What are the dangers of homemade baby formula?

New cases of babies suffering from severe nutritional deficiencies are highlighting the dangers of homemade baby formula.

Two unrelated infants were admitted to the pediatric intensive care unit of the Nemours/Alfred I. duPont Hospital for Children in Wilmington, Delaware, within a span of five days last month.

Both had been fed homemade vegan baby formula and were suffering from hypocalcemia — blood calcium levels that are too low — with cardiac and nervous system problems from the nutritional deficits, hospital officials said.

One infant has now been released from the hospital, but the other had severe electrolyte abnormalities and suffered cardiac arrest, which led to brain damage, said Nicole Fragale, manager of clinical nutrition at the Nemours Children’s Health System. That baby is still recovering in the hospital, but is no longer in the intensive care unit.

Such cases are rare, but seeing two within a week was really concerning, Fragale noted.

It’s not the vegan part of the formula that’s unsafe but the homemade aspect of it, she added.

“We do worry about what kind of information families are finding out there and what other families might be putting their children on these formulas, which are so dangerous,” Fragale told TODAY.

“I don’t think that these were intentional acts of neglect, it was just pure lack of knowledge of diet and what’s appropriate for an infant.”

She’s seen “extremely concerning” online recipes for baby formula that include unpasteurized milk, protein powders, and vitamin and mineral supplements meant for adults.

A baby’s nutritional needs are very specific, so the American Academy of Pediatrics and the U.S. Food and Drug Administration warn against using homemade infant formula because it could contain too little or too much of certain vitamins and minerals. In the case of the two babies hospitalized last month, the formulas were missing calcium and vitamin D, Fragale said.

Mild forms of hypocalcemia can be treated by giving babies oral doses of calcium and vitamin D, but more severe cases require intravenous replacement, said Dr. Meg Frizzola, chief of pediatric intensive care and chair of pediatrics at Nemours Children’s Health System, Delaware Valley.

Calcium is needed for the heart and other muscles to work properly. When a baby suffers cardiac arrest, it’s often difficult to know the extent of the neurologic injury and how the child will recover, Frizzola noted.

Raising a vegan baby

A well-planned vegan diet can be healthful and appropriate for all stages of life, including infancy and childhood, according to the Academy of Nutrition and Dietetics.

You can “absolutely” raise a healthy baby with a plant-based diet, Fragale said. She recommended starting with breast milk, calling it the perfect blend of vitamins, minerals and macronutrients such as protein, fats and carbohydrates. For vegan moms and their babies, there’s no moral contradiction in breastfeeding, People for the Ethical Treatment of Animals noted.

Soy formula is the only option for vegan infants who are not being breastfed, the American Academy of Pediatrics said. The FDA regulates commercial baby formulas, including soy-based options.

Parents shouldn’t confuse soy formula — which is formulated to mimic breast milk — with soy milk, which doesn’t provide optimal nutrients for a baby’s growth and development, Fragale cautioned.

Plant-based milk can be given to kids who are at least 1 year old, she added.

When introducing solid food, parents should focus on protein sources, making sure the child is getting a good variety of grains, legumes, nuts and tofu, Fragale said.

When feeding vegetarian or vegan children, parents should pay close attention to their intake of vitamins B12 and D, calcium, iron, protein and dietary fiber, the Academy of Nutrition and Dietetics advised. A multivitamin may be needed.

“I would recommend if a family has a young child who is following a vegan diet, it would be good to touch base with a registered dietitian just to review the diet and make sure it’s well-rounded and meeting all the vitamin and mineral requirements,” Fragale advised.

There have been cases of children left severely malnourished or even dying after being fed vegan diets inappropriate for their needs.