Formula vs Breastfeeding: Feeding Your Baby
Most experts agree that breast milk is superior to baby formula; some go even further as to claim that formula is unsafe for infant consumption.
In fact, there is evidence that the US could reduce the annual costs of medical care by $13 billion if 90 percent of mother’s nursed exclusively for six months after giving birth and provided their babies the optimal nutrition and immune defense contained in their breast milk (17).
In the US approximately 25% of babies receive formula within 2 days of being born, around 37% are supplemented with formula before 3 months, and between 42% and 44% are fed formula by 6 months of age (18)
Here we will discuss the possible dangers of this trend but also how, if formula feeding is necessary, to feed babies the best formulas in the safest way possible.
Previously thought to be only in contaminated baby formula originating from China, the FDA found trace amounts of melamine in a US product in October of 2008 (6). It is believed the melamine was introduced into the formula via processing contamination or leached into it from can liners, as none of the ingredients used were from China (6). In addition, another brand of formula tested positive for cyanuric acid, a compound produced as melamine degrades (6).
FDA standards allow both melamine and cyanuric acid to be present in foods at minute levels, and all contaminated samples fell below the allowed amounts, but these safety standards were not meant to apply to infants or their food. Playing it safe when the contaminated samples were first found, the FDA initially stated that more data was necessary before they were willing to set infant-specific standards; however, it soon after claimed that infant formulas with levels of melamine or cyanuric acid below 2.5 ppm were not a cause for concern (the contaminated US products were below this amount) (6). Then, as quickly as the following month the FDA decided to set levels deemed safe for infants at 1 ppm, a level which all contaminated US products were still below (7).
However, no new tests or studies had taken place between early October, when the FDA said not enough information was known to say what exposure rate was infant safe, and November, when the FDA set its official 1ppm infant safety standards (7). This standard is the same as that of China and Canada, but Taiwan’s regulations require the contaminants to be 20 times lower (7).
As melamine is a chemical used to produce fertilizers, pesticides, and cleaning supplies, is not naturally present in any food sources, and has been linked to the hospitalization of thousands of Chinese babies and children, its use should be concerning. Its questionable regulation does little to diminish these concerns. Especially since the FDA states that infants are particularly sensitive to contaminants like melamine and that their underdeveloped kidneys cannot protect them against harmful chemicals (6).
High Fructose Corn Syrup and Other Sugars
Many baby formulas that are popularly sold on the market contain high concentrations of sugars. Similac Sensitive Formula for Fussiness and Gas lists corn syrup solids as its first ingredient, sugar as its second, and Enfamil Soy Toddler Formula also has corn syrup solids at the very beginning of its ingredient list (8). Gerber’s Good Start Protect Formula includes corn maltodextrin, a main component in Splenda artificial sweetener (8). Parent’s Choice Organic Infant Formula, Earth’s Best Organic Infant Formula with DHA and ARA, and Nature’s One Dairy Formula each contain one of the following ingredients: organic corn syrup solids, organic glucose syrup solids, or organic brown rice syrup (8).
High fructose corn syrup (HFCS) is believed to be the leading cause of childhood obesity and it has been scientifically determined that individuals consuming high fructose corn syrup, while ingesting the same overall calories as other individuals, gain more weight (9). In addition, it appears that the syrup bypasses control mechanisms of the body set off by normal sugars (such as those in breast milk) that biochemically signal satiation, therefore most individuals over-consume syrup-containing foods and beverages (9). Formulas with lactose (the sugar found in milk) are superior to those with fructose syrup for this reason, as lactose is recognized and properly processed by the body (9).
In addition to obesity, HFCS is linked to type 2 diabetes, heart disease, and elevated triglyceride levels (9). Artificial sweeteners are also unhealthy and promote an addiction to sweet foods and set children up for a lifetime of unhealthy dietary choices and consequent health problems (9).
Finding a formula with the least amount of sugar may prove more difficult than most realize. Although formulas list their ingredients, most do not display the actual amount of sugar per serving and are not required to do so by the FDA. Furthermore, the FDA has failed to set limits on the amounts of sugars allowed.
