Parents of a new baby have a million things to do, but menu-planning isn't one of them. Until a baby is 4 to 6 months old, for breakfast, lunch, and dinner--and of course, the infamous middle-of-the-night feeding--the only items on the menu are either breast milk or infant formula.

Breast Milk Is Best

Usually a manufacturer won't announce that the competition's product is a better choice. But when the competition is breast milk, infant formula manufacturers concede — right on the label — that breast milk is best.

Human breast milk is the ideal nourishment for human babies. Its protein content particularly suited for a baby's metabolism, and the fat content is more easily absorbed and digested than the fats in cow's milk.

Breast milk also protects the infants against certain diseases, infections and allergies. A mother's milk contain cells from her immune system and antibodies against diseases to which she has been exposed. Antibodies she develops after the baby is born are also passed to the baby through the breast milk.

For example, if Mom catches the flu, she develops antibodies to that strain of flu virus. Richard Schanler, M.D., associate professor of pediatrics at Baylor College of Medicine, Houston, explains, "The baby will get some protection. The baby might not get the flu at all, or the case may be milder...than if he or she wasn't breast-fed to begin with."

However, risks of breast milk may outweigh advantages if a nursing mother takes certain medications or abuses drugs. The quality and quantity of the mother's diet may affect the quality and quantity of breast milk. (see "Good Nutrition for Breast-Feeding Mothers" in the December 1986-January 1987 FDA Consumer.)

Breast-Feeding Success

"Learn about breast-feeding before the baby is born," says Julie Stock of the La Leche League, an international breast-feeding support and educational organization. "If you know a lot beforehand, you start to build a sense of confidence. Many attempts at breast-feeding fail because of wrong information."

Once the baby is born, breast-feeding as soon as possible after delivery and often is the first of three essential keys for success, says Stock.

The second key is no artificial nipples — that includes pacifiers as well as bottles of water or formula — during the first few weeks. Stock explains that some babies can become very confused by the different feel and different way of sucking needed with a bottle or pacifier, and they may not be able to switch back to the breast.

Finally, it is important to make sure that the baby "latches on" to the mother's nipple correctly. "If a mother has those three things going for her, in general that will eliminate about 90 percent of the common problems that mothers have," says Stock.

The La Leche League has local chapter meetings throughout the country where expectant and new mothers can learn about breast-feeding, nutrition, and other aspects of child care. For the number of your local chapter, call the La Leche League at 1-708-455-7730 or write to La Leche League International, 9616 Minneapolis Avenue, P.O. Box 1209, Franklin Park, Illinois, 60131-8209.

Second Best

The composition of infant formula is similar to breast milk, but it isn't a perfect match. Further, the exact chemical makeup of breast milk is still unknown. "We're always discovering things in human milk that ar there in small quantities that hadn't been looked at before," says John C. Wallingford, Ph.D, an infant nutrition specialist with FDA's Center for Food Safety and Applied Nutrition. "But infant formula is increasingly close to breast milk, especially in the area of fatty acids and lipids."

More than half the calories in breast milk come from fat, and the same is true for today's infant formulas. This may be alarming to many American adults watching their intake of fat and cholesterol, especially when high saturated fats, such as coconut oil are used in formulas. (High saturated fats tend to increase blood cholesterol levels more than other fats or oils.) But the low-fat diet recommended for adults doesn't apply to infants.

"Infants have a very high energy requirement, and they have a restricted volume of food that they can digest," says Wallingford. "The only way to get the energy density of a food up is to increase the amount of fat."

Homemade Isn't Best

Homemade formulas should not be used, says Nick Duy, assistant to the director in FDA 's division of regulatory guidance. Homemade formulas based on whole cow's milk don't meet all of an infant's vitamin and mineral needs. In addition, the high protein content of cow's milk makes it difficult for an infant to digest and may put a strain on the baby's immature kidneys. Substituting evaporated milk for whole milk may make formula easier to digest, but it is still nutritionally inadequate when compared to commercially prepared formula. Use of soy drinks as an infant formula can actually be life-threatening (See accompanying article).

Commercially prepared formulas are regulated by the Food and Drug Administration as a food for special dietary use. "Infant formulas are the most heavily regulated food that there is," says Wallingford.

FDA regulations specify exact nutrient level requirements for infant formulas, based on recommendations by the American Academy of Pediatrics Committee on Nutrition. The following must be included in all formulas: Protein, fat, linoleic acid, vitamin A, vitamin D, vitamin E, vitamin K, thiamine (vitamin B1), riboflavin (vitamin B2), vitamin B, vitamin B12, niacin, folic acid, pantothenic acid, vitamin C, calcium, phosphorous, magnesium, iron, zinc, manganese, copper, iodine, sodium, potassium, and chloride.

In addition, formulas not made with cow's milk must include biotin, choline and inositol.

The safety of commercially prepared formula is also enhanced by strict quality control procedures that require manufacturers to analyze each batch of formula for required nutrients, to test representative samples for stability over the shelf life of the product, to code containers to identify the batch, and to make all records available to FDA investigators.

Tags: Breastfeeding, Nutrition, Pediatrics

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