Cow's Milk or Soy?
Normal, full-term infants should get a conventional cow's-milk-based formula, says John N. Udall Jr., M.D., chief of nutrition and gastroenterology at Children's Hospital of New Orleans. However, adverse reactions to the protein in cow's milk formula or symptoms of lactose intolerance (lactose is the carbohydrate in cow's milk) may require switching to another type of formula, he says.
Symptoms that may indicate an adverse reaction to cow's milk protein include vomiting, diarrhea, abdominal pain, and rash. With lactose intolerance, the most common symptoms are excessive gas, abdominal distension and pain, and diarrhea. Since some of the symptoms overlap, a stool test may be necessary to determine the culprit. Usually, lactose intolerance will produce acidic stools that contain glucose. If the protein is the problem, stools will be nonacidic and have flecks of blood.
The main alternative to cow's milk formula is soy formula. About 20 percent of the formula sold in the United States is soy. "Lactose intolerance is probably the biggest reason to switch to soy formula," says William J. Klish, M.D., chairman of the American Academy of Pediatrics Committee on Nutrition.
The carbohydrates in most soy formulas are sucrose and corn syrup, which are easily digested and absorbed by infants. However, soy is not as good a protein source as cow's milk. Also, babies don't absorb some minerals, such as calcium, as efficiently from soy formulas. Therefore, according to the American Academy of Pediatrics, "Healthy full-term infants should be given soy formula only when medically necessary."
For a child who can't tolerate cow's milk protein, Klish recommends the use of hydrolyzed-protein formula. Although hydrolyzed-protein formulas are made from cow's milk, the protein has been broken up into its component parts. Essentially, it's been predigested, which decreases the likelihood of an allergic reaction.
