Amanda Watters,1 ND, Meghan Holpuch,2 ND, Leslie Solomonian,3 ND, MPH
Addendum to: CAND Journal. 2023;30(2):14–19.
https://doi.org/10.54434/candj.130
In Table 2 of the article “Challenging the Maligning of Homemade Human Milk Substitutes During a Shortage of Commercial Formula,” we analyzed nutrition based on the recommended energy intake per day1 and received feedback post-publication that analyzing by standard volume would be helpful to readers. For ease of analysis by volume, in this Addendum we compare an approximation of the nutritional profile of 100 mL of human milk2,3 with the same quantity of a commercial substitute,4 a homemade substitute, and the World Health Organization (WHO) emergency infant feeding recipe.5 See Table 3 below. While feeding needs vary depending on an infant’s age and weight, for context we have also noted the volume required for a 4.75 kg (10.47-lb) infant, which is the standard reference point for the United States Department of Agriculture recommended dietary intake (USDA RDI).1 It is imperative to note that in order to meet this caloric target, an infant must ingest a 45% greater volume of the WHO emergency recipe than of human milk or a commercial substitute. Practically speaking, increasing the quantity that an infant ingests by this amount would be a near impossible task, arguing for a more nutritionally dense alternative. In comparison, this homemade substitute requires 13% less volume than human milk to achieve the same caloric goal, while also providing the vitamins and minerals essential for infant development (many of which are missing from the WHO formula). As was discussed previously, although there are some clear nutritional excesses that could pose risks in the long term, in emergency feeding situations where both human milk and commercial formula are unavailable, homemade substitutes such as the one analyzed here could provide a reasonably safe option for short-term use.
TABLE 3 Comparison of human milk, commercial formula, homemade substitute, and WHO emergency recipe by volume, with USDA RDI standards provided as a reference
1National University of Natural Medicine, Portland, OR, USA;
2Independent Scholar, Steamboat Springs, CO, USA;
3Canadian College of Naturopathic Medicine, Toronto, ON, Canada.
1. Faizan U, Rouster AS. Nutrition and hydration requirements in children and adults. [Updated 2022 Aug 29]. In: StatPearls [Internet]. StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562207/
2. Pietrzak-Fiećko R, Kamelska-Sadowska AM. The comparison of nutritional value of human milk with other mammals’ milk. Nutrients. 2020;12(5):1404. https://doi.org/10.3390/nu12051404
Crossref
3. Prentice P, Ong KK, Schoemaker MH, et al. Breast milk nutrient content and infancy growth. Acta Paediatr. 2016;105(6):641–647. https://doi.org/10.1111/apa.13362
Crossref PubMed PMC
4. Meade Johnson and Company, LLC. Enfamil A+ infant formula, powder tub, 663G. Enfamil Canada. 2023. Accessed August 13, 2023. https://www.enfamil.ca/products/enfamil-a
5. World Health Organization. Infant feeding in emergencies. Published September 1997. Accessed August 13, 2023. https://apps.who.int/iris/bitstream/handle/10665/107984/E56303.pdf;jsessionid=D9E1A21D1A6460D7069C710B8185358F?sequence=1
Correspondence to: Leslie Solomonian, 1255 Sheppard Avenue E, Toronto, ON, M2K 1E2, Canada. E-mail: lesliend@gmail.com
To cite: Watters A, Holpuch M, Solomonian L. Addendum: Challenging the maligning of homemade human milk substitutes during a shortage of commercial formula. CAND Journal. 2023;30(3):28-29. https://doi.org/10.54434/candj.156
Received: 22 August 2023; Accepted: 22 August 2023; Published: 28 September 2023
© 2023 Canadian Association of Naturopathic Doctors. For permissions, please contact candj@cand.ca.
CAND Journal | Volume 30, No. 3, September 2023