Fertility

Finding The Best Formula For Spit-Up And Gas: Everything You Need To Know

Updated on 7 November 2021 • 12 minute read
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Overview 

Spit-up and gas are two of the most common issues in pediatrics. Both commonly happen to healthy infants worldwide, formula-fed and breastfed babies alike. But is there a way to keep your baby from experiencing them?

Babies actually spit up and may have a lot of gas due to several reasons. It’s important to know why it’s happening to your baby so you can find a suitable remedy or way to deal with the situation.

The exact cause of gastroesophageal reflux (or spit-up) and gas may not be easy to determine, but they may be due to the following: (1)

  • Swallowing too much air while feeding
  • A by-product of digestion of their still-developing tummies
  • Lactose sensitivity
  • Lactose intolerance
  • Cow’s milk allergy
  • Cow’s milk protein allergy
  • Poor absorption of carbohydrates
  • Other digestive issues

 

Note that infant reflux or spit-up isn’t considered a disease. It’s common and normal in babies, especially because their digestive system is still developing. 

It typically peaks between four to five months old as your baby’s antireflux barrier (a lower part of their esophagus) begins to mature.

While spit-up doesn’t require treatment, your baby might feel uncomfortable about it, especially when it’s accompanied by gas.

If your little one is gassy or frequently spits up due to digestive issues, check with your pediatrician if you have to change to a different type of formula:

  • Thickened formulas with rice starch
  • Lactose-free
  • Lactose-reduced
  • Formulas with smaller, hydrolyzed proteins
  • Dairy-free (soy formulas or other plant-based sources)
  • Formulas with probiotics
  • Formulas with prebiotics
  • Formulas with a combination of probiotics and prebiotics
  • Formulas with amino acids
  • Hypoallergenic formula

 

You can also try these remedies to deal with fussiness from gas and spit ups:

  • Burp your baby several times during feeding
  • Hold your child upright for 20 to 30 minutes after feeding
  • Change to anti-colic bottles or nipples
  • Eliminate cow’s milk, other dairy products, eggs, and spicy foods from your diet if you’re a breastfeeding mom

 

You should bring your little one to the doctor if acid reflux continues after 24 months of age because this could be a sign of GERD (gastroesophageal reflux disease).

 

The Best Formulas For Spit-Up And Gas

In choosing the best baby formula, it’s important to not just focus on whether it can relieve your baby’s tummy. You should also check if it can provide your child with complete nutrition for proper brain development and a healthier immune system.

The following products from different formula brands may be easier on your baby’s stomach:

  • Enfamil A.R. – 19.5 oz tub, single pack: $31.99
  • Similac For Spit-Up Non-GMO Powder Baby Formula – 12 oz can, one pack: $17.98
  • Similac Alimentum – 19.8 oz can, one pack: $39.99
  • Enfamil Nutramigen Enflora LGG Hypoallergenic Colic Baby Formula – 19.8 oz can: $45.99
  • HiPP Dutch Organic Combiotic Infant Milk Formula – 28.22 oz can: $46.99
  • Baby’s Only Organic Sensitive DHA/ARA Formula – 12.7 oz can: $14.99
  • Parent’s Choice Soy Infant Formula – 22 oz can: $13.12
  • Gerber Good Start Soothe Pro (HMO) Non-GMO Infant Formula – 30.6 oz can: $36.48
  • Holle Goat Based Formula – 14.12 oz can, pack of four: $32.99 each

Read more about each powder infant formula below.

 

Enfamil A.R.

Pricing

  • 19.5 oz tub, single pack: $31.99
  • 19.5 oz tub, pack of four: $117.99

 

Best Features & Safety

  • It’s a thickened formula with rice starch.
  • It’s formulated to help reduce reflux and spit-up.
  • According to the brand’s website, it’s clinically proven to reduce spit-up by over 50% in one week based on a study of infants who spit up at least five times a day.
  • It features two different types of prebiotics that may improve your child’s gut health.

