The Risk of Homemade Infant Formulas with Farryl Bertmann, PhD, RDN
- Inadequate nutrition and provision of nutrients in homemade infant formula
- Kidney health concerns due to inaccurate provision of minerals in homemade infant formula
- Food safety concerns and potential for foodborne illness from homemade infant formula
- Food allergy risk for babies
- Why families and individuals would consider and explore and experiment with making homemade infant formula, including a discussion about the recent infant formula shortage
- What the serious health consequences and outcomes are for babies who are subjected to insufficient nutrition from homemade infant formula, including case studies
- How healthcare practitioners can counsel and assist families about adequate infant nutrition needs and help prevent the use of nutritionally inferior and dangerous homemade infant formulas

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Episode Description
Commercially prepared infant formula is a safe and effective substitute for human milk. Homemade infant formula has been linked to documented, serious injuries and negative health outcomes in babies. In this episode Farryl Bertman, PhD, RDN joins me to talk about the risks and dangers of homemade infant formulas.
Farryl Bertmann is a Senior Lecturer in the UVM Nutrition and Food Sciences Department and faculty with the University of Vermont Food Systems Program. She works in the area of food security and nutrition assistance programs and co-authored the paper The Risk of Homemade Infant Formulas: Historical and Contemporary Considerations.
The four primary problems with homemade infant formula that are discussed in this interview are:
- Inadequate nutrition and provision of nutrients in homemade infant formula
- Kidney health concerns due to inaccurate provision of minerals in homemade infant formula
- Food safety concerns and potential for foodborne illness from homemade infant formula
- Food allergy risk for babies
Read Dr. Bertman and colleagues’ paper The Risk of Homemade Infant Formulas: Historical and Contemporary Considerations here.About the Guest
About the Guest
- Dr. Farryl Bertmann is a researcher and lecturer in nutrition at the University of Vermont
- Her areas of expertise include inclusive and equitable approaches to community-based nutrition education, and global food sovereignty
- Dr. Bertmann and colleagues co-authored the recent paper The Risk of Homemade Infant Formulas: Historical and Contemporary Considerations which you can read here.
Links from This Episode
- Baby-Led Weaning with Katie Ferraro program with the 100 First Foods™ Daily Meal Plan, join here: https://babyledweaning.co/program
- Baby-Led Weaning for Beginners free online workshop with 100 First Foods™ list to all attendees, register here: https://babyledweaning.co/baby-led-weaning-for-beginners
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Katie Ferraro (1s):
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Faryyl Bertmann (58s):
The ramifications of Homemade Infant formula that cost benefit of long-term renal failure. Cardiac arrest changes in the shaping of the bone of the Infant. If Infant formula is not available, this is when you tap into your community.
Katie Ferraro (1m 14s):
Hey, there I'm Katie Ferraro, Registered dietician, college nutrition professor and mom of seven specializing in baby led weaning here on the baby Led Weaning Made Easy podcast. I help you strip out all of the noise and nonsense about feeding, leaving you with the confidence and knowledge you need to give your baby a safe start to solid Foods using BABYLED Weaning. Can you realistically make a replica of human milk or commercial Infant formula using ingredients you find in your home kitchen? No, absolutely not. Full stop. End of discussion. But do people on TikTok show you how to make Homemade Infant formula?
Katie Ferraro (1m 54s):
Oh yeah, you can bet that. And this whole Homemade Infant formula trend has really picked up steam in light of the commercial Infant formula shortage. And yet this is an incredibly dangerous practice with very serious consequences for infants. My guest today is Dr. Farryl Bertmann and she's the author of a recently published article in the journal of the academy of nutrition and dietetics called the risk of Homemade Infant formula Historical and Contemporary Considerations. So the journal of the academy of nutrition and dietetics is the publication, the peer-reviewed publication of the professional association for dietician. So I am a dietician, Dr. Bertmann is a PhD dietician, and she's also a senior Lecturer at the university of Vermont in their nutrition and food Sciences department.
Katie Ferraro (2m 37s):
And I have to admit, I was pretty surprised to see this practice article in our journal since there is not a lot of concrete data on Homemade Infant formula. And yet we know of course, anecdotally that it's a thing. If you have spent five minutes, you know, cruising, Infant feeding content on TikTok, you can't help, but see Homemade Infant formula recipes that are being passed around and at great expense. And So I read this article and it was really well done accompanied by some really scary case studies and references to documented instances of infants being harmed by these Homemade Infant Formulas. So I wanted to interview Dr. Bertmann because her team who wrote this article, they had some unique perspectives on the underlying root causes of Homemade Infant Formulas.
