Baby Development – AAP Changes Its Stance on Infant Soy Formula

By Colleen Hurley, RD, Certified Kid’s Nutrition Specialist

For mothers who are not breastfeeding, choosing the right infant formula for your baby can be a tough decision.  While many mums and physicians alike often attribute colic to the type of formula an infant is eating, this may not always be the case.  Switching from a cow’s milk based formula to a soy based that utilizes the proteins found in soybeans was previously the protocol for infants suspected of a cow’s milk allergy. The American Academy of Pediatrics announced this week they have a change of opinion regarding soy based infant formulas.

A new clinical report by the American Academy of Pediatrics (AAP) revises its 10 year old position statement on the use of soy based formulas.  Instead of switching to a soy infant formula, the AAP now advises the use of a hypoallergenic formula due to the fact that about 10-14% of infants with a cow’s milk allergy are also allergic to soy. 

Most infants in North America are drinking some type of formula by 2 months of age, with a quarter of formula sales going to soy.  The AAP wants to make it clear to parents and pediatricians that there are actually very few reasons to give a baby a soy based formula.

According to the new report, the only formula fed babies who should receive a soy formula are babies with:

• a true lactose intolerance: actually more rare in babies than in older kids, but not the same as a cow’s milk allergy as lactose intolerance is the inability to digest lactose (the main sugar in milk) while a milk allergy is an immune mediated response to the proteins in cow’s milk
•  parents who are strict vegans: those who do not eat animal products of any kind including meat, dairy, and eggs
•  congenital galactosemia: a condition where babies lack the enzyme needed to convert galactose (found in lactose) into glucose. This is typically a genetic condition that can pose serious health risks as galactose builds up in the bloodstream

The AAP also recommends a hypoallergenic formula for babies who have had gastrointestinal upset from cow’s milk such as abdominal pain, blood in stools, or diarrhea; because 30-64% of babies will have a similar reaction to soy.  In addition, the report addresses the phytoestrogens (estrogen-like plant compunds) known as isoflavones found in soy to not have any adverse affects on human development, reproduction, or endocrine function.  All the major health organizations agree that breast milk is best for at least the first 6 months of life.  If you choose not or are unable to breastfeed, be sure to discuss infant formula options with your physician.

Resource:
 “Use of Soy Protein-Based Formulas in Infant Feeding," Pediatrics, May 2008