Soy Baby Blues.

Can We Trust Alternatives to Milk-Based Formulas?

While most American women realize that breastfeeding is best for their baby, lifestyle choices and job realities can dictate the use of formula instead. When your baby is allergic to cow's milk formula (or you're a dairy-eschewing vegetarian), it can be a relief to find there's a widely available alternative: soy-based powders and liquids.

Soy formula, used for centuries in Asia but only since 1909 in the west, has become enormously popular, capturing 25 percent of the formula market. Soy's good reputation makes it the healthy choice, right? Unfortunately, it's not that simple. Research on thyroid and reproductive disorders, as well as rising concerns over genetically engineered (GE) soybeans, suggests soy-based infant formula could be setting up your baby for a triple whammy.

Adults who regularly eat soy may enjoy lower cholesterol, stabilized hormone balance and less risk of developing breast or prostate cancer. However, what's good for adults isn't always good for babies. Infants react differently than adults to the high levels of disease-fighting phytoestrogens in soy. "With adults, half their phytoestrogens are freed into the bloodstream to bind to estrogen receptors, which help fight breast cancer," explains Patricia Bertron, dietician director of the Physicians Committee for Responsible Medicine. "But with infants, less than five percent are available to bind to receptors," Studies by the Animal and Veterinary Sciences Group at Lincoln University in New Zealand suggest this may pose a risk to the sexual development of infants and children, although the research is inconclusive.

In 1996, Dr. Kenneth Setchell of the Children's Hospital Medical Center in Cincinnati studied five leading brands of soy-based baby milk. He found the products contain the phytoestrogen level of several contraceptive pills every day, about six to 11 times the amount that alters the menstrual cycle.

Thyroid Problems

"Infants on soy formula are two to three times more likely to develop thyroid disease than if they were drinking cow formula or breast milk," says Dr. Naomi Baumslag, clinical professor of pediatrics at Georgetown University Medical School.

In a 1991 study by Japanese researchers at the Ishizuki Thyroid Clinic, half of 17 healthy adult participants developed goiters following three months of eating 30 grams of soybeans a day. The goiters disappeared a month after the excessive soybean diet stopped. Infants fed soy-based formula take in about 16 times the levels of phytoestrogens received by subjects of the Ishizuki study.

But before you throw out your miso soup and Tofutti ice cream, remember that soy has many positive benefits--at least for adults. Eating moderate levels of natural, organic soy is a time-tested health benefit. But because the milk source makes up nearly the entire diet of infants, soy babies are at an increased risk for harm.

"Infant soy formula exposure appears to provide the highest of all phytoestrogen doses," writes Dr. Dan Sheehan of the FDA's Department of Health and Human Services. "Large carefully controlled studies in this exposed infant population are a high priority."

Ross Laboratories, which markets the most popular soy-based formulas, as well as the soy-alternative Alimentum, denies that there's a serious health issue. "Soy has been used in infant formula for generations," says Ross spokeswoman Susan Finn, a nutritionist. "We've been marketing this product for a long time with the utmost care and standards."

Bio Babies

Another concern about soy formula involves the uncertainties of genetically engineered (or transgenic) food. The Infant Formula Council (IFC) supports the Food and Drug Administration's view that GE soybeans are safe. However, the Center of Ethics and Toxics (CETOS), a nonprofit research organization, recently published research indicating a 200 to 300 percent increase in phytoestrogen levels of transgenic soybeans.

"There may be a big difference when you genetically modify plants from their original form," says CETOS' Mark Lappe. "The assumptions that the FDA and U.S. regulators have made exempting transgenic food from harm may be fallacious." The lack of long-term research on GE foods is especially disturbing, because 38 percent of last year's soybean crops were transgenic.

Even if you're certain that your soy formula was produced from organic, non-GE sources, you're left with questions about safe dosage levels. Unfortunately, no standards exist. The FDA regards supplements and baby formulas as food, not drugs, and exempts them from extensive testing protocols. "Soy is used like water here and I think that's very scary," says Baumslag. "People are getting their information from drug and food companies rather than from careful research."

Ross Laboratories' Finn admits that the company has "enormous amounts of GE ingredients in our food," but claims it has extensively studied the health implications of genetically engineered soybeans. "And the FDA has determined that our products are safe and equivalent, if not better, than traditional ingredients" she says. "It would be pretty hard to find non-GE soy formula in America."

The FDA uses breast milk as the basis for the nutritional content of infant formulas. But according to Dr. Chessa Lutter of the World Health Organization, baby formulas are missing thousands of compounds linked to increased health and mental capacity in breast-fed children. "No formula is nutritionally superior to breast milk," she says. But what can mothers do if breastfeeding is out of the question?

Unfortunately, there are not many trouble-free alternatives to soy formulas. One choice, hydrolized cow protein formula, more closely resembles breast milk than cow's milk, making it easier to digest. The protein is essentially predigested, decreasing the likelihood of an allergic reaction. But some babies are too milk-sensitive for even hydrolized formulas. For them, a non-milk, non-soy-based formula is needed, such as the hypoallergenic formula Alimentum, produced by Ross/Abbott Laboratories (which, of course, also makes soy formula). There are no U.S.-made GE-free soy formulas. Baby Milk Action lists Heinz/Farley, Sainsbury, Boots, Babynat and Cow & Gate as companies producing GE-free soy formula, but all are in the United Kingdom, where concern about GE foods is much higher.

Returning to Work

The best alternative to using soy formula is, obviously, breastfeeding, but this presents an incredible challenge to working mothers. Despite studies showing $4 billion in reduced health costs if all American women breast-fed their babies, it is a rare workplace that has daycare facilities for its workers or allows for breastfeeding breaks. A 1998 bill introduced in Congress by Representative Carolyn Maloney (D-NY) would provide a mandated daily one hour of unpaid leave for expressing breast milk, as well as tax incentives for employers who provide a "lactation-friendly" environment. Today, only Minnesota requires employers to provide both break times and a room for expressing milk.

Even without federal legal protection, you can ask your pediatrician for a "disability note" to give to your employer if your baby is allergic to milk-based formulas. If possible, this would allow you to stay home to breastfeed through the first 12 months. Pediatricians Bill and Martha Sears say a formula allergy in a baby usually qualifies for disability leave of the mother. A discrimination lawsuit is a last resort.

Other options include: pumping as much milk as possible to build up a large supply during the weeks or months before your return to work; obtaining breast milk from one of the seven large-scale "banks" in North America; and, if your breast pump doesn't produce enough supplementary breast milk, mixing pumped milk with a non-soy formula.

The bottom line appears to be this: The breast is best. As the American Academy of Pediatrics reports, "Healthy, full-term infants should be given soy formula only when medically necessary." CONTACT: Physicians Committee for Responsible Medicine, 5100 Wisconsin Avenue, Suite 404, Washington, DC 20016/[phone]); Center of Ethics and Toxics, PO Box 673, 39141 South Highway 1, Gualala, CA 95445/[phone]; World Health Organization, 525 23rd Street NW, Washington, DC 20037-2895/ [phone]; Baby Milk Action, 23 St. Andrews Street, Cambridge, England CB23AX/ [phone]; FDA Department of Health and Human Services, Jefferson, AR 72079-9502; Abbott Laboratories, 200 Abbott Park Road, Abbott Park, IL 60064-3537/[phone]. More information on the New Zealand study is available online at www.soyonlineservice.co.nz, and on breast feeding at www.breastfeeding.com.

KATHERINE KERLIN is a journalism student at the University of Missouri and an intern at E Magazine.