Tuesday, March 1, 2022

DEATH, SADNESS AND TEARS; CRONOBACTER AND INFANT FORMULA


 "As subjects of research, breastfeeding and breastmilk have attracted much attention during recent decades, yet as academic careers thrive on discoveries of how breastfeeding works and what breastmilk contains, women and their babies are still prevented from fulfilling this unique relationship.  As knowledge about breastfeeding increases, so do global sales of artificial milks and feeding bottles."  by Gabrielle Palmer, The Politics of Breastfeeding, 2009 pg1.

A second US baby died from Cronobacter infection caused by Abbott’s infant formula. So far this makes 5 babies exposed to pathogens (4 cases Cronobacter, 1 case Salmonella) from Abbott Lab’s infant formulas. The following video news clip mentions that some moms have been seeking donor milk from milk banks due to the difficulty of obtaining infant formula from stores. No one mentions that mothers might want to consider relactation (reintroducing lactation).  Having relactated with my first baby, it is an option mothers might not be aware of and might want to consider. https://www.khou.com/article/news/nation-world/abbott-recalls-more-similac-formula/507-dd8aac3e-7c7b-4c49-963e-52e290ba71f2

In 2002 the FDA notified Health Care Professionals that milk-based powdered infant formula was the source of Enterobacter sakazakii (now called Cronobacter) infections. So officially we have known for 20 years that powdered infant formula is a risk for Cronobacter infections.  Yet only one state in the US is required to report Cronobacter infections.  How many babies must die, be injured, and/or hospitalized before all states are required to report this deadly infection? Where is the support for breastfeeding not just pumping breastmilk? How about maternity and family leave so that mothers can get breastfeeding off to a good start?

“Although the natural habitat of E. sakazakii [now called Cronobacter] is unknown, milk-based, powdered infant formula has been epidemiologically identified as the source of E. sakazakii infections, as was reported in an alert issued to United States Health Care Professionals by the United States Food and Drug Administration (USFDA) in April 2002. In addition to powdered milk-based formulas, powdered human milk fortifiers may also pose a hazard.” US Patent #7749724, entitled,”Flurogenic selective and differential medium for isolation of Enterobacter sakazakii, filed in 2006, assigned to Washington State University

 “Research has shown that the sources of Cronobacter spp. Contamination are mainly from these areas.” US Patent #10743544, entitled, “Method for inactivating Cronobacter sakazakii,” assigned to the Northeast Agricultural University of Harbin China.  The three areas are “hospitals, powdered infant formula, and the natural environment (soil, sewer, plant roots, and animal excrement).”

If an infant formula factory has contamination of Cronobacter and Salmonella within its facilities, isn’t it possible that it will not be just powdered infant formula that needs to be recalled, but also liquid formulas produced in the same contaminated environment? 

“[0016]It has been unexpectedly found that stable, concentrated liquid human milk fortifiers and concentrated liquid nutritional compositions can advantageously be prepared with a low water activity and/or low pH level.  The low water activity for example, a water activity of less than 0.90 and/or low pH, for example, a pH within the range of 4.6 to 6.5, of the liquid can reduce or even inhibit bacterial growth in the liquid such as Cronobacter sakazakii, preventing food spoilage.” US Patent Application #20140370153, filed in 2012, assigned to Abbott Labs

The result of Cronobacter infections on infants can be sepsis, necrotizing entercolitis (NEC), or neonatal meningitis.  Exclusive breastfeeding lowers the risk of all 3 sometimes fatal illnesses.  While researchers continue to repeat how rare Cronobacter is; this cannot be known, when only one state in the US is required to report this infection.

“E. sakazakii [now named Cronobacter] is a rare, but life threatening cause of sepsis, necrotizing entercolitis [NEC], and neonatal meningitis.  In general, the case-fatality rate varies from 40-80% among newborns diagnosed with this type of severe infections.” US Patent #7749724, “Flurogenic selective and differential medium for isolation of Enterobacter sakazakii, filed in 2006, assigned to Washington State University

“However, despite improvements in formula compositions over the past 10-15 years, formula-fed infants are still at a 6- to 10-fold higher risk than breast-fed infants.  The data suggest that human milk contains something else that is missing in formula  and protects breast-fed infants from NEC [Necrotising Enterocolitis].  Identifying the protective component in human milk as well as its mechanisms of action would pave the way for the development of desperately needed additional options to treat and maybe even prevent this devastating disorder.” US patent #9675649, entitled, “Disialyllacto-N-tetraose (DSLNT) or varients, isomers, analogs and derivatives thereof to prevent or inhibit bowel disease,” Lars Bode-inventor, assigned to The Regents of the University of California, filed in 2012

“In a large prospective multicenter study of 926 infants 51 infants (5.5%) developed NEC.  The mortality rate was 26%.  In exclusively formula-fed infants, the incidence was 6 to 10 times more common then in those who received human milk exclusively.  In those who received human milk and formula, it was three times more common than in the exclusively breastfed group…The comparison was more dramatic at more than 30 weeks’ gestation, when formula-fed infants were 20 times more apt to develop NEC than human milk-fed infants.” Lawrence et al., Ninth Edition Breastfeeding:  A Guide for the Medical Profession, 2022 pg.531-532.

“It was concluded that human milk feeding is associated with a significantly decreased incidence of nosocomially [from the hospital] acquired sepsis…” Lawrence et al., Ninth Edition Breastfeeding:  A guide for the Medical Profession, 2022 pg.532

“Breastfed infants rarely have bacterial infections of any kind, especially bacterial meningitis (Cochi et al., 1986; Fallot, 1980; Istre et al., 1985; Leventhal, 1986).” 2nd Edition Breastfeeding and Human Lactation, Riordan & Auerbach, 1999, pg.641 

Infant formula is a mass-produced, manufactured, artificial food.  It has its risks. Are they acceptable risks? Do parents understand the risks?                                           Copyright Valerie W McClain, 2022

 

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