Soy Formulas Use

WIC contract soy formulas can be provided through the WIC office without prescription. According to the American Academy of Pediatrics Policy on Soy Protein-based Formulas: Recommendations for use in Infant Feeding, the Committee on Nutrition recommended the following:1

1. Isolated soy protein-based formula has no advantage over cow milk protein-based formula as a supplement for the breastfed infant.
2. Soy protein based formulas are lactose free and thus are appropriate for use in infants with galactosemia and the very rare hereditary lactase deficiency.
3. Isolated soy protein formula may be suitable for parents seeking a vegetarian diet for their term infant.
4. Previously well infants with acute gastroenteritis can usually be managed after rehydration with continued use of breast milk or cow milk based formula. WIC contract soy protein lactose free formula may be indicated when a young infant (typically under 3 months of age) has severe recalcitrant gastroenteritis.2Some infants with severe gastroenteritis may require evaluation by a pediatric gastroenterologist and management with an elemental formula.
5. Congenital lactase deficiency is an extremely rare disorder manifested by persistent diarrhea. When this disorder is considered, the child should be promptly referred to a pediatric gastroenterologist.
6. Soy protein formulas do not have a role in management of cows milk allergic infants.
7. Soy protein formulas have no proven value in the management of infantile colic.
8. Soy protein formulas are not designed or recommended for preterm infants less than 9 months postnatal age due to the development of significant osteopenia in preterm infants fed soy formula. Cow milk protein-based formulas designed for preterm infants are clearly superior to soy protein-based formula for preterm infants.
9. There is no conclusive evidence that soy protein formula adversely affects human development, reproduction or endocrine function. 3
10. WIC Programs may authorize non-contract brand infant formulas without medical documentation in order to meet the requirements of familys religious eating patterns. Since Nestle Good Start Soy Plus is certified as both Kosher and Halal, this contract formula may be considered for families with these religious eating preferences. Likewise, WIC contract soy formula may be substituted for cows milk protein formula based on family preference.

References

1. Soy Protein-Based Formulas: Recommendations for Use in Infant Feedings. American Academy of Pediatrics Committee on Nutrition. Pediatrics. 1998:Vol 101. No 1:148-153.
2. AAP Committee on Nutrition. Lactose Intolerance in Infants, Children and Adolescents. Pediatrics. 2006:Vol 118. No 3:1279-1286.
3. Bhatia, J, Greer, F and the AAP Committee on Nutrition. Use of Soy Protein-Based Formulas in Infant Feeding. Pediatrics. 2008:Vol 121, No5:1062-1068.

The Maine WIC Nutrition Program provides whole milk for children age 12 to 23 months. Recommendations of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents (National Cholesterol Education Program/NIH), The American Academy of Pediatrics Committee on Nutrition, and The American Heart Association Nutrition Committee state that fat and cholesterol should not be restricted during the first two years of life (AAP, Pediatric Nutrition Handbook, 1993, page 44; NIH, Report of the Expert panel on Blood Cholesterol Levels in Children and Adolescents, 1991, page 1)

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