Among the changes to minerals and vitamins there have been some increases to upper limits, such as vitamins A and D1, iodine and selenium. Folic acid is now to be listed as folate.1

Minerals are added to the infant formula in proportion to calorie content of the infant formula. There are 14 specified minerals: sodium, potassium, chloride, calcium, phosphorous, magnesium, iron, zinc, copper, iodine, selenium, manganese, molybdenum, and fluoride. The minimum and maximum levels for iron, phosphorous and zinc are higher in protein hydrolysate-derived infant formula.

Most mineral levels are the same for follow-on formula, but the regulations set higher minimum and maximum levels for iron.

Vitamin specifications set minimum and maximum levels for vitamin A, vitamin D, thiamine, riboflavin, niacin, pantothenic acid, vitamin B6, biotin, folate, vitamin B12, vitamin C, vitamin K and vitamin E (alpha-tocopherol).

Concerns were raised about the possibility of infants up to 4 months receiving too much vitamin D. This might occur through high consumption of formula containing 3μg/100kcal of vitamin D, or if combined with additional vitamin D intake through supplementation, and may pose safety risks.3 The 2019 amendment addresses this by lowering the maximum vitamin D content for infant formula to 2.5μg/100 kcal.

Inositol, sometimes known as vitamin B8, is required in infant formula but not follow-on formula. This is also the case for choline, a source of methyl groups used in metabolism including synthesising phospholipids in cell membranes.1,9

Five different nucleotides, the organic molecular units used to build DNA and RNA, may be added, up to specified levels.1