Enriched Infant Formula: What is it and Should it Matter for You?
Have you seen all the headlines this week about enriched baby formula and future academic performance?
Or maybe you saw a headline that use the term fortified baby formula.
Either way, you’ve been curious about exactly what is enriched baby formula. In this post, we’ll tell you about enriched formula and whether these headlines should matter to you.
The History of Enriched Baby Formula
The birth of modern, processed infant formula can be traced back to around 1865, when chemist Justus von Liebig, a competitor of Pasteur and the founder of agricultural chemistry[1] developed and sold Liebig's Soluble Food for Babies. The same year, pharmacist Henri Nestlé, launched a similar product Larine Lactée in Switzerland.
Ever since von Liebig, manufacturers have sought to optimize formula components and recipes. In 2002, Mead Johnson introduced a new formula, Enfamil® LIPIL®, the first infant formula to contain DHA and ARA.
Here is there the story of enriched baby formula begins. . .
DHA is the abbreviation for docosahexaenoic acid, an omega-3 fatty acid that is critical for the structure of the brain. ARA is arachidonic acid, an omega-6 fatty acid is also abundant in the brain. Mead Johnson used this connection to advertise its new formula blend.
Enriched Baby Formula Marketing and Health Claims
From the beginning, Mead Johnson marketed their new Enfamil LIPIL formula heavily. And, by heavily, I mean the 50-ton truck heavy. (I was a pediatric registered dietitian at the time and had first-hand experience.)
One of their bolder marketing claims was that their LIPIL blend of DHA and ARA would lead to better eye development and baby IQ.
Formula-feeding parents may have been thrilled, but scientists were skeptical. Not just about better baby IQ, but also about better brain development. So, they did research and tested if giving DHA or ARA after birth showed benefits, which it does not.
Despite multiple warnings, Mead Johnson stuck by its claim, which eventually led to a complaint to the Federal Trade Commission in 2009. They were also sued three times for false advertising.
Today they no longer mention IQ replacing it with the vague description of “brain-building.”
And, almost 20 years after the introduction of Enfamil LIPIL, research continues to push back against these former claims.
Enriched Baby Formula Research
On November 101, 2021, BMJ published an article, they accepted less than a month prior, titled , Effect of Nutritionally Modified Infant Formula on Academic Performance: Linkage of Seven Dormant Randomised Controlled Trials to National Education Data”
The article linked together a series of infant formula trials with school records in the UK. The term “nutrient enriched formula” was used because they combined trials for slightly different formula ingredients. Two looked directly at DHA and ARA. Other trials looked at the effects of nucleotides, an ingredient with associations to absorption of fats like DHA and ARA. The final group of trials looked at another specialty fat, sn-2 palmitate and low
The article concludes:
Evidence from these randomised controlled trials indicated that the infant formula modifications did not promote long term cognitive benefit compared with standard infant formulas.
Baby Formula Health Claims
Unlike the rest of the world, the United States allows direct to consumer marketing of infant formulas. At the center of this advertisement and promotion are purported health benefits of ingredients, which in regulatory parlance are called “health and nutrition claims.” Commonly, they compare formula to components of breastmilk. And here is the shocker:
Infant formula health claims do not need to meet a scientific standard.
Infant health claims are protected by the First Amendment. Claims must only be “truthful and not misleading.” How do formula makers prove that a claim is truthful? By publishing research, poorly designed and biased research, which some experts believe is potentially harmful to infants.
Infant Formula Marketing Shouldn’t Drive Research
The idea of enriched formula being better is very attractive, but infant formula research to-date doesn’t make the case that enriched formulas are better than simpler baby formulas.
We need better research on infant formulas!
Another research group, found that infant formula trials are riddled with bias, lacked transparency, and overly influenced by the formula industry. Bad research muddies the water making it difficult to make sense of infant formula.
In September 2016, the US FDA released draft guidance for formula markers on substantiation of function claims made on infant formula. Five years later, that guidance remains in draft form with recommendations that cannot be enforced.
[1] Nutrition geek trivia: Twenty years prior to his formula, von Liebig developed a process for concentrating beef extracts that lead to the development of beef bouillon cubes. An altruistic endeavor, he hoped to improve the nutritional status of Europe’s poor. Exaggerated marketing claims about the curative powers of his “meat teas” ultimately led skepticism and a change in marketing tactics that led it to be a household staple by the early 1870s for enhancing stew flavor.