Baby formula: missing key fats?Baby Formula: Missing Key Fats?
Infant formula Infant formula is an artificial substitute for human breast milk. Formulas are designed for infant consumption, and are usually based on either cow milk or soy milk. Use of infant formula has been decreasing in industrial countries for over forty years as a result of antenatal isn't just any old food. The nation learned that lesson the hard way in the late 1970s, and it may be about to learn it again. In 1978, a California-based company named Syntex accidentally left chloride out of its two formulas, Neo-Mull Soy and Cho-Free. As a result, hundreds of babies suffered from poor muscle control, delayed speech development, and slowed growth.
But the damage may not have ended there, says Carol Laskin, one of the parents who started an organization to represent the victims.
Now that the children are second-and third-graders, preliminary studies suggest that they are more likely than their peers to have learning disabilities and speech and language disorders. (1) "At each step where you need to do more abstract thinking, it seems that more kids shake out," says Laskins.
In 1980, spurred by the chloride disaster, Congress passed the Infant Formula Act, which mandates the Food and Drug Administration to see that formula contains all the nutrients that babies need.
But a growing body of evidence suggests that all of the formulas now on the market are missing an ingredient that babies may require for optimal health. And it may take years before the FDA FDA
Food and Drug Administration
n.pr See Food and Drug Administration.
n.pr the abbreviation for the Food and Drug Administration. requires (or even allows) the industry to add it to their products.
The parents of bottle-fed babies shouldn't panic. this isn't another Neo-Mull Soy. But even if the effects of this new deficiency are more subtle, and possibly reversible, they demand immediate attention...simply because it's formula.
"Infant formula has to be as good as possible because it is the sole source of norishment for a very fragile individual during peak brain development," says Laskin. "If your child weighs five pounds less, that's okay. If the brain doesn't develop properly, that isn't okay. The consequences last forever."
The Missing Hex hex, witchcraft or one who works it. The word is of German origin, and beliefs connected with it spread from Europe to the United States, especially to the Pennsylvania Dutch country. . The ingredient now missing from infant formula is docosahexaenoic (doh-KOH-suh-HEX-uh-ee-NOH-ick) acid, or DHA DHA docosahexaenoic acid.
n.pr See acid, docosahexaenoic. , which is one of the two major omega-3 fatty acids This is a list of omega-3 fatty acids.
Common name Lipid name Chemical name
α-Linolenic acid (ALA) 18:3 (n-3) octadeca-9,12,15-trienoic acid
Stearidonic acid 18:4 (n-3) octadeca-6,9,12,15-tetraenoic acid found in the fish oils that may help prevent heart disease.
But DHA isn't just for hearts. It is one of the most prevalent fats in the human brain and the retina of the eye.
Nature seems to want babies to accumulate DHA. During the last half of pregnancy, the fetus holds on to more DHA than to other fats that it get s from its mother's bloodstream.
Human breast milk contains DHA. In fact, the milk from mothers of premature babies (who get less DHA before birth) has even more DHA than the milk from mothers of full-term babies.
Formula has no DHA.
"Our results and preliminary studies reported by others support an essential role for omega-3 fatty acids in normal eye and brain development," says Ricardo Uauy, of the University of Texas Southwestern Medical Center in Dallas.
While Uauy believes the evidences is strong enough to require DHA in infant formulas, other researchers do not. But they do agree on one point: formulas should at least contain linolenic acid linolenic acid /lin·o·len·ic ac·id/ (lin?o-len´ik) a polyunsaturated 18-carbon essential fatty acid occurring in some fish oils and many seed-derived oils. , an omega-3 fatty acid omega-3 fatty acid
Any of various polyunsaturated fatty acids that are found primarily in fish, fish oils, vegetable oils, and leafy green vegetables, and that seem to reduce the risk of stroke and heart attack. that babies can convert, at least to some extent, to DHA. And several powdered formulas--Isomil, Similac, Gerber, amd Carnation--have virtually no linolenic acid.
