Pediatric experts warn that feeding babies homemade baby formula can be dangerous. Dr. Meg Frizzola, chair and chief of pediatric critical care medicine for Nemours Children’s Health System in Wilmington, Delaware, and Nicole Fragale, manager of clinical nutrition there, join CBSN’s Lana Zak to discuss.
LANA ZAK: In “Health Watch,” pediatric experts warn that they are seeing a rise in infants admitted to the hospital after being fed homemade baby formula. Some parents have been making formula at home to save money during the pandemic, others may see it as a healthier alternative to commercial products. But doctors say homemade formulas can sicken babies, lead to nutrient deficiencies, or stunt physical and mental growth.
For more on this, I want to bring in Dr. Meg Frizzola and Nicole Fragale. Dr. Frizzola is the Chair and Chief of Pediatric Critical Care Medicine for the Nemours Children’s Health System in Wilmington, Delaware. And Nicole is the Manager of Clinical Nutrition there. Thank you, both.
Dr. Frizzola, I’m going to start with you. You have been treating babies who had to be admitted to the pediatric ICU after being fed homemade baby formula. Tell us about those cases and what symptoms those babies had.
MEG FRIZZOLA: Sure. We noticed a disturbing trend of two infants ages four and five months who presented within a one-week time period with signs of seizures, and respiratory distress, and sleepiness, and ultimately, cardiac arrest.
LANA ZAK: Cardiac arrest. That– that seems incredible. I mean, it can’t be underscored how serious this is. So Dr. Frizzola, why is this happening now?
MEG FRIZZOLA: Sure. Those symptoms can be very generic, and at first we didn’t realize what the problem was. Certainly, electrolyte imbalances are one of the causes of seizures, and twitching, and sleepiness, and irritability, and ultimately, your heart can stop, or cardiac arrest. And so we certainly sent all of the laboratory values and determined that both of these children had significantly low levels of calcium in their bloodstream, which ultimately has the impact and can potentially be fatal.
LANA ZAK: I have to ask, how are those babies doing now?
MEG FRIZZOLA: Fortunately, one child presented and was able to very quickly be resuscitated with IV calcium, and vitamin D, and some other electrolyte replacements and was discharged from the hospital after just a few days on oral supplementation of calcium and vitamin D with an appropriate commercially available formula. The other child who did suffer a cardiac arrest is still in the hospital, is– is fortunately doing better, is off the ventilator and is out of the intensive care unit, but the long-term impacts we aren’t sure of yet. They’re still receiving physical therapy and occupational therapy, as well as speech therapy. And we won’t know the long-term cognitive impact for quite some time.
LANA ZAK: That is so frightening and those poor parents. Nicole, we have seen this trend on the rise during the pandemic. Is it at all possible to make healthy and safe baby formula at home?
NICOLE FRAGALE: So we do not recommend making homemade infant formulas at home. We know that the FDA regulates infant formula, and there are very specific requirements in terms of the macronutrients that are in infant formulas in terms of the amount of protein, the carbohydrate, the fats. There are very specific blends that are needed for appropriate growth and development in infants.
And in addition to that, there are very specific amounts of vitamins and minerals that must be in an infant formula in order for a baby to thrive. And we know that these infant formula recipes, these homemade recipes that are available out there on the internet just do not– do not measure up, and they cannot meet the needs of what you will find in the FDA-regulated infant formulas.
LANA ZAK: So Dr. Frizzola, I’m wondering with these patients, the parents of the infants that you treated, why did they say they made their baby formula at home? And what were some of the first signs that their babies were in trouble?
MEG FRIZZOLA: Sure. There are many reasons that– that parents choose to try to make a homemade formula. And I have to stress that most of them truly just want the best and think they’re doing the right thing for their children. One of them was very worried about lactose intolerance, and they thought that they needed to give a dairy-free formula, so searched the internet and found these recipes. They’re– they’re very abundant on the internet, which is somewhat worrisome. The other family really wanted to have a vegan formula for their child. They thought that organic, natural, healthy products would be the best for their infant, not realizing the damage that– that can occur, particularly in children less than one year.
They first started noticing these babies were a little bit sleepier, not waking up for feedings. They were a little bit fussy when they were awake. They started vomiting. And then they started twitching, which is the early signs of potentially seizures, which shows, in this case, low calcium. Eventually, they had trouble breathing, and ultimately, they– they came to the emergency rooms to be treated.
LANA ZAK: Dr. Frizzola, I know firsthand how expensive some of those formulas can be, the specialty formulas, especially if you have a lactose-intolerant infant. I’m wondering, is the real problem here malnutrition for these babies? Or are you more concerned about other things getting in there that baby’s can’t have when parents are trying to make this formula at home?
MEG FRIZZOLA: Sure. There are several types of malnutrition, and one of them is– is kind of the traditional version where you see a child or an infant that looks emaciated. Their eyes are sunken in, and their– their muscles are wasting. And– and that really shows a lack of fats and energy that your body needs.
And that’s not what we’re seeing with these homemade formulas. What we’re seeing is more on the inside in your electrolytes, in your micronutrients, your vitamins and your minerals. And it isn’t quite as apparent, and it’s a lot more difficult to see.
LANA ZAK: And Nicole, if parents are unable to breastfeed or need to supplement, how can they determine which commercial formula will be best for their– their baby, particularly if– if cost is an issue in their family?
NICOLE FRAGALE: Sure. So there is such a variety of infant formulas available on the shelves these days, it can certainly be overwhelming. And if that’s the case and a family has a very specific need that they’re looking for for their child and they just feel stuck, they certainly could reach out to their pediatrician or registered dietitian who could help guide them. A parent may be looking for a vegan formula, in which case we would recommend a soy-based FDA-regulated formula.
Or that there may be other issues at hand, such as intolerance, in which case, we could recommend a formula that has a little bit more of a broken down protein. And there also are some hypoallergenic formulas out there that are meant for babies with have multiple food allergies. So I can speak to the families who can’t afford it. There are government assisted programs out there, such as WIC, also known as Women, Infant, and Children, and the SNAP program, Supplemental Nutrition Assistance Program, which can help families to afford and obtain infant formulas.
LANA ZAK: One last question for you, Dr. Frizzola, given– I’m just thinking about what you said, that these recipes are so plentiful online and given the pandemic and the constraints that people have faced, they’ve seemed to have flourished in this time period. Do you think that they should be– people should be held accountable for putting up this information or that this information ought to be accompanied by a warning given what you’ve seen?
MEG FRIZZOLA: I absolutely do. We actually, as soon as our second child presented and we realized it was the exact same recipe from the exact same website on Pinterest and YouTube, we alerted the FDA. And they actually issued a MedWatch for this exact issue. I actually just met with our state legislator earlier today, and they are taking action to try to get warnings associated with all of these postings so that families are educated. We understand it won’t necessarily influence everyone’s choice and decisions, but we can’t stress enough the dangers of using these homemade vegan formulas without regulation.
LANA ZAK: A really important warning for parents, as you say, who are trying to do the best for their children. Dr. Meg Frizzola and Nicole Fragale, thank you.
MEG FRIZZOLA: Thank you.
NICOLE FRAGALE: Thank you.