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 ------------------------- 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.