Skip to main content
Top
Published in: International Breastfeeding Journal 1/2014

Open Access 01-01-2014 | Commentary

Regulating fatty acids in infant formula: critical assessment of U.S. policies and practices

Author: George Kent

Published in: International Breastfeeding Journal | Issue 1/2014

Login to get access

Abstract

Background

Fatty acids in breast-milk such as docosahexaenoic acid and arachidonic acid, commonly known as DHA and ARA, contribute to the healthy development of children in various ways. However, the manufactured versions that are added to infant formula might not have the same health benefits as those in breast-milk. There is evidence that the manufactured additives might cause harm to infants’ health, and they might lead to unwarranted increases in the cost of infant formula.
The addition of such fatty acids to infant formula needs to be regulated. In the U.S., the Food and Drug Administration has primary responsibility for regulating the composition of infant formula. The central purpose of this study is to assess the FDA’s efforts with regard to the regulation of fatty acids in infant formula.

Methods

This study is based on critical analysis of policies and practices described in publicly available documents of the FDA, the manufacturers of fatty acids, and other relevant organizations. The broad framework for this work was set out by the author in his book on Regulating Infant Formula, published in 2011.

Results

The FDA does not assess the safety or the health impacts of fatty acid additives to infant formula before they are marketed, and there is no systematic assessment after marketing is underway. Rather than making its own independent assessments, the FDA accepts the manufacturers’ claims regarding their products’ safety and effectiveness.

