Natural Family Online Special Report:
The deadly influence of formula in America
By Dr. Linda Folden Palmer
Editor’s Note: This groundbreaking
analysis from noted author, health educator and advocate Dr. Linda
Folden Palmer is the first time a health expert has published
an examination of the available scientific research comparing
the death rates of formula-fed and breastfed babies. While the
results hold no surprises for breastfeeding educators and advocates,
the study may prove to be a rude awakening for the millions of
Americans who have bought into the myth that infant formula is
a perfectly safe breast milk substitute. We’ve summarized
Dr. Palmer’s detailed research for our cover story here.
Read the full text with
footnotes and references.
Read the follow-up
article on optimizing the health of formula-fed babies.
Homebirth or hospital? Cloth or
disposable? Early exposure to large numbers of other children?
Extreme or relaxed sanitation? Pets in the house?
The answers to the swirl of questions
surrounding the birth of a baby are not simple. There are no overall
right or wrong answers. Parenting involves a huge number of choices,
starting from before conception and reaching through childhood
In many cases, we don’t have
the time or energy to investigate and choose from all the available
options. We opt for the status quo or simply what seems easiest
for our families. Other times, we do not have the luxury of choice;
circumstance prevails. Traveling in a car with our children, for
instance, is a risk that most of us take because we have little
Still, many major parenting decisions,
including the decision to breastfeed or use infant formula, remain
conscious choices for most parents. What’s often missing
from this decision are the facts. Sure, we’ve all heard
that “breast is best” -- but what are the solid statistics?
Is infant formula the perfectly safe breast milk substitute we’ve
been led to believe?
The deadly influence of
Infant formula was designed to be a medical nutritional tool for
babies who are unable to breastfeed. Formula does not fully meet
the nutritional and immunity needs of infants, leaving their immune
systems flailing. An infant’s immune system has three aspects:
her own immature, developing immune system; the small component
of immunities that passes through the placenta during natural
childbirth (and to a lesser degree with premature births and cesarean
sections); and the most valuable, living portion that is passed
on through mother’s milk on an ongoing basis. Remove any
of those components and you take away a vital support structure.
This brings us face to face with
the safety and effectiveness of infant formula as a breast milk
substitute. Is formula actually as safe as we have been led to
believe? In fact, the answer is a resounding “no.”
In fact, the use of infant formula doubles the risk of infant
death for American babies.
While the dangers of formula feeding
aren’t something you’re likely to hear in your doctor’s
office, the conclusions can be derived through an examination
of the available scientific research on infant mortality in the
United States and across the world. There are studies showing
artificial feeding’s impact on overall infant death rates
in both developing and undeveloped countries. While studies offering
comparative death rates are not available for industrialized regions,
there are numerous studies providing comparative occurrence rates
for many illnesses and disorders in the United States and other
industrialized nations. Many more reports are available extolling
superior survival rates and decreased illness rates among breastfed
infants, but only those with solid numbers are useful here. We
can assemble the statistics from these studies to build a firm
picture of the ratio of infant deaths for U.S. formula-fed babies
against those who are breastfed.
Why do U.S. babies die?
Total U.S. births in 1999: 4,000,000
Total U.S. infant deaths in 1999: 28,000
So how does formula play into these
deaths? Let’s look at some of the common causes of infant
death and see what current research has to say on the involvement
of infant formula.
Sudden Infant Death Syndrome
(SIDS) Studies have found a five-fold risk of infant
death from SIDS for American formula-fed babies.
Heart, circulatory and
respiratory failure Scientists worldwide have documented
higher blood pressure among formula-fed infants, as well as more
apnea and episodes of oxygen desaturation, inferior body temperature
regulation, less growth and longer hospital stays.
Researchers in the United Kingdom have confirmed that formula-fed
infants develop necrotizing enterocolitis six to 10 times more
often than breastfed babies.
Diarrhea A summary
article for industrialized nations demonstrated an average of
triple the risk of diarrhea for formula-fed babies. The risk in
China and Israel is reported as slightly less than triple; in
Scotland, the risk is five-fold; and a doubled risk is measured
Respiratory illnesses It
is clear that respiratory infections are at least triple in the
United States for formula-fed infants. The death rate is likely
to be even higher, since some of these studies note that both
the severity and extent of respiratory illnesses are considerably
higher once they occur.