 

Ingredients 

  • Nonfat milk
  • Rice starch
  • Vegetable oil (palm olein, soy, coconut, or high oleic sunflower oils)
  • Lactose
  • Maltodextrin
  • Mortierella alpina oil (for ARA source)
  • Crypthecodinium cohnii oil (for DHA source)
  • Galactooligosaccharides (prebiotics)
  • Polydextrose (prebiotics)

 

Nutritional Facts

Each serving (5 fl oz) of the formula has the following:

  • Calories: 100 calories
  • Total fats: 5.1 g
  • Total carbohydrates: 11.3 g
  • Proteins: 2.5 g
  • Vitamin A: 300 IU
  • Vitamin C: 12 mg
  • Iron: 1.8 mg
  • Calcium: 78 mg
  • Linoleic acid: 780 g

 

Product Recall

  • None

 

Pros & Cons

Pros

  • It meets the reflux reduction guidelines of the AAP (American Academy of Pediatrics), such as making the formula thicker using rice starch. (2)

 

Cons

  • This formula may be more prone to clumping.
  • It may be too thick for some babies.
  • It can cause constipation.
  • It contains palm olein oil which can decrease calcium absorption. (3)
  • It contains maltodextrin and vegetable oils.

 

What Customers Say

Positive Reviews 

My LO was dx with both acid reflux and lactose sensitivity. Gave this formula a shot and it has been perfect.” – Reviewer on Amazon.

Negative Reviews 

I bought this for my daughter since she has acid reflux and it was recommended by her doctor and she was severely constipated to the point where she was throwing up from trying to go.” – Reviewer on Amazon.

 

Similac For Spit-Up Non-GMO Powder Baby Formula

Pricing

  • 12 oz can, one pack: $17.98
  • 12 oz can, pack of six: $121.34

 

Best Features & Safety

  • According to the brand’s website, it’s clinically proven to reduce spit-up frequency in healthy babies by 54% compared with regular milk-based formulas.
  • It has rice starch for a thicker consistency.
  • It’s made from non-GMO ingredients. Eating foods with GMOs (genetically modified organisms) may lead to antibiotic resistance, allergic reactions, toxicity, cancer, immunosuppression, and loss of nutrition. (4)
  • It may be suitable for babies with lactose sensitivity.
  • It features OptiGRO, a blend of special ingredients lutein, vitamin E, and DHA (docosahexaenoic acid, an important omega-3 fatty acid). They’re important in supporting your baby’s brain and eye development.

 

Ingredients 

  • Corn syrup solids
  • Rice starch
  • Milk protein isolate
  • High oleic safflower oil
  • Sugar (sucrose)
  • Coconut oil
  • Soy oil
  • Mortierella alpina oil (ARA)
  • Crypthecodinium cohnii oil (DHA)
  • Nucleotides

 

Nutrition Facts

Each serving (5 fl oz) has the following:

  • Calories: 100 calories
  • Total fats: 5.4 g
  • Total carbohydrates: 11 g
  • Proteins: 2.1 g
  • Vitamin E: 1.5 IU
  • Iron: 1.8 mg
  • Calcium: 84 mg
  • Linoleic acid: 1,000 mg
  • Choline: 24 mg
  • Iodine: 15 mcg

 

Product Recall

  • None

 

Pros & Cons

Pros

  • According to the company’s website, it’s clinically proven to help reduce the frequency of spitting up.
  • It doesn’t have artificial growth hormones.
  • It doesn’t contain palm olein oil.

 

Cons

  • The rice starch can make the formula look grainy and difficult to mix, but Similac assures that this is normal and shouldn’t affect feeding.
  • It has added sugars (sucrose) and vegetable oils.

 

What Customers Say

Positive Reviews 

Our little girl was spitting up so much and not able to keep anything down! But when the nurses gave us these bottles, we cried because she was able to eat and keep down her food.” – Reviewer on Similac’s website.

Negative Reviews 

Switched my baby to this thinking it would help with spit up and he would poop more now he’s pooping once a week and it hurts him to poop and he spits up worse.” – Reviewer on Similac’s website.

