Monday, October 22, 2012

Formula Facts Versus Fiction - Part 1

As you know, JaneMD loves Part 1 and 2's. So here comes another one on formula . . . particularly since some people have expressed some interest in more about newborn care/prices

Real conversation in the outpatient office:

Patient's Mom: My baby spit up alot since I changed to step 1 formula at 2 months. So we tried the sensitive formula; she was still gassy. I tried soy for a few weeks and she seemed better, but after she had a big spit up, I went out and bought some Alimentum now that she's five months.  She doesn't like it very much, but she's stopped spitting up. I know she's lactose intolerant.
Me: How many ounces were you feeding her at a time when she was 2 months old?
Patient's Mom: Eight
Me: How many ounces does she take now at a time?
Patient's Mom: Six or seven

This mom has fallen into a trap that I think of as 'The Great Formula Lie.' This mom had no idea she was taken in by advertising and false claims. She spent alot of money and time switching formulas for spitting up when if she had not overfed her two month old, took some precautions like sitting her baby upright after feeding, or asked her doctor, she very likely would have it avoided completely. 

So in this two parter, I will discuss major lies - I mean 'selling points' that marketing trying to use on you.

#1 - Stepwise formula:
Ah, Enfamil. Even though I was a solid breastfeeding mother for the first 7 months of life, you continued to send me formula samples. Your advertisements said things like 'I am not a baby, I am an infant.' All ridiculous lies. I appreciate that you sent me a sample of Newborn and Step 1 once a month, though because it was free.

I once set those Newborn and Step 1 cans next to each other and examined the ingrediates and nutrients. Essentially exactly identical. The ONLY difference was Newborn had 75 units of Vitamin D and Step 1 had 60 units per 5 ounces. That is all. The entire difference. Both claimed to have prebiotics, both claimed to have DHA and ARA. 

Well, Vitamin D must make a difference, right? Not really. Your child is recommended after the age of 3 months, if breastfeeding, to get 400 IU of Vitamin D daily. Step 1 formula would require drinking of 33 ounces and Newborn formula would require 27 ounces a day. The newborn formula claims to be used 0-3 months, and the step 1 is 0-12 months. Except you don't need vitamin D supplement until 3 months of age and then you don't really need the newborn formula, or you could buy all newborn formula since the difference is so small.

I grabbed Walmart formula and guess what - it is completely identical to Step 1 Enfamil! Everything is the same - including its claims for DHA, ARA, and prebiotics. This is because the US FDA controls what is in formula and it must meet a certain requirement so all formulas, Enfamil, Similac, any generic are nutritionally, for all intents and purposes, the SAME. In fact, there are no studies that show outcome (IQ, growth, and so forth) over any type of formula in a normal child. These claims are like stating that using a 'Graco' carseat over a 'Costco' carseat will make your child more likely to graduate college.

Enfamil also started sending us 'Enfagrow' stage 2 powder for kids older than 1 year old. However, there is no reason to be giving formula to a normal child after he/she turns 1. The label claims to be much better than whole milk - though hilariously the first ingredient is whole milk. If you are still feeding your child formula at a year, you are failing introducting new foods.  Your child should be taking up to 24 ounces of milk a day and all the rest of his/her nutrition should be from FOOD. Not formula! For much cheaper, feel free to feed your child whole milk and give them a chewable vitamin with iron once a day. Many kids can be picky eaters, and this is just to bolster any nutritient they may be missing.

#2 - Marketing through fear:
The label on the advertisement for Enfagrow reads "Enfagrow Preminum Toddler or Milk? **You decide**" (It really said that.)
Translation: You are failing your child if you do not buy this formula. Even better, they have a random well groomed woman in a white coat holding her glasses. I assume, since she is unlabeled, not wearing an ID, and testifying her love of Enfamil, she is a model portraying your friendly pediatrician. (Similac is has similar ads; I just happen have the advertisement on hand)

Look at the claims on a typical can of formula. You'll see they claim improved brain growth, size increase, and all sorts of other things. As I said, since formula is controlled through the FDA, all of the differences between the standard formulas are going to be minimal. You can't fail on any of them. We did all Walmart formula for the first child and are currently using Enfamil because I get it free as a hospital employee.

Don't be confused - there is nothing wrong with using formula. Not everyone wants or needs to breastfeed and that is OK. Just don't fall for the marketing that tries to convince you one is better than the other.

To be continued in Part 2 next week where I'll discuss various types of formula that are out there.

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