Cancer A joint
study between the United States and Canada on neuroblastoma, a
common childhood cancer, revealed a doubled risk for children
who did not receive breast milk for more than one year. This study
is consistent with several other childhood cancer studies in other
Low birth-weight and pre-term
birth A U.S. study performed at George Washington University
Hospital found 2.5 times the number of infections among formula-fed
infants in the intensive care unit than among those receiving
human milk. Another study at Georgetown University Medical Center
also found more than double the number of infections in very low
birth-weight infants not receiving human milk. A San Diego study
found twice as many infections in pre-term, formula-fed infants
compared with infants who received human milk.
It is worth noting that the eye
damage that can occur in very low birth-weight infants, retinopathy
of prematurity, occurs only half as often in infants who receive
some breast milk. Even a disorder as apparently unrelated to feeding
methods as inguinal hernia has been discovered to occur twice
as often in artificially fed infants and even more frequently
when compared with infants who are exclusively breastfed.
Twenty percent of U.S. infant deaths are attributed to birth defects.
While death certificates often list the initial abnormality as
the cause of death, infection is actually the final factor in
many of these deaths. We have already seen how drastically infection
rates and deaths are reduced by breastfeeding. It is clear that
the youngest and weakest infants are the ones who are most strongly
endangered by infant formula’s inadequacies.
For example, infants born with
phenylketonuria (PKU), a defect in handling a certain protein
in the diet, need specialized supplementation to breast milk in
order to prevent mental retardation and other difficulties. Yet
a study demonstrated that infants who had been breastfed before
being diagnosed with PKU fared far better than those who had been
fed on formula. The greatest complications for infants with cystic
fibrosis are lung infection, decreased oxygenation and malnutrition
– all of which are recognized to be complicated by formula
Complications of pregnancy
and birth Complications of pregnancy and birth produce
a wide range of injuries and problems for babies. Infection, insufficient
neurological recovery and inadequate oxygenation lead to many
infant deaths. Artificial feeding certainly has some degree of
impact on mortality in these cases.
Accidents It seems
logical that accidents happen equally among artificially and naturally
fed infants. Figures bear this out. One paper actually measured
accidental injuries between breast- and formula-fed infants, finding
an equal number in both.
The big picture
The relative risk for formula feeding in many categories was clearly
defined by studies. We are able to select conservative but appropriate
rates, as seen in the table below.
Formula’s Final Impact
U.S. infant deaths (1999)
risk for formula-fed infants
IMR for breastfed babies
if all were breastfed
if all were formula-fed
saved if all were breastfed
|Complications of pregnancy
|Respiratory distress &
Infant Mortality Rates (IMR)
are the number of infant deaths per 1,000 live births, from 0
to 12 months of age.
Based on the current U.S. infant
death rate of 6.7 and an average breastfeeding rate of 50%, the
American infant mortality rate would climb to 9.4 if all infants
were formula-fed and would drop to 4.7 if all were breastfed.
Twenty-two nations with high rates of breastfeeding have infant
mortality rates below 5, while the United States ranks higher
in infant death than 41 other nations. Clearly, lower rates for
the United States are a possibility.
The ugly truth about formula
From the above statistics, we see that formula feeding costs
American babies three or four additional lives per thousand.
relative risk for formula feeding comes out to 2 – that’s
double the risk of death for American infants who are fed with
formula, compared with babies who are fed naturally.
A multitude of studies demonstrate
that when breastfeeding is accompanied by formula supplementation,
illness and death rates are much closer to those of babies who
are fully formula-fed. Studies also reveal conclusively that the
longer breastfeeding lasts, the greater the measurable difference
in illness and death rates.
Answering the detractors
Criticisms are often spread about studies that find increased
illness and death rates associated with formula feeding. For just
this reason, each later study aggressively attempts to take into
account any factors that have been purported as distorting previous
study outcomes. These research papers address as many aspects
as possible, from maternal education, to smoking, to income level,
to day care usage and many more possibilities. The results continue
to reveal the risks of formula feeding.
