You may all remember that I am trying to get soy-based formula removed from
our hospital. Below is a copy of the final draft that was sent to our
department head for distribution. Many thanks to Arly Helm and Joy who helped
with mountains of references
I will keep you posted on what happens
Marie
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Subject: Soy-Based Infant Formulas

Recent reports regarding soy-based infant formula raise renewed concerns
about its continued use in infants.

* A March 1996 report by the AAP Committee on Nutrition cites soy-based
formula as a potential source for aluminum toxicity (especially in the
preterm).  Soy-based formulas contain aluminum as a contaminant, and may
contain as much as 500-2400 mg/l.  [n1]
* Soy formula has been implicated as a risk factor for the onset of juvenile
IDDM.[n2] In another report (Nov 1994) the following recommendation was made:
"The substitution of soy-based formulas is not advised for either the general
or high-risk infant feeding practices because of animal studies linking the
ingestion of soy protein intake to the development of diabetes." [n3]
* Soy formula may not meet the infant's need for zinc.  Soy protein binds to
zinc rendering it unusable to the infant. Soy protein may also bind calcium.
* Soy formula is associated with a significantly higher incidence of
Autoimmune Thyroid Disease (A.T.D) in children.  They found that a child with
this condition was 2-3 times more likely to have received soy formula than a
cow's milk formula.[n4]
* There is no scientific basis for supplementing breastfed infants with
soy-based formulas in order to prevent allergies.
* Of greatest concern is that soy formulas, available in the U.S.,  may
contain phytoestrogens.  It is well established, in adult studies, that
daidzein and genistein are bioavailable in soy-based products.  [n5]  The use
of soymilk has been recommended for menopausal women as an
adjunct/alternative to estrogen replacement.
 Four New Zealand researchers believe that the amount of daidzein and
genistein in soy based infant formulas represent a significant risk.  [n6]
Soy-based formulas may equal "an intake, per kilogram of body weight, of
approximately three to five times as much  daidzein and genistein [estrogen]
than amounts which disrupt the menstrual cycle when fed to premenopausal
women."
 Other researchers have similar concerns about exposing young infants to
phytoestrogens.  The introductory program presented by US FDA Department of
Health at a recent phytoestrogens conference notes: "phytoestrogens have some
of the same capabilities to induce developmental toxicity as do other
estrogens" and "given the DES tragedy, it would be foolish to ignore the
possibility that some phytoestrogens constitute a developmental hazard." [n6]

 Soy formula may have the potential to become the next DES tragedy. They
concluded: "It would be prudent for general sales of soy-formulas to be
stopped." [n6,n7]
 It must be noted that the levels of phytoestrogens and their bioavailability
has not been determined in U.S.  formulas.

However, we have decided the most prudent course of action is to err on the
side of caution.  Therefore, we recommend that the use of soy-based formula
be discontinued immediately.  To prevent the accidental use of soy-based
formulas by staff members unfamiliar with the potential risks, all soy-based
formulas should be removed from supply carts in the Family Care Center,
Nurseries and Pediatric Units.  Infants showing sensitivity to cow's milk
based formula, should be given Nutramigenx.

References
[n1]  Klish, WM. (Chair AAP Committe on Nutrition) et al.  Aluminum Toxicity
in Infants and Children.  Pedatrics 1996; 97: 413-416.
[n2]  Scott, Fraizer.  AAP Recommendations on Cow Milk Soy and Early Infant
Feeding.  Pediatrics 1995; 96: 515-517.
[n3] Drash, Allan (AAP Chair, Workgroup on Cow's Milk Protein and Diabetes
Mellitus) et al.  Infant Feeding Practices and Their Possible Relationship tp
the Etiology of Diabetes Mellitus.  Pediatrics 1994; 94: 752-754.
[n4]  P. Fort et al Journal of the American College of Nutrition Vol. 9 No 2.
164-167 1990.
[n5] Clarkson, T.B. Anthony, M.S., Hughes, C.L.  "Estrogenic Soybean
Isoflavins and Chronic Disease. Risks and Benefits."  Trends Endocrinol Matab
6:11-16, 1995.
[n6] Irvine, C.; Fitzpatrick, M.; Robertson, I.; and Woodhams, D..  "The
Potential Adverse Effects of Soybean Phytoestrogens in Infant Feeding." New
Zealand Medical Journal 25 May 1995, 108: 208-209.
[n7] Soy-Formulas Should Be Stopped. INFACT Newsletter, Winter '96.