Items per page
Buying infant formula: Which is the right “stage” for my baby? “When should my baby switch to Stage 2 formula?” “Can my baby continue to consume Stage 1 formula instead of changing to Stage 2 or Stage 3?” Parents may often be puzzled when they hear others talk about infant formula stages. Actually, infant formulas that comply with the standards set by the Codex Alimentarius Commission (CAC) can be divided into 4 stages (Stages 1 – 4). Stage 1 (infant formula) It is suitable for newborn babies until 12 months old and is intended as a substitute for breast milk. This formula is specially made to satisfy the nutritional requirements of babies without additional supplements. Stage 2 (follow-up formula) It is also known as the “big baby’s formula”. It is intended as a substitute for breast milk or infant formula. It is suitable for babies who are older than 6 months but younger than 36 months as they are starting to ingest solid foods. As they begin to ingest diverse foods, Stage 2 formula can be taken as a liquid diet component but should not be treated as the only source of nutrients. Stage 3 and Stage 4 (follow-up formulas) These are suitable for babies aged one or above for acquiring extra nutrients. It is not difficult to find out the stage of a particular infant formula as it is usually indicated on the container in a larger font size. When should my baby switch to “big baby’s formula”? Perhaps many parents are puzzled by this question. Although “big baby’s formula” is a bit different from infant formula in terms of ingredients, there is no need to switch as long as the baby has other food sources to attain adequate nutrition. When the baby is over 1 year old and has a more diversified diet, the formula will become supplementary, and parents may consider switching to cow’s milk until the baby is weaned onto solid foods. Babies between ages 1 and 2 can take whole milk as they require sufficient fats for development. For those between 2 and 5, parents may consider low-fat milk as long as they have sufficient nutrient intake from solid foods. Children above 5 may switch to skimmed milk as excessive fats and calories may increase the risks of developing obesity and cardiovascular diseases. Let’s take a look at the ingredients of infant formulas in advertisements! In the advertisements, we often hear manufacturers claiming that their products contain ingredients such as probiotics, DHA and PhD, which contribute to the development of the brain, eyesight and immune system in babies, as well as improve their bowel movements. However, are these ingredients really capable of providing sufficient nutrients and supporting babies’ normal development as claimed by the manufacturers? Probiotic Probiotics are active microorganisms that can improve the balance of intestinal microbiota. Sufficient intake of probiotics is good for health. The more representative probiotics include Lactobacillus, Bifidobacterium and Streptococcus. Prebiotic It is claimed that prebiotics (also known as prebiotic fibres) can improve babies’ intestinal health. They are organic substances that cannot be digested in the human body but can stimulate probiotic growth or activity in the intestines. Prebiotics are usually oligosaccharides and soluble dietary fibres. DHA DHA, commonly associated with brain development in babies, is the abbreviation for docosahexaenoic acid, which is a type of omega-3 fatty acid (or ω-3 fatty acid or n-3 fatty acid). In our daily diet, our intake of DHA mainly comes from fish, especially oily fish such as salmon, mackerel, herring, anchovies and sweetfish. AA Similarly, it is claimed that AA can also help in the development of the brain and nervous system. AA is the abbreviation for arachidonic acid and is a type of omega-6 fatty acid (or ω-6 fatty acid or n-6 fatty acid). Intake of AA in our daily diet mainly comes from animal fats, liver, eggs and fish. Breast milk naturally contains DHA and AA, but cow’s milk does not. Therefore, DHA and AA are additives in cow’s milk . Besides, healthy babies can produce DHA and AA from the linoleic acid and α-linolenic acid in infant formulas. Regarding the above ingredients, although there are individual studies indicating that adding these ingredients in infant formula products is beneficial to babies, more research is needed to prove their clinical efficacies and whether they should be added as essential ingredients. According to the current standards of CAC, these ingredients are not essential in infant formula products. β-Glucan It is claimed that β-Glucan can enhance babies’ immune systems. β-Glucan is a form of carbohydrates that is mainly composed of the cell walls of fungi, yeast, some bacteria and grains (such as oats and barley). However, according to current findings, there is not enough evidence to prove that β-Glucan can enhance the immune system of babies. PhD (Phospholipid) PhD is neither a pizza restaurant nor an academic degree here. It is a type of lipids that is claimed to facilitate the development of babies’ brains. Breast milk and cow’s milk naturally contain PhD. According to infant formula labels, the source of their PhD is from the added "emulsifier (soy lecithin)". Lecithin is actually a common ingredient