An independent company, Deibel Laboratories, measured sugar levels in seven brands of formula: two had between 13.5 and 12.4 grams per serving and two had added sucrose, an especially sweet sweetener, in amounts of 3.5 grams and 3.8 grams per serving, equated with dumping a teaspoon of sugar into every 5 ounces (10). Many other countries have banned excessively sweet sugars like sucrose from infant formulas due to health concerns but it is still allowed in the United States.
Dartmouth researchers tested 17 different baby formulas and found that two listing organic brown rice syrup as main ingredients (an alternative to high fructose corn syrup) had inorganic arsenic levels as high as 20 times the amount found in those that did not contain organic brown rice syrup (11). Arsenic, a carcinogen linked to several diseases and developmental problems, is believed to have been absorbed by the rice through the soil and is not linked to pesticide use. Brown rice is a top arsenic absorber compared to other varieties (11).
One brand of organic baby formula with organic brown rice syrup was found to have twice as much inorganic arsenic as the official Environmental Protection Agency allowance for drinking water (11). Drinking water levels are not set with babies or infants in mind, but are for adults, and babies are most likely much more vulnerable to the contaminant making these levels, already considered dangerously high, even more alarming (11).
The FDA had no set regulations on arsenic levels allowed in foods as of February 2012; although, it does hold the power to pull any offending foods off the sales floor in the interest of public safety (11).
Plant Fatty Acid Additives
According to the FDA supplementing formulas with synthesized DHA and ARA from algae and fungi (long-chain polyunsaturated fatty acids similar to those found in breast milk) may help infant vision and neural development (1). However, despite positive short-term results, long-term studies have not had similarly optimistic findings (1).
In response to inconsistencies the FDA concludes that only time and the accumulation of data will ultimately prove whether or not synthetic DHA and ARA are dangerous. Since both ingredients in their plant-based versions have only been used since 2002 there is simply not enough information for the FDA to officially deny them GRAS (generally recognized as safe) status (2, 5). In the meantime nearly every brand and product can expose children to these substances and label their products as healthier because of their addition, all the while without knowing their ultimate effect.
Here are some facts. The plant-based DHA and ARA oils have a different chemical structure than their human breast milk counterparts and may have undesirable effects on health as a consequence. An independent panel of scientists that reviewed the premarket tests by the Martek company, the producer of synthetic DHA and ARA, found some alarming statistics: lab rats fed the plant-based oils developed heavier spleens and livers than normal (5).
There are also documented unexpected deaths of infants fed algal and fungal DHA and ARA in formula during scientific studies; other babies developed health complications such as diarrhea, jaundice, and apnea (5). As many as ninety-eight official reports were filed with the FDA by January of 2003 on side effects from Martek’s supplemented formulas, including claims that babies required intensive care and suffered from dehydration and seizures (5).
In addition to any problems caused by structural differences, the synthesized oils used in baby formulas are extracted using the chemical hexane, which has known neurotoxic properties and is, in fact, labeled an air pollutant by the Environmental Protection Agency (4). The Occupational Health and Safety Administration considers hexane a risk to the nervous systems of manufacturer employees as well as a potentially lethal substance due to its highly explosive properties (it is a gasoline refining by-product and a Martek processing plant did cause an explosion in Winchester, Kentucky in 2003) (5).
Tests have found that some hexane residue remains in oils after they are processed (5). These are then fed to newborn infants via supplemented baby formula. Again, there is technically not enough data to determine the effects of ingesting hexane-laced oils, but given what we do know about the solvent, they are likely detrimental.
Increased Health Problems
Formula-fed babies are more likely to develop meningitis, infections of the respiratory and urinary tracts, bacteremia, diabetes type 1 and 2, diarrhea, ear infections, and necrotizing enterocolitis and to die within their first year from Sudden Infant Death Syndrome (5). Health problems linked to formula-feeding continue on into life and as adults individuals that were given formula are at a higher risk for several types of cancers, obesity, high cholesterol, and asthma (5).