Katie Ferraro (3m 17s):
So Dr Bertmann inside of this interview is gonna be going through actually three of the CDC case studies documenting harm to infants by this, you know, seemingly popular trendy practice. And this is definitely a conversation that's longer than most of our interviews. But I think that If you who are listening are at all interested in the intersection of food security and nutrition assistance, as well as the topics of inclusive and equitable approaches to community based nutrition education. My hope is that you will find some value in learning from Dr. Bertmann. As I know, I certainly did. I had a lot of opinions about Homemade Infant formula and the people who do it coming into this interview. And I can't say that she changed all of them, but she certainly opened my eyes to some of the realities surrounding again, what is a concerning trend in social media?
Katie Ferraro (4m 4s):
So a lot of our discussion speaks to more of the concepts and larger constructs of healthism. We talk about health halos as well as the very damaging impact of social media. And when dangerous practices are passed off as trends or when uncredentialed individuals are providing nutrition and feeding advice, we see real true harm. These aren't just trends that will pass. These are actual people harming other infants and not meaning to do that. So we're gonna talk about some of those underlying causes, a little bit heavy. I have to admit, but Dr. Bertmann article from the journal of the academy of nutrition and dietetics, again, it's entitled The Risk of Homemade Infant formula, Historical and Contemporary Considerations.
Katie Ferraro (4m 45s):
I'm gonna link that up in the Shownotes for this episode at BLW podcast.com/ 252. And I'll also share of some of the other resources and source documents that she talks about in sites. So with no further ado here is Dr. Farryl. Bertmann talking about the risk of Homemade Infant formula.
Faryyl Bertmann (5m 4s):
Great to be here. I'm really excited to do this.
Katie Ferraro (5m 7s):
I have to say I was so intrigued when I saw your professional practice article in the journal of the academy of nutrition and dietetics. And it was about the risk of Homemade Infant Formulas. And I think like a lot of dietician, I get the journal and I like thumb through it. And I'm like 99% of this is like not pertaining to what I do. And I was like, whoa, the risk of Homemade Infant formula. Like I was reading every single word. I was so impressed by the research. And I know we're gonna talk a little bit about it, but just real quick, before we get into it, could you share a little bit about your background and where you work and what you do for work?
Faryyl Bertmann (5m 37s):
Yeah, happy to do so. So I am at the university of Vermont. I am a senior Lecturer and I'm also the program director for our coordinated program with a master's of dietetics. So I have dietetic interns that are in the field right now today, and I was teaching undergraduate classes, but now I'm teaching more, this, this graduate program, my research involves food insecurity, nutrition assistance programs. I'm working heavily on inclusive practices within health promotion. So I I've been working on a more weight neutral sort of equity, diversity inclusion lens to health promotion. And with that, a lot of work on health equity, which brought me to this article and it really started with my dissertation years ago.
Katie Ferraro (6m 24s):
And what was that on?
Faryyl Bertmann (6m 26s):
So I was looking at I'm a qualitative researcher. I do do some quantitative research, but I, I really love to work with folks who are having experiences around food and feeding infants and, and managing their households and all of the different drivers that lead them to making choices around their health. And so for my dissertation, I was looking at the WIC program and I was really curious back during that time during my dissertation, there was vouchers for fruit and vegetable redemption and folks in the state where I was doing my dissertation, Arizona were not using them at the same level as other states.
Faryyl Bertmann (7m 7s):
And So I went to WIC clinics and I interviewed moms. I also, I interviewed moms in English. I do not speak Spanish, but I worked with a translator to interview moms in Spanish. And we just looked at why folks were not utilizing these programs. And it, it complimented other interests. I'm also a clinical lactation manager. And so sort of coming together between the WIC and breastfeeding support and stigma really, I think was a nice on-ramp for this paper.
Katie Ferraro (7m 37s):
So I recently interviewed Darlena Birch from the national WIC association. We were talking a lot about the proposed changes to the WIC program, and she was explaining a lot about the fruit and vegetable voucher and how far it's come. So I kind of familiar with where it is now. I'm just curious. Why were the WIC participants in Vermont not utilizing the vouchers?
Faryyl Bertmann (7m 54s):
It was actually, I did my doctoral work in Arizona.
Katie Ferraro (7m 57s):
Oh, it was in Arizona. Okay. I was like how, yeah. How many Spanish speakers are in Vermont, but I don't know.
Faryyl Bertmann (8m 1s):
Yeah. Well, more than I think people are really dialing in on, but it was one of the biggest barriers is you have your young child, you're coming to the point of pay. And if something doesn't qualify or there was a, a misunderstanding about what you can purchase at the point of pay, there were some uncomfortable interactions and folks were thinking like this isn't worth it. I just left my house, have my infant in toe. And now folks are being less helpful at the point of sale. And it's just uncomfortable. And you know, at the time for $5 or $7 a month of fruits and vegetables, it just ended up wasn't worth it, of not being worth it.
Katie Ferraro (8m 44s):
Interesting.
Faryyl Bertmann (8m 45s):
Yeah.
