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Summer 2005 News Archives

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Molly's Recommended Reading:

Articles about the AAP's
New SIDS
Recommendations
October 2005

The Milky Way of
Doing Business
by Katie Allison
Granju

How Safe Is Soy Infant
Formula? - high levels of
manganese in soy formula ,

Breastfeeding can reduce
inequalities in child health
Unicef Article: Nov. 2004

In the News- Spring 2006

FOR IMMEDIATE RELEASE Media Inquiries: Catherine McDermott 301-827-6242 February 22, 2006 Consumer Inquiries:
888-INFO-FDAFDA INFORMS PUBLIC OF NATIONWIDE INFANT FORMULA RECALL
The U.S. Food and Drug Administration (FDA) is alerting the public to a recall being conducted by Mead Johnson for their GENTLEASE powdered
infant formula, lot number: BMJ19, use by 1 Jul 07. This lot was found to contain metal particles, consisting of up to 2.7 millimeter in size.

No illnesses have been reported to date. However, in the rare instance that an infant were to inhale the infant formula into the lungs, the presence of
these particles could present a serious risk to the infant’s respiratory system and throat. Any injuries associated with this problem would be likely to
show up within three to four hours. The symptoms could be varied depending on whether there is damage to the throat or lungs. Damage to the
throat may include coughing, difficulty swallowing or difficulty breathing. Similarly damage to the lungs could include coughing and difficulty breathing.
If you may have fed this lot of GENTLEASE to your baby, and you have any concerns about your baby’s health, you should contact your baby’s
health professional for guidance.

There were approximately 41,464 24-ounce cans of this lot of recalled product distributed, beginning on December 16, 2005, through many major
retail stores across the country, so the consumer should concentrate on the code on the can rather than on the place of purchase. The affected
products can be identified by the lot number and expiration/use by date embossed on the bottom of the can of BMJ19, use by 1 Jul 07.

Mead Johnson informed the FDA of this problem. FDA and Mead Johnson are currently investigating the cause of the metal particles found in the
infant formula in this highly unusual incident.

Consumers who have a can of this batch of GENTLEASE powdered infant formula should not use the product and should contact Mead Johnson at
888-587-7275 immediately.

