Saturday

Bone mineralization


In a document called Ross Infant Formula Applications of September 2006, a statement is made about the bioavailability of calcium from breastmilk versus infant formulas.
"The calcium bioavailability for infant formulas was assumed to be about 38% versus 58% for breastmilk (Foman & Nelson, 1993). Consequently higher levels of calcium was added to infant formula....to compensate for lower bioavailability."
"The high bioavailability of calcium from human milk can be partly ascribed to the molecular structure of triacylglycerides (TG)..."
They also state, "there is now a body of clinical data that shows palm olein or oil (PO) as the predominant fat in infant formula decreases fat and calcium absorption, and resultant bone accretion. A recent meta-analysis (Koo et al 2006) study revealed six controlled clinical studies (Carnielli et al. 1995, 1996; Lucas et al. 1997; Nelson et al. 1996; Ostrom et al. 2002; Tomarelli et al. 1968) showing lowered calcium/or fat absorption, and thre clinical studies (Kennedy et al. 1999; Koo et al 2003, Specker et al. 1997) showing lowered BMC and BMD in infants (age range birth to 192 days) fed PO predominant formulas."
Now, Abbott/Ross has a patent # 6620427 called "Method for improving bone mineralization," filed in 2001. That patent states, "Infants consuming formula containing plam olein oil had lower rates of calcium absorption." Thus the body of research they have at their disposal, shows them that past formulas decreased fat and calcium absorption. One can wonder how many children on those formulas as infants had higher rates of bone fractures or health problems?? Won't know, not a question we ask because infant formula is rarely questioned. Of course breastmilk/breastfeeding is thoroughly questioned. Currently, the premise regarding preterm infants and breastmilk is that there isn't enough calcium. This is partly the basis for fortification of breastmilk for preterm infants. Yet in looking at the various studies, most if not all studies are funded by the infant formula industry (some of the researchers in these studies are the inventors to patents in the infant formula industry). Should we question this research?
One of the problems of feeding premature infants is that these babies are often fed through plastic tubing not at the breast. We know that alot of the fat content of human milk will stick to that tubing. How much of the problem of weight gain, bone mineralization (bioavailibility of calcium dependent on certain fats) in preterms fed breastmilk is in the way they are fed? Many of the moms of preterm babies that I worked with in the WIC Program, never actually put their baby to the breast until they were at home. Their babies had gotten pumped breastmilk and supplements. Many of these moms never did get the baby to the breast at home. Some continued to pump but most found pumping and making up special formulas too overwhelming. This was between 1994-1998 and I can only hope that things are better than 10 years ago.
The question, though, is whether medical protocol based on research funded by the infant formula industry is based in truth/reality. We have a body of research supporting the supplementation of the preterm infant fed breastmilk. Yet, it seems rather strange that we are trying to make infant formula just like breastmilk. How logical is our belief system when it is based on the wants and wishes of an industry?

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