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Soy protein-based infant formula is rarely indicated.


Bhatia J, Greer F, American Academy of Pediatrics Committee on Nutrition. Use of soy protein-based formulas in infant feeding. Pediatrics, 2008; 121(5): 1062-8.

Although there is no conclusive evidence that soy protein-based (SPB) infant formula is harmful to infants, there are few indications for its use in place of cow milk-based formula, according to a report by the American Academy of Pediatrics (AAP). These indications include infants with galactosaemia and hereditary lactase deficiency (rare) and in situations in which a vegetarian diet is preferred.

The AAP reviewed the limited indications and contraindications of SPB formulas, and on-going concerns of potential harmful effects of the phytoestrogens/isoflavones they contain on sexual development and reproduction, neurobehavioral development, immune function and thyroid function. No conclusive evidence was found from studies of animal, adult human or infant populations that dietary soy isoflavones affect human development, reproduction or endocrine function adversely. Also, term infants with normal renal function do not seem to be at substantial risk of developing aluminum toxicity from SPB formulas. The AAP recommended that:

* For infants with documented cow milk protein allergy, extensively hydrolyzed protein formula should be considered, as 10% to 14% of them will also have a soy protein allergy

* Most previously-well infants with acute gastroenteritis can be managed after rehydration with continued use of breastmilk or standard dilutions of cow milk-based formulas--SPB formulas may be indicated when secondary lactose intolerance occurs

* SPB formula has no advantage over cow milk protein-based formula as a supplement for breastfed infants, unless the infant has one of the indications noted above

* SPB formulas are not designed for or recommended for preterm infants

* Routine use of SPB formula has no proven value in the prevention or management of infantile colic or fussiness

* Infants with cow milk protein-induced enteropathy or enterocolitis are frequently as sensitive to soy protein and should not be given soy protein-based formula. They should be provided formula derived from hydrolyzed protein or synthetic amino acids

* The routine use of SPB formula has no proven value in the prevention of atopic disease in healthy or high-risk infants.
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Title Annotation:CLINICAL PAPERS
Publication:Community Practitioner
Geographic Code:1USA
Date:Jun 1, 2008
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