Conclusions

The FDA is not adequately regulating the use of fatty acid additives to infant formula. This results in exposure of infants to potential risks. Adverse reactions are already on record. Also, the additives have led to increasing costs of infant formula despite the lack of proven benefits to normal, full term infants. There is a need for more effective regulation of DHA and ARA additives to infant formula.
Literature
5.
go back to reference Codex Alimentarius Commission: Standard for Infant Formula and Formulas for Special Medical Purposes Intended for Infants. CODEX STAN 72–1981. (Formerly CAC/RS 72–1972. Adopted as a world-wide Standard 1981. Amended 1983, 1985, 1987. Revision 2007. Amended 2011). [http://www.codexalimentarius.org] Codex Alimentarius Commission: Standard for Infant Formula and Formulas for Special Medical Purposes Intended for Infants. CODEX STAN 72–1981. (Formerly CAC/RS 72–1972. Adopted as a world-wide Standard 1981. Amended 1983, 1985, 1987. Revision 2007. Amended 2011). [http://​www.​codexalimentariu​s.​org]
7.
go back to reference Gibson RA, Barclay D, Marshall H, Moulin J, Maire J-C, Makrides M: Safety of supplementing infant formula with long-chain polyunsaturated fatty acids and Bifidobacterium lactis in term infants: a randomized controlled trial. Br J Nutr. 2009, 101 (11): 1706-1713. 10.1017/S0007114508084080.CrossRefPubMed Gibson RA, Barclay D, Marshall H, Moulin J, Maire J-C, Makrides M: Safety of supplementing infant formula with long-chain polyunsaturated fatty acids and Bifidobacterium lactis in term infants: a randomized controlled trial. Br J Nutr. 2009, 101 (11): 1706-1713. 10.1017/S0007114508084080.CrossRefPubMed
8.
go back to reference Kent G: Regulating infant formula. Amarillo, Texas: Hale Publishing; 2011. Kent G: Regulating infant formula. Amarillo, Texas: Hale Publishing; 2011.
11.
go back to reference Living Wholesome: Horizon organic gets flogged for bending its definition of ‘organic’. Living Wholesome 2011. Living Wholesome: Horizon organic gets flogged for bending its definition of ‘organic’. Living Wholesome 2011.
13.
go back to reference U.S. Department of Health and Human Services: Letter to Deputy Administrator of National Organic Program, USDA. Washington, DC: USDHHS: Food and Drug Administration; 2011. U.S. Department of Health and Human Services: Letter to Deputy Administrator of National Organic Program, USDA. Washington, DC: USDHHS: Food and Drug Administration; 2011.
16.
go back to reference Qawasmi A, Landeros-Weisenberger A, Leckman JF, Bloch MH: Meta-analysis of long-chain polyunsaturated fatty acid supplementation of formula and infant cognition. Pediatrics. 2012, 129 (6). Qawasmi A, Landeros-Weisenberger A, Leckman JF, Bloch MH: Meta-analysis of long-chain polyunsaturated fatty acid supplementation of formula and infant cognition. Pediatrics. 2012, 129 (6).
17.
go back to reference Simmer K, Schulzke S, Patole S: Longchain polyunsaturated fatty acid supplementation in preterm infants. Cochrane Database Syst Rev 2008. Simmer K, Schulzke S, Patole S: Longchain polyunsaturated fatty acid supplementation in preterm infants. Cochrane Database Syst Rev 2008.
18.
go back to reference Simmer K, Patole S, Rao SC: Longchain polyunsaturated fatty acid supplementation in infants born at term. Cochrane Database Syst Rev 2008. Simmer K, Patole S, Rao SC: Longchain polyunsaturated fatty acid supplementation in infants born at term. Cochrane Database Syst Rev 2008.
24.
go back to reference Colombo J, Carlson SE: Is the measure the message: the BSID and nutritional interventions. Pediatrics. 2012, 129 (6): 1166-1167. 10.1542/peds.2012-0934.PubMedCentralCrossRefPubMed Colombo J, Carlson SE: Is the measure the message: the BSID and nutritional interventions. Pediatrics. 2012, 129 (6): 1166-1167. 10.1542/peds.2012-0934.PubMedCentralCrossRefPubMed
26.
go back to reference Kent G: The nutritional adequacy of infant formula. Clin Lactation. 2012, 3 (1): 21-25.CrossRef Kent G: The nutritional adequacy of infant formula. Clin Lactation. 2012, 3 (1): 21-25.CrossRef
28.
go back to reference Rowlands JC, Hoadley J: FDA perspective on health claims for food labels. Toxicology. 2006, 221: 35-43. 10.1016/j.tox.2005.10.023.CrossRefPubMed Rowlands JC, Hoadley J: FDA perspective on health claims for food labels. Toxicology. 2006, 221: 35-43. 10.1016/j.tox.2005.10.023.CrossRefPubMed
29.
go back to reference Schneeman B: FDA’s review of scientific evidence for health claims. J Nutr. 2007, 137 (2): 493-494.PubMed Schneeman B: FDA’s review of scientific evidence for health claims. J Nutr. 2007, 137 (2): 493-494.PubMed
30.
go back to reference Reuterswärd AL: The new EC regulation on nutrition and health claims on foods. Scand J Food Nutr. 2007, 51 (3): 100-106. 10.1080/17482970701685625.CrossRef Reuterswärd AL: The new EC regulation on nutrition and health claims on foods. Scand J Food Nutr. 2007, 51 (3): 100-106. 10.1080/17482970701685625.CrossRef
32.
go back to reference Chung CS, Yamini S, Trumbo PR: FDA’s health claim review: whey-protein partially hydrolyzed infant formula and atopic dermatitis. Pediatrics. 2012, 130: 2.CrossRef Chung CS, Yamini S, Trumbo PR: FDA’s health claim review: whey-protein partially hydrolyzed infant formula and atopic dermatitis. Pediatrics. 2012, 130: 2.CrossRef
44.
go back to reference Neuberger Z: WIC food package should be based on science: foods with new functional ingredients should be provided only if they deliver health or nutritional benefits. Washington, DC: Center on Budget and Policy Priorities; 2010. [http://www.cbpp.org/files/6-4-10fa.pdf] Neuberger Z: WIC food package should be based on science: foods with new functional ingredients should be provided only if they deliver health or nutritional benefits. Washington, DC: Center on Budget and Policy Priorities; 2010. [http://​www.​cbpp.​org/​files/​6-4-10fa.​pdf]
46.
go back to reference Minchin MK: Milk Matters: Immune Disorder and Infant Feeding. Alma Publications, in press 2014. Minchin MK: Milk Matters: Immune Disorder and Infant Feeding. Alma Publications, in press 2014.
50.
go back to reference Collier R: Squabble over risks of probiotics infant formula. Can Med Assoc J. 2011, 181 (3–4): E46-E47. Collier R: Squabble over risks of probiotics infant formula. Can Med Assoc J. 2011, 181 (3–4): E46-E47.
51.
go back to reference Mugambi M, Musekiwa A, Lombard M, Young T, Blaauw R: Probiotics, prebiotics infant formula use in preterm or low birth weight infants: a systematic review. Nutr J. 2012, 11 (58). Mugambi M, Musekiwa A, Lombard M, Young T, Blaauw R: Probiotics, prebiotics infant formula use in preterm or low birth weight infants: a systematic review. Nutr J. 2012, 11 (58).
53.
go back to reference Shafai T: Routine supplement of prebiotics and probiotics to newborn infants are not recommended [Letter]. Pediatrics. 2009, 123: e543-e544. 10.1542/peds.2008-3557.CrossRefPubMed Shafai T: Routine supplement of prebiotics and probiotics to newborn infants are not recommended [Letter]. Pediatrics. 2009, 123: e543-e544. 10.1542/peds.2008-3557.CrossRefPubMed
54.
go back to reference Yu VY: Scientific rationale and benefits of nucleotide supplementation of infant formula. J Paediatr Child Health. 2002, 38 (6): 543-549. 10.1046/j.1440-1754.2002.00056.x.CrossRefPubMed Yu VY: Scientific rationale and benefits of nucleotide supplementation of infant formula. J Paediatr Child Health. 2002, 38 (6): 543-549. 10.1046/j.1440-1754.2002.00056.x.CrossRefPubMed
Metadata
Title
Regulating fatty acids in infant formula: critical assessment of U.S. policies and practices
Author
George Kent
Publication date
01-01-2014
Publisher
BioMed Central
Published in
International Breastfeeding Journal / Issue 1/2014
Electronic ISSN: 1746-4358
DOI
https://doi.org/10.1186/1746-4358-9-2

Other articles of this Issue 1/2014

International Breastfeeding Journal 1/2014 Go to the issue