in foods. Apart from soybeans, eggs, liver, beef and peanuts, vegetables and fruits such as cauliflowers, potatoes, oranges, and apples also contain lecithin. However, there is not enough evidence to prove that PhD is especially beneficial to babies’ intellectual development. Hydrolyzed formula Proteins are formed by linking discrete amino acids. Under normal circumstances, human bodies (including babies’) can digest and absorb proteins after ingestion. What are hydrolyzed proteins? Through hydrolysis, long-chain proteins are broken down into shorter proteins or free amino acids. It is claimed that the process helps babies to digest proteins more easily. Infant formulas containing hydrolyzed proteins are also called hydrolyzed formulas. According to the degree of hydrolysis, they can be classified as "amino acid-based formula", "extensively hydrolyzed formula" or "partially hydrolyzed formula”. The first two are also known as "hypoallergenic infant formula". "Extensively hydrolyzed formula" is generally used as a therapeutic formula for babies who cannot digest protein in cow's milk or are allergic to it. However, there is still not enough evidence to prove that "partially hydrolyzed formula" specifically improves babies’ digestion, absorption and immunity. In conclusion, according to the standards of CAC and expert opinions, the above-mentioned ingredients are not essential ingredients for infant formulas. Basically, the ingredients of infant formulas are similar across brands, so parents should not be overly concerned and influenced by the product claims and promotions. Instead, parents should check the product labels and consider factors such as their actual need and the supply of products. What can product labels tell you? 1. Food label and ingredient list You can check the ingredients such as lactose, vegetable oil and skimmed milk powder emulsifier, etc. in infant formulas to find out if they contain possible allergens for babies. 2. Nutrition information Most product labels on infant formula containers indicate the nutrients and their amounts per 100g so that parents can find out the type and proportion of nutrients that their babies ingest. In addition, the labels also indicate the nutrients per 100ml so that parents can check whether their babies’ daily intake of nutrients is above or below the standard. 3. Preparation steps and recommended feeding amount Different manufacturers may use different production processes and methods, so the preparation steps and amount of infant formula to be used are also different. If the infant formula is not prepared according to the instructions, you may end up with undissolved powder or an over-diluted feed. At the same time, most infant formulas have a feeding chart which shows the recommended amount of infant formula and warm water to be used per feeding, and the number of feeding per day, according to the baby’s age (in months). It is best to feed your baby according to the recommended amount, otherwise you may end up with a feed that is too concentrated or diluted, which will lead to 2 problems: Prolonged intake of concentrated infant formula: Babies will cry due to thirst. Parents may mistakenly think that their babies are still hungry and feed them again, leading to overfeeding; Prolonged intake of over-diluted infant formula: Babies will feel hungry and cry shortly after feeding, and may suffer from malnutrition in the long run. (Note: The specific amount for each feeding depends on the needs of individual babies or the instructions of medical practitioners.) 4. Shelf life Since infant formulas do not decay very easily, consumers can tell their shelf life by referring to the “Best Before” dates printed on sealed infant formula containers. However, once opened, infant formulas can only be kept for 3-4 weeks in general (or according to the instructions on the packaging). Unsealed products that have been left for a long time should be discarded. Therefore, consumers should consider buying products in smaller sizes if the serving is small. 5. Special storage or instructions of use If a particular infant formula requires special storage methods to maintain its shelf life or requires special instructions of use, these requirements must be specified on the labels. Infant formula preparation: 7 steps to know As sterilization is not yet adopted in the existing manufacturing processes of infant formulas, it is necessary to pay extra attention to hygiene and food safety when preparing infant formulas to avoid harming babies’ developing digestive system. Let’s look at the following steps and precautions: 1. Cleaning Clean your hands and surroundings properly. After washing your hands with liquid soap and water, dry them with a piece of clean cloth or tissue paper. 2. Preparing the baby bottle Take out the sterilised baby bottle. If there is condensation inside the bottle, discard it first. 3. Measuring the amount Measure the amount of infant formula and water in the prescribed ratio as per instructions. The size of the spoon provided in the container differs across brands, therefore consumers should use the spoon provided by the original manufacturer. Besides, do not compress the powder in the spoon to avoid adding extra infant formula and making the milk too concentrated. 