Lecture 9 Flashcards
Complementary feeding -Infant formula
Infant Formula Feeding Recommendation
If an infant is not BF, then an infant formula should be used until the infant is one year of age
Three types of products on the shelves
-Infant formula (suitable for infants 0-<12 months)
-Follow on formula (suitable for infants 6-<12 months)
-Infant formula products for special dietary use
Regulation of Infant Formula
We need to regulate our infant formula so it is safe for our infants to consume
New Zealand standard and schedule
Standard 2.9.1- Infant formula Products
Schedule 29- Special purpose foods
All commercially produced infant formula products available in Australia and NZ must
comply with the composition and safety requirements outlined in the code
Standard 2.9.1 specifies
The mandatory nutrient content for infant formula and flow on formula to ensure that the nutrition requirements of infants aged up to 12 months are met
Includes labelling requirements for infant formula products and specifically
prohibits some types of claims, images and symbols on product labels
The standard also controls
food additives that can be added
Proposal P1028
what is it?
Review of the regulatory requirements (June 2024)
Proposal P1028
Purpose?
To ensure infant formula ramains safe, suitable and takes account of current science, market developments and the international regulatory context
Proposal P1028
Revision of …. standards and …. schedules
Transition period of …. years
5 standards and 8 schedules
transition period of 5 years
Proposal P1028
Key amendements:
-Prohibiting cross promotion of similar products on infant formula product labels
-Mandating NIP to better assist caregivers in informed choice
-Restriction on the scale of special medical purpose products, to ensure appropriate access and use
Infant formula products:
Current and amended Division 1
Current:
Preliminary
-Definitions
-Interpretation of compositional requirements
Amended:
-preliminary matters
-Definitions
-Interpretation of compositional requirements
Infant formula products:
Current and amended Division 2
Current:
General compositional requirements for infant formula products
Amended:
Compositional requirements for infant formula and follow on formula
Infant formula products:
Current and amended Division 3
Current:
Infant formula and follow on formula
- compositional requirements
Amended:
Labelling and packaging requirements for infant formula and follow on formula
Infant formula products:
Current and amended Division 4
Current:
Infant formula products for special dietary use
Three subcategories:
- Products formulated for premature or low birthweight infants
-Products for metabolic, immunological renal, hepatic, and malabsorptive conditions
-Products for special dietary use based on a protein substitute
Amended:
Special Medical purpose products for infants (SMPPi)
-Sale
-Compositional requirements
-Labelling requirements
Current has a Division 5 and 6 as well
5-Labelling and packaging requirements
6- Guidlines
Food giant warns that ….
441 jobs and $1b of exports at risk from infant formula labelling plan
They are advertising this formula to pregnant women who are…
Tired and in pain
Majority of infant formula health claims are poorly supported
41 groups of ingredients tied to…..
1884 claims
What percentage of these claims were not specific to an ingredient
50%
what percentage of these claims were supported by evidence
26%
what percentage was funded by formula companies or had authors with industry connections
88%
A lot of these health claims on infant formula have very
small or limited literature
They believe by removing health claims its going to
benefit to the purchaser
Home made infant formula
Safety concerns of the Paleo diet for infant and paleo DIY infant formula
Paleo DIY infant formula recipe was available online made from liver, cod liver oil, bone broth with no assurance for the safety, nutritional quality or appropriateness for infants
-Immature kidneys and GI tract
-Upper limits Vitamin A, high in sodium, protein and iron
-Microbiological risk with ingredients such as honey (botulism risk), runny eggs (salmonella) and raw liver, raw milk (listeria and salmonella)
Even famous cooks can make dangerous inventions for young ones
Pete Evans -2015
- Bubba Yum Yum
Chelsea Winter- 2020
Dairy-free toddler milk
Alternatives NOT recommended for infants <12 months
-Cows milk as a drink (instead of infant formula or breastmilk
-Plant-based milk alternatives (soy, oat, almond, coconut)as a drink
-Condensed milk
-Evaporated milk
There is two types of protein in infant formula
Casein and whey
Whey is ……..whereas casein …..
Whey is quickly digested whereas casein forms curds that are more slowly digested, resulting in slower gastric emptying
Expressed as casein:whey ratio
Breastmilk……
Whey dominant infant formula ……
Casein dominant infant formula…..
