The American Academy of Pediatrics stresses that breast milk is the best food for babies. Formulas based on soy protein have been available for nearly a century as an alternative to cow's milk formulas for babies who can't tolerate them.
The Academy has now updated its advice on soy formula and set out the pros and cons of the phytoestrogens (plant oestrogens) it contains. Today all soy formulas are free of cow's milk protein and lactose and give 67 kcal per 100 ml; they are fortified with iron, zinc, vitamins and minerals to the Academy's standards, with soy protein isolate, L-methionine, L-carnitine and taurine. Their fat comes mostly from soy, palm, sunflower and coconut oils, with added arachidonic acid and docosahexaenoic acid (DHA), and their carbohydrates from sucrose and corn maltodextrin.
There has been growing interest in possible harmful effects of phytoestrogens on reproduction and sexual development, behaviour, immunity and the thyroid; on the other hand, studies suggest phytoestrogens may help protect adults against chronic diseases such as heart disease and breast, womb and prostate cancer.
The main recommendations
- Soy protein formulas can be used instead of cow's milk formulas for normal growth in babies with galactosaemia or inherited lactase deficiency, and when a vegetarian diet is preferred.
- Babies allergic to cow's milk protein should be given an extensively hydrolysed formula, because 10–14% of them are also allergic to soy protein.
- Apart from galactosaemia and inherited lactase deficiency, soy formula has no extra benefit over cow's milk formula.
- Routine use of soy formula has no clear effect in preventing or managing colic.
- Babies with bowel problems caused by cow's milk protein are often sensitive to soy protein too, so they should be given hydrolysed or amino acid formulas rather than soy formula.
The recommendations were published in Pediatrics in 2008.
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