Colleagues:
Although there have been a very few case reports of infants with  
enterobacter sakazakeii infection, presumably from contamination of the powdered  
formula, the whole issue of the "danger" of powdered formula and powdered  
fortifiers has been way overblown.  
 
Although I would wish that no infant, child or adult die from foods or  
medications, it happens, and it is not always preventable.  It is typical  of 
USA thinking that "some-one" has to be to blame and the huge number of  
lawsuits over ridiculous things testifies to this.  We tend to lose sight  of the 
big picture and the public health implications when we make blanket  
statements like "no infant less than 2 months old should receive powdered  
formula", especially in the USA where our water is clean and plentiful.
 
In 30 years as a neonatologist I have never seen a case of sepsis,  
meningitis, NEC or other infection due to a powdered formula/fortifier  
contaminant.  I have seen 3 infants die of NEC/sepsis due to pathogens in  the mothers' 
milk.  Should I ban human milk?
 
Nancy
Nancy E. Wight MD, IBCLC, FABM, FAAP
Neonatologist, San  Diego Neonatology, Inc.
Medical Director, Sharp HealthCare Lactation  Services
Sharp Mary Birch Hospital for Women and Newborns
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