http://www.jpost.com/servlet/Satellite?pagename=JPost/JPArticle/Printer&cid=
1068446567982

 Nov.10.2003
Formula for disaster

For years Israeli parents had been lulled by manufacturers, advertisers, and
regulators into believing that baby formula is safe for consumption - until
this week.

It now turns out that the milk substitute manufactured especially for
Israeli importer Remedia by German firm Humana lacked, for the past six
months, the vital vitamin B1 (thiamine). Due to the consequent vitamin
deficiency and neurological problems, three babies have died, and 14 others
are still hospitalized, possibly having sustained irreversible damage.

The doubts this scandal casts over the reliability of food labels brings to
a new low an already deteriorating level of our trust in Israeli standards
and public institutions.

Neither Humana nor Remedia - which had earned Israeli Good Manufacturing
Process (GMP) certification - reported its "minor formula change" to the
Health Ministry's Food and Nutrition Service. In fact, since both firms
failed to explain their allegedly criminal negligence, the ministry had to
send a fact-finding team to Germany to investigate.

Remedia, which "merely" imports and packages the powder, is fingering
Humana, which so far denies any wrongdoing.

Having not tested samples of the formula powder for some three years, the
ministry did not detect the changed composition on its own. Only when three
comatose infants were admitted within one week to Schneider Children's
Medical Center of Israel in Petah Tikva did its pediatricians sound the
alarm, and ministry epidemiologists who interviewed the families pounced on
the common denominator: All three had been fed the Remedia soy-based
formula, as had others in various hospitals whose symptoms were not regarded
as unusual enough to be reported.

The ministry ordered the product - its amended formula unlicensed and
dangerous - off the shelves, alerted the State Attorney's Office about the
companies' alleged crime, and sent parents reeling with fear and suspicions.

The ministry says that even if its Food and Nutrition Service had 10 times
the number of inspectors and lab workers it does, it couldn't sample and
test every month all the food products sold in Israel. GMP certification,
granted to serious firms after passing a long series of examinations, is
supposed to ensure that these are produced at the highest standards. Until
the next (infrequent) ministry test, companies are their own watchdog,
relied on by the health authorities on the grounds that meeting rigorous
standards is in the firms' own interests.

After the Remedia scandal and the tragic deaths of infants, that can no
longer be taken for granted.
If the Health Ministry lacks the manpower to conduct frequent checks,
perhaps companies should pay a fee to the ministry to out-source
inspections, so they can be conducted frequently and unexpectedly.

There are other long-term lessons from this tragedy.

The ministry should prepare a list of symptoms and conditions that did not
end in death that hospitals and clinics must report to it via a centralized
computerized system. This would likely have picked up the unusual cases in
time to save the babies and could solve other medical mysteries in the
future.

The authorities also have a duty to do more to encourage breast-feeding, for
the sake of both mothers' and babies' health. While most mothers nurse their
infants just after delivery, by the time maternity leave from work ends, the
overall rate of breast-feeding rapidly declines.

Women should get more assistance in continuing to breast-feed, with
mother-friendly spots in public buildings, time off from work without job
discrimination or penalty, and counseling on pumping and freezing breast
milk for bottle-feeding. Those who don't want to or cannot breast-feed
should get better advice from family health clinics (tipot halav) and
pediatricians.

All experts agree that cow-based formula is preferable to soy-based formula.
But even though allergies to cow milk affect only two or three percent of
newborns, five or six times as many infants are getting the non-dairy
formula due to misconceptions and misinformation. The message should
especially get through to Orthodox Jewish families using formula who
reportedly tend to opt for the non-dairy type even though there is no
halachic basis for such a preference.

The health authorities, police, and the courts will ultimately have to find
who is to blame and punish them. It will be too late for the unfortunate
victims and their families, but perhaps the quality of manufacturing,
supervision, and enforcement will improve.

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