Infant formula is made to mimic breast milk as close as possible. Breast milk has foremilk, which is thinner and typically the first thing that comes out of your nipple, and hindmilk, the thicker version with more fat globules. Liquid concentrate and powdered infant formula have the same thickness so long as it is made with the same ratio of water according to the manufacturer's instructions.
The thickness of your baby's formula can play a role in managing feeding issues a baby may have. The thickener in your infant formula can be a blessing or an additive that can create more problems.
A thickener helps keep liquid together. This is ideal for that period of time between packaging and consumption. Thickeners also tends to stay in the stomach better, which helps minimize or prevent spit ups.
Gastroesophageal reflux (GER) is when food gets backed up and your baby spits up. This is common in many babies and is only a serious, though rare, issue if there is an allergy or block in the digestive system. That is when it is diagnosed as gastroesophageal reflux disease (GERD)
Aspiration is a condition in which your baby swallows so quickly that they breathe in their formula. Your baby may cough or choke during feedings or have a gurgle in the throat after swallowing. Even if your baby coughs it up, it can still lead to respiratory problems like pneumonia. This condition can be related to GERD as well as many other health or developmental factors.
Dysphagia is when an individual has trouble swallowing. Infants, especially premature babies, may not be coordinated in sucking or swallowing. They may also have a weak suck.
Locust bean gum is an ideal thickener for infants with allergies because it has a low risk of allergic reaction. This is because it is an insoluble fiber. Hipp uses locust bean gum in some of its formulas.
Maltodextrin is a starch derivative used in organic infant formula. It is a thickener as it comes from corn, rice, or potatoes, but it also helps balance the sweetness in infant formula. Holle infant formulas contain maltodextrin.
Xanthan gum is a common thickener in processed food. It comes from fermented corn sugar and contains the bacteria xanthomonas campestris. For some babies, they may be allergic to xanthan gum and you will find that it causes more problems during and after feedings. Bloating and abdominal pain is not uncommon if your baby is also allergic to corn, wheat, or soy.
Carrageenan is a natural thickener that is derived from seaweed and is classified as organic. However, its connection with intestinal inflammation and colon tumors is part of the reason it is not allowed in European foods like infant formula.
The addition of thickener should be a last resort to other types of treatments or adjustments you can make after consulting your pediatrician. Smaller feedings and more frequent meals are a few days to make dietary modifications. You can also change your child's formula to a thicker variety. For example, Hipp Anti-reflux formula contains locust bean gum from the carob bean. It does not digest and does not cause an immune response or allergic reaction in many cases. Overall, these natural adjustments means less need for medication for diseases like GERD.
The addition of a commercial thickener is appropriate for expressed breast milk as well as infant formula. They have not been approved for all infants and have their own limitations regarding gestational age, weight, or potential allergens. One thickener, SimplyThick, has a warning on it for preemies as it can cause necrotizing enterocolitis with fatal results.
If you are considering thickening your baby’s formula, do not do this by adjusting the powder to water ratio when mixing formula. If you use more powder than recommended, you are actually taking away some of the water your baby needs for hydration. Over time, this can do damage to your baby’s kidneys. Adding a thickener or using Hipp AR are healthier options by far.
Edited and reposted from April 2018
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