Risks of Artificial Feeding Babies

(Studies done mostly in affluent societies)

Risks to infant and child



1. Walker M. A fresh look at the risks of artificial feeding. J Hum Lact 1993;9:97-107

2. Cunningham AS, Jelliffe DB, Jelliffe EFP. Breastfeeding and health in the 1980’s: a global epidemiologic review. J Pediatr 1991;118:659-66


Formula Feeding Risks To Cognitive Development:


CD (review): Andraca I, Uauy R. Breastfeeding for optimal mental development. Simopoulos AP, Dutra de Oliveira JE, Desai ID (eds): Behavioral and Metabolic Aspects of Breastfeeding. World Rev Nutr Diet. Basel, Karger, 1995;78:1-27

CD (review): Gordon N. Nutrition and cognitive function. Brain and Development 1997;19:165-70

CD-1: Morrow-Tlucak M, Haude RH, Ernhart CB. Breastfeeding and cognitive development in the first 2 years of life. Soc Sci Med 1988;26:635-9

CD-2: Taylor B, Wadsworth J. Breastfeeding and child development at five years. Dev Med Child Neurol 1984;26:73-80

CD-3: Lucas A, Morley R, Cole TJ, Lister G, Leeson-Payne C. Breastmilk and subsequent intelligence quotient in children born preterm. Lancet 1992;339:261-4

CD-4: Nettleton JA. Are n-3 fatty acids essential nutrients for fetal and infant development. J Am Diet Assoc 1993;93:58-64

CD-5: Rogan WJ, Gladen BC. Breastfeeding and cognitive development. Early Hum Dev 1993;31:181-93

CD-6: Silver LB, Levinson RB, Laskin CR, Pilot LJ. Learning disabilities as a probable consequence of using chloride-deficient infant formula. J Pediatr 1989;115:97-9

CD-7: Willoughby A, Moss HA, Hubbard VS, Bercu BB, Graubard BI, Vietze PM, et al. Developmental outcome in children exposed to chloride deficient formula. Pediatrics 1987;79:851-7

CD-8: Wing CS. Defective infant formulas and expressive language problems: a case study. Language, Speech and Hearing Services in Schools 1990;21:22-7

CD-9: Crawford MA. The role of essential fatty acids in neural development: implications for perinatal nutrition. Am J Clin Nutr 1993;57(suppl):703S-10S

CD-10: Temboury MC, Otero A, Polanco I, Arribas E. Influence of breastfeeding on the infant’s intellectual development. J Pediatric Gastroenterol Nutr 1994;18:32-36

CD-11: Pollock JI. Longterm associations with infant feeding in a clinically advantaged population of babies. Dev Med Child Neur 1994;36:429-40

CD-12: Makrides M, Neumann MA, Byard RW, Simmer K, Gibson RA. Fatty acid composition of brain, retina and erythrocytes in breast and formula fed infants. Am J Clin Nutr 1994;60:189-94

CD-14: Anderson GJ, Connor WE, Corliss JD. Docosohexaenoic acid is the preferred dietary n-3 fatty acid for the development of the brain and retina. Pediatr Res 1990;27:87-97

CD-15: Neuringer M, Connor WE, Lin DS, Barstad L, Luck S. Biochemical and functional effects of prenatal and postnatal fatty acid deficiency on retina and brain in rhesus monkeys. Proc Natl Acad Sc USA 1986;83:4021-5

CD-16: Florey C Du V, Leech AM, Blackhall A. Infant feeding and mental and motor development at 18 months of age in first born singletons. Int J Epidem 1995;24 (Suppl 1):S21-6

CD-17: Wang YS, Wu SY. The effect of exclusive breastfeeding on development and incidence of infection in infants. JHL 1996;12:27-30

CD-18: Greene LC, Lucas A, Livingstone BE, Harland PSEG, Baker BA. Relationship between early diet and subsequent cognitive performance during adolescence. Biochem Soc Trans 1995;23:376S

CD-19: Riva E, Agostoni C, Biasucci G, Trojan S, Luotti D, Fiori L, et al. Early breastfeeding is linked to higher intelligence quotient scores in dietary treated phenylketonuric children. Acta Pædiatr 1996;85:56-8

