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Though most health organizations note that breastfeeding is best for infant nutrition, infant formulas are widely used to supplement or replace breastfeeding in a variety of conditions. Although these formulas need to be nutritionally adequate, some have been advertised as providing additional cognitive benefits.

According to a recent study, however, modified infant formulas did not promote long-term cognitive benefits compared with standard infant formulas. This comes amid increasing concerns about the potential for Similac, Enfamil, and other infant formulas to increase the risk for the dangerous digestive disease necrotizing enterocolitis (NEC) in premature infants.

Scientists Find No Cognitive Benefit for Infant Formulas with Supplements

For the study, researchers tested three different types of infant formulas:

  1. Standard infant formula
  2. Formula supplemented with long-chain polyunsaturated fatty acids (LCPUFAs)
  3. And formula fortified with iron

Nutrient-enriched formulas are often designed to meet the additional requirements of preterm babies after discharge from the hospital and to support catch-up growth in infants born small for gestational age at term. Manufacturers add LCPUFA with the hope of improving visual and cognitive outcomes, and iron to avoid the adverse effects of iron deficiency on cognitive development. Manufacturers then tout these formulas as providing additional benefits for infants.

The researchers examined data for 1,763 adolescents (425 born pre-term, 299 born at term and small for gestational age, 1,039 born at term) who took part in one of seven randomized controlled trials of infant formula in infancy. They then looked at school records as the students got older, comparing math and English scores at 11 years and 16 years.

The results showed no benefit for those children fed supplemented formula compared to standard infant formulas. Scientists also found potential for adverse cognitive outcomes with formulas supplemented with LCPUFAs:

“No cognitive benefit, as measured by academic performance, was found for any of the modified formulas…” the scientists concluded.

Manufacturers of Infant Formula Facing Lawsuits Concerning NEC

Though breastfeeding is acknowledged as the healthiest option for babies, those born prematurely often need additional nutrients to continue proper growth and development, or may not be able to suck properly. In these cases, doctors may recommend infant formula.

Recent studies have shown, however, that necrotizing enterocolitis (NEC)—a bacterial disease that infects, inflames, damages, and kills the cells in parts or all of the intestines—is more common in premature infants fed infant formula. In a 2019 Cochrane review, researchers found that feeding premature infants with formula increases rates of growth during the hospital stay, “but is associated with a higher risk of developing the severe gut disorder called ‘necrotizing enterocolitis.’”

Scientists aren’t sure why this may be but theorize that the premature gut cannot protect itself from the potential inflammatory agents that may be present in infant formula.

Manufacturers of infant formulas like Similac and Enfamil are currently defending lawsuits filed by parents who allege the companies aggressively marketed their products knowing they may pose risks of NEC.

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