The UK has two main different categories of milk, which are suitable for babies from birth as a substitute for breast milk – those that are whey protein based and those that are casein protein based.
If whey based formulas are closer to breastmilk when might a casein formula be appropriate? Whey formulas are the preferred choice when bottle feeding from birth or when moving from breastfeeding as they are the closest in composition to breastmilk. Cow & Gate recommend that if an infant is not breastfed, they should receive a whey dominant milk; and as long as the infant appears satisfied, we would not suggest changing to casein dominant infant milk.
However, when feeding choices are placed in their social context there are some reasons why healthcare professionals may consider suggesting the use of casein milks to help address wider issues of health and family stress levels;
Where the parent is considering weaning the child prematurely.
Studies have shown that one of the strongest influences on parents to wean early is the perception that the child is hungry and needs more food
1. By delaying the interval between feeds casein dominant milk can help alleviate this perception long enough to prevent early weaning. The Department of Health opposes the premature introduction of solids
2, and considers that the use of casein based milks preferable to the premature introduction of solids
3
Where sleep deprivation is affecting the ability of the parent to operate effectively.
Casein dominant milks slow down gastric emptying, resulting in a fuller stomach for longer. Protein composition seems to be the essential factor. The more casein a milk contains, the slower the gastric emptying
4. Therefore in practice, casein dominant milks, can be used for the final feed of the day even if whey dominant feeds are used during the day, to help the parents get a few more hours of undisturbed rest.
Common myths about casein formulas
Q1. Casein dominant milk contains more fat and calories doesn’t it?
A. No – in fact there are no significant differences in either. Cow & Gate Premium contains 3.5g/100ml fat, and Plus contains 3.3g/100ml fat. The calorific value per 100ml is the same for both the casein and whey dominant milks in the Cow & Gate range.
Q2. Doesn’t this different protein put stress on the baby’s body in other ways?
A. No important differences have yet been demonstrated between the biological value (how efficiently the body utilises protein), of whey dominant and casein dominant formulas
3. The only difference on the body that has been found with casein dominant milks is the speed of gastric emptying; apart from this the body appears to use the protein in the same way.
Q3. Babies on casein milks have harder stools don’t they? A. The introduction of prebiotics in Cow & Gate casein dominant milks has resulted in babies fed on our milks having softer stools, which are more comfortable to pass.
Q4. Casein dominant milk must given after 4 months of age
A. In fact casein dominant first milk is approved for use from birth for hungrier babies, although we would always recommend whey dominant milks as the first choice.
A comparison between whey, casein formulas and breast milk
References
1. Wright CM et al. Why are babies weaned early? Data from a prospective population based cohort study. Arch. Dis Child. 2004; 89:813-816
2. Department of Health (1994). ‘Weaning and the Weaning Diet’. Report on the Health & Social Subjects, No. 45. HMSO: London.
3. Department of Health (1988). ‘Present day Practice in infant Feeding’. Report on the Health and Social Subjects, No. 32. HMSO: London.
4. Billeaud C et al. Eur J Clin Nutr 1990; 44:577-583
