Social media does a great job keeping us up to date on the hottest new baby products (we’re looking at you Lalo high chair) and newest infant trends (breast milk necklaces!?). One of the recent baby trends going viral during Covid and supply chain challenges is homemade baby formula. It’s not safe and it’s certainly not formula that is FDA regulated.
To take a deep dive into this emerging new trend, we brought the conversation to Instagram live. Elieke Kearns, Registered Dietitian, PhD and Medical Lead at Bobbie, sat down with Dr Dina Dimaggio and Dr Anthony Porto, board certified pediatricians and Bobbie Medical Advisors.
Elieke: As board certified practicing pediatricians and co-authors of The Pediatrician’s Guide to Feeding Babies and Toddlers, can you share info on how your guide can be an important feeding resource to parents listening today?
Dr DiMaggio: This book was Anthony/my baby! We wrote it some years ago when our kids were starting solids. We were disappointed with the lack of trusted information out there. We wrote this with many of our friends who are sub-specialists in certain fields to give parents a source of trusted medical information based on research from the American Academy of Pediatrics (AAP) and our own clinical experience. We also included anecdotes on our own personal experience as parents to show how feeding can be messy and not always go according to plan. We wanted to create a trusted source that parents could turn to for guidance.
Elieke: It’s practical, relatable and we’re very thankful you both pulled this together for us!
Dr Porto, you are a board certified pediatrician and also hold the title of pediatric gastroenterologist. Can you share the elevator pitch of what a gastroenterologist is?
Dr Porto: As a pediatric gastroenterologist, I take care of specific conditions that affect the stomach, the esophagus and intestines. Kids with reflux, infant constipation, diarrhea and focusing on nutrition. Everything touches nutrition.
The homemade infant formula trend
Elieke: Today we’re going to talk about homemade formulas. We’re seeing this trend on the rise. My personal pediatrician said that, during Covid, she has seen more and more families making baby formula themselves. She expressed concern about it. Curious to get your perspective. From my background as a dietitian, I know the Academy of Nutrition and Dietetics released a Professional Practice Paper about the serious risks of homemade infant formula.
Why is this a trend? And why are we seeing parents doing this?
Is it even possible to make your own baby formula?
Dr DiMaggio: Everyone in the end wants the best for their infants. There is so much misinformation out there on the internet. As pediatricians and AAP spokespeople, we emphasize breastfeeding for the first 6 months, followed by solid foods and breastfeeding continuing up till one year (or as long as the mom desires). But there are a lot of moms who can’t breastfeed or need to supplement and we don’t want any guilt in there.
There are a lot of bloggers saying that baby formula is full of unhealthy ingredients, pesticides and bad sugars which is simply not true.
Why are people making homemade formula?
Dr DiMaggio: Parents who were illegally purchasing foreign formula are having a harder time getting it so a lot of people are turning to making their own formula due to supply chain issues and some of the misinformation out there.
How common is the homemade infant formula trend?
Elieke: Parents want to do what’s best, I understand, How common is this trend of homemade baby formula?
Dr Porto: We’re still trying to figure this out. We started studying these trends and with Covid we’re seeing it a lot more. We heard from the CDC that there are patients in the hospital that were sick from homemade formula. How do we get the message out there?
We’re working on a national survey to get the actual prevalence of this trend. What we’re finding is there is a lot of distrust in the current environment, and we think about this as pediatricians and as parents (I remember Googling this myself as a new parent).
In the US, we have one food in the country that has its own act: infant formula.
The Infant Formula Act is here to protect infants and ensure adequate development.1 But it was created in 1980 and there are a lot of changes that need to occur to make us feel more confident that the act is not only protecting our children, but also giving our children the best start for life.
What is the alkaline diet and how does it relate to homemade infant formula?
Dr DiMaggio: Social media is so prevalent, one of the big trends we saw is the alkaline adult diet that a lot of adults were following— thinking it was more healthy. That translated into the alkaline baby formula diet. We’re now seeing the CDC coming out saying that babies were hospitalized for it.
