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Infant formula

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An infant being fed by bottle.

Infant formula is a modern artificial substitute for human breast milk. Formulas are designed for infant consumption, and are usually based on either cow milk or soy milk. Modern scientific research has established that breastfed babies have lower rates of medical problems and hospital admissions,[citation needed] and most major medical and health organizations strongly advocate breastfeeding over the use of infant formula except in unusual circumstances.<ref name="WHO">World Health Oraganization, Executive Board (2001-11-24). "Infant and Young Child Nutrition". ', World Health Organization.</ref>

Contents

[edit] History of Formula

[edit] Early Infant Foods

Throughout history, mothers who could not (or chose not to) breastfeed their babies either employed the use of a wet nurse<ref name="Schuman">Dr. Andrew Schuman, M.D. (2003-02-01). "A concise history of infant formula (twists and turns included)" (HTML). Contemporary Pediatric. Retrieved on 2006-09-16. </ref> or, less frequently, prepared food for their baby, a process known as "dry nursing."<ref name="food-timeline">Olver, Lynne (2004). Food Timeline -- history notes: baby food. Retrieved on 2006-09-16.</ref><ref name="Schuman">-</ref> Baby food composition varied according to region and economic status.<ref name="food-timeline">-</ref>. In Europe and America during the early 19th century, the prevalence of wet nursing began to decrease, while the practice of feeding babies mixtures based on animal milk rose in popularity.<ref name="Spaulding">Spaulding, Mary, Penny Welch (1994). Nurturing Yesterday's Child: A Portrayal of the Drake Collection of Paediatric History. B C Decker Inc. ISBN 0-920474-91-8. </ref><ref name="Hale">[Sarah Josepha] (1852). The Ladies' New Book of Cookery: A Practical System for Private Families in Town and Country.. New York: H. Long & Brother, 437.</ref>
Image:Nestle-milk-poster.jpg
This trend was driven both by cultural changes as well as increased sanitation measures<ref name="IOM FNB"> Committee on the Evaluation of the Addition of Ingredients New to Infant Formula (2004). "Infant Formula: Evaluating the Safety of New Ingredients" (HTML). The National Academies Press. Retrieved on 2006-09-16.</ref>, and it continued throughout the 19th and much of the 20th century, with a notable increase after Elijah Pratt invented and patented the India-rubber nipple in 1845.<ref name="bottle museum">The history of the feeding bottle. Retrieved on 2006-09-16.</ref><ref name="Schuman">-</ref> As early as 1846, scientists and nutritionists noted an increase in medical problems and infant mortality was associated with dry nursing.<ref name="simon">Simon, Johann Franz (1846). Animal chemistry : with reference to the physiology and pathology of man. Lea and Blanchard. OCLC 5884760. </ref><ref name="Spaulding"> - </ref> In an attempt to improve the quality of manufactured baby foods, in 1867, Justus von Liebig developed the world's first commercial infant formula, Liebig's Soluble Food for Babies.<ref name="Levenstein"> Levenstein, Harvey (1988). Revolution at the Table: The Transformation of the American Diet. New York: Oxford University Press. ISBN 0-520-23439-1.</ref> The success of this product quickly gave rise to competitors such as Mellin's Inftant Food, Ridge's Food for Infants and Nestle's Milk.<ref name="levenstein2">Levenstein, Harvey (June, 1983). ""Best for Babies" or "Preventable Infanticide"? The Controversy over Artificial Feeding of Infants in America, 1880-1920". Journal of American History 70 (1): 75-94. Retrieved on 2006-09-16. </ref>

[edit] Raw Milk Formulas

As physicians became increasingly concerned about the quality of such foods, medical recommendations such as Thomas Morgan Rotch's "percentage method" (published in 1890) began to be distributed, and gained widespread popularity by 1907.<ref name="Schuman">-</ref> These complex formulas recommended that parents mix cow's milk, water, cream, and sugar or honey in specific ratios to achieve the nutritional balance believed to approximate human milk reformulated in such a way as to accommodate the believed digestive capability of the infant.<ref name="Fomon"> Fomon, Samuel J. (2001). "Infant Feeding in the 20th Century: Formula and Beikost". {{{booktitle}}}, San Diego, CA: Department of Pediatrics, College of Medicine, University of Iowa. Retrieved on 2006-09-16. </ref>