In addition to providing natural resistance to allergies and infections, breastfeeding has been found to boost intelligence (15). Breast-fed babies showed superior cognitive abilities to bottle fed babies by the time they reached preschool age in direct correspondence with the length of time they were breast fed; IQ’s were 2.6 points higher if breast fed for up to six months and 3.8 points higher if fed breast milk for longer periods of time (13).
By age 6 and a half, breast fed children have an average higher IQ of 5.9 points and perform 7.5 points better in verbal skills and 2.9 points better in non-verbal intelligence than those who were not breast fed (15). By age 15 teenagers who were breast fed still performed at higher levels than others in the areas of math, sentence completion, and nonverbal ability (12).
A Mother's Health
It is believed that because breastfeeding is normal physiologically, a mother’s body is ill equipped to skip the process, resulting in various health problems (17). Mothers who choose not to breastfeed at all are at a higher risk for diabetes, breast and ovarian cancer, cardiovascular disease, and postpartum depression than mothers who do (5, 16, 17). In another study it was found that women who breastfed for less than a year were more likely to develop elevated lipid and blood pressure levels, diabetes, and cardiovascular disease than women who breast fed for a year or longer (17).
There are several reasons why mothers cannot, and even should not, breastfeed (19, 20, 21):
·Milk production difficulties
·Active tuberculosis infection (if treated, breastfeeding is safe)
·Human T-cell leukemia virus type 1 infection
·Elevated lead levels
·Illegal drug use (including marijuana, cocaine, and heroine)
·Use of a medication proven unsafe
·Radioactive compound exposure
·Breast infections (this usually only requires a temporary break from breastfeeding)
·Infants with special conditions or dietary needs requiring alternative formulas or supplemental feedings
·Work scheduling conflicts, etc.
In such instances, never give a baby cow’s milk as a substitute, as it is lacking in key nutrients needed for nourishment and growth and may even cause anemia or kidney problems (22). Some formulas are made with cow’s milk as their basis, but it is in an altered form; it has added essential nutrients and has been processed to be more easily digestible (22).
Raw, unpasteurized milk is unsafe as it may be contaminated with salmonella, E. coli, or listeria (20).
Safer Formula Feedings
When choosing a formula brand keep in mind that Nestle’s Good Start Supreme Infant Formula with iron had melamine and Enfamil LIPIL with iron had cyanuric acid when tested by the FDA in 2008 (6).
Look at ingredient listings and avoid high fructose corn syrup, sucrose, corn maltodextrin, and organic brown rice syrup (linked to arsenic) when possible. The ideal sugar should be lactose-based (found naturally in milk). Be skeptical of formulas with supplemented DHA and ARA that are supposedly superior but have yet to be scientifically proven safe.
Powdered formula is better than liquid versions. The metal cans containing liquid formula are lined with BPA-epoxy, placing their contents at a high risk for contamination (23). Furthermore, powdered formula is diluted with more water and so any BPA that it does contain will be in lower concentrations than liquid formulas which do not require much additional fluid (23).
Ideally, baby bottles should not be plastic, but glass. This is because bottles of hard plastic and the label “7” or “PC” may release the chemical BPA, exposing infants to toxins (23). Liners for bottles made of plastic can also transfer chemicals into milk or formula and should be avoided (23).
Thoroughly sterilize new bottles and nipples before first use and wash them between each use thereafter with hot and soapy water (22). Silicone nipples are best, as babies can have latex rubber allergies (23). Latex may also contain carcinogenic substances (23).
Boil the water used in formula preparation for 60 seconds after running it through a carbon filtration system (a reverse osmosis system if it contains fluoride) unless it is sterilized, fluoride-free bottled water (22, 23). Always make sure heated water has cooled to a warm temperature before incorporating it into the formula.
Do not heat formula in a microwave, as heat is not always evenly distributed and microwaved chemicals are more likely to be released from plastic bottles (23). A superior heating method is to place bottles in hot (not boiling) water and let them warm gradually (23).
Leftover formula needs to be thrown out, not recycled; if contamination occurred during processing microorganisms will grow over time, especially when stored in less than ideal conditions (22).