What is A2 Milk Formula? Is it Better for Sensitive Stomachs?
The US infant formula crisis of 2022 has brought many new European and Australian baby formulas to the US market. With new formulas, come new ingredients to understand!
One ingredient that is very popular in Australia baby formulas is A2 milk. This ingredient has been in the US market already for a couple years. Similac®, Enfamil® and Good Start® all offered A2 baby formula before the formula crisis. However, these formulas were not heavily marketed and may not be familiar to parents.
This post is to help you make sense of this newer ingredient, which is sometimes promoted for infants with sensitive stomachs.
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What is A2 Milk?
A2 infant formula contains a specific kind of cow’s milk that is simply called A2 milk. Some grocery stores carry A2 cow’s milk in the dairy case. A2 baby formula is made only with this kind of milk.
To explain A2 milk, and whether it helpful, we’ll need to give some background information about milk proteins.
Proteins in Milk: Casein and Whey
There are two major proteins found in milk ¾ casein and whey. Milk proteins can be further divided into subtypes. Casein has four subtypes. Two of these are classified as beta-caseins.
The most common casein sub-type is called A2 beta-casein. The second is named A1 beta-casein.
While some cows make milk with both A1 and A2 beta caseins, others make milk only with A2 beta-caseins. The breed of the cow determines whether she makes A2 milk or milk that contains both A1 and A2. In other words, A2 milk is a genetic variant of casein milk protein.
Figure by Lisa Richardson
What is the Difference Between A2 Milk and Regular milk?
Regular milk in the United States contains a mixture of A1 and A2 proteins. When milk comes from cow’s that only make A2 proteins, it is simply called A2 milk. Goat milk is also A2 milk, because the goat milk industry has made that the standard for the genetics of the nanny goats that they use.
A2 milk is the same as regular milk in all other ways. At least as far as fact-based differences. As you’ll read later, some people may tolerate A2 milk better than traditional milk.
Is A2 Milk Lactose Free?
No. This is a common misconception. A2 milk straight from the cow contains lactose, the natural milk carbohydrate. You may find lactose-free A2 milk in the dairy case at the grocery store. This has been specially processed to remove lactose.
The confusion about lactose and A2 milk comes from research on adults with lactose intolerance (People unable to break down and digest lactose.)
Recent research loosely suggests that adults with lactose intolerance may tolerate A2 only milks better than those that contain A1 and A2. Adults who prefer A2 milks may prefer to feed their infants A2 infant formula.
What is A2 Infant Formula?
Infant formulas that have A2 in their name are made from cow milk that only contains the A2 beta-caseins. They do not contain any of the A1 beta casein.
Goat milk infant formula only comes from nanny goats who produce A2 caseins. However, these formulas do not contain A2 in their names. You may find it mentioned in the baby formula marketing materials. In general, it is safe to assume that goat milk baby formula is only A2 milk.
What is Special About A2 Baby Milk?
Human milk is rich in beta-caseins. The A2 form of cow beta-casein is structurally more like the kind of casein found in human milk than is A1 form that some cows make. Since human milk is the model for infant formula, some people prefer infant formula that only has A2 beta-casein.
Pre-clinical studies done in animals and cellular models hint that the A2 caseins may also be less allergenic than the A1 proteins. Importantly, this line of research is very limited and despite what one reads online.
However, The American College of Allergy, Asthma, & Immunology continues to state that people with a milk cow’s milk allergy may also be allergic to milk from other animals. In addition, the Kids with Food Allergies website by the Asthma and Allergy Foundation of America continues to warn that “people allergic to cow’s milk have a high likelihood of reacting to goat’s milk.”
Shanice McKenzie/Nappy.co
Is A2 Milk Safe for Babies?
Yes. It is perfectly safe to drink a formula made only with A2 milk. The safety of these types of milk have never been questioned! And since human milk is also rich in beta-caseins, it seems like good idea to have it in formula. Although it can be promoted as being better for sensitive stomachs, there isn’t any hard data to support that idea.
Which Formulas Have A2 Milk?
A2 baby milk is very popular in Australia. Two of the Australian baby formulas, Bubs and Care A2+, imported through the FDA discretionary policy are A2 only formulas. The other Australian brand being imported, Bellamy Organic, also makes an A2 baby milk, but it isn’t the one being imported.
Here is a list of infant formulas that are contain A2 proteins and little to no A1 proteins:
Enfamil Premium A2
Good Start Gentle Supreme
Similac Organic with A2
Bubs Goat Milk
Bubs Supreme A2
Kendamil Goat Milk
Is A1 Milk Ever Harmful?
You may have heard that A1 containing formulas are bad for your baby’s health. This would be a very concerning since most infant formulas are made with A1 proteins.
But, it isn’t the case at all. There is one study from China that showed self-reported problems with drinking A1 containing milk. But this study had many design problems and made a serious logic mistake. Not all research out there is good!
Simply stated ¾ drinking A1 beta-casein in milk does not cause disease or increase the risk for any disease.
The controversary around A1 milks was caused by bad experimental design. Research studies must be designed correctly to reach specific conclusions. And crucially, they must be based on what happens in the body, not in a test tube.
The A1 milk controversary grew from poorly designed research about how beta-caseins are digested. If you want to learn about this controversary, keep reading, if not, skip to the end and the important points to remember.
Beta-Casein Protein Digestion
Digestions of milk containing A1 beta-casein creates a snippet of protein called beta-casomorphin-7 (BCM-7). This snippet is a natural part of digestion.
Proteins are long chains of amino acids that are strung together like beads on a string. Protein digestion begins when enzymes in the GI tract break the long amino acid chain down into shorter chains, which are called peptides.
Beta-casomorphin-7 is a peptide created when A1 beta-casein milk protein is digested naturally. Digestive enzymes cut up proteins at very precise location along the amino acid chain. Digestions of A1 beta-casein creates BCM-7 peptides while A2 beta-casein digestion does not.
A1 Beta-Casein Safety
Peptides like BCM-7 have their own biological effects on organ systems, including the cardiovascular, nervous, immune, and digestive systems.
Beta-casomorphin-7 (BCM-7) is associated with biological processes of the GI tract and the immune system. Some research connected these effects with increased risk for type1 diabetes and milk intolerances. However, that research had many research design problems, thus the conclusions were not accurate.
In fact, the European Food Safety Authority (the European equivalent of the US FDA) did an extensive review and did not find evidence that BCM-7 causes any disease. Other researchers have come to the same conclusion.
The long story short: Drinking A1 beta-casein in milk does not cause disease or increase the risk for disease.
Important points to remember:
A2 milk is a genetic variant of casein milk protein
Infant formulas made with A2 beta-caseins and contain no or very little A1 beta-casein. Cow milk formulas are usually simply called A2 for short. Goat milk formulas are not labeled as A2, but contain very little A1 proteins.
A2 formula has no nutritional or safety advantage over formula made with traditional milk. At the same time, human milk contains a lot of A2 proteins.
Research showing that drinking A1 beta-casein could cause health problems is outdated and was poorly designed. Recent, rigorous research shows that digestion of A1 beta-casein does not cause any disease.
It is possible that adults with lactose intolerance may have fewer GI problems when drinking lactose containing A2 milk. This effect has not been studied in infants or young children.
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