Saturday, April 02, 2011

Dr. McDougall and "the Best Baby Formula"

Differential growth patterns among healthy infants fed protein hydrolysate or cow-milk formulas by Julie A. Mennella, published in the journal Pediatrics found, “…that CMF-fed (cow milk formula-fed) infants' weight gain was accelerated, whereas PHF-fed (protein hydrolysate formula-fed) infants' weight gain was normative.”1 The authors noted that rapid rates of growth during the first year increase the risk for obesity, metabolic syndrome, and mortality from cardiovascular disease later on in life. Thus excessive weight gain for an infant is undesirable. Using breast-fed babies as the “gold standard of normal,” formula feeding has long been known to cause excessive weight gain. Growth differences were attributable to differences in gains in weight, not length. Soy-based formula was not tested.

Comment: As a practicing doctor, I find it very difficult to recommend any kind of artificial infant feeding. I can only recommend human breast milk (preferably from its original container, the breast). Bottle-feeding is known to cause an increase in the risk of sudden infant death syndrome (crib death), pneumococcal pneumonia (occurring 60 times more frequently during the first three months of life), hospitalization (occurring 10 times more frequently during the first year), reduced IQ, behavioral and speech difficulties, and an increase in ear infections. Much of the research states that feeding babies formula rather than breast milk contributes to type-1 diabetes. Furthermore, recent evidence suggests feeding PHF formula rather than cow’s milk-based formula will reduce the risk of children developing type-1 diabetes.2

Soy formulas promote estrogen-like activities due to their soy proteins. Lifetime exposure to estrogenic substances, especially during critical periods of development, has been associated with cancers and several deformities of the reproductive systems, including hypospadias in male babies.3 Research published in the February 2011 issue of the American Journal of Clinical Nutrition found negative effects of bottle-feeding on the health of young children’s arteries.4

My strong recommendation is that at the first hint of a problem with breast-feeding, mothers need to connect with a lactation consultant (like La Leche League). The health and happiness of the entire family depends on successful breast-feeding.

What about those rare circumstances when breast-feeding by the real mother is impossible? The next choice is a surrogate mother (a wet nurse). Unfortunately, this option is no longer the social norm in our society. Milk from a breast-milk bank is the next best choice. If left with the choice between various chemical concoctions called formula, protein hydrolysate formula is the most reasonable one to make.

Protein hydrolysate formulas are also known as “hypoallergenic cow’s milk-based formulas.” They are commonly recommended for infants who cannot tolerate (are allergic to) intact proteins (usually cow’s-milk proteins). In preparing these formulas, the milk proteins are broken down by enzymes and then ultra-filtrated to remove large molecules. Brands of these formulas include Similac Alimentum, Advance Ross Pediatrics EleCare, and Nutramigen Lipil. Thus, when parents and grandparents ask me what the best formula alternative to breast milk is; under duress, I recommend hypoallergenic cow’s milk-based formula.

1) Mennella JA, Ventura AK, Beauchamp GK. Differential growth patterns among healthy infants fed protein hydrolysate or cow-milk formulas. Pediatrics. 2011 Jan;127(1):110-8.

2) Knip M, Virtanen SM, Seppä K, Ilonen J, Savilahti E, Vaarala O, Reunanen A, Teramo K, Hämäläinen AM, Paronen J, Dosch HM, Hakulinen T, Akerblom HK; Finnish TRIGR Study Group. Dietary intervention in infancy and later signs of beta-cell autoimmunity. N Engl J Med. 2010 Nov 11;363(20):1900-8.

3) Bar-El DS, Reifen R. Soy as an endocrine disruptor: cause for caution? J Pediatr Endocrinol Metab. 2010 Sep;23(9):855-61.

4) Evelein AM, Geerts CC, Visseren FL, Bots ML, van der Ent CK, Grobbee DE, Uiterwaal CS. The association between breastfeeding and the cardiovascular system in early childhood. Am J Clin Nutr. 2011 Apr;93(4):712-8.


-from Dr. McDougall's March Newsletter.

4 comments:

Macon said...

"Bottle-feeding is known to cause an increase in the risk of sudden infant death syndrome (crib death), pneumococcal pneumonia (occurring 60 times more frequently during the first three months of life), hospitalization (occurring 10 times more frequently during the first year), reduced IQ, behavioral and speech difficulties, and an increase in ear infections."

As you know, we are fans of breast feeding, but these claims are quite serious and detract from his very important point. First, from a credibility standpoint, not having links to substantiate these claims makes me immediately suspicious that this is merely rhetoric. Second, "causes" SIDs? Really? Last I read, SID was still called that because there were no known causes, only suspicions and correlations. Finally, these other things seem to correlate so strongly with socio-economic levels that to state causation with no backup looks like wishful thinking to me.

I want to believe. But this doesn't seem to me to be McDougall's best work.

Paul said...

McDougall cites to authorities for many of his propositions. He does this for several of his points in the I quote that I post (as you know, because I left them in the quote).

I don't know about the SIDs issue. I don't know whether he has already given reseach citations in previous articles on SIDs that he wrote. Yet I don't think he is making this idea up from whole cloth. But the point you make is a good one, of course. McDougall's statements are not holy writ and should be the beginning of one's own careful consideration of the issue.

Macon said...

I looked at those references prior to posting. He does not link to any research regarding SIDS. And this seems like such a radical claim to me. He's saying, essentially, that children more often die in their sleep because they don't breast feed. This is so absurd on the face of it that I have a hard time taking anything below it seriously.

He does not reference anything on hospitalization, IQ, behavioral/speech &/or ear infections, either. These are the things that, like SIDS, look to correlate strongly with generally poor parenting &/or people who can't afford to do good parenting things. Let's see a study that controls for that, and the absurdity might go away to the claims.

His reference (2) is to diabetes. And that reference checks out, which is why I didn't dispute it in my first post.

But his other claims in this paragraph sound like pure quackery to me.

Which is a shame! Because the first paragraph stands on its own. He didn't have to pile on and so overstep his own ability to reference & have good science.

Paul said...

See my latest post on this issue.