CD-20: Niemelä A, Järvenpää A-L. Is breastfeeding beneficial and maternal smoking harmful to the cognitive development of children? Acta Pædiatr 1996;85:1202-6

CD-21: Rodgers B. Feeding in infancy and later ability and attainment: a longitudinal study. Devel Med Child Neurol 1978;20:421-6

CD-22: Horwood LJ, Fergusson DM. Breastfeeding and later cognitive and academic outcomes. Pediatrics 1998;101:p. e9

CD-23: Paine BJ, Makrides M, Gibson RA. Duration of breastfeeding and Bayley's mental developmental Index at 1 year of age. J Paediatr Child Health 1999;35:82-5

CD-24: Fergusson DM, Beautrais AL, Silva PA. Breastfeeding and cognitive development In the first seven years of life. Soc Sci Med 1982;16:1705-8

CD-25: Vestergaard M, Obel C, Henriksen TB, Sørensen HT, Skajaa E, Østergaard J. Duration of breastfeeding and developmental milestones during the latter half of Infancy. Acta Paediatr 1999;88:1327-32


Formula Milk & Neurologic Outcome


N-1: Lanting CI, Fidler V, Huisman M, Touwen BCL, Boersma ER. Neurological differences between 9 year old children fed breastmilk or formula milk as babies. Lancet 1994;344:1319-22

N-2: Lanting CI, Patandin S, Weisglas-Kuperus N, Touwen BCL, Boersma ER.Breastfeeding and neurological outcome at 42 months. Acta Paediatr 1998;87:1224-9


Formula's Link to SIDS:


SIDS-1: Mitchell EA, Scragg R, Stewart AW, Becroft DMO, Taylor BJ, For RPK, et al. Results from the first year of the New Zealand cot death study. NZ Med J 1991;104:71-6


Baby Formula, Breastfeeding, and Insulin Dependent Diabetes:

Working Group on Cow’s Milk Protein and Diabetes Mellitus of the American Academy of Pediatrics. Infant feeding practices and their possible relationship to the etiology of diabetes mellitus. Pediatrics 1994;94:752-4

JD-1: Karjalainen J, Martin JM, Knip M, Ilonen J, Robinson BH, Savilahti E, et al. A bovine albumin peptide as a possible trigger of insulin-dependent diabetes mellitus. N Eng J Med 1992;327:302-7 (Editorial: 1992:327:348-9)

JD-2: Mayer EJ, Hamman RF, Gay EC, Lezotte DC, Savitz DA, Klingensmith J. Reduced risk of IDDM among breastfed children. Diabetes 1988;37:1625-32

JD-3: Virtanen SM, Räsänen L, Ylönen K, Aro A, Clayton D, Langlholz B, et al. Early introduction of dairy products associated with increased risk of IDDM in Finnish children. Diabetes 1993;42:1786-90

JD-4: Virtanen SM, Räsänen L, Aro A, Lindström J, Sippola H, Lounamaa R, et al. Infant feeding in Finnish children <7 yr of age with newly diagnosed IDDM. Diabetes Care 1991;14:415-17

JD-5: Gerstein HC. Cow’s milk exposure and type I diabetes mellitus. Diabetes Care 1994;17:13-9

JD-6: Kostraba JN, Cruickshanks KJ, Lawler-Heavner J, Jobim LF, Rewers MJ, Gay EC, et al. Early exposure to cow’s milk and solid foods in infancy, genetic predisposition, and risk of IDDM. Diabetes 1993;42:288-95

JD-7: Pérez-Bravo F, Carrasco E, Gutierrez-López MD, Martínez MT, López G, García de los Rios M. Genetic predisposition and environmental factors leading to the development of insulin-dependent diabetes mellitus in Chilean children. J Mol Med 1996;74:105-9

JD-8: Gimeno SGA, De Souza JMP. IDDM and milk consumption. Diabetes Care 1997;20:1256-60

JD-9: Hammond-McKibbon D, Karges W, Gaedigk R, Dosch H-M. Immunological mechanisms that link cow milk protein and insulin dependent diabetes: a synopsis. Can J Allergy and Clin Immunol 1997;2:136-46


Cow Milk Allergy and Intolerance:

CM-1: Høst A. Importance of the first meal on the development of cow’s milk allergy and intolerance. Allergy Proc 1991;12:227-32


