Wednesday, December 13, 2006

Fifth Significant Commercial Infant Formula Danger for 2006

I believe that this FDA report is fifth significant/reported commercial infant formula danger in 2006 alone, the 3rd or 4th in the US: metal fragments in two different instances, chemicals, too much iron, no vitamin C, now too little calcium and phosporus (reported by the FDA 7 months after its discovery, if I am reading the article below correctly)...

The US goverment, through USDA/WIC is the largest single purchaser of formula in the US, and perhaps globally. One would hope that the monitoring and regulation would be more timely and more effective.

Given that the WIC breastfeeding support is supported by kick-backs, called "rebates", from the formula companies - which must be significantly overpaid for the formula by the government in order to be able to supply these "rebates" at the level of millions of dollars to each state. Isn't this situation worth some exploration?

FDA warns Nestle infant formula fails nutrition standards
By Jennifer Corbett Dooren
Last Update: 11:44 AM ET Dec 12, 2006
WASHINGTON (MarketWatch) -- The U.S. Food and Drug Administration warned Nestle S.A. (NSRGY) that a sample of its Good Start infant formula failed to meet minimum nutrition standards for calcium and phosphorus.
The Nov. 27 warning letter was posted Tuesday on the FDA's Web site.
The letter stemmed from a May inspection of a Nestle facility located in Eau Claire, Wis.
The FDA said on May 26, 2006, it collected a sample of Nestle brand Good Start Infant Formula with Iron, 13 fluid ounces, and tested it. The agency said the formula fell just short of the required FDA standards for calcium and phosphorus and also was less than the amount stated on the formula's label...The FDA said Nestle was in violation of federal regulations and was required to respond to the FDA detailing steps it has taken or will take to correct the problem. A message left with a spokeswoman for Nestle's U.S. unit in Glendale, Calif., wasn't immediately returned."

Tuesday, December 05, 2006

Reasons why formula use is associated with increased salmonella

CBS reported on a new study by T Jones et al in Peds found that there was less risk of salmonella in breastfed babies. (see news article below - bolds were added)
May I share with you my surprise that they report that "the reason is not clear" for the lowered incidence among breastfed babies? Here are just a few reasons they may wish to consider:
1. Breastfed babies are protected against bacteria, including salmonella.
2. Breastfed babies are not exposed to formula, which is factory sterile, not sterile in the sense often assumed.
3. Any formula use would increase the chance of exposure to pathogens, so what surprises me is that it is not seen as often in those who use powdered formula as opposed to concentrate. I would be curious to review sample size and other variables associated with the choice of concentrate or powder. (Perhaps it is that open concentrate is stored in the refrigerator with other foods, while powder may be stored away from other foods? or is the concentrate in a can, in which case, the can opener may be a source of contamination?)

I am looking forward to reading the complete article, as perhaps the new reported misunderstood, and perhaps these are discusse inthe article..

CBS, Dec. 4, 2006 Salmonella Risk Factors For Babies (WebMD) Salmonella infection strikes babies more than any other age group, and many of these cases may be preventable. Researchers from the CDC, FDA, and seven state health departments report that news in Pediatrics. The scientists included Timothy Jones, MD, of Tennessee's health department. The study looked at 442 infants in eight states diagnosed with salmonella infection before their first birthday. There are different types of salmonella bacteria; Jones' team focused on nontyphoidal salmonella not linked to an outbreak.
The babies' most common symptoms were diarrhea and fever. They typically recovered within a week; however, two babies died as a result of their infection. The babies' parents completed extensive questionnaires about their child's animal exposure, food, and drink in the five days before salmonella infection. For comparison, the researchers gave similar questionnaires to parents of 928 babies the same age who were not affected by the bacteria.

Key Differences
The interviews showed six key differences between babies who got salmonella infection and those who didn't:

1. Breastfed babies were less likely to get salmonella infection. The reason for that isn't clear, but Jones' team says other studies have shown similar results.
2. Exposure to reptiles upped babies' chance of infection. Reptiles can carry salmonella. The CDC recommends that homes with kids under 5 years old not include reptiles.
3. Babies who rode in a shopping cart next to meat or poultry were more likely to get infected. Putting meat and poultry in a part of the cart away from kids might help; so might better packaging, the researchers note.
4. Babies over 3 months old who traveled outside the U.S. were more likely to get infected.
5. Babies who drank concentrated liquid infant formula were more likely to get salmonella infection. The reason for that isn't clear. Concentrated formula is sterile, but tainted water, unhygienic preparation, or poor storage of opened cans might be a problem, say the researchers.
Salmonella infection wasn't linked to ready-to-drink liquid infant formula or powdered infant formula.
6. Babies older than 6 months were more likely to get salmonella infection if they attended day care with a child who had diarrhea.

More studies are needed to make recommendations about salmonella prevention in babies, write the researchers.

SOURCES: Jones, T. Pediatrics, December 2006; vol 118: pp 2380-2387. News release, American Academy of Pediatrics.

Friday, December 01, 2006

Perinatal circumstances and suicide: breastfeeding not considered

A recently published study (Riordan D et al. Perinatal circumstances and risk of offspring suicide: Birth cohort study The British Journal of Psychiatry (2006) 189: 502-507) found that a higher suicide risk as young adults was associated with having been born 1) to a mother of higher parity and younger age (<25 years), 2) with parents of non-professional occupations and 3) with low birth weight (<2500 g).

Given the literature that has shown the association of lack of breastfeeding with increased anxiety in childhood, and given that lack of breastfeeding is more prevalent in the same populations that were shown in this study to be associated with increased risk of suicide, it is a pity that this study did not history of breastfeeding as a possible variable, not in the discussion. It is very possible that breastfeeding is an important confounder in these findings, and certainly should have been discussed.