Keeping up with mother's milk No formula has been invented that nourishes a baby as well, but the makers keep trying. By Alice
Lesch Kelly, Special to The Times, February 2006
Parents selecting baby formula have their work cut out for them. Supermarkets contain shelves full of choices, with new ones seemingly coming all
the time. There are formulas designed for babies with fussiness or gas, formulas made with organic ingredients, and formulas enriched with omega-
3 fatty acids, suggested to enhance vision and brain development. Future formulas may contain the live bacteria found in yogurt. Such a wide array
of options can baffle parents, and many may be tempted to buy brands with recipes rejigged in response to the latest nutritional discoveries. But in
fact, child nutrition experts say these new products may not benefit babies as much as their ads suggest — and that any brand, including less
expensive ones, will offer adequate nutrition, although none as good as breast milk. All must meet strict standards set by the Food and Drug
Administration. "There's very little difference, frankly — they just tweak it a little," says Linda Heller, a registered dietitian and clinical nutrition
manager at Childrens Hospital Los Angeles. Formula makers hint, and some parents hope, that such tweaks will enhance the development and
health of a baby. A developing substitute The American Academy of Pediatrics recommends that women breastfeed exclusively until babies are 6
months old. Only about one-third of women do so. The alternative, infant formula, is historically fairly new. Until the Civil War, babies who were not
breastfed received milk from cows or donkeys. Then in 1867, Henri Nestlé (a Swiss pharmacist who later founded the Nestlé food company)
developed an infant formula made with malt, cow's milk, sugar and wheat flour. It took a while for Nestlé's invention to catch on. During the first half
of the 20th century, most mothers weren't convinced they needed commercial formula. When not breastfeeding their babies, they made their own
concoctions with evaporated milk, water and table sugar or corn syrup. Commercial formulas begin to gain wide acceptance during the post-World
War II baby boom years. Many doctors began to believe that formula was more nutritious than breast milk. By the 1970s, just 25% of babies — a
record low — were still being breastfed by the time they were discharged from the hospital. (Today, that number is 70%.) Formula companies keep
trying to emulate human milk, but the mixture still differs from the real stuff in key ways. "We know a lot about what's in breast milk, but it's hard to
replicate all the ingredients," says Dr. Richard J. Deckelbaum, a professor of pediatric nutrition at Columbia University and chairman of the Institute of
Medicine's infant formula safety committee. Those ingredients include, among other things, living cells, hormones, active enzymes and antibodies
that fight infection. Such differences appear to have real health effects. Studies have found that breastfed babies have lower rates of pneumonia,
bronchitis, colds, meningitis, urinary tract infections, asthma, ear infections and possibly sudden infant death syndrome. Studies also suggest that
people who were breastfed are less likely to become overweight or obese and to develop breast cancer, allergies, insulin-dependent diabetes, and
chronic intestinal diseases such as Crohn's disease. And, intriguingly, several large studies have shown that breastfed babies have IQs that are,
on average, about six points higher than formula-fed babies. Re-formulating As they work to close the breast milk-formula gap, manufacturers have
been tweaking recipes pretty much since the substance was invented. In the 1960s, for example, they started adding iron to formula, which led to a
significant drop in the incidence of iron-deficiency anemia in bottle-fed babies. In the 1990s, manufacturers started enriching formula with
nucleotides, chemicals present in breast milk that are the building blocks of the body's genetic material, after studies showed that babies fed formula
with nucleotides had less diarrhea. Likewise, different brands have been introduced to meet special needs of some babies. In 1929, for example,
manufacturers discovered cow's milk formulas bothered some babies, and introduced soy-based formula. Later they learned that lactose, a natural
sugar in milk, gave some babies colic-like symptoms such as fussiness, gas and diarrhea. And so, in the 1990s, they developed lactose-free
formulas. Manufacturers have also developed formulas for babies with allergies. Made with hydrolyzed protein, they are easier to digest and
reduce the likelihood of triggering an allergic reaction. (A 2005 study found that such formula, compared with standard types, may help prevent the
development of allergies in babies whose parents suffer from them.) Formulas for preterm babies have also been developed, because babies born
prematurely have different nutritional needs than full-term babies. (They need more protein, fat and calcium, for example.) These formulas "have
really helped premature babies achieve better weight gain, bone health, and in some cases allows for earlier discharge from neonatal intensive care
units," says Erin Feldman, a registered dietitian and board-certified specialist in pediatric nutrition at Cedars-Sinai Medical Center. In addition,
manufacturers have developed specialized formulas for babies with certain illnesses, such as one for babies with cystic fibrosis. But for babies
born normally, nutrition experts and pediatricians see little to choose between. Brands may be formulated slightly differently — for example,
containing different kinds of proteins and fats — but the FDA has specifications for minimum amounts of 29 nutrients and maximum amounts for nine
of those nutrients. Manufacturers must analyze each batch of formula to check nutrients and purity. And they must test samples from store shelves
to make sure they remain safe during their shelf life. Omega-3 bandwagon Manufacturers today are heavily marketing formulas that contain two
omega-3 fatty acids, DHA (docosahexaenoic acid) and ARA (arachidonic acid). Sold in Europe for 10 years, these formulas were first introduced in
the U.S. in 2002, and have since become increasingly popular. Scientists have long known that breast milk naturally contains DHA and ARA, and
that breastfed babies have higher blood levels of these chemicals than do formula-fed babies. They are important in the development of the brain
and visual system, and some nutrition experts have suggested that their presence in breast milk may partly answer why breastfed babies have
higher average IQ scores. However, child nutrition experts also say that these formulas may not make much difference for healthy, full-term babies.
"For the preterm baby they are advantageous to improve their brain development and visual acuity. But the research does not indicate there is a big
impact on brain development and visual acuity if the baby is full-term," says Heller. For example, in 2005, Australian researchers conducted an
analysis of 14 previous studies of formulas containing DHA and ARA and found that formulas with these chemicals have no effect, positive or
negative, on full-term babies' weight, length or head circumference (a measure of normal brain development). And a report by the Cochrane
Collaboration, an organization that evaluates medical evidence, found omega-3 formulas safe, but said there was not much evidence that they
provided long-term benefit to the vision or intellectual ability of full-term infants. The American Academy of Pediatrics neither endorses nor warns
against including omega-3s in formula. The FDA, which permits DHA and ARA in formula, notes the mixed evidence and that there have been no
published studies of the long-term effect. Formula manufacturers choose their words carefully, merely noting that DHA and ARA are "compounds
found in breast milk that support infant eye and brain development." The formula frontier Nutrition experts predict that formulas will continue to
evolve. The next likely wave: ones containing probiotics, live bacteria and yeasts found in substances such as yogurt. These organisms are not
found in breast milk, but the hope is that they'll help boost the ability of babies to fight infection. Studies suggest that formula lacks some of the
infection-fighting components of breast milk, causing higher rates of intestinal upset, infection and diarrhea in formula-fed infants. In a 2004 study
published in the American Journal of Clinical Nutrition, infants and toddlers receiving formula containing two probiotic bacterial strains
(Bifidobacterium lactis and Streptococcus thermophilus) experienced less colic-like symptoms, and were prescribed fewer antibiotics, than children
who received ordinary formula. Despite all these advances and future ones no doubt waiting in the wings, nutrition experts believe that formula will
never be as good as the complex, poorly understood white fluid that our bodies naturally produce. "Factories," says Deckelbaum, "just don't do as
well as the human mammary gland."