4. Preparing infant formula Boil tap or distilled water and allow it to cool for no more than 30 minutes. Use water of at least 70°C to prepare infant formula in order to kill any harmful bacteria in it. However, one should note that water which is too hot will destroy the vitamins in the infant formula. Also, avoid using mineral water to prepare infant formula due to its high mineral content. Remember to pour water first, and then add formula powder. Fill the spoon with the formula powder and level off with a clean knife. Do not compress the formula powder into the spoon. 5. Dissolving formula powder Put the teat , cap and other components on the baby bottle, and then gently shake or rotate the bottle to completely dissolve the formula powder. Do not shake too vigorously, lest a large amount of air may enter, causing foaming. 6. Cooling the hot milk At this point, the temperature of the milk is still not suitable for consumption. You need to put the baby bottle under running water or in cold water to cool it down to around body temperature. It should be noted that the water level must be lower than the bottle mouth and should not come into contact with the teat. You can test the temperature by dripping some milk on the inside of your wrist or using a colorimetric temperature patch. 7. Consuming immediately To prevent bacterial growth, the prepared infant formula should be consumed immediately and should not be left at room temperature for too long. It should be thrown away if not consumed within 2 hours. Once the bottle has been sucked on, bacteria from the oral cavity may contaminate the bottle and its content and therefore it should not be reheated for further consumption. If you want to store prepared infant formula, you should minimise the time it is left at room temperature. You can put the prepared infant formula in the refrigerator (but not the freezer) and store it at 4°C or below. Unconsumed infant formula that has been stored in the refrigerator for more than 24 hours should also be discarded. Things to note when feeding babies 1. Consume prepared infant formula After removing the prepared infant formula from the refrigerator, you can put the baby bottle in warm water to warm up the content. This process should be done within 15 minutes to reduce the growth of germs. Avoid heating milk in the microwave because the uneven temperature of the heated milk can cause burns to babies. Shake the bottle well before feeding. 2. Do not let babies consume infant formulas by themselves Do not raise the bottles and let babies suck the bottles by themselves due to risks of suffocation. 3. Know when the baby is full Look out for signals that the baby may be full during feeding. If the baby stops sucking, parents should not force the baby to finish the bottle. 4. Do not let the baby sleep with the bottle If the baby has fallen asleep during feeding, you should remove the bottle. Do not let the baby develop a habit of sleeping with the bottle which may increase the risks of tooth decay. Is my baby allergic to cow’s milk? If your baby shows signs of discomfort after being fed with formula containing cow’s milk proteins, it may be suffering from galactosemia or allergic to cow’s milk proteins. Babies who are allergic to cow's milk proteins may also be allergic to soya and goat milk proteins, and therefore soya or goat milk formulas are also not suitable for consumption. Parents should consult medical staff to find out whether their babies need special medical formulas. Will my baby suffer from constipation after consuming infant formulas? In fact, the protein content in infant formulas may be related to constipation. Milk proteins can be roughly divided into whey and casein. Cow’s milk contains a higher proportion of casein compared with breast milk, and its physical and chemical properties are also different. The casein in cow's milk is more difficult to digest by babies. In addition, dry and hard stools are also related to the fat content in infant formulas. The palmitic acids in infant formulas are in the Sn-1 and Sn-3 positions of triglycerides. After being released by digestive enzymes, free palmitic acids will combine with calcium in the intestines to form calcium soaps, which will lead to dry and hard stools. As calcium and iron are usually added to infant formulas, this makes babies’ stools more solid. However, since babies can consume other foods after 6 months, constipation can be eased if their diet includes enough fruits and vegetables. Breastfeeding is still the top choice Breastfeeding is actually the best option for mothers. First, there is no need to prepare infant formula and to worry about water quality and the cleanliness of utensils. Second, breast milk has all the necessary nutrients for babies, and adapts to the living environment of both the mother and the baby to meet babies’ needs. It can also improve babies’ resistance to illnesses. The palmitic acid in breast milk is at the Sn-2 position of triglycerides. After digestion, it is easily absorbed by the intestines. Therefore, breastfeeding is less likely to cause dry and hard stools. In addition, breastfeeding time is the most intimate moment between mothers and babies, which can help the development of babies’ cognitive ability and is critical for the growth of babies. Breastfeeding can also reduce the mothers’ risks of developing breast cancer or ovarian cancer. The Consumer Council tested 15 pre-packaged infant formulas on the market to assess product safety and the actual nutrient content. Watch the video below to learn about the results: https://www.youtube.com/watch?v=eM5YGwElxP0 (Chinese version only) For the detailed report, please refer to the article, “Infant Formulas Tested, 9 Models Were Found to Contain Contaminants and Carcinogens” CHOICE Magazine, Issue 526 (Chinese version only).
