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Date: | Sun, 18 Dec 2005 08:53:43 EST |
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Kathy has asked about how we could "prove" that a baby with runny stools is
experiencing a side effect of DHA/ARA supplemented formula. The option always
exists to have the mother pump her milk and use that rather than formula. If
the mother is unwilling or unable to pump enough milk, she could use a
formula without the added DHA/ARA or one with only a minimal amount and see if that
makes a difference. NABA began receiving reports of this problem from nurses
when these formulas were being given in the maternity unit prior to
discharge. I have written a couple of pieces on this from past issues of the NABA
newsletter and would certainly be happy to forward these to people who are
interested in this topic. Some mothers are being duped into thinking that their
own milk is deficient in DHA/ARA and use the supplemented formula "just in
case." I just saw this in a home visit I made. A can of Enfamil Lipil was
sitting on the counter and the mother told me they would use it (it came in the
hospital discharge bag) "just in case" I could not fix the breastfeeding
problem! The runny stools most likely have the potential to eliminate fat soluble
vitamins and other nutrients and certainly throw off diaper counts. Most of us
rely on diaper counts as one of the criteria for assessing adequate intake.
You can report this problem to the FDA's MedWatch program when you encounter
it with a mother/baby pair. You don't actually need to see the diaper. Go to
_www.fda.gov_ (http://www.fda.gov) and click on the MedWatch program. There
is a form for clinicians to use to electronically submit the report. Make
sure you also report this to the formula manufacturer as they are obligated to
keep complaints on file.
The claims being made about these formulas are highly misleading and
affecting many mothers' decision regarding breastfeeding and especially exclusive
breastfeeding. The Better Business Bureau's National Advertising Division is
another place to file a complaint about false and misleading advertising if you
find that mothers are telling you that formula is equivalent to breast milk
or when you see ads that claim this. The Federal Trade Commission also has
complaint forms available online at _www.ftc.gov_ (http://www.ftc.gov) .
All mothers and clinicians should be advised that runny stools and other GI
side effects are a possibility with these formulas, especially the ones that
contain the most DHA/ARA. Side effects of this additive were noted in animal
studies very early on in the testing phase of the product. Steatorrhea (fat
loss in the stools) was a side effect seen in animal testing. Makes you wonder
what we are putting into babies and why some people so blindly accept that
infant formula use is not without risk.
Marsha Walker, RN, IBCLC
Weston, MA
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