Goat milk infant formula and gut health: from traditional nutrition to scientific innovation

When breastfeeding is not possible, goat milk-based infant formula (GMF) provides an alternative to cow's milk-based formula. This narrative review evaluates clinical, observational, and mechanistic evidence on the nutritional suitability of GMF and its potential relevance to infant gut health. Randomized trials and meta-analytic evidence support the safety and nutritional adequacy of GMF. Its distinct composition, including a higher β -casein-to-αs1-casein ratio and differences in the profile and concentrations of oligosaccharides and bioactive proteins compared with cow's milk, provides biological plausibility for differences in curd formation, protein digestion kinetics, and microbial fermentation. However, these mechanistic findings do not establish clinical benefit. Controlled evidence does not currently demonstrate that GMF prevents or treats feeding-related gastrointestinal symptoms, including infant colic and functional constipation, although observational studies suggest possible symptom differences in some infants. Well-designed randomized trials in symptomatic infants are needed to evaluate gastrointestinal outcomes, microbiota development, immune effects, and the potential value of emerging formula innovations. Future GMF development may combine the goat milk matrix with recombinant human milk proteins or microbiome-targeted ingredients to complement components that are absent, present at low concentrations, or altered during processing; however, their application and clinical benefits in GMF remain to be established.