The following post is the third in a series of excerpts adapted from Unlatched: The Evolution of Breastfeeding and the Making of a Controversy by Jennifer Grayson, out now from HarperCollins.
No one but the formula manufacturers themselves had done the research when, thirty-five years ago, on the advice of my pediatrician, my parents chose to feed me Isomil, a soy formula produced by Abbott Laboratories beginning in 1966.
That's because, to this day, the Food and Drug Administration (FDA) does not actually approve a formula before it can be marketed. Companies need only to provide documentation that the formula meets the federal nutrient requirements for infant formula and that the ingredients in their proprietary products have either already been approved by the FDA or are listed in a category known as GRAS.
GRAS stands for generally recognized as safe but boils down to innocent until proven guilty. The manufacturer of the substance tells the FDA it appears safe, or takes a look at the existing research around that additive and then tells the FDA it appears safe. And so FDA adds it to the GRAS list -- no further study or testing required.
Soy protein isolate, the primary ingredient in soy formula, is one of those GRAS ingredients, as are dozens of other additives in the more widely used cow's milk-based formulas. Both galacto-oligosaccharides and fructooligosaccharides -- two nonhuman oligosaccharides scientists have warned could be harmful -- are GRAS ingredients. The genetically modified corn-based ingredients in most infant formulas are not technically on the GRAS list, but the FDA clarified in a 1992 policy statement that foods derived from genetically modified organisms, or GMOs, are presumptively GRAS as well. Trans fat was on the GRAS list until the FDA called an oops on that one this past year.
Since breastfeeding my own children and then subsequently realizing that the early building blocks of my own life were barely FDA approved, I've often wondered just how safe soy protein isolate and other formula additives really are. The overall evidence on soy, for instance, is inconclusive, but there have been many questions raised about its role as a possible endocrine disruptor.
Although maybe someone should consider using me as a case study since I've struggled with health issues for half my life to date: debilitating chronic fatigue in my teens; a hypothyroidism diagnosis in my early twenties; and now, in the wake of hormonal changes from pregnancy, an intermittent asthma-like condition that leaves me coughing for weeks anytime I catch a cold. (Thankfully, I was able to conceive and give birth to two healthy daughters, knock on wood.) All this in spite of the fact that I'm a light drinker, my favorite pastime is hiking, and I've been teased my entire life about a diet so ridiculously pristine that even when I lived in my two-hundred-square-foot New York City apartment, I made three meals a day from scratch.
Some of my health problems were probably just hereditary, doctors said, and when I looked around at my family, that seemed plausible enough. My father suffered severe food allergies as a child; my brother, too, has severe allergies; my mother and aunt and a bunch of cousins have autoimmune thyroid disease; and there have been two family members with another, more severe autoimmune disease: multiple sclerosis.
But when I began to dig into all those health histories, I realized that a common thread had been overlooked. Every single one of those family members had been either exclusively or predominantly formula-fed as a baby. This is not to say, of course, that formula feeding had been the cause of my family's collective health issues. Yet, in my attempt to get to the root of my health problems (and in my family members' attempts to get to the root of their health problems), it is remarkable that no doctor ever asked a very simple question: How were you fed as a baby?
In light of the astonishing findings that scientists are only beginning to uncover about the intricate systems at play in the beginning of our lives, this is a question we should be asking. Because here's the crazy thing: despite the fact that no one but the industry itself is extensively testing infant formula and its additives for safety, despite the fact that we're essentially giving companies the benefit of the doubt when it comes to a substitute that has only been around for a mere century (and is not, as it turns out, a substitute for a food but for a human tissue, as University of California, San Diego microbiologist Lars Bode explained), we've placed the burden of proof on our bodies and our lives, while breast milk has sustained our species for hundreds of thousands of years.
Breast is best? Prove it! the media shouts with every study, unraveling a stream of headlines like "Should I Breastfeed My Baby to Make Him or Her Smarter?" Such headlines, unfortunately, trivialize the depth or greater context of the real science, or else misrepresent it altogether. The unthinking substitution of formula for breast milk is virtually as if, during the past century, we had decided to swap out the blood supply in our bodies, to replace it with an artificial blood substitute -- and then demanded that the people who support real blood prove that it really worked better than the manufactured alternate.
Let me be clear: I am not claiming that formula is poison. I sincerely hope that it's not, because if it is, I'm in big trouble. But the media and even the scientific studies now urge consideration of the benefits of breastfeeding, and that makes it seem as though formula is the norm and the eons-old elixir streaming from our bodies is merely providing a boost the likes of which one would get from a packet of vitamins.
Of course, our era isn't the Dublin Foundling Hospital of the 1700s or even America at the turn of the last century, where feeding an infant anything other than breast milk was tantamount to a death sentence. Four generations of human beings have now been reared on infant formula, and millions upon millions of people would attest that they're fine. But maybe we should stop talking about the benefits of breastfeeding and instead start considering the risks of not breastfeeding, since I'm certainly not fine. Are you fine? Are we -- an overweight nation of chronically ill, medicine-dependent formula feeders -- fine?
Here are the facts: Nearly 40 percent of Americans will be diagnosed with cancer at some point in their lifetimes. Obesity and diabetes are epidemic, with childhood and adolescent diagnoses of type 2 and type 1 diabetes (long thought to be genetic) rising more than 20 percent in the past decade alone. Autoimmune diseases and allergies are skyrocketing, including anaphylactic food allergies in children and the mysterious affliction of autism. In my work as an environmental journalist, I have long examined health-damaging pesticides, flame-retardant chemicals, and other pollutants in our air and in our water. These are viable threats to consider. But in the weeks and months after my daughter Izzy was born, amid all the joy and the love I felt as I put her to my breast, there also existed an uneasiness; questions suddenly loomed before me, as a mother and a journalist.
In the epidemic of our nation's ill health, what if we are overlooking an utterly simple piece of the puzzle -- that what and the way we feed our young, radically altered for the first time in human history, has played a role?
Excerpt from Unlatched: The Evolution of Breastfeeding and the Making of a Controversy. Copyright © 2016 Jennifer Grayson. Reprinted with permission from HarperCollins.
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