40:60
40:60
80:20
Whey and casein protein in breastmilk
Dominant whey protein in BM is alpha-lactoalbumin (low levels in formula)
Dominant casien is beta Casein (same as goats milk formula)
whey and casein protein in Cows milk formula
Dominnat whey protein in formula is beta-lactoglobulin (not found in BM)
Dominant casein is alpha casein
Infants who are struggling to digest cows milk they will be suggested to …
goats but this doesn’t usually work because if they struggle with cows they most likely will struggle with other mammalian milk
Soy based infant formula
Soy formulas contain….
The protein is…..
Soy formulas contain no cows milk, no casein and whey
Protein is soy protein isolate
Soy protein isolate is a
High digestible protein with high amounts of essential amino acids, it os supplemented with methionine, taurine and carnitine (EAAs)
Recommended for babies >6 months
Protein -infant weight regulation
Breastmilk: 1.5g/100kcal
Formula 2.2g/100kcal
formula-fed infants have tend to have greater weight gain than breastfed infants
Led to early protein hypothesis
Protein quality in in infant formula is positively associated with…..
Increased risk of overweight and obesity, and these effects may have a long-term impact beyond the first 2 years of life
FSANZ proposed standar changed because of
Growing interest in lowering the reuirements to potentially lower risk of obesity in childhood
2019 Nestle dropped
follow up formula only from 0.45g/100kJ to 0.38g/100kJ
July 2021 FSANZ considers that
More evidence is required to demonstrate the advantages of lower protein intakes for younger infants
- Proposed to keep minimum 0.45g/100kJ
Carbohydrate
Lactose is the major carbohydrate in human breast milk, cows milk and in most milk based infant formulas
Lactose intolerance is … in infants
Rare
Primary lactase enzyme deficiency
-Uncommon before 203 years of age
-Symptoms: Diarrhea, cramps, bloating, vomiting and gas
Secondary lactase enzyme deficiency
-More common
-Results from bowel injury, as an example infants who have experienced non-IgE-mediated cows milk allergy or viral gastroenteritis
Lactose free formulas generally contain
Corn syrup solids rather than lactose
-Many soy-protein formulas also do not contain lactose
FSANZ proposed standard changes
Codex STAN 72-1981 includes guidance on the type of digestible carbohydrate to be used (e.g preffered sources of carbohydrate and that sucrose and fructose should be avoided but this is not mandatory
Lactose and glucose polymers are the preferred carbohydrate
source in infant formula
Fat
Provides a significant percentage of energy 40-50%
Ratio of PUFA to saturated fat in milk affects…
Digestibility and facilitates absorption of calcium and fat from the gut
Main sources pf the fat
Vegetable oils, including : corn, soy, Linolenic acid within a specific ration and range
LCPUFAS are added to formulas at..
at a cost to the consumer (premium formula or “Gold”)
FSANZ proposed standard changes (fat)
Proposed to lower the maximum amount of trans fatty acids to 3% (from 4%)
Trans-fatty acids are?
Manufactured fats created during a process called hydrogenation, which is aimed at stabilzing polyunsaturated oils to prevent them from becoming rancid and to keep them solid at room temperature. Linked with heart disease and my pose a risk for cancers.
Other Optional substances ????
Prebiotic -Oligosaccharides
Probiotic
Organic Infant formula still need to
Meet regulations they need to meet their organic regulations which results in a higher price in organic infant formulas
Guide to choosing infant milk
Soy, lactose free, cow or goat protein based, partially hydrolysed or amino acid infamt formulas are…
suitable from birth
Codes applies to infant formula marketing
NZIFMA applies to the manufacturers, marketers and sistributors of infant formula
New Zealand Infant formulas in 2020 and expected in 2025
In 202 the revenue generated from infant formula exports from NZ exceeded $1.8 billion. By 2025, forcasted to reach $2.7 billion
Contaminated with melamine
Organic base chemical most commonly found in the form of white crystals rich in nitrogen
- added to milk powdered to increase the volume
Cause kidney stones and kidney failure
2008 melamine
Estimated 300 000 victims with six infants dying from kidney damage and 54, 00 infants hospitalised
Covid 19
Supply issues of infants formula
- Lead to increased demand for breast milk donations in milk banks
In covid 19 google searches for homemade formula recipes increased by
2400%
Society’s collective responsibility
Prevention of reocurrence
- Public education to increase confidence
-Strategy for production -multiple sites
-Breastfeeding support
