|
|
Feeding Baby Nature and Nurtureby Dori Stehlin |
CreditsSourceFDA ConsumerContentsIn the BeginnningBreast Milk is Best Breast-Feeding Success Second Best Homemade Isn't Best Formula Choices Vitamin Supplements Solid Evidence ForumsHealth, Safety, Nutrition and KidsRelated ArticlesGuidelines for a Healthy Diet (Health Guide)Preventing Baby Bottle Tooth Decay |
In the BeginningParents of a new baby have a million things to do, but menu-planning isn't one of them. Until a baby is 4 to 6 months old, for breakfast, lunch and dinner--and, of course, the infamous middle-of-the-night feeding--the only items on the menu are either breast milk or infant formula.Back to the Table of Contents Breast Milk Is BestUsually a manufacturer won't announce that the competition's product is a better choice. But when the competition is breast milk, infant formula manufacturers concede--right on the label-that breast milk is best.Human breast milk is the ideal nourishment for human babies. Its protein content is particularly suited to a baby's metabolism, and the fat content is more easily absorbed and digested than the fats in cow's milk. Breast milk also may protect the infant against certain diseases, infections and allergies. A mother's milk contains cells from her immune system and antibodies against diseases to which she has been exposed. Antibodies she develops after the baby is born are also passed to the baby through the breast milk. For example, if Mom catches the flu, she develops antibodies to that strain of flu virus. Richard Schanler, M.D., associate professor of pediatrics at Baylor College of Medicine, Houston, explains, "The baby will get some protection. [The baby] might not get the flu at all, or the case may be milder... than if he or she wasn't breast-fed to begin with." [Graphic Omitted] However, risks of breast milk may outweigh advantages if a nursing mother takes certain medications or abuses drugs. The quality and quantity of the mother's diet may affect the quality and quantity of breast milk. (See "Good Nutrition for Breast-Feeding Mothers" in the December 1986-January 1987 FDA Consumer.) Back to the Table of Contents Breast-Feeding Success"Learn about breast-feeding before the baby is born," says Julie Stock of the La Leche League, an international breast-feeding support and educational organization. "If you know a lot beforehand, you start to build a sense of confidence. Many attempts at breast-feeding fail because of wrong information."Once the baby is born, breast-feeding as soon as possible after delivery and often is the first of three essential keys for success, says Stock. The second key is no artificial nipples--that includes pacifiers as well as bottles of water or formula--during the first few weeks. Stock explains that some babies can become very confused by the different feel and the different way of sucking needed with a bottle or pacifier, and they may not be able to switch back to the breast. Finally, it is important to make sure that the baby "latches on" to the mother's nipple correctly. "If [a mother] has those three things going for her, in general that will eliminate about 90 percent of the common problems that mothers have," says Stock. The La Leche League has local chapter meetings throughout the country where expectant and new mothers can learn about breast-feeding, nutrition, and other aspects of child care. For the number of your local chapter, call the La Leche League at 1-708-455-7730 or write to La Leche League International, 9616 Minneapolis Ave., P.O. Box 1209, Franklin Park, Ill. 6013 1-8209.