"I'm concerned about powdered formulas without linolenic acid," says Susan Carlson, of the University of Tennessee The University of Tennessee (UT), sometimes called the University of Tennessee at Knoxville (UT Knoxville or UTK), is the flagship institution of the statewide land-grant University of Tennessee public university system in the American state of Tennessee. in Memphis. "I don't think they should be sold."
Babies Are Our Business. Even though more mothers breast-feed breast-feed
To feed a baby mother's milk from the breast; suckle. now than in the 1950s and 1960s, the formula business is booming. In 1989, an estimated 60 to 70 percent of two-months-olds were bottle-fed. By four months of age, 75 to 80 percent are on the bottle. The numbers are even greater among low-income babies.
Infant formula comes either as a liquid or as a powder that has to be reconstituted with water. Liquid formulas are usually made with soybean oil Soy´bean oil
n. 1. an oil obtained from the soybean (Glycine max), rich in protein, fats, sterols, and phospholipids, used as a food and in paints and varnishes and in various industrial applications; - , a good source of linolenic acid. (That's true of all brands, whether they contain milk or soy protein Soy protein is generally regarded as the storage protein held in discrete particles called protein bodies which are estimated to contain at least 60–70% of the total soybean protein. .)
Unfortunately, powdered Isomil, Similac, and Gerber formulas are made with coconut and corn oils, which contain little linelenic acid. What's more, corn oil is loaded with linoleic acid linoleic acid /lin·o·le·ic ac·id/ (lin?o-le´ik) a polyunsaturated fatty acid, occurring as a major constituent of many vegetable oils; it is used in the biosynthesis of prostaglandins and cell membranes. , which can impede an infant's ability to convert linolenic acid to DHA.
Abbott Lab's Isomil and Similac powdered formulas have no linolenic acid "because of the technical difficulty of adding it without rancidity rancidity
the state of being rancid. ," says company spokesperson Jed Weiner.
But Mead Johnson has recently found a way to add linolenic to its powdered Enfamil and Pro-Sobee, says spokesperson Holly D'Amour. "Our stability studies show no difference between Enfamil and Pro-Sobee with or without soy oil." Gerber's formula (which is made by Mead Johnson) still has no linolenic acid, but the company ways it expects to add it by the end of 1990.
Several small brands--Wyeth's S.M.A. and Nursoy and Carnation's Good Start--are not made with linoleic-rich corn oil, so they need less linolenic acid. S.M.A. and Nursoy probably have enough linolenic; Good Start probably should have more.
At Least Linolenic. Some of the strongest evidence that babies need linolenic acid was published years ago by Martha Neuringer and William Connor, of the Oregon Health Sciences Center in Portland.
"Monkeys that are deficient in all omega-3 fatty acids perform worse in terms of vision and behavior than monkeys fed formula that contains soybean oil," says Connor.
He and Neuringer found that 12-week-old monkeys fed a linolenic-acid-rich formula averaged about 20/45 vision, but monkeys fed no linolenic acid and extremely high levels of linolenic acid had only 20/90 vision. What's more, at the age of 21 months, the deficient monkeys' eyes took longer to recover from a bright flash of light. (2)
Now the question is whether babies can convert linolenic acid to DHA efficiently enough to meet their needs. In other words Adv. 1. in other words - otherwise stated; "in other words, we are broke"
put differently , is there enough evidence to require not just linolenic acid, but DHA, in formulas? So far, the experts disagree.
Do Babies Need DHA? Levels of DHA in red blood cells Red blood cells
Cells that carry hemoglobin (the molecule that transports oxygen) and help remove wastes from tissues throughout the body.
Mentioned in: Bone Marrow Transplantation
red blood cells drop precipitously during the first months of life in babies fed linolenic-rich formula, but not in those fed breast milk or DHA-supplemented formula. (3), (4)
Still, low blood levels don't prove that babies require DHA. Scientists need evidence that DHA deficiency causes harm. And so far, they differ over whether that evidence is in.
