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Q: I have breastfed my daughter for 10 months and am going back to work in eight weeks. She takes a bottle with water, but I have not yet supplemented her with anything else. What are your recommendations in terms of formula or milk?

A: First of all, let me congratulate you on your daughter and breastfeeding her for the time you did. By doing so, you have provided her with optimal immunity which has been shown to reduce allergies and asthma in adulthood. Research also shows that by breastfeeding, you have provided yourself with protection against various cancers including breast, uterine and ovarian cancer.

In terms of formula, the two options available are soy or dairy formula. If a child shows food sensitivity to dairy, then soy is typically recommended. Symptoms of food sensitivities or allergies in an infant include allergic shiners (dark shiny circles under their eyes), colic, constipation, diarrhea, eczema, wheezing, vomiting, hives and irritability. My recommendation is to begin with a dairy formula that has been completely hydrolyzed. In other words, the proteins in the formula have been broken down for easier absorption in an infant's immature digestive system. It is not enough to purchase formulas labelled partially hydrolyzed. The words you are looking for on the label are: whey-based hydrolysate formula, casein hydrolysate formula or an amino acid formula. The type of completely hydrolyzed formula I fed my son when switching from breast milk is called alimentum and can be special ordered from most pharmacies.

I do not recommend using milk in an infant's bottle. Because cow's milk is so protein dense (15 per cent protein content vs. human milk which is 5 per cent protein content) it is a common trigger for an allergic reaction. In addition to the protein content, the electrolyte (salt) in cow's milk can put stress on a baby's immature kidneys.

Dr. Joey Shulman