Deficiencies of Milk Substitutes for Babies

    Q: With reference to the breastfeeding issue that made headline news, I am hoping you can clarify some questions and concerns that I am sure other readers will also find useful.

    I am referring to the sentencing of the parents of baby boy who weighed 4.3 kilograms when he died at the age of seven months. His parents had self-diagnosed him with gluten intolerance and a lactose allergy.

    I don't think it's uncommon for parents to self-diagnose these days, and with so much talk against formula milk and dairy products, it is understandable that they looked elsewhere.

    What is of concern is that they seem to have lost touch with the weight of the baby! Surely they should have sought medical attention sooner. I also wonder why such health-conscious parents did not breastfeed? Apparently the mother did not produce breastmilk. Why? Another puzzling question.

    And why was the milk they gave him (quinoa, buckwheat, rice and oat milks) not sufficient? Did it lack essential fatty acids perhaps?

    This story really saddens me. P.F.

    A: MARIANNE LITTLEJOHN REPLIES:

    It’s very interesting that parents may be oblivious to obvious signs of malnourishment in their offspring. This oversight occurs with farmers and farm animals too. Dr Pol, a veterinary surgeon in Michigan, recently advised a farmer to feed his calves more milk after some of the calves became ill with diarrhoea and died. The reason they died was that they were starving and had been fed too little. Undernourished baby animals are also very placid, easy to manage and pleasing. They have no energy and do not ‘bother’ the parents with their mobility or needs. They are just starving.

    There are a few reasons why vegetable/grain/nut milks do not work for babies. One reason is that they are low in protein or amino acids, needed for building babies’ brains and bodies. Human babies also have high needs for complex-chain fatty acids and carbohydrates (sugars) in a form the tender gut can digest. Another big factor is the gut flora that need to grow in a baby’s gut to optimise digestion and absorption. There is a close relationship between the gut flora and the immune system, and human breastmilk supports this relationship by providing the beneficial gut microbes and immune boosters. If a baby is fed with a ‘breastmilk substitute’, it needs to be scientifically assimilated from cow’s milk to make it digestible and to ensure the correct ratio of nutrients are present.

    Why this couple did not choose to breastfeed is not mentioned. It is possible that, on a vegan diet, the mother did not produce enough breastmilk. Another deficit that may occur in a vegan diet for a baby is a lack of vitamin B12. If the mother is vegan and breastfeeding, she needs to take supplements to ensure the baby gets enough vitamin B12 through breastmilk. Babies can die of vitamin B12 deficiency. Vitamin B12 is obtained from animal products such as milk, eggs, cheese and meat. Vitamin B12 is not available in any grain/nut/vegetable milk substitutes. When breastmilk and donor breastmilk are not available, the next best choice of milk for babies is infant formula.

    The International Code of Marketing of Breastmilk Substitutes is a set of recommendations to regulate the marketing of breastmilk substitutes, feeding bottles and teats. The Code aims to contribute ‘to the provision of safe and adequate nutrition for infants, by the protection and promotion of breastfeeding, and by ensuring the proper use of breast-milk substitutes, when these are necessary, on the basis of adequate information and through appropriate marketing and distribution.’

    The Code was formulated in response to the realisation that poor infant feeding practices were negatively affecting the growth, health and development of children, and were a major cause of mortality in infants and young children. The Code is complemented by a series of subsequent resolutions that further clarify and define its provisions.

    Editor's note: According to the World Health Organisation, less than half of children are breastfed exclusively for the first six months of life. Many women lack the support they need to breastfeed, with over half a billion working women globally lacking adequate maternity protections. Meanwhile, misleading formula milk marketing claims undermine breastfeeding at every turn.  For more on milk, read The Udder Truth about Cow’s Milk, by Jacqueline Wildish.

    Further reading

    1. Review of Infant Feeding: Key Features of Breast Milk and Infant Formula

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