KidSource Editor's Note: Contact Info Update (9/98) Second BestThe composition of infant formula is similar to breast milk, but it isn't a perfect match. Further, the exact chemical makeup of breast milk is still unknown."We're always discovering things in human milk that are there in small quantities that hadn't been looked at before," says John C. Wallingford, Ph.D., an infant nutrition specialist with FDA's Center for Food Safety and Applied Nutrition. "But [infant formula] is increasingly close to breast milk, especially in the area of fatty acids and lipids." More than half the calories in breast milk come from fat, and the same is true for today's infant formulas. This may be alarming to many American adults watching their intake off at and cholesterol, especially when high saturated fats, such as coconut oil are used in formulas. (High saturated fats tend to increase blood cholesterol levels more than other fats or oils.) But the low-fat diet recommended for adults doesn't apply to infants. "Infants have a very high energy requirement, and they have a restricted volume of food that they can digest," says Wallingford. "The only way to get the energy density of a food up is to increase the amount of fat." Back to the Table of Contents |
|
Homemade Isn't BestHomemade formulas should not be used, says Nick Duy, assistant to the director in FDA's division of regulatory guidance. Homemade formulas based on whole cows' milk don't meet all of an infant's vitamin and mineral needs. In addition, the high protein content of cow's milk makes it difficult for an infant to digest and may put a strain on the baby's immature kidneys. Substituting evaporated milk for whole milk may make the formula easier to digest, but it is still nutritionally inadequate when compared to commercially prepared formula. Use of soy drinks as an infant formula can actually be life-threatening (see accompanying article Soy Beverages).Commercially prepared formulas are regulated by the Food and Drug Administration as a food for special dietary use. "Infant formulas are the most heavily regulated food that there is," says Wallingford. FDA regulations specify exact nutrient level requirements for infant formulas, based on recommendations by the American Academy of Pediatrics Committee on Nutrition. The following must be included in all formulas:
The safety of commercially prepared formula is also enhanced by strict quality control procedures that require manufacturers to analyze each batch of formula for required nutrients, to test representative samples for stability over the shelf life of the product, to code containers to identify the batch, and to make all records available to FDA investigators. Back to the Table of Contents Formula ChoicesThe most common sources of protein in infant formulas are either cow's milk or soybeans. "For term infants, soy formulas appear to be as nutritionally sound as milk-based formulas, and their use is unlikely to expose infants to nutritional risk," wrote pediatrician Samuel J. Foman in 1987 in the American Journal of Clinical Nutrition. Baylor's Schanler agrees, but says that there is some question about whether the minerals in soy-based formulas can be used by the infant's body as well as those from cow's milk formula.For a healthy, full-term infant, "cow's milk formula would be the first choice," Schanler says. "The only indication that I see for soy formula is for babies with lactose intolerance." Lactose, also known as milk sugar, is the main carbohydrate in milk. Infants who don't have enough of the enzyme lactase to digest the lactose may suffer from abdominal pain, diarrhea, gas, bloating, or cramps. There is no lactose in soy formula. Schanler does not think soy formula is a good choice for infants with milk allergies, however. "If there is a real history of [milk] allergy in the family, the baby might be allergic to soy, too," he says. Instead of soy, Schanler recommends special cow's milk formulas known as protein hydrolysates, which won't cause allergic reactions because the proteins are already broken down. "That way the chance of a cross reaction with the soy protein is eliminated," he explains. Both milk and soy formulas are available in powder, liquid concentrate, or ready-to-feed forms. The choice should depend on "whatever the parents find convenient and can afford," says Schanler. Whatever form is chosen, proper preparation and refrigeration are essential. Opened cans of ready-to-feed and liquid concentrate must be refrigerated and used within the time specified on the can. Once the powder is mixed with water it should also be refrigerated, if it is not used right away. The exact amounts of water recommended on the label must be used. Under-diluted formula can cause problems for the infant's organs and digestive system. Over-diluted formula will not provide adequate nutrition, and the baby may fail to thrive and grow. Warming the formula isn't necessary for proper nutrition, says William MacLean, M.D., a pediatrician at infant formula manufacturer Ross Laboratories. "There is nothing magical about having [the formula] warmed up to body temperature," he says. "But if it's cold, some babies may refuse it. It's the baby's preference." Bottles should not be heated in microwave ovens because the ovens don't heat evenly, MacLean warns. "The drop a mother tests on her wrist could be fine," he says. But, he explains, undetected "hot spots" in the formula could seriously burn the baby. The best way to warm a bottle of formula is by placing the bottle in a pot of water and heating the pot on the stove, according to Christine Watson, a nurse who specializes in maternal and newborn care at the Shady Grove Adventist Hospital