Washington, May 21: Before opening that packet of formula food for your little bundle of joy, think again.
The seemingly-harmless top-up can cause serious damage to your baby's liver.
According to a new study, babies with inherited intolerance of fructose face a risk of acute liver failure, if they are fed with certain formulas, containing fructose.
Baby formula manufacturers should remove fructose or sucrose, or explicitly label their products to allow parents to avoid those sweeteners if necessary, the doctors have demanded.
In a recent paper in Molecular Genetics and Metabolism, Emory Geneticists Hong Li, MD, PhD and Michael Gambello, MD, PhD together with Children's Healthcare of Atlanta Paediatric Hepatologist Miriam Vos, MD and colleagues reported four cases of hereditary fructose intolerance (HFI), all diagnosed in early infants.
All had acute liver failure that resolved when the infants switched to formula without fructose, the report noted. HFI is estimated to occur in one out of 20,000 live births. It comes from mutations in the aldolase B gene, resulting in an inability to metabolise fructose, said the medicos.
Early symptoms include nausea, vomiting, abdominal pain and failure of an infant to gain weight. If unrecognised, HFI can result in liver and kidney damage, seizures or death, they warned.
HFI-related problems do not appear if an infant is being breastfed exclusively. It is normally recognised when fructose-containing solid foods, such as fruit, are introduced into the diet several months after birth, the doctors explained.
However, some baby formulas, often soy-based, contain sweeteners such as high-fructose corn syrup or sucrose (table sugar), which is made of fructose and glucose linked together. Sometimes, the label only says 'sugar,' instead of sucrose.
"In some of the cases we describe in this article, the treating physician had to call the formula manufacturer to confirm that sucrose was a component. It underlines why accurate and explicit labeling is necessary," said Dr Li, assistant professor of human genetics and pediatrics at Emory University School of Medicine.
In babies with digestive problems or allergies, parents or paediatricians may seek to avoid formulas based on cows' milk. However, in alternative formulas, there is a higher chance the manufacturer will add sucrose or fructose as a sweetener and carbohydrate source.
HFI is, in a sense, a mirror image of galactosemia, an inherited intolerance of lactose, which Li said, is better known.
"Most paediatricians are aware of galactosemia, and the liver symptoms that may bring an infant to see a doctor actually resemble galactosemia, even if they come from a different origin," she said.
"In case of HFI, choosing formulas that avoid lactose, like soy-based formulas containing fructose or sucrose, can make things worse. Once parents switch formula, improvement happens very fast," Dr Li told the Science Daily. UNI
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