 

Similac Alimentum

Pricing

  • 12.1 oz can, one pack: $28.99
  • 19.8 oz can, one pack: $39.99
  • 19.8 oz can, pack of four: $167.99

 

Best Features & Safety

  • It’s a hypoallergenic formula with hydrolyzed (broken-down) proteins that can be easier to digest by your baby’s sensitive tummy.
  • It can also be ideal for babies with food allergies.
  • The fats are shorter MCTs (medium-chain triglycerides) that can be easier to absorb.

 

Ingredients 

  • Casein hydrolysate derived from milk
  • Corn maltodextrin
  • Sugar
  • High oleic safflower oil
  • Medium-chain triglycerides
  • Soy oil
  • Crypthecodinium cohnii oil (for DHA)
  • Mortierella alpina oil (for ARA)

 

Nutrition Facts

Each serving (5 fl oz) contains:

  • Calories: 100 calories
  • Total fats:5.54 g
  • Total carbohydrates: 10.2 g
  • Proteins: 2.75 g
  • Vitamin A: 300 IU
  • Vitamin C: 9 mg
  • Iron: 1.8 mg
  • Calcium: 105 mg

 

Product Recall

  • The Similac Alimentum powdered formula hasn’t been recalled.
  • Only the ready-to-drink (liquid) formula was recalled in September 2006 due to a manufacturing defect that may gradually reduce the vitamin C content in the bottle. (5)

 

Pros & Cons

Pros

  • It’s a hypoallergenic formula.

 

Cons

  • It contains added sugars, maltodextrin, and vegetable oils.
  • Once the can is open, it needs to be stored in a cool place.

 

What Customers Say

Positive Reviews 

My son has always spit up and this has helped a ton!” – Reviewer on Amazon.

Negative Reviews 

The powder formula smells horrible. My daughter only drank an ounce and than gagged disappointed and now I’m out $.” – Reviewer on Similac’s website.

 

Enfamil Nutramigen with Enflora LGG Hypoallergenic Baby Formula

Pricing

  • 12.6 oz can: $34.99
  • 19.8 oz can: $45.99
  • 27.8 oz can: $58.99

 

Best Features & Safety

  • According to the company’s website, this formula is clinically proven to reduce colic from cow’s milk allergy within 48 hours.
  • This is a lactose-free, hypoallergenic formula.
  • It features the gut-friendly bacteria LGG (Lactobacillus rhamnosus GG).
  • Enfamil claims that this formula can help reduce the future incidence of allergies (such as eczema, urticaria, rhinoconjunctivitis, and asthma).

 

Ingredients 

  • Corn syrup solids
  • Vegetable oil (soy, coconut, high oleic sunflower, and palm olein oils)
  • Modified casein hydrolysate
  • Modified corn starch
  • Lactobacillus rhamnosus (probiotics)
  • Mortierella alpina oil (for ARA)
  • Schizochytrium sp. Oil (for DHA)

 

Nutritional Facts

Each serving (5 fl oz) contains:

  • Calories: 100 calories
  • Total fats: 5.3 g
  • Total carbohydrates: 10.3 g
  • Proteins: 2.8 g
  • Vitamin E: 2 IU
  • Iron: 1.8 mg
  • Calcium: 94 mg
  • Choline: 24 mg
  • Iodine: 15 mcg

 

Product Recall

Mead Johnson Nutritionals issued a recall on 4.6 million cans of Enfamil Nutramigen in 2001. The massive recall was due to potentially deadly preparation instructions written in Spanish on the label. (6)

According to the advisory, following these incorrect instructions can lead to serious health problems and possible death. (6)

 

Pros & Cons

Pros

  • It has no added sucrose (table sugars).
  • It contains no artificial growth hormones.

 

Cons

  • It has palm olein, corn syrup, and vegetable oils.
  • There has been a formula recall for this product due to potentially dangerous label instructions. (6)
  • It can cost more than other formulas.

 

What Customers Say

Positive Reviews 

I really love this formula. This is the only formula that does not make my 3 month old fussy.” – Reviewer on Enfamil’s website.

Negative Reviews 

I was recommended to use this bcuz my baby was SOOO colicky but it only made it worse.” – Reviewer on Amazon.

