By Dr. Ari Brown
Every medical organization, including the American Academy of Pediatrics (AAP), recommends exclusive breastfeeding for the first six months of life with the addition of complementary solid foods at that point. For moms who can’t breastfeed or who decide not to, or who need to supplement breastfeeding, infant formula is a healthy alternative.
The Food and Drug Administration (FDA) requires all infant formulas to resemble human milk, containing 30 essential ingredients. But with over 90 infant formulas on the market, it can be rather daunting when trying to make a decision. (Brown; Fuchs 2023) Historically, the U.S. infant formula market consisted of cow milk-based or soy milk-based formula for babies with certain medical conditions. Goat milk-based formula has been used worldwide for decades but only recently been an option in the U.S.
Kabrita, which is based in the Netherlands and is the leading manufacturer of goat milk-based formula worldwide, was actively conducting clinical trials as part of the formal FDA review process for infant formula prior to the shortage of 2022. It is a process that takes years. As a result, in June 2023, Kabrita became the first and only company to receive long-term FDA authorization for its goat milk-based infant formula. Long-term FDA authorization is critical because this means not only does the infant formula meet government nutrition and safety requirements, but parents can rely on it to be available for a baby’s entire feeding journey. Kabrita will be available online to U.S. families by early January 2024.
Why has goat milk formula suddenly hit the American store shelves?
The FDA maintains strict requirements when it comes to infant formulas and previously did not permit goat milk formulas to be sold in the U.S. unless, like Kabrita, it had submitted clinical trials for review. However, the severe nationwide shortage of baby formula in 2022 forced authorities to investigate alternatives to help ease the crisis. One was to allow baby formula imports from foreign makers that do not usually sell their products here, under special regulations. European and Australian companies including Kendamil, based in the UK and Australia-based Bubs, helped supply the U.S. with goat milk-based formula during the crisis under FDA emergency use authorization. These goat milk-based infant formulas meet all safety and nutritional standards set by the FDA (Abrams 2023).
Now that the shortage has subsided these companies are working with the FDA to meet the necessary requirements that will allow them to continue selling their products in the U.S.
It’s time to normalize the use of goat milk-based infant formula in the U.S.
As of 2023, both the FDA and the American Academy of Pediatrics endorse the use of goat milk-based infant formula. Goat milk, like cow milk and soy milk, is used as a base that has been modified to meet an infant’s complete nutritional needs. Pediatricians now recommend goat, cow, and soy milk-based products as equally appropriate, safe, and acceptable as first line choices in infant formula.
Goat milk formula may feel new to American parents, but milk from both cows and goats have been used for over 200 years to provide nutrition in non-breastfed infants. (Brown)
Is there an advantage to using goat milk formula?
Both cow and goat milk infant formulas are healthy and nutritionally complete food products. But babies may have less intestinal discomfort with goat milk formula. Simply put, goat milk more closely resembles human milk.
One key difference between cow and goat milk is the protein. Goat milk protein, composed of whey and casein, is digested more similarly to human milk. The whey proteins in goat milk and human milk have more rapid transit time through the gut compared to cow milk. (Source: Matthus, PArk, PArk, Cevallos see Elieke’s slide deck.)
The casein proteins (beta casein) of goat milk and human milk are also more alike. Cow milk contains more A1 casein than goat milk, and the A1 type of casein is associated with firmer and less digestible curds.
Research suggests that goat milk-based formula is actually better tolerated and more gentle on the gut, as compared to cow milk formulas. (Abrams 2023; Fuchs 2023; Verduci 2019) Many parents of infants who are partially or fully formula fed report that their babies have some degree of gastrointestinal discomfort in the early months of life. But babies who are fed goat milk-based formula are reported to experience fewer of these symptoms. Source: COMISS study, see Ausnutria citation #1 A. López Escobar (HM Hospitales, Madrid, Spain)
So which formula to choose?
The AAP recommends that cow or goat milk based infant formulas are perfectly acceptable as optimal first line nutrition for non-breastfed babies or breastfed-supplemented babies in the first year of life. Families deserve high-quality formula options, guidance from their pediatrician, and a stable and reliable formula supply to choose the right product for their baby.
References
Adapted from Brown A and Fields D. Baby 411: Clear Answers and Smart Advice for your baby’s first year. 10th edition. Windsor Peak Press, Boulder CO. Last updated 11/1/2023.
Abrams SA. Why are we seeing baby formula brands on the shelves from companies I haven’t heard of before? Healthchildren.org. Last Updated 10/20/2023 https://www.healthychildren.org/English/tips-tools/ask-the-pediatrician/Pages/why-are-we-seeing-baby-formula-brands-on-the-shelves-from-companies-i-havent-heard-about-before.aspx
Fuchs G. Choosing a Baby Formula. Healthchildren.org. Last Updated 10/20/2023 https://www.healthychildren.org/English/ages-stages/baby/formula-feeding/Pages/choosing-an-infant-formula.aspx
Thank you.
Glenda, Charlie and David Cates