In new, unpublished studies, researchers Uauy and Carlson have independently found that premature babies fed DHA-deficient, linolenic-containing formula have poorer vision six months after the date they should have been born than preemies fed DHA-containing formulas that companies have made available for experiments. (5), (6)
But questions remain:
* Do botle-fed babies catch up? "[DHA-containing fish] oil improves visual acuity visual acuity
Sharpness of vision, especially as tested with a Snellen chart. Normal visual acuity based on the Snellen chart is 20/20.
The ability to distinguish details and shapes of objects. and retinograms at four months, but by 9 to 12 months, there's no difference at all," says Carlson, who followed her infants longer than Uauy followed his.
Still, she adds, "these infants are probably deficient in [DHA] in the first six months. We could do better by them."
* Does DHA slow weight-gain? In Carlson's study, the preemies fed DHA-containing formula gained weight slightly more slowly. But Uauy calls her results "equivocal" for several reasons. One is that the DHA-supplemented babies didn't get arachidonic acid arachidonic acid /arach·i·don·ic acid/ (ah-rak?i-don´ik) a polyunsaturated 20-carbon essential fatty acid occurring in animal fats and formed by biosynthesis from linoleic acid; it is a precursor to leukotrienes, prostaglandins, and , another fat found in human milk.
It's also possible that something in the fish oil that was added to Carlson's formula--other than the DHA--slowed tha babies' growth. But that doesn'r deter Uauy, or even the more cautious Carlson. "I think DHA is important for development," she says. "We just haven't yet figured out the best way to put it into formula."
* Do only premature babies need DHA? So far, well-designed studies have only been done on preemies, who are at greater risk for omeg-3 deficiency. But Uauy has preliminary evidence that full-term babies also better if they're fed human milk rather than formula.
Babies Can't Wait. Despite its mandate to ensure that infant formula is as complete as possible, the FDA isn't moving fast enough on omega-3s.
"We're going to request that the American Academy of Pediatrics The American Academy of Pediatrics ("AAP") is an organization of pediatricians, physicians trained to deal with the medical care of infants, children, and adolescents. Its motto is: "Dedicated to the Health of All Children. study the issue for us," says the FDA's John Wallingford. If the Academy decides that preemies do need linolenic acid or DHA, the FDA will then ask it about full-term babies.
But that could take years, especially if the Academy recommends adding DHA. Unlike soybean oil, DHA is not already on the Generally Recognized As Safe Generally Recognized as Safe (GRAS) is a United States of America Food and Drug Administration (FDA) designation that a chemical or substance added to food is considered safe by experts, and so is exempted from the usual Federal Food, Drug, and Cosmetic Act (FFDCA) food (or GRAS GRAS - A public domain graph-oriented database system for software engineering applications from RWTH Aachen. ) list.
(When manufacturers asked the FDA for permission to add a non-GRAS nutrient--the amino acid amino acid (əmē`nō), any one of a class of simple organic compounds containing carbon, hydrogen, oxygen, nitrogen, and in certain cases sulfur. These compounds are the building blocks of proteins. taurine-to formula, the FDA took three years to act, even though human milk contains taurine taurine /tau·rine/ (taw´ren) an oxidized sulfur-containing amine occurring conjugated in the bile, usually as cholyltaurine or chenodeoxycholyltaurine; it may also be a central nervous system neurotransmitter or neuromodulator. . In the end, the agency decided not to officially respond, effectively approving the new ingredient.)
Meanwhile, tens of thousands of parents are buying powdered formulas that have no linolenic acid, when experts agree formulas should have DHA's precursor, if not DHA itself.
Oregon's William Connor believes that what babies eat during their first six months is critical, and that damage caused then can't be repaired later. How many infants will pass through those first six months before the FDA acts?
"The brain gets bigger right after birth," says Connor. "By the age of two, it's close to adult size. Man's future depends on what his food is as an infant."
(1) J. Pediatr. 115: 97, 1989.
(2) Proc. Nat. Acad. Sci. 83: 4021, 1986.
(3) Am. J. Clin. Nutr. 36: 106, 1982.
(4) Pediatr. Res. 21: 507, 1987.
(5) Pediatr. Res. 27: 292A, 1990.
(6) Pediatr. Res. 25: 285A, 1989.