I am very disappointed in my colleagues who are publicly stating—not just
implying—that infant formula with added DHA or AHA is superior to infant
formula without these experimental additions. I consider this to be a
violation of our patients’ trust and of the WHO Code. Stop it, please.
(I initially ended this diatribe with that paragraph. Now I have said it
twice.)
Before anything else, if anyone out there has any evidence that we really
KNOW what happens when DHA and or AHA are added to artificial baby milk,
please forward that data either to me privately or to the list. This is just
another aspect of the grand experiment: Seeing whether or not human infants
suffer major long-term damage or just multiple minor medical complications
from cow's milk, soy milk or other formulas. A massive immoral, illegal
experiment. Doctors who supply legitimacy to the addition of these
substances to formula should think much harder about what they're doing.
Many mothers in my practice have asked me which formula they should use if
they "need" to. Many of these needs have sounded legitimate, but there is
still a huge risk if I recommend one formula over the others: They might
assume that I think this ABM is OK or "more OK" than the others.
Now, I have come to have a greater fear of exclusive soy formula and can
easily tell families that I think a "mono-diet" of soy is not safe. I can
also quote chapter and verse to them about the dangers of cow's milk
concoctions or amino acid fragment formulas.
In some ways, this makes things much easier for me because I can follow this
brief set of warnings with a clear statement about the dangers of losing
breastfeeding, lessening breastfeeding, pumping and only giving breast milk
in a bottle and so on.
Then, many people press me harder. They have twins, premies, exigent work
conditions and demands, or, the easiest issue of all, an adopted baby. Yes,
adoptive moms can breastfeed, we all know that, but most of them need some
sort of supplement unless they are lucky (or rich) enough to have access to a
full complement of donated breast milk. These moms need to feel good about
their adoptive nursing and about the baby in general and it would be cruel
and insensitive to imply that all formulas are dangerous or worse. I can't
do this. With adoptive parents, I will discuss the differences among
conventional formulas, homemade mixes and the unapproved health food store
alternatives. I will make my best effort to find donors and encourage them
to buy milk from a bank.
Moms who deliver their own babies, have only solvable problems but think they
"need" milk do not get the back of my hand, but they do get a persistence
from me, from my nurses and from Christy the office's ace IBCLC which they
don't always like. I have lost a few patients who felt unsupported in their
desire to nurse less and formula feed more. (I have also lost patients who
didn't like my prescription for treating their child's pneumonia with
antibiotics; A parallel medical issue and not a "personal choice.")
What do I do when moms ask which formula to use? I tell them that they are
all equal in their adequacy in supporting a baby's growth and all equal in
their gross inferiority to mother’s milk. Again, I’ll willingly soften this
for adoptive families or for mothers with strict medical contraindications to
breastfeeding. These, of course, are few and far between.
Again, there is NO scientific justification for doctors or others publicly
stating—not just implying—that infant formula with added DHA or AHA is
superior to infant formula without these experimental additions. Accepting
funding from these companies or advertising their products on a web site is a
violation of our patients’ trust and of the WHO Code. Stop it, please.
Jay Gordon, MD, FAAP, IBCLC
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