An all-time high, 77% of women in the United States start out breastfeeding their newborns.1 By 2 months of age, however, most North American infants are receiving at least some formula.2 A significant percentage (about 25%) of the formula sold in the United States is soy protein based, despite limited indications for the use of soy-based formulas.2 The American Academy of Pediatrics recently updated its review of soy protein-based formulas.2 The following are the recommendations of the American Academy of Pediatrics:

* The limited indications for soy protein-based formulas are galactosemia, hereditary lactase deficiency (rare disorders), or situations in which a vegetarian diet is preferred.

* Infants with documented cow milk protein allergy should be fed extensively hydrolyzed protein formula because 10% to 14% of these infants also have a soy protein allergy.

* Isolated soy protein-based formula has no advantage over cow milk protein-based formula as a supplement for breastfed infants.

* Soy protein-based formulas are not designed or recommended for preterm infants.

* The routine use of isolated soy protein-based formula has no proven value in the prevention or management of infantile colic or fussiness.

* Infants with documented cow milk protein- induced enteropathy or enterocolitis frequently are as sensitive to soy protein and should not be given isolated soy protein-based formula. They should be provided formula derived from hydrolyzed protein or synthetic amino acids.

* The routine use of isolated soy protein-based formula has no proven value in the prevention of atopic disease in healthy or high-risk infants.

On a reassuring note, the report also stresses that there is no conclusive evidence from animal, adult human, or infant populations that dietary soy isoflavones adversely affect human development, reproduction, or endocrine function.

References