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LETTER: Information about baby formula 'misleading'

Public health nutritionist responds to column about breast milk alternatives, saying it 'could be harmful'
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BradfordToday welcomes letters to the editor at [email protected]. Please include your daytime phone number and address (for verification of authorship, not publication). The following letter is in response to a column about breast milk alternatives, published Dec. 12.
The Simcoe Muskoka District Health Unit thanks the writer for her promotion of breastfeeding and breastmilk. However, we would like to correct some information provided by the writer, who suggested that homemade infant formula could be used as an alternative to breastfeeding.

This information is misleading and could be harmful.

Breastfeeding is the normal and unequalled method of feeding infants and young children, and is supported by Health Canada, the Canadian Pediatric Society, Dietitians of Canada, the Breastfeeding Committee of Canada, and the World Health Organization. Canadian infant feeding guidelines recommend exclusive breastfeeding for the first six months of life, with the introduction of solid foods to baby at around six months of age with continued breastfeeding to two years of age and beyond.

Breastfeeding can go on for as long as mother and baby wish to continue.

For babies who are not being breastfed or receiving breast milk, only commercial infant formula is recommended by Health Canada as a breast milk substitute. In 2014, Health Canada and the Canadian Paediatric Society issued a warning about the use of homemade infant formulas stating that these formulas can cause severe malnutrition and potentially fatal illnesses.

The recipe provided in the column poses many significant nutritional concerns due to it containing mostly water and likely low in both protein and overall calories, factors that have been associated with poor growth in infants. Rice and coconut beverages are both very low in protein, about one gram of protein per cup. Canada’s Food and Drug Regulations state that manufacturers of rice and coconut beverages cannot label their product as ‘milk’ because the protein content is too low. By comparison, cow’s milk typically contains eight grams of protein per cup. Collagen hydrolysate is likely added to this recipe as a protein source but the amount of collagen hydrolysate in this recipe exceeds the daily maximum of 10 grams (one teaspoon equals 15 grams) and can lead to gastrointestinal upset.

The amounts of cod liver oil and liver supplements added to this recipe exceed the level of vitamin A considered safe for infants. If these ingredients are added to the formula as instructed, this recipe contributes approximately 750 micrograms RAE (350 micrograms RAE from .25-teaspoon cod liver oil and 400 RAE from five grams of liver supplements), well in excess of 600 microgram, the amount that increases the risk of toxic effects.

Infants who consume this or other homemade formulas for any length of time may not grow and develop adequately and may experience negative health effects.

All infant formulas available for sale in Canada are required to meet growth and development criteria before they can be approved for sale in Canada. Canada’s Food and Drug Regulations require a specific ratio of carbohydrates, proteins and fats, and specific minimum and maximum levels of vitamins and minerals. Infant formulas that align with the regulations have undergone testing and been proven to effectively support infant growth and development.

Babies who are not receiving any breast milk should be given commercial baby formulas to at least nine to 12 months of age as the main milk source. While most commercial infant formulas available in Canada are cow milk based, soy-based formulas are also available and have met the nutrient criteria outlined in Canada’s Food and Drug Regulations. The evidence for negative health effects related to the consumption of soy formula remain unproven.

Current Canadian infant feeding recommendations state that healthy, full-term babies can start consuming full-fat cow’s milk (3.25 per cent milk fat) or full-fat goat’s milk between nine and 12 months of age. There is no requirement for breastfed infants to transition to whole cow milk at nine to 12 months. Any milk offered to an infant should be pasteurized.

Parents or caregivers who have any questions about breastfeeding, infant formula, the introduction to solids, what type of milk to feed babies or young children are encouraged to talk to their primary care provider or call or email Simcoe Muskoka District Health Unit’s Health Connection at 705-721-7520 or 1-877-721-7520 to talk with a public health nurse, or call Health Connect Ontario at 811 to talk to a registered dietitian and/or lactation consultant.

Becky Blair
Public health nutritionist
Simcoe Muskoka District Health Unit