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Lactation Information and Discussion <[log in to unmask]>
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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