in Gaithersburg, Md. "You can also run hot tap water over the bottle, but that isn't very quick," she says. Back to the Table of Contents Soy Beverages Not Complete FormulasA severely malnourished 5-month-old infant was admitted to Arkansas Children's Hospital, Little Rock, Ark., in February 1990 with symptoms including heart failure, rickets, vasculitis (blood vessel inflammation), and possible neurological damage. According to the hospital, the baby girl had been fed nothing but Soy Moo since she was 3 days old. Soy Moo is a soy beverage sold in health food stores.This kind of soy beverage, sometimes improperly called "soy milk," should not be confused with soy-based infant formulas. Unlike true infant formulas, which are nutritionally complete and appropriate for infants, soy beverages are lacking some of the nutrients infants need. Analysis of Soy Moo by the Arkansas Children's Hospital revealed deficiencies in calcium, niacin, and vitamins D, E and C. Labels on Soy Moo cartons and literature about the drink do not suggest that Soy Moo be used as an infant formula. In addition, an FDA investigation found no evidence that the infant's parents were explicitly told that Soy Moo could be used as a baby's sole nourishment. Nevertheless, Soy Moo's distributor, Health Valley Foods, Irwindale, Calif., has voluntarily stopped distribution until new labels stating "Do Not Use As Infant Formula" can be printed. FDA learned of a similar incident that occurred in April 1990 when a California couple questioned a physician about their 2-month-old daughter's failure to gain weight. The physician discovered that the baby had been exclusively fed Edensoy, another brand of soy beverage. A midwife had recommended Edensoy to the parents, according to the FDA investigator assigned to the case. In response to this incident, Edensoy's manufacturer, Eden Foods, Clinton, Mich., wrote all its retailers in the United States and Canada to remind them that Edensoy is not an infant formula. In addition, the letter said, "Please make sure that no store personnel suggest or imply that Edensoy or other soy beverages are suitable for use as infant formula." In an effort to prevent this problem with similar soy beverages, FDA asked all 68 known manufacturers, importers, and private label distributors of these products to include a warning against using the beverages as infant formula. The agency does not, however, have the regulatory authority to require this warning. --D.S. [Graphic Omitted] [Graphic Omitted] Soy drinks like the ones shown above should never be used as infant formula because they are not nutritionally complete as a sole source of food for infants. True infant formulas made with soy proteins, such as those shown below, may be used for babies who can't digest lactose, the main carbohydrate in cow's milk formulas. Back to the Table of Contents Vitamin Supplements--Yes or No?The American Academy of Pediatrics says "the normal breast-fed infant of the well-nourished mother has not been shown conclusively to need any specific vitamin and mineral supplement. Similarly, there is no evidence that supplementation is necessary for the full-term, formula-fed infant and for the properly nourished normal child."Many physicians recommend supplements, nevertheless--especially for breast-fed infants. "There is definitely some controversy here," says Wallingford. The controversy on supplements usually revolves around the following:
Solid EvidenceSometime between a baby's 4-month and 6-month birthdays solid food can be introduced. Exactly when depends on several factors.One factor involves the disappearance of the involuntary action called the extrusion reflex. Before this reflex disappears, feeding solids usually involves putting a spoonful in the mouth and scraping most of it off the baby's face as he or she spits it back out. Also, babies should be able to sit up and turn their heads away. That way, Schanler explains, they can communicate that they're not ready for the next spoonful or just not hungry anymore. Usually, the first food recommended is a single-grain, iron-fortified infant cereal. Starting with single-grain cereals makes it easier to pinpoint any allergic reactions. (For more information on introducing solids, see "Good Nutrition for the Highchair Set" in the September 1985 FDA Consumer.) The biggest concern with feeding solids too early is that the solids will replace breast milk or formula in the baby's diet. "Solids vary nutritionally depending on the food," says Schanler. "None of them is as complete as formula or breast milk. You don't want to rob [the baby] of milk." Feeding babies exclusively with breast milk or formula during the first few months is not only the best thing for the babies' health, it can also be a blessing for busy, overtired parents. Now if only the baby would sleep through the night. Back to the Table of Contents CreditsDepartment of Health and Human Services Public Health Service Food and Drug Administration Office of Public Affairs 5600 Fishers Lane Rockville, Md. 20857 Reprinted and updated from September 1990 DHHS Publication No.(FDA) 91-2236 We hope you found this reprint from FDA Consumer magazine useful and informative. FDA Consumer, the magazine of the U.S. Food and Drug Administration, provides a wealth of information on FDA-related health issues: food safety, nutrition, drugs, medical devices, cosmetics, radiation protection, vaccines, blood products, and veterinary medicine. For a sample copy of FDA Consumer and a subscription order form, write to: Food and Drug Administration, HFI-40, Rockville, Md. 20857. Note: Graphics Omitted for on-line version (as well as notes where graphics would have been) Back to top |