Respiratory Illness & Breastfeeding:


RI-1: Pullan CR, Toms GL, Martin AJ, Gardner PS, Webb JKG, Appleton DR. Breastfeeding and respiratory syncytial virus infection. Br Med J 1980;281:1034-6

RI-2: Chiba Y, Minagawa T, Mito K, Nakane A, Suga K, Honjo T, Nakao T. Effect of breastfeeding on responses of systemic interferon and virus-specific lymphocyte transformation with respiratory syncytial virus infection. J Med Virology 1987;21:7-14

RI-3: Wright AL, Holberg CJ, Martinez FD, Morgan WJ, Taussig LM. Breastfeeding and lower respiratory tract illness in the first year of life. Br Med J 1989;299:946-9

RI-4: Porro E, Indinnimeo L, Antognoni G, Midulla F, Criscione S. Early wheezing and breastfeeding. J Asthma 1993;30:23-8

RI-5: Burr ML, Limb ES, Maguire JM, Amarah L, Eldridge BA, Layzell JCM, Merret TG. Infant feeding, wheezing, and allergy: a prospective study. Arch Dis Child 1993;68:724-28

RI-6: Pisacane A, Graziano L, Zona G, Granata G, Dolezalova H, Cafiero M, et al. Breastfeeding and acute lower respiratory infection. Acta Pædiatr 1994;83:714-18

RI-7: Beaudry M, Dufour R, Marcoux S. Relation between infant feeding and infections during the first six months of life. J Pediatr 1995;126:191-7

RI-8: Okamoto Y, Ogra PL. Antiviral factors in human milk: implications in respiratory syncytial virus infection. Acta Pædiatr Scand Suppl 1989;351:137-43

RI-9: Downham MAPS, Scott R, Sims DG, Webb JKG, Gardner PS. Breastfeeding protects against respiratory syncytial virus infections. Br Med J 1976;2:274-6

RI-10: Wright AL, Holberg CJ, Taussig LM, Martinez FD. Relationship of infant feeding to recurrent wheezing at age 6 years. Arch Pediatr Adolesc Med 1995;149:758-63

RI-11: Yue Chen. Synergistic effect of passive smoking and artificial feeding on hospitalization for respiratory illness in early childhood. Chest 1989;95:1004-07

RI-12: Wilson AC, Forsyth JS, Greene SA, Irvine L, Hau C, Howie PW. Relation of infant diet to childhood health: seven year followup of cohort of children in Dundee infant feeding study. Br Med J 1998;316:21-5 (also shows higher blood pressure in formula fed children)

RI-13: Oddy WH, Holt PG, Sly PD, Read AW, Landau LI, Stanley FJ, Kendall GE, Burton PR. Association between breastfeeding and asthma in 6 year old children: findings of a prospective birth cohort study. Br Med J 1999;319:815-9

RI-14: César JA, Victora CG, Barros FC, Santos IS, Flores JA. Impact of breastfeeding on admission for pneumonia during postneonatal period in Brazil: nested case-control study. Br Med J 1999;318:1316-20

RI-15: Pisacane A, Impagliazzo N, De Caprio C, Criscuolo L, Inglese A, da Silva MCMP. Breastfeeding and tonsillectomy. Br Med J 1996;?:?

RI-16: López-Alarcón M, Villalpando S, Fajardo A. Breastfeeding lowers the frequency and duration of acute respiratory infection and diarrhea in infants under 6 months of age. J Nutr 1997;127:436-43


Otitis Media:

OM-1: Saarinen UM. Prolonged breastfeeding as prophylaxis for recurrent otitis media. Acta Pediatr Scand 1982;71:567-71

OM-2: Teele DW, Klein JO, Rosner B. Epidemiology of otitis media during the first seven years of life in children in greater Boston: a prospective cohort study. J Infect Dis 1989;160:83-94

OM-3: Duncan B, Ey J, Holberg CJ, Wright AL, Martinez FD, Taussig LJ. Exclusive breastfeeding for at least 4 months protects against otitis media. Pediatrics 1993;91:867-72

OM-4: Owen MJ, Baldwin CD, Swank PR, Pannu AK, Johnson DL, Howie VM. Relation of infant feeding practices, cigarette smoke exposure and group child care to the onset and duration of otitis media with effusion in the first two years of life. J Pediatr 1993;123:702-11