It’s commonly said that formula
feeding does not risk lives in industrialized nations where education
and medical advances prevent increased deaths. The evidence is
quite to the contrary. Some insist that the blame for the United
States’ relatively high infant death rate lies with underprivileged
communities. Again, it has been shown that elevated death rates
among U.S. blacks cannot be attributed to poverty. Hispanic Americans
rank similarly to African-American populations for socio-economic
factors, but they match non-Hispanic whites in their lower infant
mortality rates. The difference is not socio-economic; rather,
the difference is in rates of formula use versus breastfeeding.
A New York study sought to establish
the connection between education, income and infant survival.
It concluded strongly that the number of illnesses is increased
by two to three times in formula-fed babies regardless of socioeconomic
status or level of parental education. A later study in Israel
confirmed the effects of formula feeding across all classes and
education levels. The most recent analysis of this issue, again
performed in the United States, reiterated that higher illness
rates among formula-fed or formula-supplemented infants “did
not differ among income groups.”
And beyond the first year
While the extent of breast milk’s health protection declines
with age, a great number of studies demonstrate the continued
survival advantage of breastfeeding through the second year and
beyond. A World Health Organization study of less-developed countries
found a doubled risk of death in the second year of life for those
weaned prematurely or never receiving breast milk. A study in
The Netherlands found a strong correlation between the extent
of breastfeeding and the number of illnesses in children. Significant
protection from breastfeeding was noted during the first three
years of life. Other studies show a sizeable increase in illnesses
throughout all of childhood for those who were never breastfed
or prematurely weaned. In fact, an increased risk of death throughout
life has been well documented for people who were formula-fed.
Higher blood pressure, more heart disease, obesity, diabetes and
artery disease, a nearly doubled rate of Crohn’s disease
and tripled rates of celiac disease have all been associated with
early formula feeding.
What your doctor doesn’t
Pediatricians spend much time frightening parents with something
like a 1 in 100,000 combined risk from vaccine-preventable diseases
when parents question the utility and safety of vaccines. “Would you want to risk
the life of your child?” they demand. Yet these very same
professionals offer formula samples with the other hand –
when the magnitude of health risks associated with the use of
formula is 500 times greater.
Parenting is all about making choices
and weighing risks and benefits. Many parents need to make the
riskier choice of formula feeding in order to balance other factors
that benefit the family. Yet some parents who have lost their
children, possibly based on pediatric advice condoning or encouraging
formula-feeding, would surely wish that they had been informed
of the very real risks related to using formula.
We’ve summarized Dr.
Palmer’s detailed research for our cover story here. Read
the full text with footnotes and references.
Dr. Linda Folden Palmer consults
and lectures on natural infant health, optimal child nutrition
and attachment parenting. After running a successful chiropractic
practice focused on nutrition and women’s health for more
than a decade, Linda’s life became transformed eight years
ago by the birth of her son. Her research into his particular
health challenges led her to write Baby
Matters: What Your Doctor May Not Tell You About Caring for Your
Baby. Extensively documented, this healthy parenting
bookpresents the scientific evidence behind attachment parenting
practices, supporting baby's immune system, preventing colic and
sparing drug usage. You can visit Linda’s web site at www.babyreference.com.
Deadly Influence of Formula in America
was listed on 12/04/03 at www.mercola.com/blog
with Dr. Joseph Mercola who said, "This groundbreaking and
MUST read analysis from a noted author is the first time a health
expert has published an examination of the available scientific
research comparing the death rates of formula-fed and breastfed
babies. While the results hold no surprises for breastfeeding
educators and advocates, the study may prove to be a rude awakening
for the millions of Americans who have bought into the myth that
infant formula is a perfectly safe breast milk substitute.
Infant formula was designed to
be a medical nutritional tool for babies who are unable to breastfeed.
Formula does not fully meet the nutritional and immunity needs
of infants, leaving their immune systems flailing. An infant’s
immune system has three aspects: her own immature, developing
immune system; the small component of immunities that passes through
the placenta during natural childbirth (and to a lesser degree
with premature births and cesarean sections); and the most valuable,
living portion that is passed on through mother’s milk on
an ongoing basis. Remove any of these components and you take
away a vital support structure. You
can review my article earlier this year on healthy alternatives
for further information."