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Soy formula is widely used in the United States, accounting for 15% of formula sales. It is commonly recommended by physicians in response to a perceived feeding or behavioral problem such as excessive crying or spitting, or chosen by parents for the same reasons, recommended generally by another parent, or sometimes, no reason at all. Soy formula use raises several concerns.
First is the fact that soy is definitely more prone to producing constipation than cow milk based formula, especially the partially hydrolysed brands (Gentlease®, Good Start®). Babies with constipation problems should not be fed soy formula unless there is a good medical reason for it, such as documented milk allergy.
The second relates to concerns about substances known as isoflavones present in soy protein that have known estrogen-like hormonal effects. Widespread use of soy formulas has been suggested as a reason for the documented mild decline in male fertility in the United States over the last few decades. While there is no conclusive evidence of this idea, the American Acadamy of Pediatrics has issued a position statement1 discouraging soy formula use except for galactosemia, hereditary lactase deficiency (very rare), and parental preference for vegitarianism. While soy formula is often tried for fussiness or colic, there is no scientific evidence of effectiveness for soy substitution. Nor is there a documented advantage for routine use of soy to supplement nursing babies. The use of soy for children with documented cow milk allergy is discouraged as well, since 10-14% of these children have soy allergy as well. The AAP Committee on Nutrition recommends that soy-based formulas only be used for the listed indications, and that physicians document the need based on objective evidence of cow milk protein formula intolerance.2
1. The Use of Soy Protein-Based Formulas in Infant Feeding (Pediatrics 2008;121:1062-1068)
2. Digested from Bhatia J S, Greer F, AAP News, May 2008 29;5:39.