OM-5: Harabuchi Y, Faden H, Yamanaka N, Duffy L, Wolf J, Krystofik D. Human milk secretory IgA antibody to nontypeable Hæmophilus influenzæ: Possible protective effects against nasopharyngeal colonization. J Pediatr 1994;124:193-8

OM-6: Aniansson G, Alm B, Andersson B, Håkansson A, Larsson P, Nylén O, et al. A prospective cohort study on breastfeeding and otitis media in Swedish infants. Pediatr Infect Dis J 1994;13:183-8

OM-7: Paradise JL, Elster BA, Tan L. Evidence in infants with cleft palate that breast milk protects against otitis media. Pediatrics 1994;94:853-60

OM-8: Sassen ML, Brand R, Grote JJ. Breastfeeding and acute otitis media. Am J Otolaryn 1994;15:351-7

OM-9: Dewey KG, Heinig J, Nommsen-Rivers LA. Differences in morbidity between breastfed and formula fed infants. J Pediatr 1995;126:696-702 (risk also increased in FF infant for diarrhea)

OM-10: Scariati PD, Grummer-Strawn LM, Fein SB. A longitudinal analysis of infant morbidity and the extent of breastfeeding in the United States. Pediatrics 1997;99:e5


Risks for the premature baby:

P-1: Lucas A, Cole TJ. Breastmilk and neonatal necrotizing enterocolitis. Lancet 1990;336:1519-23

P-2: El-Mohandes AE, Picard MB, Simmens SJ, Keiser JF. Use of human milk in the intesive care nursery decreases the incidence of nosocomial sepsis. J Perinatol 1997;17:130-4

P-3: Daniels L, Gibson R, Simmer K. Selenium status of preterm infants: the effect of postnatal age and method of feeding. Acta Pædiatr 1997;86:281-8 (M:23)

P-4: Uauy RD, Birch DG, Birch EE, Tyson JE, Hoffman DR. Effect of dietary omega-3 fatty acids on retinal function of very low birth weight neonates. Pediatr Res 1990;28:485-92 (M:18)

P-5: Lucas A, Morley R, Cole TJ, Lister G, Leeson-Payne C. Breastmilk and subsequent intelligence quotient in children born preterm. Lancet 1992;339:261-4 (CD: 3)

P-6: Bishop NJ, Dahlenburg SL, Fewtrell MS, Morley R, Lucas A. Early diet of preterm infants and bone mineralization at age five years. Acta Paediatr 1996;85:230-6

P-7: Carlson SE, Rhodes PG, Ferguson MG. Docosahexaenoic acid status of preterm infants at birth and following feeding with human milk or formula. Am J Clin Nutr 1986;44:798-804

P-8: Foreman-van Drongelen MMHP, van Houwelingen AC, Kester ADM, Hasaart THM, Blanco CE, Hornstra G. Long-chain polyunsaturated fatty acids in preterm infants: status at birth and its influence on postnatal levels. J Pediatr 1997;126:611-8

P-9: Bier JB, Ferguson AE, Morales Y, Liebling JA, Oh W, Vohr BR. Breastfeeding infants who were extremely low birth weight. Pediatrics 1997;100:p e3

P-10: Morley R, Cole TJ, Powell R, Lucas A. Mother's choice to provide breastmilk and developmental outcome. Arch Dis Child 1988;63:1382-5


Childhood Cancer:

CC-1: Schwartzbaum JA, George SL, Pratt CB, Davis B. An exploratory study of environmental and medical factors potentially related to childhood cancer. Med pediatr Oncol 1991;19:115-21

CC-2: Davis MK, Savitz DA. Graubard BI. Infant feeding and childhood cancer. Lancet 1988;2:365-8

CC-3: Freudenheim JL, Marshall JR, Graham S, Laughlin R, Vena JE, Bandera E, et al. Exposure to breastmilk in infancy and the risk of breast cancer. Epidemiology 1994;5:324-31

CC-4: Shu XO, Linet MS, Steinbuch M, Wen WQ, Buckley JD, Neglia JP, Potter JD et al. Breastfeeding and the risk of childhood acute leukemia. J Nat Cancer Institute 1999;91:1765-72

