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Effects of Infant Formula Type on Early Childhood Growth Outcomes: A Retrospective Cohort Study

Uzma Rani1, Roba Alwasila2, William T Story3

  • 1Stead Family Department of Pediatrics, Division of General Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA.

Nutrients
|October 16, 2025
PubMed

Insights

Non-standard infant formulas, like lactose-reduced or hydrolyzed types, show higher growth z-scores in infants during the first year compared to standard formulas. Further research is needed on long-term effects and obesity risk.

Area of Science:

  • Pediatrics
  • Nutrition Science
  • Growth and Development

Background:

  • Infant feeding practices significantly impact early childhood growth and development.
  • Cow's milk-based infant formulas vary in composition, including standard, lactose-reduced, and hydrolyzed types.
  • Understanding the differential effects of these formulas on growth is crucial for public health.

Purpose of the Study:

  • To compare the effects of non-standard (lactose-reduced, hydrolyzed) cow's milk-based infant formulas versus standard formulas on infant growth.
  • To assess growth outcomes in infants fed non-standard formulas, standard formulas, or breast milk.
  • To identify potential differences in growth trajectories associated with various infant feeding types.

Main Methods:

  • Retrospective cohort study of full-term infants with birth weight >2500 g.
  • Data on infant formula type and breastfeeding status collected at 2-month visits.
  • Growth outcomes (weight-for-age, length-for-age, BMI, weight-for-length z-scores) assessed at 12 and 24 months using WHO standards.
  • Generalized linear mixed models used for statistical analysis, controlling for covariates.

Main Results:

  • Infants fed non-standard formulas exhibited significantly higher weight-for-age, BMI, and weight-for-length z-scores at 12 months compared to standard formula users.
  • These differences persisted for weight-for-age and BMI z-scores at 24 months.
  • Both non-standard and standard formula groups showed significantly higher z-scores for multiple growth parameters compared to exclusively breastfed infants at both 12 and 24 months.

Conclusions:

  • Non-standard infant formulas may influence infant growth differently than standard formulas, particularly in the first year of life.
  • The findings suggest a potential impact on growth trajectories that warrants further investigation.
  • Long-term health implications and the risk of obesity associated with non-standard formula use require additional research.

Keywords:
breastfeedinggrowthinfant nutrition

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