Luncheon meat Are you consuming veterinary drugs at the same time? People are generally very vigilant when it comes to antibiotics, but they may not know that antibiotics exist in the luncheon meat they eat! Pig farms sometimes add antibiotics and other veterinary drugs in the pig feeds to prevent diseases. These veterinary drugs may remain and become part of the luncheon meat. About 3 to 6% of the population are allergic to sulfonamide antibiotics (sulfadimidine), and may suffer from symptoms like rash and swollen face, mouth and tongue. Besides, risks of antibiotic-resistant bacteria surviving in human bodies may also increase. Among the 25 samples of luncheon meat tested by the Consumer Council (or the “Council”), 1 sample was detected with sulfadimidine at 199.3μg/kg. The drug can´t be decomposed even when put in boiling water at 100 ºC for 2 hours, which gives rise to health concerns. "Low sodium" – fact or just another advertising gimmick? People nowadays are becoming more health-conscious. It is widely known that excessive sodium intake raises the risks of chronic diseases such as heart disease and stroke. Therefore, more and more canned foods, advertising “low sodium", have emerged in the market. But how many of them really live up to their claims? During the production process, adding a large amount of salt can help in extracting myosin from the meat, which can improve the binding and emulsion-forming properties of the meat mixture. However, excessive sodium intake can bring health issues. According to the definition of the UK´s Food Standards Agency (FSA), food containing more than 600 mg of sodium per 100 grams (600mg/100g) is considered “high sodium”. When measured against this standard, most canned processed meats are high in sodium. In Hong Kong, some luncheon meats are advertised as "less sodium" but how far could they meet the claim? If you want to find out which model is healthier, please refer to the article, “Luncheon Meat and Sausages with High Sodium and Fat Contents are Harmful. Antibiotics Found in 1 Sample”. CHOICE Magazine, Issue 488 (Chinese version only). Ingredients are equally important! Read the nutrition labels carefully. In addition to assessing the nutrition value, consumers should also pay attention to the ingredients and check if there are additives that shouldn’t be there. Corn starch, potato starch, and milk protein are normally added as binding agent and for water retention, thus delivering a smoother texture. Consumers should, however, watch out for “strange-looking” ingredients. Overall, it is better not to consume too much processed meat. The International Agency for Research on Cancer (IARC) under the World Health Organization (WHO) classified processed meat as a Group 1 carcinogens to humans in 2015. There has been ample evidence showing that processed meat can lead to cancer, especially colorectal cancer. Even though consumers are now staying at home more often, they should refrain from consuming too much processed meat. Canned fish Sardines and tunas contain heavy metal contaminants Want to eat something less “heavy”? Is canned fish a good choice? The Council previously conducted a test and found that some canned fish contained heavy metals. But these heavy metals did not come from the metal cans, but actually from the fish! Heavy metal residuals may have occurred naturally in the environment or come from industrial waste, and have entered the air, soil and water system via different channels. After being ingested, they end up accumulated inside the fish. Larger predatory fish tend to accumulate more as they prey on smaller fish which also have these residuals. When humans consume these fishes, they will also ingest the heavy metals, which will then accumulate in the bodies causing health issues. Among the many types of heavy metals, arsenic, mercury, cadmium and lead are the more commonly found metals which are harmful to human bodies. Because sardines and tunas are both sea fish, their heavy metal levels can be largely affected by the environment of the origins. The Council tested a variety of canned fish, and 90% of the sardine samples were found to contain cadmium. Excessive intake of cadmium may lead to chronic poisoning in kidneys. 