CC-5: Davis MK. Review of the evidence for an association between Infant feeding and childhood cancer. Int J Cancer 1998;Supplement II:29-33


Gastrointestinal Disease and Infections:

GI-1: Koletzko S, Sherman P, Corey M, Griffiths A, Smith C. Role of infant feeding practices in the developement of Crohn’s disease in childhood. Br Med J 1989;298:1617-8

GI-2: Greco L, Auricchio S, Mayer M, Grimaldi M. Case control study on nutritional risk factors in celiac disease. J Pediatr Gastroenterol Nutr 1988;7:395-8

GI-3: Duffy LC, Byers TE, Riepenhoff-Talty M, La Scolea L, Zielezny M, Ogra PL. The effects of infant feeding on rotavirus-induced gastroenteritis. A prospective study. Am J Pub Health 1986;76:259-63

GI-4: Hanson LA, Lindquist B, Hofvander Y, Zetterstrom R. Breastfeeding as a protection against gastroenteritis and other infections. Acta Pediatr Scand 1985;74:641-2

GI-5: Ruiz-Palacios GM, Calva JJ, Pickering LK, Lopez-Vidal Y, Volkow P, Pezzarossi H, et al. Protection of breastfed infants against Campylobacter diarrhea by antibodies in human milk. J Pediatr 1990;116:707-13

GI-6: Cruz JR, Gil L, Cano F, Caceres P, Pareja G. Breastmilk anti-Escherichia coli heat labile toxin IgA antibodies protect against toxin-induced infantile diarrhea. Acta Pediatr Scand 1988;77:658-62

GI-7: Gillin FD, Reiner DS, Wang C-S. Human milk kills parasitic intestinal protozoa. Science 1983;221:1290-2

GI-8: France GL, Marmer DJ, Steele RW. Breastfeeding and Salmonella infection. Am J Dis Child 1980;134:147-52

GI-9: Haffejee IE. Cow’s milk-based formula, human milk and soya feeds in acute infantile diarrhea: A therapeutic trial. J Pediatr Gastroenterol Nutr 1990;10:193-8

GI-10: Lerman Y, Slepon R, Cohen D. Epidemiology of acute diarrheal diseases in children in a high standard of living rural settlement in Israel. Pediatr Infect Dis J. 1994;13:116-22

GI-11: Howie PW, Forsyth JS, Ogston SA, Clark A, Du V Florey C. Protective effect of breastfeeding against infection. Br Med J 1990;300:11-6

GI-12: Duffy LC, Riepenhoff-Talty M, Byers TE, La Scolea LJ, Zielezny MA, Dryja DM et al. Modulation of rotavirum enteritis during breastfeeding. Am J Dis Child 1986;140:1164-8

GI-13: Haddock RL, Cousens SN, Guzman CC. Infant diet and salmonellosis. Am J Pub Health 1991;81:997-1000

GI-14: Scariati PD, Grummer-Strawn LM, Fein SB. A longitudinal analysis of infant morbidity and the extent of breastfeeding in the United States. Pediatrics 1997;99, June 1997;e5 (also for otitis media)

GI-15: Heacock HJ, Jeffery HE, BAker JL, Page M. Influence of breast versus formula milk on physiological gastroesophageal reflux In healthy, newborn Infants. J Pediatr Gastroenterol Nutr 1992:14:41-6


Urinary Tract Infection:

UT-1: Pisacane A, Graziano L, Mazzarella G, Scarpellino B, Zona G. Breastfeeding and urinary tract infection. J Pediatr 1992;120:87-9



MA-1: Labbock MH, Hendershot GE. Does breastfeeding protect against malocclusion? An analysis of the 1981 child health supplement to the national health interview survey. Am J Prev Med 1987;3:227-32

MA-2: Palmer B. The influence of breastfeeding on the development of the oral cavity: A commentary. J Hum Lact 1998;14:93-8


Formula as a heavy metal cocktail:

HM-1: Koo WWK, Kaplan LA, Krug-Wispe SK. Aluminum contamination of infant formulas. J Parenteral Enteral Nutrition 1988;12:170-3