 

HiPP Dutch Organic Combiotic Infant Milk Formula

Pricing

  • 28.22 oz can: $46.99
  • 28.22 oz can, pack of six: $45.99 each
  • 28.22 oz can, pack of 10: $42.99 each

 

Best Features & Safety

  • This organic formula is made from non-GMO cow’s milk.
  • It features natural ingredients found abundantly in human breast milk: galacto-oligosaccharides (for prebiotics) and Lactobacillus Fermentum (for probiotics).
  • It doesn’t use synthetic preservatives.
  • It’s a European formula manufactured in Germany using ingredients sourced from farms that strictly comply with the EU (European Union) standards for organic farming.

 

Ingredients

  • Organic whey
  • Organic skim milk
  • Organic vegetable oils (sunflower oil, palm oil, or rapeseed oil)
  • Whey protein
  • Organic lactose
  • Organic galacto-oligosaccharides (from organic lactose)
  • Fish oil
  • Choline
  • Mortierella alpina oil (ARA source)
  • Hereditum Lactobacillus Fermentum CECT5716 lactic acid cultures 

 

Nutrition Facts 

Each serving (3.4 oz) of this formula has:

  • Total fats: 3.6 g
  • Total carbohydrates: 7 g
  • Added sugars: 0 g
  • Fibers: 0.3 g
  • Proteins: 1.25 g
  • Vitamin E: 0.7 mg
  • Vitamin K: 5.1 mcg
  • Iron: 0.5 mg
  • Calcium: 51 mg
  • DHA: 13.2 mg 
  • ARA: 13.2 mg
  • Omega-3 fatty acids: 0.06 g
  • Omega-6 fatty acids: 0.4 g

 

Product Recall

Able Groupe recalled this formula and other products from HiPP, along with other  European formula brands Holle, Bioland, and Kendamil in August 2021 for: (7)

  • Lack of FDA approval
  • Low iron content below the recommended 1 mg per 100 calories
  • Missing the label that indicates the need for possible iron supplementation

 

Pros

  • It goes through minimal manufacturing processes with certified organic ingredients but has a stable shelf life.
  • It has DHA from fish oil.
  • This formula is free from corn syrup, gluten, peanuts, soy, artificial preservatives, colors, flavors, or other unnatural ingredients and additives.

 

Cons

  • It contains vegetable oils.
  • It has been recalled in the US for insufficient iron levels plus other issues. (7)
  • Your baby may need iron supplements if you’re using this formula.
  • It’s more expensive than other formula brands.

 

What Customers Say

Positive Reviews 

The HiPP Dutch works so well for my baby.” – Reviewer on Little Bundle’s website.

Negative Reviews 

My son did not do well on this formula.” – Reviewer on Shopper Approved.

 

Baby’s Only Organic Sensitive DHA/ARA Formula

Pricing

  • 12.7 oz can: $14.99
  • 12.7 oz can, pack of six: $89.94
  • 12.7 oz can, pack of 12: $179.88

 

Best Features & Safety

  • It features DHA and ARA from certified organic egg yolks.
  • It’s made from non-GMO ingredients.

 

Ingredients 

  • Organic milk protein concentrate
  • Organic brown rice syrup
  • Organic canola oil
  • Organic high oleic oil (safflower or sunflower)
  • Organic linoleic sunflower oil
  • Organic coconut oil

 

Nutritional Facts

Each serving (4 fl oz) of this formula contains:

  • Calories: 80 calories
  • Total fats: 4.5 g
  • Total carbohydrates: 9 g
  • Added sugars: 3 g
  • Proteins: 2 g
  • Vitamin A: 70 mcg
  • Iron: 1.4 mg
  • Calcium: 70 mg

 

Product Recall

  • None

 

Pros & Cons

Pros

  • It’s gluten-free.
  • It’s certified to have no dairy, meat, or dairy and meat derivatives. 
  • It contains no palm olein oil or corn syrup.

 

Cons

  • It’s for children over one year old.
  • It has potential allergens: milk and egg.
  • It has brown rice syrup and vegetable oils.

