Low-Protein Infant Formula: What to Tell Parents
Nutrition in the first 2 years of life has a significant long-term effect on a child’s health, and lower-protein infant formulas that are less energy-dense have emerged as a strategy to reduce or prevent overweight and obesity later in childhood.
Newly introduced formulas with varying amounts of calories and protein, coupled with other available formula choices (reduced iron, reduced lactose, added prebiotics, added probiotics, soy-based or milk-based, etc), are sure to raise questions among parents as they try to choose the best formula for their infant.
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Pediatricians Frank R. Greer, MD, and Steven A. Abrams, MD, help answer these questions in a March article published online ahead of print in AAP News, the news magazine of the American Academy of Pediatrics.1 The article features links to supporting studies in the medical literature.
The authors write that the risk of overweight is higher in formula-fed infants, since their protein and total energy intake generally is greater than that that of breastfed infants. They note that some evidence suggests that this difference results from an increased volume of intake in formula-fed babies.
“There are two important issues here. The first is whether the historically used protein content (1.4 g per 100 mL) and energy density (67 kcal per 100 mL) in formulas can be decreased safely. The second is whether such changes will meet the objective of decreased weight gain,” they write.
The new formula contains 1.3 g of protein per 100 mL and 64 kcal per 100 mL, approximately a 5% decrease from traditional infant formulas. “However, no studies have evaluated the risks or benefits of decreasing protein content and energy density by this amount in U.S. infants,” they write.
Parents should be advised that the U.S. Department of Agriculture requires that formulas used for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) deliver 67 kcal per 100 mL. Because WIC accounts for just over half of all formula consumed in the United States, “the majority of U.S. infants would not be able to readily obtain newly released lower protein and energy dense formulas,” the article notes.
“Pediatricians must weigh the theoretical benefits of a 5% decrease in calories and protein against limited studies with no long-term outcome data to support the changes,” they advise.
—Michael Gerchufsky
Reference:
1. Greer DR, Abrams SA. What pediatricians need to know about new low calorie/low protein formulas (published ahead of print March 28, 2014). AAP News. doi:10.1542/aapnews.20140328-1.