C-Sections, Breastfeeding and Bugs For Your Baby -What the doctor probably won't tell you by Jeff Leach (zinjboss)

There I was, with a camera in one hand and wiping the tears from my eyes with other. It was delivery day -- I was going to be a dad. Like an eerie
scene from a B-rated alien movie, out popped his little head from an amazingly small incision in my then wife's stomach. The flash from my camera filled
the room; this was the happiest day of my life.

Since that day over 11 years ago, my then wife and I had another beautiful child, also through cesarean delivery. I had not given much thought to the fact
that both my children entered this world through a small incision rather than the birth canal until recently, when the Center for Disease Control's National
Center for Health Statistics released its update on births in the United States in late 2005.

Since my first child was born, the rate of c-section deliveries appear to have been rising at a steady clip, jumping over 40 percent since 1996. In 2004,
29.1 percent of all children born in the United States were delivered through c-section -- that's nearly 1.2 million incisions. The reasons for the increase
are complicated, but have a lot to do with medical malpractice associated with vaginal deliveries, parental preference, health of the mother and or the
unborn child, and just plain old convenience.

In the days following the release of the CDC report, I scoured the media outlets that picked up the story to see if anyone mentioned an interesting and
potentially alarming consequence of the rise c-sections. I was looking for the mention of words human biology, bacteria, mammals, and the new
nine-letter curse word of 2005 -- evolution. Nary a mention from a single report, not one.

As a right of passage, the delivery of a fetus through the vaginal canal of the mother completes one of the most important cycles in the evolutionary
history of humans. From an evolutionary point of view, our sudden adoption of c-sections as an increasingly preferred mode of child delivery, may be
tinkering with some very important processes that took millions of years to develop. Let me explain.

In what famed British "Darwinist" Richard Dawkins calls an evolutionary stable strategy, humans have evolved a symbiotic relationship with a particular
and complex set of bacteria in our intestinal system -- a.k.a. the gut. The 500 or so species of bacteria, whose numbers are measured in the trillions,
occupy every inch of our gut, with most of them living in an ecological niche they literally carved for themselves in our colon. As the evolutionary stable
strategy suggests, the presence of these few hundred species, among all the tens of thousands of species of bacteria found in the air, water and soil
throughout the world that theoretically have access to our "open" intestinal ecosystem (think mouth to anus), is not random. This means our established
intestinal ecosystem is composed of a set of bacteria that can live in nutritional and physiological harmony with us. Importantly, current members make it
their evolutionary determined job to keep out new members -- i.e., pathogens that seek to do us harm.

The intestine of the unborn fetus in the mother's womb is sterile, devoid of any bacteria at all. However, during vaginal delivery the newborn comes in
contact with bacteria-rich vaginal and fecal matter of the mother. These bacteria quickly invade and populate the newborn child. Saving of umbilical
cords and the creepy ritual of eating the mother's placenta aside, this cycle links the co-evolution of intestinal "microflora" of the mother to child, and may
represent a more significant bond for those who understand it exist. This evolutionary bacterial right of passage has been and continues to be critical to
the success of our species, and all mammals for that matter.

A child born through c-section essentially skips this critical evolutionary process. Though a c-section baby does receive bacteria from the mother, it's not
the diverse and dense "base population" that it would have received from the vaginal fluids and fecal matter via a traditional birth. In either birthing
method, the baby is subject to all the bacteria in the room -- that even means the weird looking rubber-gloved fellow in the corner -- who appears to be
assisting the delivery staff in some way. But who can be sure?

Once this truly amazing and scary ritual of childbirth is completed, the newborn is typically cleaned, shown to the mother for short period, and then
whisked off to some warm place to spend some quality time with other new members of our species. The mother usually settles in for some much
needed rest and the new father anxiously paces the corridors mumbling to his self all the things his is going to change or do better in his life. Seems
some things are timeless.

But the next 24 for 48 hours pose another critical evolutionary step for mother and child - breast-feeding. Like all other mammals -- and that includes our
tree swinging cousins -- the secretion and release of fluid from breasts (mammae) is the sole nourishment or food for the newborn child. Yet, over 30
percent of new mother's do not breastfeed in the hospital. It is often the case that some mother's never get their milk, others have problems getting the
newborn to suckle, and others are just not interested.

At six months of age, the number of baby's receiving breast milk drops to around 31 percent, and at 12 months it drops further to 17 percent. The number
of baby's receiving some level of breast milk at 24 months hardly makes a blip on the radar screen.

