As lactation consultants, we face the problem of what to do when an infant
cannot receive all its nutritional needs through breastmilk.  So when milk
banking is not accesible to a mother, what do we recommend?  It is so ironic
that we, the breastfeeding advocates, have to know more about infant formula
than we ever really wanted to know.

We may assume that the evidence is out in regard to a particular brand of
infant formula.  For instance, the studies on the addition of DHA and AA to
infant formula are voluminous and seem to suggest that this addition is
absolutely required in all formulas.  We have a gold standard--human
milk--and the infant formula industry is obliged to imitate the real thing.
Yet doesn't this beg the question?  Are we deluding ourselves by assuming
that it is possible to get a close approximation to the real thing?

In reading the patents on infant formula ingredients, I believe that infant
formula companies have massive evidence for the inclusions of this or that
ingredient.  Where did they get this massive evidence?  The studies are based
on human milk studies.  It is the reason that you will find information on
human milk within the Nestle Nutritional Workshop Series of books.  The
infant formula industry had to understand the competition and they are
compelled to imitate it.  But trully, if the premise of the science of infant
feeding is based on an illusory goal, then we are like Don Quixote and just
battling windmills.

Nestle has a number of patents in the US Patent Office.  This particular
patent discusses some of the problems they had with previous "recipes."
Adding trypsin which is used to manufacture the protein hydrolysates has been
problematic for Nestle hence this particular patent.  This is patent number
6420156 called "Purified proteolytic enzyme and method." by Braun et al with
the assignee being Nestec SA (Nestle)

"Such breakdown products may manifest themselves both in liquid products and
in powders by the appearance of stability or organoleptic defects, for
example spots, poor taste, or by their toxicity leading to side effects, for
example of an inflammatory type in breastfeeding infants."

One can assume that this patent will do the job and stop leading to toxic
side effects--such as the inflammatory type in breastfed infants. Yet after a
survey of infant formula patents since the 80's one may assume that they have
resolved one problem but usually another one crops up.  I believe the problem
is not the ingredients but the belief that we can make a safe substitute for
human milk.

In another patent by Nestle they mention that lipases in their products may
or may not be genetically modified from such organisms as Mucor miehei and
Candida cylindracea.  For those who might be somewhat nervous about gmo
products, maybe a Nestle product is not such a good pick.  But then in
reading the patents from various infant formula companies, one realizes that
Nestle isn't the only company that is using such food technology.

So do we really know what is in the can of infant formula that we are
recommending?  Should we recommend one over the other?  Why are we
recommending Nestle?  Because we are upset over Lipil?  What makes us believe
that Nestle is a safer bet?

I really believe that it is dangerous to recommend one infant formula over
another.  If the parent takes our word that one infant formula is safer and
that infant has a problem with that particular brand of infant formula; then
the faith of our clients maybe quite shaken.  Do we even know what is in that
particular brand of infant formula?  I would say no, not possible.  The
answer to parents may be unsatisfactory.  We don't know which one to
recommend because we don't know what is in it nor whether that particular
infant will have a problem with it.  Maybe those kind of answers to parents
would start to create consumer demand for a milk banking system that can
respond to all infants requirement of the real thing.  Valerie W. McClain,
IBCLC



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