Formula Update

Naomi's Formula Update

Recently, Consumer Reports came out with information about testing they did on heavy metals and infant formula that has worried some parents. I am NOT a formula expert, but wanted to share some helpful information I found.

First of all, the good news is many formulas tested just fine, including a couple I often recommend people try (Bobbie and Bubs) which are organic and we knew followed higher standards. I hear good reports from folks about their babies tolerating these formulas, and they are also usually pretty widely available (Target, etc). Both have alternatives for babies who have difficulties digesting the first line formula. But there are lots of good formula options in the "Top Choices" category! Remember, all formulas will equally meet the essential dietary requirements of babies.

Unfortunately, a few of the formulas that did not test well are the ones that some families and pediatricians turn to most frequently when babies are struggling with a cow's milk protein allergy or other digestive issues - Nutramagin, EleCare, and Alimentum. I know this will worry families using these formulas! So, a few thoughts:

• Our Sainted Emily Oster  - also on Instagram - (if you don't know her, she calls herself a 'reproductive economist', she looks at all the data around pregnancy, birth and parenting) shared useful context around the report. Consumer Reports was measuring four metals specifically: arsenic, lead, mercury and cadmium. None of the formulas were found to have mercury or cadmium. Some formulas had elevated levels of arsenic and lead, even getting to the higher 50% - 100% of the maximum allowable dose level (MADL) as recommended. HOWEVER, she points out that the maximum allowable dose for formula is (understandably) still FAR under the safety bar that the government sets. In other words, your babies are ok, and likely not being exposed at a meaningful level. (Quotes below from Emily Oster)

• "To slightly elaborate, let’s begin with lead. I have written about this before, but the MADL set by California is one-thousandth the level at which any negative impacts have been seen. In other words, saying that something has “50% of the MADL” is the same as saying it is one two-thousandth of the level that has been shown to have negative effects." 

• "In the case of arsenic, again the levels here are very different from those in many of the studies of concern. In Latin America, levels of arsenic in the water can rise as high as 2,000 parts per billion. Similar levels are seen in parts of West Bengal, India. Obviously, negative impacts can occur at lower levels than this — but it is worth keeping in mind that these levels are perhaps 100 times as high as those seen in the formulas tested and this is exposure in water, a much larger part of consumption. The simplest way to express this point about arsenic may be to note that the EU limit on arsenic in formula is 20 parts per billion. All of the formulas tested were below this."

• I also appreciated this Substack post from a pediatrician. He notes that what happens frequently is that babies who need these special formulas are put on them, and not taken off, often until they age out of formula at 12 months. Commonly, we see babies grow out of a cow's milk protein allergy around 6 months. So it is worth making periodic experiments with standard formulas to see if your baby can tolerate it again - partly to avoid these formulas with more of the heavy metals, but also because they are much more expensive and babies tend to not like them as much. 

I also really like this explainer on the issue from one of my favorite formula resources, The Formula Mom (click on the saved highlights Heavy Metals at the top of her page). She’s a good one to follow, if you don’t already.

If you have more questions about bottlefeeding or formula, the Infant Feeding Counseling session is for you - I’m here to help if I can! In the meantime, try not to stress - this news is not as bad as the headlines made it appear at first glance.

Keep up the good work!

~ Naomi, Infant Feeding Expert