 

What Customers Say

Positive Reviews 

This sensitive formula has worked so good for my baby, he doesn’t have stomach issues anymore and this has made the transition easier for us!” – Reviewer on Nature’s One website.

Negative Reviews 

He had one sip and spit it out. I encouraged him to drink more. He did but after that he began to throw up. I had a sip and then I understand why he spit it out. Gross taste.” – Reviewer on Amazon.

 

Parent’s Choice Soy Infant Formula

Pricing

  • 22 oz can: $13.12
  • 22 oz can, pack of four: $51.97

 

Best Features & Safety

  • This soy formula can provide your baby with complete nutrition.
  • It’s a lactose-free formula made from soy that’s specially formulated for fussiness and gas.
  • It has DHA, lutein (for better eyesight), and vitamin E.
  • It contains prebiotics that may help support your baby’s immune system and sensitive tummy.

 

Ingredients 

  • Soy protein isolate
  • Palm olein
  • Corn syrup
  • Soy oil
  • Coconut oil
  • High oleic (safflower or sunflower) oil
  • Mortierella alpina oil (source of ARA)
  • Crypthecodinium cohnii oil (source of DHA)
  • Lutein

 

Nutrition Facts

Each serving (5 fl oz) has:

  • Calories: 100 calories
  • Total fats: 5.46 g
  • Total carbohydrates: 10.4 g
  • Choline: 12 mg
  • Proteins: 2.45 g
  • Vitamin A: 300 IU
  • Vitamin C: 9 mg
  • Iron: 1.8 mg
  • Calcium: 110 mg

 

Product Recall

  • There has been no recall for Parent’s Choice Soy Infant Formula.

 

Pros & Cons

Pros

  • It’s certified kosher by the Orthodox Union – UDE
  • It’s gluten-free.
  • It can be cheaper than other milk alternatives.

 

Cons

  • It can be difficult to dissolve properly and prone to clumping.
  • It contains corn syrup.
  • It has palm olein oil and other vegetable oils.
  • It also has potential allergens: soy.

 

What Customers Say

Positive Reviews 

A great alternative to Similac Soy. Love the price!” – Reviewer on Walmart.

Negative Reviews 

My baby is miserable after using this.” – Reviewer on Walmart.

 

Gerber Good Start Soothe Pro (HMO) Non-GMO Infant Formula

Pricing

  • 30.6 oz can: $36.48

 

Best Features & Safety

  • It’s formulated for gas, colic, crying, fussiness, and mild spit-up.
  • It uses comfort proteins, a special blend of 100% whey proteins (partially broken-down), prebiotics (2’-FL HMO), and probiotics that may promote better gut health.

 

Ingredients 

  • Corn maltodextrin
  • Whey protein concentrate (enzymatically hydrolyzed from milk)
  • Vegetable oils (coconut, palm olein, soy, high-oleic safflower, or high-oleic sunflower)
  • Lactobacillus reuteri DSM 17938 probiotic cultures 
  • Mortierella alpina oil (ARA source)
  • Crypthecodinium cohnii oil (DHA source)

 

Nutrition Facts

Each serving (5 fl oz) has:

  • Calories: 100 calories
  • Total fats: 5.1 g
  • Total carbohydrates: 11.2 g
  • Proteins: 2.2 g
  • Vitamin E: 2 IU
  • Iron: 1.5 mg
  • Calcium: 72 mg
  • Linoleic acid: 900 mg
  • Choline: 24 mg

 

Product Recall

  • None

 

Pros & Cons

Pros

  • It has a combination of prebiotics and probiotics abundant in breast milk. The blend can promote a better digestive system.

 

Cons

  • It tends to form lumps and may be more difficult to dissolve.
  • It has maltodextrin, palm olein, and vegetable oils.

 

What Customers Say

Positive Reviews 

My child had a tough time with her stomach after being on intravenous antibiotics in the Nicu for a week after birth. The antibiotics wiped out a lot of her healthy gut bacteria so she was in a lot of pain. The only baby formula that worked for her was this!” – Reviewer on Amazon.

