Kathy and others have described some common side effects of formula  
supplemented with DHA/ARA. Spitting up and runny bowel movements are an adverse  
effect of these ingredients and as such should be reported every time you see  it 
to the FDA's MedWatch program at _www.fda.gov_ (http://www.fda.gov) . This 
should also be reported to the  manufacturer each time you see a baby with the 
particular side effect. These  side effects happen in a subgroup of babies who do 
not tolerate algal and fungal  sources of fats. It reminds me of what happens 
to some adults when they consume  olestra in snack foods. Olestra caused the 
same type of side effects and for  awhile the FDA required that this side 
effect be mentioned on the product label  to warn consumers of possible diarrhea 
and uncontrollable fecal leakage. Snack  food makers pressured the FDA to 
remove the warning because it was bad for  sales, so now these products just list 
olestra in their ingredient list, and woe  to the person who is sensitive to 
this stuff and doesn't read the label!
 
In my opinion we are seeing a similar pattern with DHA/ARA supplemented  
formula. Mead Johnson supplements Enfamil products with almost double the amount  
that some of the other formula makers use, so it is not surprising to see  
adverse effects in some babies. Their clinical studies usually eliminated babies  
who had side effects so they never bothered to report this in their published 
 data. All formula labels should contain a message to parents that some 
babies  react poorly to DHA/ARA supplements. Clinicians should also be made aware 
of  this side effect as it could cause incorrect evaluation of infants' intake, 
 mistaken assurances that the baby is getting enough, and a skewed assessment 
of  babies with GI or weight gain problems. We don't know if fat soluble  
vitamins are also lost through a constantly runny stool and how much pain the  
baby may be in.
 
As Kathy has pointed out, we really need to ask how much formula a  breastfed 
baby is receiving when we assess diaper counts. A poorly feeding baby  with 
runny stools is a set up for dehydration, jaundice, and poor weight  gain.
 
Marsha Walker, RN, IBCLC
Weston, MA

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html