At the dawn of the 20th century in the United States, most infants were still breastfed, although many received some formula feeding as well. Home-made "percentage method" formulas were more commonly used than commercial formulas in both Europe and the United States.<ref name="friedenwald"> Friedenwald, Julius, John Ruhrah (1910). Diet in Health and Disease. New York: W.B. Saunders Co.. </ref> They were less expensive and were widely believed to be healthier. However, formula-fed babies exhibited more diet-associated medial problems, such as scurvy, rickets and bacterial infections than breastfed babies. By 1920, the incidence of scurvy and rickets in formula-fed babies had greatly decreased through the addition of orange juice and cod liver oil to home-made formulas. Bacterial infections associated with formula remained a problem more prevalent in the United States than in Europe, where milk was usually boiled prior to use in formulas.<ref name="friedenwald">-</ref>

[edit] Evaporated Milk Formulas

In the 1920's and 1930's, evaporated milk began to be widely commercially available at low prices, and several clinical studies suggested that babies fed evaporated milk formula thrive as well as breastfed babies<ref name="Schuman">-</ref><ref name="Marriott">Marriott, William McKim, Schoenthal, L. (1929). "An experimental study of the use of unsweetened evaporated milk for the preparation of infant feeding formulas". Archives of Pediatrics 46: 135-148. </ref> (these findings are not supported by modern research.) These studies, accompanied by the affordable price of evaporated milk and the availability of the home icebox initiated a tremendous rise in the use of evaporated milk formulas.<ref name="Fomon">-</ref> By the late 1930's, the use of evaporated milk formulas in the United States surpassed all commercial formulas, and by 1950 over half of all babies in the United States were reared on such formulas.<ref name="Schuman">-</ref>

[edit] Commercial Formulas

In parallel with the enormous shift (in industrialized nations) away from breastfeeding to home-made formulas, nutrition scientists continued to analyze human milk and attempt to make infant formulas that closer matched its composition.<ref name="Fomon">-</ref> Maltose and dextrins were believed nutrionally important, and in 1912, the Mead Johnson Company released a milk additive called Dextri-Maltose. This formula was made available to mothers only by physicians. In 1919, milkfats were replaced with a blend of animal and vegetable fats as part of the continued drive to closer simulate human milk.This formula was called SMA for "simulated milk adapted."<ref name="Schuman">-</ref>

In the late 1920's, Alfred Bosworth released Similac (for "similar to lactation"), and Meade Johnson release Sobee<ref name="Schuman">-</ref>. Several other formulas were released over in the next decades, but commercial formulas did not begin to seriously compete with evaporated milk formulas until the 1950's. The reformulation and concentration of Similac in 1951, and the introduction (by Meade Johnson) of Enfamil in 1959 were accompanied by marketing campaigns that provided inexpensive formula to hospitals and pediatricians.<ref name="Schuman">-</ref> By the early 1960's, commercial formulas were more commonly used than evaporated milk formulas, which all but vanished in the 1970's. By the early 1970's, over 75% of babies in the United States were fed on formulas, almost entirely commercially produced. <ref name="Fomon">-</ref>

During the 1960s, when birth rates tapered off, infant formula companies began marketing campaigns in non-industrialized countries. Unfortunately, poor sanitation led to steeply increased mortality rates among infants fed formula prepared with contaminated (drinking) water.[citation needed] Organized protests, the most famous of which was the Nestlé boycott of 1977, called for an end to unethical marketing. This boycott is ongoing, as the current coordinators maintain that Nestlé engages in marketing practices which violate the International Code of Marketing of Breast-milk Substitutes.

[edit] Resurgence of Breastfeeding

In the 1960's and 70's, a dramatic increase in breastfeeding began to occur in industrialized countries worldwide. Unlike the shift to home-made formula in the early 20th century, or the shift to commercial formula in the 1950's, this movement seems to have arisen from the general public rather than from the health profession<ref name="Fomon">-</ref>. Various sources have cited the woman's liberation movement, negative publicity against the formula industry,<ref name="Fomon">-</ref> and better antenatal education of mothers.<ref name="lewis">Lewis, PJ, C. Devenish, C. Kahn (Feb, 1980). "Controlled trial of metoclopramide in the initiation of breast feeding.". British Journal of Clinical Pharmacology 9 (2): 217-19. PMI 6986894. Retrieved on 2006-09-16. </ref> Continued research has shown that breast milk provides unique benefits to both babies and mothers, including reduced incidence of food allergies, stronger immune response, and reduced infant hospitalization.[citation needed]

Initiatives have begun to encourage a resurgence of breastfeeding mothers. As a result of the International Code of Marketing of Breast-milk Substitutes, infant formula companies are now required to preface their product information with statements that breastfeeding is the best way of feeding babies and that a substitute should only be used after consultation with health professionals. However, the vast majority of infant formula manufacturers ignore other parts of the code, including the ban on advertising, free samples, and coupons.

