Why we should not feed animal milk to babies
Wednesday, June 22, 2022
I am sure many of you have heard about the recent baby formula shortage in the country. This news got me thinking about the varying nutritional needs at different stages of our lives. Infant nutrition is particularly critical for healthy physical and cognitive development. Indeed, U.S. Department of Agriculture’s (USDA) Scientific Report of the 2020 Dietary Guidelines Advisory Committee notes that “nutritional exposures during the first 1,000 days of life not only contribute to long-term health, but also help shape taste preferences and food choices.”
United Nations Children's Fund, formally United Nations International Children's Emergency Fund (UNICEF), is an agency of the United Nations responsible for providing humanitarian and developmental aid to children worldwide. UNICEF’s “the Global Breastfeeding Collective” initiative supports a program known as the Global Breastfeeding Scorecard which strongly advocates for breastfeeding and documents progress on the promotion, protection and support of breastfeeding. The latter program promotes breastfeeding as “one of the most effective ways to ensure child health and survival” and estimates that inadequate breastfeeding is responsible for 16% of child deaths every year. It is expected that breastfed children perform better on intelligence tests and are less likely to be overweight or obese during later stages of their life. Breastfeeding is also good for women. Women who breastfeed are expected to have a reduced risk of cancer and type II diabetes. The American Academy of Pediatrics advises that infants are exclusively breastfed for about the first six months and continued breastfeeding combined with complementary foods for at least one year.
Mothers who cannot or do not want to breastfeed, resort to baby/infant formula to feed their babies. According to the American Academy of Pediatrics (AAP), children under 1 year old should not be fed cow's milk because cow's milk does not provide sufficient amounts of Vitamin E, iron and essential fatty acids that human body cannot produce. Furthermore, infant digestive system cannot handle the high protein, sodium and potassium amounts present in cow’s milk. Also, the types of protein and fat present in cow’s milk are very hard to digest for babies.
Commercial infant formula is specifically formulated to meet the nutritional needs of infants. The Federal Food, Drug, and Cosmetic Act defines infant formula as “a food which purports to be or is represented for special dietary use solely as a food for infants by reason of its simulation of human milk or its suitability as a complete or partial substitute for human milk.” The Infant Formula Act enacted in 1980 and amended in 1986 and the U.S. Food and Drug Administration (FDA) infant formula regulations requires that the ingredients used in infant formulas must be generally recognized as safe (GRAS) and meet the FDA’s food additive regulations.
The recipes for healthy full-term infants and infants with an inborn error of metabolism, low birth weight, or an unusual medical or dietary problem vary slightly. But all infant formula must contain protein, fat, linoleic acid, vitamin A, vitamin D, vitamin E, vitamin K, thiamin (vitamin B1), riboflavin (vitamin B2), vitamin B6, vitamin B12, niacin, folic acid, pantothenic acid, biotin, vitamin C (ascorbic acid), choline, inositol, calcium, phosphorus, magnesium, iron, zinc, manganese, copper, iodine, selenium, sodium, potassium, and chloride. There are minimum level requirements for all 30 nutrients and maximum levels for protein, fat, vitamin A, vitamin D, iron, iodine, selenium, sodium, potassium and chloride. Considering that a wide range of different types of infant formula is available in the market today, selection of one can be daunting for parents. FDA recommends that parents should consult with their infant's health care provider about their questions while selecting a formula.
Some of the ongoing research in this field involve reduction of the allergenicity of cow’s milk and soy protein and addition of docosahexaenoic acid (DHA) for improved cognitive development and visual acuity. The ultimate goal of the ongoing research is to develop products that are similar to human milk. Breast milk contains carbohydrates such as lactose and oligosaccharides, casein and whey proteins; fats (cholesterol, linoleic acid, DHA) and carnitine, which is a compound important for fat metabolism; and lipase enzymes that aid fat digestion. Some of the human milk fat components such as milk fat globule membrane (MFGM) may protect cells, modulate cell signaling and have anticancer and antimicrobial properties. Vegetable oils used in infant formula do not contain MFGM. Hence, scientists believe that addition of a byproduct generated during butter production, bovine MFGM, which is similar to human MFGM, to infant formula may be beneficial and support brain and cognitive development. A better understanding of human milk biology, infant physiology, and large meta and controlled clinical research studies will certainly help with the future improved infant formula development efforts.
I think it is important for parents to remember that the recent shortage stemmed from reported illnesses among infants consuming powdered infant formula produced by a company. Although FDA does not approve infant formulas prior to marketing, all formulas sold in the United States must meet federal nutrient requirements and infant formula manufacturers must notify the FDA prior to marketing a new formula. FDA’s Coordinated Outbreak Response and Evaluation (CORE) Network, the Centers for Disease Control and Prevention (CDC) and state and local partners investigate consumer complaints and/or reports related to foods including infant formula to ensure safety of the products for consumption. Although, the infant shortage is a serious problem, I believe that the voluntary recall of the product in question by the manufacturer and the quick response from FDA and CDC to the safety issue are indication of presence of a robust food safety system in the country. Vigilant consumer reporting and regular inspection of food safety and quality related issues by the local and federal authorities are critical to minimize the damage caused such incidences.
Resources
https://www.globalbreastfeedingcollective.org/
https://www.dietaryguidelines.gov/2020-advisory-committee-report
https://www.fda.gov/food/people-risk-foodborne-illness/questions-answers-consumers-concerning-infant-formula https://www.similacrecall.com/us/en/home.html