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Follow-on Formula: Definition, Nutrients & Recommendations

Follow-on formula is a specially designed infant food for babies from 6 months of age, used alongside solid foods. It provides key nutrients to support healthy growth and development.

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Things worth knowing about "Follow-on formula"

Follow-on formula is a specially designed infant food for babies from 6 months of age, used alongside solid foods. It provides key nutrients to support healthy growth and development.

What is Follow-on Formula?

Follow-on formula (also called follow-on milk) is an industrially produced infant food specifically designed for babies from the age of 6 months. It is intended to complement the introduction of solid foods (weaning foods) and follows the stage of starter infant formula (stage 1 formula). In the European Union, follow-on formula is regulated by Delegated Regulation (EU) 2016/127, which sets mandatory nutritional standards to ensure safety and suitability for older infants.

Composition and Nutritional Profile

Follow-on formula is typically based on cow's milk protein, which may be partially hydrolysed. It contains a carefully balanced combination of carbohydrates, fats, proteins, vitamins, and minerals tailored to the needs of babies aged 6 months and older. Key nutritional components include:

Iron: Follow-on formula generally contains higher levels of iron than starter formulas, as iron requirements increase from 6 months and the infant's natural iron stores begin to deplete.
Vitamin D and Calcium: Support healthy bone development and the growing skeletal system.
Long-chain polyunsaturated fatty acids (LC-PUFAs): Including DHA (docosahexaenoic acid), which supports brain and visual development.
Prebiotics and probiotics: Some products include these to support gut health and the developing immune system.

When is Follow-on Formula Used?

Follow-on formula is suitable from the completed 6th month of life and is used alongside the gradual introduction of solid foods. It does not fully replace breast milk or starter formula at this stage, but rather supplements the infant's expanding diet. The World Health Organization (WHO) recommends exclusive breastfeeding for the first 6 months and notes that follow-on formula is not a necessary component of infant nutrition when breastfeeding continues.

Follow-on Formula Compared to Breast Milk and Starter Formula

Breast milk remains the optimal source of nutrition for infants and young children and should be continued where possible. Starter infant formula (stage 1) is designed for newborns up to 6 months of age and can continue to be used beyond this point. Follow-on formula, by contrast, is specifically formulated for older infants from 6 months and contains higher amounts of certain nutrients such as iron. It must not be used for newborns or infants under 6 months of age.

Safety and Recommendations

Follow-on formula must meet strict European food safety standards. Preparation should always follow the manufacturer's instructions, as incorrect preparation (too concentrated or too diluted) can be harmful to the infant's health. Parents should also be aware of the following:

Always prepare follow-on formula fresh and do not store prepared bottles for later use.
Regularly sterilise bottles and feeding equipment.
In cases of intolerances or allergies (e.g., cow's milk protein allergy), use specialised hypoallergenic (HA) products or alternatives recommended by a physician.

Critical Perspective and Medical Advice

Nutrition experts and paediatricians point out that follow-on formula is not medically necessary if the baby continues to be breastfed or receives starter formula. Key nutritional needs from 6 months onwards, especially iron, can also be met through appropriate solid foods. Parents are advised to consult a paediatrician or lactation consultant for personalised guidance on infant feeding.

References

European Commission: Delegated Regulation (EU) 2016/127 – Requirements for Infant Formula and Follow-on Formula. Brussels, 2016.
World Health Organization (WHO): Infant and young child feeding. Fact Sheet, 2023. Available at: https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding
Koletzko B. et al.: Global Standard for the Composition of Infant Formula. Annals of Nutrition and Metabolism, 2005; 49(Suppl 1):1–11.

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