Infant formula remains the best substitute when breast milk is not available or is withheld, although numerous studies have shown that infant formula provides inferior nutritional value when compared to breast milk.[citation needed] Some studies show that not breastfeeding one's infant can increase the risk of infection and disease, both immediately and later in life, for infants and for their mothers.[citation needed] Infant formulas cannot come close to reproducing the bioactivity and immune protection of human breast milk.[citation needed]

[edit] Reasons for formula feeding

Feeding with infant formula may be practised for a number of reasons, including but not limited to the following examples:

[edit] Nutritional content

Besides breast milk, infant formula is the only other infant milk which the medical community considers nutritionally acceptable for infants under the age of one year. Cow's milk is not recommended because of its high protein and electrolyte (salt) content which may put a strain on an infant's immature kidneys. Evaporated milk, although perhaps easier to digest due to the processing of the protein, is still nutritionally inadequate.

Most of the world's supply of infant formula is produced in the United States. The nutrient content is regulated by the American Food and Drug Administration (FDA) based on recommendations by the American Academy of Pediatrics Committee on Nutrition. The following must be included in all formulas produced in the U.S.:

In addition, formulas not made with cow's milk must include:

[edit] Variations

Infant formula is available in powder, liquid concentrate and ready-to-feed forms, which are prepared by the caregiver or parent in small batches and fed to the infant, usually with either a baby bottle or cup. It is very important to measure powders or concentrates accurately to achieve the intended final product. It is advisable that all equipment that comes into contact with the infant formula be cleaned and sterilized before each use. Proper refrigeration is essential for any infant formula which is prepared in advance, since infant formula is especially susceptible to bacterial growth. Powdered, cow's milk-based infant formulas are not recommended for premature or sick infants, or for infants under one month of age. Powdered infant formulas are not sterile and may be contaminated with Enterobacter sakazakii, bacteria that may lead to neonatal meningitis, sepsis and necrotizing entercolitis in infants with weak or compromised immune systems.

[edit] Controversy and Science

The use of infant formula itself has come under scrutiny. Many scientists believe that infant formula exposure increases the risk of several conditions including insulin dependent diabetes mellitus[1] asthma, and eczema. It is well-established that non-breastfed infants suffer significantly more middle ear infections, respiratory, intestinal and other bacterial infections[2]. An association with lower cognitive development has also been shown in several studies[3]. The U.S. government has identified breastfeeding as an important measure of infant and maternal health. However, it is also believed that later-life conditions that are associated with formula-fed babies are the result of a multitude of factors. For instance, while it is often noted that formula-fed babies are at greater risk for obesity, it is also true that formula-fed babies who live in households in which proper nutrition and physical activity are emphasized generally fare well.

Breastfeeding experts and the American Academy of Pediatrics contend that feeding anything (even breast milk) to a child with a bottle can interfere with successful establishment of breastfeeding in the first two months. Supplementing with formula also decreases breast milk supply in proportion to the amount of substitute offered, however pumping breast milk when a substitute is offered can eliminate this drop in breast milk supply. Bottlefeeding can be less successful than breastfeeding in promoting the natural bonding process of mother and child. (See The Womanly Art of Breastfeeding below). Infant formulas, like other processed food products, are the subject of occasional recalls, usually due to bacterial or foreign object contamination. Recently, infant formula has been recalled in several countries other than the U.S. for nutrient deficiencies leading to infant illness and death. Though infant formula is available without a prescription, it is generally recommended that its use be under the supervision of a medical professional. The health professionals most knowledgeable about breastfeeding are IBCLCs: International Board Certified Lactation Consultants (see IBLCE, below).

[edit] Manufacturers

Major infant formula manufacturers include:

[edit] See also

[edit] References

<references/>

  • Benn, C. S., Wohlfahrt, J., Aaby, P., Westergaard, T., Benfeldt, E., Michaelsen, K. F., Bjorksten, B., and M. Melbye. 2004. "Breastfeeding and risk of atopic dermatitis, by parental history of allergy, during the first 18 months of life," American Journal of Epidemiology, 160(3): 217-223.
  • McCann, J. C., and B. N. Ames. 2005. "Is docosahexaenoic acid, an n-3 long-chain polyunsaturated fatty acid, required for development of normal brain function? An overview of evidence from cognitive and behavioral tests in humans and animals," American Journal of Clinical Nutrition, 82(2): 281-295.
  • Riordan, J. M. 1997. "The cost of not breastfeeding: A commentary," Journal of Human Lactation, 13(2): 93-97.
  • Sadauskaite-Kuehne, V., Ludvigsson, J., Padaiga, Z., Jasinskiene, E., and U. Samuelsson. 2004. Diabetes/Metabolism Research Reviews, 20(2): 150-157.
  • La Leche League International. The Womanly Art of Breastfeeding. Several editions 1958 to 2005 (which is ISBN 0-452-28580-1).

[edit] External links

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