7 sardine samples from Morocco had cadmium level at ≥ 50% of the maximum limit as stipulated in the Food Adulteration (Metallic Contamination) (Amendment) Regulation 2018 with effect from 1 November 2020. This suggested that the ocean around Morocco might be quite polluted. In addition, 90% of the tuna samples were found to have methylmercury. Excessive intake of methylmercury may affect the brain development of fetuses and toddlers, leading to a decrease in intelligence. Parents should be very careful! Fish in a “can” can also have good nutrition value? Canned foods can also be rich in nutrients! Despite being processed at high temperature, most canned fish can still retain their nutrients. When cooked properly, you can turn them into delicious dishes. Apart from benefiting from the fish’s own nutrition content, consumers can also increase their calcium intake by eating the fish bones which have been softened (and made edible) by the high-temperature and high-pressure production process. From the test samples, canned dace were found to have higher calcium level, which can help the development of teeth and bones and prevent osteoporosis. However, many canned dace have high sodium content, so they should be consumed in moderation to avoid risks of hypertension, stroke, or cardiovascular diseases. On the other hand, sardines are rich in omega-3 fatty acids, which are beneficial to the cardiovascular system and help prevent heart disease and stroke. Finally, if you want to reduce the sodium intake, then avoid consuming the oil or sauce that the fish are canned in. The Council tested 46 canned fish samples. If you want to find out more from the results on food safety and nutrition value, please refer to the article, “Metal Contaminants, Carcinogens and Nutrition Value of Canned Dace, Sardines and Tunas”. CHOICE Magazine, Issue 525 (Chinese version only). Instant noodles Behind the convenience, watch out for the sodium intake! It´s difficult to resist a bowl of hot and mouth-watering cup noodles when one is hungry, and it only takes a few minutes to make. Notwithstanding the convenience, consumers should not overlook the sodium level of instant noodles. The World Health Organization (WHO) recommends that an average adult should consume less than 2,000 mg of sodium per day. The Consumer Council tested 10 pre-packaged cup / bowl noodles. The 3 samples with the highest sodium content were found to contain 3,150 mg, 2,577 mg, and 2,244 mg sodium, respectively. Consuming just 1 bowl will already exceed the daily sodium intake limit, which is insane. For more information and find out whether your favorite cup noodles fall into the “evil” list, please refer to the article, “Beware of Your Sodium Intake! 76 Asian Soup Noodles Exceeded Daily Intake Limit”. CHOICE Magazine, Issue 496. (Chinese version only). Try these health tips We know it is hard to “part” with your favorite instant noodles. If consumers want to have a healthier way of eating instant noodles, just remember the following “1-2-3”: 1: Cut down the amount of seasoning and sauce poured into the noodles. Only add bit by bit if you want to intensify the taste; 2: Don’t drink the soup which is loaded with sodium; and 3: Read the nutrition labels and pay attention to the calorie level and sodium content. Food delivery App Don’t want to go out to eat and not into the canned foods at home? Takeaway foods can be a good alternative. The following 2 cases have highlighted areas that consumers may have easily overlooked. Have you got similar experience? Case 1: Time was out and order was cancelled Are you aware of the time restrictions attached to self-pickup? Although not being prompted at the time of ordering, some food delivery platforms have set out terms and conditions which require customers to collect their foods within a time limit, and failure to do so will lead to cancellation of orders without any refund. If you opt for the self-pickup service and cannot collect the foods in time, you should contact the restaurants to try to extend the time. Otherwise, you may go all the way for nothing, but disappointment. Case 2: Incorrectly filled address A customer once waited for 1.5 hours and finally received a call from a delivery staff saying that his delivery address was outside of the service scope, and as such his orders could not be delivered. The customer was puzzled as he thought the restaurant was shortlisted according to his address input. Actually, he made a mistake by only inputting the district into the address field. And the rest of the address details, including real estate name and number were inputted in the field of “Delivery Notes”. Furthermore, the delivery staff had not been able to contact him on phone, so both the customer and the delivery staff had wasted a lot of time in “waiting”. Consumers are reminded to check and verify their address details and check if they are being inputted in the correct fields. For consumers who order takeaway foods at work as well as at home, they should pay extra attention not to mix up the addresses. To find out how these cases were resolved and other areas concerning food deliveries, please refer to the article, “Food Delivery Has Become the New Normal. Beware of the Terms and Conditions to Avoid Disputes”. CHOICE Magazine, Issue 525. (Chinese version only). Consumers are also asked to be environmental conscious and avoid the use of disposable cutleries. Nowadays, many food delivery platforms provide “opt-out” option for cutleries. Consumers are urged to use their own cutleries and make a contribution to our planet earth.