Modified Milk - Types to Consider When Making a Choice

Modified milk is a food product specially developed for infants and young children. It consists of cow's or goat's milk, which is modified to make its composition as similar as possible to that of human milk. Unfortunately, it is not possible to create milk that is identical to human milk. For many years, alternatives to breastfeeding were breastfeeding with cow's milk or breastfeeding with milk from women who were not related to the child (who often also served as caregivers). It is important to emphasize that human milk cannot be replaced by regular cow's milk, goat's milk, or plant-based beverages, as these products can overload the digestive system of infants and young children due to the high protein content and high concentration of minerals. The first substitutes for human milk were developed in the mid-19th century and consisted of cow's milk and cereals. These products were high in calories, but they lacked important nutrients such as proteins, vitamins, and minerals. Over the years, they have been improved. Nowadays, there is a wide range of products that meet all the needs of infants and young children.

Organic requirements in relation to various nutritional components vary with age, and an interesting fact is that the composition of breast milk evolves during lactation. Its nature is different immediately after birth and different several months later. The fundamental criterion for the distribution of modified milk is the age of the child. Milk types are usually designated with numbers from 1 to 5. – Initial milk (1) – intended for newborns and infants up to 6 months of age, which in this period constitutes the only food of the child and is sometimes used as a supplement to breastfeeding. – Progressive milk (2) – intended for infants aged 7-12 months, which is no longer the only component of the child's diet, although it still forms the basis. – Junior milk (3, 4, and 5) – for children successively between 1 and 2 years of age, after 2 years of age, and after completing 2.5 years.

– HA – hypoallergenic modified milk that is intended to prevent the development of a food allergy to cow's milk proteins. It is used in infants with an increased risk of allergy (e.g. allergy occurs in parents or siblings). It contains partially hydrolyzed protein, i.e. one whose structure is broken down into smaller elements (peptides). However, the protein chains are shorter, the product is less allergenic. – AR – used in children with a tendency to vomit. It contains additives such as potato starch or oatmeal, which thicken in the stomach, thereby reducing the frequency and intensity of vomiting. However, it is important to note that vomiting in the first months of life is physiological and does not cause concern, while in case of excessive vomiting or vomiting, a pediatrician should be consulted. – Sensitive – intended for healthy infants with mild digestive disorders (flatulence, constipation, colic). The milk product is easier to digest, with reduced lactose content and partially hydrolyzed protein, sometimes with the addition of prebiotics and probiotics. – Comfort/AntiColic – milk for infants with a tendency to constipation and colic; contains less lactose. – R – modified milk products enriched with rice porridge, which provide a longer feeling of satiety and are more caloric. They are intended for children who have difficulty feeding or have too low body weight. – PRE/Premature/Natal – milk intended for premature and newborn infants with low birth weight. The product usually contains more protein, fats, and mineral components and is primarily more caloric.

A doctor should supervise the selection of modified milk. It is important to know that the composition of the product is regulated by the European Union Directive and the Health Minister's Regulation, which ensures a uniform composition of essential nutrients in all preparations. The composition of modified milk is complex and contains mainly proteins (whey and casein), fats (milk, plant, and fish oil), carbohydrates (lactose and oligosaccharides), vitamins and minerals, often also probiotics and prebiotics. A controversial component is palm oil, which contains a large amount of palmitic acid, but also saturated fatty acids. In 2019, ESPGHAN noted that the addition of palm oil may affect the stool consistency of infants fed with modified milk. There is no universal mixture suitable for all children, so it is important to be guided by how the child reacts to the product and adjust the mixture to the age and health status of the child.