Elieke: The alkaline diet is a trend amongst adults. Eating is complex and these trends are a lot to unpack. But adults and babies have different needs. The diet a parent is following may not be appropriate for infants.
Dr Porto: Correct. As a pediatrician, the first thing we say is that ‘kids are not little adults’. This is key here. The alkaline diet may seem fine from a safety point of view. But what’s different for kids, is that for the first 6 months of life, baby formula (can be) their sole source of nutrition until solids are introduced. With a diet (like the alkaline diet) they’re missing the ingredients which provide macronutrients (fat, sugar, protein) as well as micronutrients and vitamins. This is getting these kids in trouble as their sole source of nutrition (lacking in these essentials).
Elieke: Nutrition is complex, for infants in particular, which is why we are grateful for The Infant Formula Act that regulates every single nutrient specifically in infant formula.1 It’s an incredible blueprint to ensure our babies are getting the best nutrition possible in a safe way.
Why making home-made baby formula is unsafe
Elieke: Let’s talk about the nutrition in these homemade formulas, what could be missing that you are very concerned about as pediatricians?
Dr DiMaggio: Some of the nutrients that we see missing are Vitamin D, calcium and iodine. Vitamin D is essential for healthy bones, we’re seeing severe cases of rickets happening which is the disease of weak bones. We’re also seeing iodine deficiency which is essential for thyroid function.
What are risks of homemade baby formula?
Elieke: Should an infant be eating a formula that doesn’t meet nutritional requirements? What are the risks?
Dr Porto: We’re seeing that for infants who eat a homemade formula diet, for even a month, could lead to severe malnutrition. It could lead to seizures because of electrolyte imbalances and mineral deficiencies. Some infants are needing to be in the intensive care unit where they need a tube to help them breathe; some infants face death.
I can’t overstate the fact that in the US, we have infant formula that is tested to ensure protein is available for your child and that’s it’s tested to have all the right amount of nutrients in there. These homemade formulas are lacking in so many different nutrients.
Is there a risk of infection with homemade baby formula?
Dr Porto: Yes, there is an infectious risk that comes with homemade baby formula! There are processes that a formula has to take to ensure they are safe and free of certain bacteria.
Pediatricians do not recommend homemade infant formula
Dr DiMaggio: We cook all the time for our kids, but we would never make our own formula. It can be very dangerous. Incorrect nutrients can lead to malnutrition and death. All of the sources have the potential for being contaminated.
Elieke: This is a really serious topic. As parents ourselves, we understand that parents want to feel confident about what you’re feeding your child, but we need to do it in a safe way that meets all of the regulations in The Infant Formula Act.1
What is a good substitute for baby formula?
Elieke: Because infants need a specific balance of nutrients for optimal growth and development, there are only two safe options: breast milk or regulated infant formula.
What should parents be aware of if they’re thinking of making their own formula?
Dr DiMaggio: As pediatricians we want to know WHY are you looking to do this? Formula is based on science. Talk to your pediatrician before you read information online that’s untrue. Our allegiance as pediatricians is to our patients. We recommend what is best for that specific patient. Your baby is our baby.
Dr Porto: One of the preliminary reports we’ve looked at, is that parents are choosing to NOT speak to/inform their pediatricians about this. Most of us pediatricians are parents and have been through this ourselves. We want parents to do what is best. Talk to your pediatrician. If you want baby formula that is organic or non-gmo, we can help you get to the best choice. Whatever you are looking for, we want to recommend something that is safe.
Elieke: You and your pediatrician are a team when it comes to deciding what’s best for your little ones.
If you have concerns about infant formula, reach out to Dr DiMaggio and Dr Porto on their Pediatricians Guide Instagram.
Editor’s Note: The United States Food and Drug Administration has an advisory warning on the making or feeding of homemade infant formulas.2 In this most recent advisory, the Agency states “Parents or caregivers of infants who have consumed a homemade infant formula should contact their healthcare provider and report any symptoms to their local Health Department. The FDA has recently received adverse event reports of hospitalized infants suffering from hypocalcemia (low calcium) that had been fed homemade infant formula.” By not providing adequate nutrition, homemade formula can lead to serious health consequences.