C-sections and short-term breast-feeding have no precedence in our evolutionary past. Before insurance companies and organized medicine, all children
entered this world via the birth canal and participated in the time-honored cycle of transfer of bacteria from mother to child. Like our monkeys and a few
of the modern forager groups that still follow traditional life-ways today, breast-feeding by the mother or other women in the group (wet nursing)
continued for 24 to 36 months, sometimes longer.

Breast-feeding newborns, like the evolutionary process of vaginal birth, is about bacteria. The breast milk of a human mother, like other mammalian
mothers, is species-specific, having been adapted over eons to deliver specific and sufficient nutrition to guarantee proper growth, health, and immunity
development. Researchers have long known that breast-fed babies possess an intestinal flora that is measurably different than formula-fed infants. Of
specific interest is a group of bacteria known as bifidobacterium. Some of you may immediately recognize the name, as they are often added to
dairy-based foods such as yogurt, often advertised as "live cultures" on the packaging. These are probiotics.

Studies have shown that at one month of age, both breast-fed and formula-fed infants possess bifidobacterium, but population densities in bottle-fed
infants is one-tenth that of breast-fed infants. The presence of a healthy and robust population of bifidobacterium throughout the first year or two of life
contributes significantly to the child's resistance to infection and overall development of defense systems -- not to mention the physical development of
the intestinal system in general. Aside from the substances secreted by these specific bacteria that are known inhibit the growth of pathogenic bacteria,
they also work to make the intestinal environment of the infant more acidic, creating an additional barrier against invading pathogens. In short, breast-fed
babies are sick less, are less fussy, have fewer and shorter duration of bouts of diarrhea, and have more frequent -- and softer -- bowel movements.

The dominance of health-giving bifidobacterium in breast-fed babies is due the presence of special carbohydrates in mother's milk known as
oligosacchrides. These special carbohydrates are virtually absent in cow's milk. From a physiological point, these special carbohydrates escape
digestion and absorption in the small intestine of the infant, and thus reach the colon intact -- where they serve as food for, among other bacteria, the
all-important bifidobacterium. As the bacteria thrive on this "food" from mother's milk, they grow in number and absorb water, resulting in more regular
and soft bowel movements. It's important to know that the bulk of infant feces are made up of live and kicking bacteria. Look next time if you don't believe
me!

Baby formula manufacturers are catching on and creating products that contain these special carbohydrates -- which are known as prebiotics
(remember, prebiotics are food for bacteria and bacteria are called probiotics). While it's virtually impossible to mimic the exact composition of mother's
milk, it is possible to mimic some of the physiological effects, specifically targeting the growth of select bacteria through the delivery of oligosacchrides.
One Belgium-based company in particular, has developed a natural variant of the mother's oligosacchrides from chicory roots (think chicory coffee).
After years of careful study and peer review, they are being added in greater and greater frequency to formula for infants. They love this stuff in Japan.
Any company that wants to stay in the lucrative baby formula business will need to adapt their products to include these ingredients, or else be left in the
dust.

In the dozens of doctor visits my then wife and I made during pregnancy, and through two births, never once did the doctor or any other person involved
tell us what I just told you. In all of the "how to be a new parent" and "how to take care of your new baby" books we read, not one detailed reference to
the critical passing of mother's microflora to the child via the birth canal or the importance of feeding bifidobacterium, was ever provided.

In many cases, c-sections are absolutely necessary and should be performed. But a 40 percent increase in just the last 10 years? This makes no sense.
As a father of two, I am acutely aware of the physical and emotional toll that breast-feeding has on an active mother -- the little creature literally sucks
the life right out of you. Face it, we live in a very different world than our not-so-distant ancestors occupied. Things are hard, but in different ways.

It's important that expecting parents to understand some of the basic evolutionary processes of bringing a new member of our species into the world. A
few snips and stitches, followed only by a small number of sips, ain't going to cut it. The physical, nutritional, and metabolic features that make us
uniquely human have been shaped by millions of years of evolution. While we are culturally and socially modern, driving around in hybrid cars and
arguing about stupid things, we are literally and biologically ancient hunter-gatherers. Just as lack of exercise (something we always did) and excess
caloric intake (something we rarely did) will make you fat -- and probably cause a number of other ailments and disease -- we just can't simply up one
day and start delivering babies through the stomach and not breast feed them. Such things have consequences, they always do.

If physicians and care givers whom we entrust the safety of the mother and child were required to have some basic understanding of Evolution 101 --
as it applies to birthing and infant health and biology -- we might all be healthier. Or at least, better rested.

Jeff Leach is an anthropologist who specializes in evolutionary trends in human nutrition and its application to modern health and well-being. You can
read more at his Web site (www.gutfeelingcolumn.com).