Commentary on breast-feeding and infant formulas, including proposed standards for formulas.

The Committee on Nutrition published’ proposed standards for infant formulas in 1967 in anticipation of a review by the Food and Drug Administration (FDA) directed to all foods for special dietary use, including infant formulas. The infant formula standards published by the FDA in 19712 were similar to those proposed by the Committee. Several developments have prompted the Committee to review the question of breastfeeding and formula standards. New developments relating to infant formulas reflect the interaction of one nutrient with another (e.g., protein with iron, vitamin E with unsaturated fats) that should be brought to the attention of pediatricians. Formulas for normal infants are being developed which use vegetable rather than milk protein as a base, and this requires modification of the standards for components of formulas. Other agencies-including the Canadian Food and Drug Directorate and the Codex Alimentarius Committee on Foods for Special Dietary Uses-have been developing standards for infant formulas. The draft standards of these agencies raised questions that required review of the FDA standards for infant formulas. Their cooperation with the Committee has resolved most of the differences so that standards will be more nearly uniform. The FDA will also be developing new regulations governing “medical” foods, i.e., foods for special dietary uses for specific medical conditions. This includes amino acid-modffied products for children with amino acid disorders. Other special problems of infancy require special formulas either made by commercial companies or compounded in medical centers. The standard for normal infant nutrition should provide a reference base for formulas for children with these special nutritional problems. These reasons have prompted the Committee to revise and expand its recommendations on standards for infant formulas. The Committee also wishes to restate its position on breast feeding.