simply informing parents who use raw milk (usually because their babies get sick from the liquid twinkies) of the various vitamins that need to be included will lead to healthier babies. Be grateful you have parents who care enough about their children that they are willing to go to these lengths- rather then bashing them for not doing it the way everyone else does it.

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  6. Could you add citations? I like sharing this post, but this is the criticism I hear most.

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  7. Dr. Roy Says:

    Sydney, sentence-by-sentence, there really isn’t anything controversial in anything I said. All of it is very basic information. What fact(s) do you want a citation for?

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  8. Smoochagator Says:

    Here via the Skeptical OB. First of all, I LOVE the term “science milk” and from now on I’m going to use it whenever describing how I feed my infants. (Well, maybe not, but still: IS AWESOME.) Secondly, the story about the infant fed on goat’s milk is horrifying and heartbreaking. Stories like that prove just how dangerous the anti-formula (anti-science) bias is.

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  9. Anna Says:

    I just ran across an article by the Healthy Home Economist (a lot of my facebook friends seem to like her articles often) about homemade formula. She discussed how to make it while traveling, right down to transporting raw milk across state lines in unlabeled bags so that the TSA wouldn’t ask questions and assume it was pasteurized milk. Because, clearly, they wouldn’t think it was suspicious that someone wasn’t willing to just buy milk when they got there. huh? She told mothers to, “resign yourself to the fact that when you travel, you must figure out a way to take these homemade baby formula ingredients with you.” Ugh.
    What a fantastic antidote you have written! Could I ask what your personal favorite formula brand to recommend is?

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  10. Dr. Roy Says:

    Thanks Anna! Here’s a post about brands of formula (it’s the fifth in a series– at the bottom are links to the other parts): https://pediatricinsider.wordpress.com/2013/09/12/the-guide-to-infant-formulas-part-5-the-final-recommendations/

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