Negative Reviews 

I find that it wants to lump and it will not shake out. I have to get a spoon in bottle and crush it down.” – Reviewer on Gerber’s website.

 

Holle Organic Goat Milk Formula

Pricing

  • 14.12 oz can, pack of 12: $28.99 each
  • 14.12 oz can, pack of six: $30.99 each
  • 14.12 oz can, pack of four: $32.99 each

 

Best Features & Safety

  • This GMO-free goat formula is processed under the strictest EU organic standards.
  • It has proteins that are smaller and may be easier to digest than cow’s milk.
  • It can be ideal for babies with cow’s milk protein allergies and sensitive stomachs.

 

Ingredients

  • Organic full cream goat’s milk powder
  • Organic maltodextrin
  • Organic lactose
  • Microalgae oil
  • Organic vegetable oils (rapeseed oil or sunflower oil)

 

Nutrition Facts

Each serving (3.4 fl oz) has the following:

  • Calories: 68 kcal
  • Total fats: 3.6 g
  • Total carbohydrates: 7.5 g
  • Proteins: 1.4 g
  • Vitamin E: 1.3 mg
  • Iron: 0.67 mg
  • Calcium: 60.7 mg
  • Linoleic acid: 510 mg
  • Choline: 21 mg
  • Iodine: 13.6 mcg

 

Product Recall

This formula is among the products from European formula brands (Holle, Kendamil, HiPP, and Bioland) recalled in August 2021 for: (7)

  • Failure to meet FDA pre-market requirements
  • Low iron content
  • Incorrect labeling

 

Pros

  • This organic formula has no soy, gluten, artificial preservatives, chemicals, flavors, colors, or added sugars.
  • It doesn’t contain brown rice syrup.
  • It doesn’t have palm olein oil.
  • It has DHA from algae.

 

Cons

  • It may be more expensive than regular formulas.
  • It has had a product recall for several issues. (7)
  • You may need to supplement your little one with iron.
  • It has maltodextrin and vegetable oils.

 

What Customers Say

Positive Reviews 

We tried this formula for my four month old she was being very gassy with the cow formula louloku but after using this formula the gassiness went down 80 percent. ” – Reviewer on My Organic Company Store.

Negative Reviews 

This product made my baby really sick. He’d throw it all up every time I gave it to him.” – Reviewer on Nursing Angel.

 

Summary & Recommendation 

These are some of the best formulas for reflux and gas that you can try:

  • Enfamil A.R.
  • Similac For Spit-Up Non-GMO Powder Baby Formula
  • Similac Alimentum
  • Enfamil Nutramigen Enflora LGG Hypoallergenic Colic Baby Formula
  • HiPP Dutch Organic Combiotic Infant Milk Formula
  • Baby’s Only Organic Sensitive DHA/ARA Formula
  • Parent’s Choice Soy Infant Formula
  • Gerber Good Start Soothe Pro (HMO) Non-GMO Infant Formula
  • Holle Goat Based Formula

 

Other Formulas To Try For Your Baby’s Sensitive Stomach

  • Similac Sensitive Infant Formula
  • Similac Pro-Sensitive Infant Formula
  • Enfamil Gentlease Infant Formula
  • Enfamil NeuroPro Gentlease Infant Formula
  • Earth’s Best Non-GMO Soy-Based Infant Formula
  • Earth’s Best Organic (Reduced Lactose) Sensitivity Infant Powder Formula with Iron
  • Enfamil ProSobeeSoy  Infant Formula

 

 

 

REFERENCES

(1) https://pedsinreview.aappublications.org/content/38/10/449

(2) https://www.aafp.org/afp/2014/0301/p395.html

(3) https://pubmed.ncbi.nlm.nih.gov/16582027/

(4) https://www.centerforfoodsafety.org/issues/311/ge-foods/ge-food-and-your-health

(5) https://www.aappublications.org/content/27/9/2006229

(6) https://www.nytimes.com/2001/07/10/us/national-briefing-science-and-health-recall-of-baby-formula.html

(7) https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/able-groupe-recalling-products-labeled-infant-formula-formulas-have-insufficient-iron-levels

 

 

 

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