HM-2: Davidsson L, Cederblad Å, Lönnerdal B, Sandström B. Manganese absorption from human milk, cow’s milk and infant formulas in humans. Am J Dis Child 1989;143:823-7

HM-3: Dabeka RW, McKenzie AD. Lead and cadmium levels in commercial infant foods and dietary intake by infants 0-1 year old. Food Additives and Contaminants 1988;5:333-42


Other Contamination due to bottle feeding:

C-1: Mytjens HL, Roelofs-Willemse H, Jaspar GHJ. Quality of powdered substitutes for breastmilk with regard to members of the family Enterobacteriaceæ. J Clin Microbiol 1988;26:743-6

C-2: Biering G, Karlsson S, Clark NC, Jonsdottir KE, Ludvigsson P, Steingrimsson O. Three cases of neonatal meningitis caused by Enterobacter sakazakii in powdered milk. J Clin Microbiol 1989;27:2054-6

C-3: Westin JB. Ingestion of carcinogenic N-nitrosamines by infants and children. Arch Environmental Health 1990;45:359-63

C-4: Schwarz KB, Cox JM, Sharma S, Clement L, Witter F, Abbey H, et al. Prooxidant effects of maternal smoking and formula In newborn Infants. J Pediatr Gastroenterol Nutr 1997;24:68-74



A-1: Lucas A, Brooke OG, Morley R, Cole TJ, Bamford MF. Early diet of preterm infants and development of allergic or atopic disease: randomized prospective study. Br Med J 1990;300:837-40

A-2: Kajosaari M, Saarinen UM. Prophylaxis of atopic disease by six months’ total solid food elimination. Acta Pediatr Scand 1983;72:411-14

A-3: Ellis MH, Short JA, Heiner DC. Anaphylaxis after ingestion of a recently introduced hydrolyzed whey protein protein formula. J Pediatr 1991;118:74-7

A-4: Saarinen UM, Kajosaari M. Breastfeeding as prophylaxis against atopic disease: prospective follow-up study until 17 years old. Lancet 1995;346:1065-69

A-5: Saylor JD, Bahna SL. Anaphylaxis to casein hydrolysate formula. J Pediatr 1991;118:71-4

A-6: Marini A, Agosti M, Motta G, Mosca F. Effects of a dietary and environmental prevention programme on the incidence of allergic symptoms in high atopic risk infants: three years’ followup. Acta Pædiatr 1996;Suppl 414 vol 85:1-19

A-7: Wright AL, Holberg CJ, Martinez FD, Halonen M, Morgan W, Taussig LM. Epidemiology of physician diagnosed allergic rhinitis In childhood. Pediatrics 1994:94:895-901


Miscellaneous articles on formula's risk and breastfeeding:

M-1: McJunkin JE, Bithoney WG, McCormick MC. Errors in formula concentration in an outpatient population. J Pediatr 1987;111:848-50

M-1a: Abrams CAL, Phillips LL, Berkowitz C, Blacket PR, Priebe CJ. Hazards of overconcentrated milk formula. JAMA 1975;232:1136-40

M-1b: Potur AH, Kalmaz N. An investigation into feeding errors of 0-4 month old infants. J Trop Pediatr 1995;41:120-2

M-1c: Green HL, Moyer VA. Improper mixing of formula due to reuse of hospital bottles. Arch Pediatr Adolesc Med 1995;149:97-9

M-1d: Coodin Fj, Gabrielson IW, Addiego JE. Formula fatality. Pediatrics 1971;47:438-9

M-1e: Wilcox DT, Fiorello AB, Glick PL. Hypovolemic shock and intestinal ischemia: a preventable complication of incomplete formula labeling. J Pediatr 1993;122:103-4

M-2: Specker BL, Tsang RC, Ho ML, Landi TM, Gratton TL. Low serum calcium and high parathyroid hormone levels in neonates fed “humanized” cow’s milk-based formula. Am J Dis Child 1991;145:941-5

M2a: Jochum F, Fuchs A, Menzel H, Lombeck I. Selenium in German infants fed breastmilk or different formulas. Acta Paediatr 1995;84:859-62

M-3: Kramer MS. Do breastfeeding and delayed introduction of solid foods protect against subsequent obesity? J Pediatr 1981;98:883-7

M-4: Dick G. The etiology of multiple sclerosis.