What are healthy qualities in infant formula?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Friday, it's Dr. Melina Jampolis, a physician nutrition specialist.

Question asked by Angela Thiery-Devins, Shelton, Washington: I have a 9-month old and need to move to formula. When I looked at the back of the formula packages, I was shocked to learn that the first ingredient in of most of them was corn syrup solids. Isn't that sugar? What should I be looking for in a formula? I am a concerned mom just trying to do the right thing for my baby. Thank you.

Expert answer

Hi Angela - First of all, congratulations on breastfeeding for 9 months. Research clearly shows that this is better for the baby whenever possible for optimal health. Since I have a 4-month-old and will be facing the transition to formula soon, I was very curious about this as well as I was somewhat surprised to find corn syrup at the top of the ingredient list for many formulas. I contacted my pediatrician, Dr. Jeremy Shapiro, who also has a master's in public health and has presented research on childhood obesity. He gave me the following explanation.

"Every formula (just like breast milk) has numerous ingredients but the three primary ones are a protein source, a fat source, and a carbohydrate source. And what are carbohydrates made of? Sugars. In fact, it's probably easiest to view sugars and carbohydrates as one in the same thing with some examples including lactose (milk sugar), sucrose (table sugar) and even corn syrup. "

He goes on the explain that "in regular milk-protein based formulas, the primary carbohydrate is lactose and not corn syrup. However, there will be times when an infant may not be able to tolerate the regular milk-protein based formulas and alternative formulas are needed. It is these formulas that may include corn syrup so that the infant may have an easier time digesting them until their system matures. So unless your child has a known sensitivity, when it comes to formulas, I would first recommend regular milk-protein based formulas that include lactose as the primary carbohydrate."

In the two primary brands of formula, lactose is the first and primary source of carbohydrates. Interestingly, in one of the major organic brands, lactose is not used, rather sucrose is the primary carbohydrate. For this reason Dr. Jeremy is not a big fan of organic formula.

It is important to point out that corn syrup is not the same as high fructose corn syrup, which some researchers believe may contribute to obesity. Both sweeteners are less expensive than sucrose, so this is probably why corn syrup is used in baby formula, which can already be fairly expensive.

The reality is we don't really know the impact of different types of sugars on infants. It is not likely as big a concern with regards to obesity because infants are not in a metabolic state to be impacted by things such as too much sugar or the glycemic index of foods since they are using every calorie for growth, unlike adults who use excess calories for fat.