Katie Ferraro (8m 45s):
So not surprisingly, the topic of Homemade Infant formula is of interest in this era of formula shortage. We had the former Politico journalist Helena Bottemiller Evich on our podcast recently. So that was an, an episode all about unpacking the Infant formula, recall and formula shortage. I'm gonna link to that in the Shownotes cuz I know people who are listening to this episode are interested in formula and possibly the shortage, but our audience is for the most part familiar with some of the underlying causes of the shortage. But these Homemade Infant formula recipes, I know parents are seeing a lot of them online, social media, primarily TikTok and as a dietician and a mom. It's just so concerning to me for a number of reasons, not specializing in food safety, I'm not an IB CLC. I'm just like, wow, you are definitely not replicating human milk with your Homemade recipe.
Katie Ferraro (9m 29s):
So just share with us please, what are the significant health risks or the potential for significant health risks from making Infant formula at home?
Faryyl Bertmann (9m 36s):
So Katie I'm just gonna like hard hit what the biggest problems are. And If you don't mind, I also brought some case studies cuz I just think it really, not only are we thinking about what the problems are, but we can see how this results in, in problems with infants. So first it's Inadequate nutrition. So there are standards or standards around protein, carbohydrates, fats, or vitamins and minerals. And If you are making Homemade Infant formula, you are not meeting the recommended amount, but also the bio availability of these nutrients. And so what we end up seeing is that in particular anemia, so iron deficiency, we also see signs of rickets.
Faryyl Bertmann (10m 17s):
We see some low levels of calcium. We are seeing some, some scurvy. So that's around that bio availability. But what I find even more concerning is how Homemade Infant formula impacts Kidney health. The, the Kidney helps remove waste and sort of too many nutrients within the system among other things. And in developing infants, there is a distinct sensitivity to the function of the Kidney when it is, it is developing in the youngest person. And so if there is an imbalance, an electrolyte imbalance or, or any type of imbalance coming from Homemade Infant formula, it can cause Kidney damage.
Faryyl Bertmann (11m 1s):
It can lead to dehydration. It can lead to electrolyte imbalances. Next is a food safety risk. So many of the Homemade Infant formula recipes. And I actually just took another quick look before I jumped on here are suggesting things like raw milk unpasteurized milk.
Katie Ferraro (11m 20s):
I saw that I was like, so now we're adding the raw milk situation and potential for health problems on top of the Inadequate nutrition and whatever else you're gonna enumerate.
Faryyl Bertmann (11m 30s):
And I mentioned that I'm at the university of Vermont, one of my colleagues who just retired, she specializes in like the many, the suite of problems for adults when they're consuming raw milk, including there are some, in some cases there's tuberculosis, there's listeria. I mean, these are things that will already create potentially deadly problems in adults, not to mention, you know, the dose response in a small, in a, in an Infant also, you know, just the safe handling and the preparation and the storage is an issue. And then lastly in the top four is allergic reaction. So when you're mixing different milks, I saw some nut milks. It's just, there can be an increased risk of allergic reaction, especially in again, these vulnerable infants
Katie Ferraro (12m 16s):
And Dr. Bertmann. I know a lot of like the raw milk. We actually don't talk a ton about raw milk on the podcast because we don't substitute cows milk in place of Infant milk, be that formula or breast milk until after age one. And my audience is primarily six to 12 months, but just anecdotally, I was a peace Corps volunteer in Nepal after college. And I lived in a very rural community where even the poorest of the poor people with very limited resources, they scolded their milk. And I remember a girl in our group was with a family that didn't have the money for firewood. They were drinking raw milk. She got brucellosis, the incredible and rapid decline in her health. She had to leave the program and she was so ill for so long. She actually eventually got better.
Katie Ferraro (12m 56s):
Came back like almost towards the end of our service. So two, almost a two year recovery from drinking raw milk. It's no fault of her own, but just so sad to see that in real life and see that there really are real life consequences. There is a reason why even communities around the world, quote unquote, pasteurize their milk. It has nothing to do with taste nutrition, et cetera. It is to kill the potentially harmful pathogens that can be in raw milk.
Faryyl Bertmann (13m 21s):
Exactly. I have some case studies I would love to share with you.
Katie Ferraro (13m 24s):
Oh please. I would love to hear more again. I like that you guys published a peer review published like a practice article in the journal, and we're gonna talk about that, but sometimes hearing the other stories, when you see one mom doing it on TikTok, let's hear about the mom who got really sick from this. So you don't see on TikTok or the baby.
Faryyl Bertmann (13m 38s):
Exactly. I'm happy to provide that in a moment. I would also love to just make this connection between raw milk and healthism. And that is a part of the impetus for this paper is we wrote this paper before the shortage. And we were noticing that there were groups of people that were turning to TikTok, Instagram blogs for Homemade Infant formula. And I think it speaks to the raw milk. There is this sense that for whatever reason, that might be a healthier choice, but we recognize that in when we're distilling nutrition information down to like these incremental ingredients, we actually end up doing incredible harm, especially when we're involving an Infant that has that dose response.
Faryyl Bertmann (14m 25s):
And I'm just so fascinated by groups of people who fit into this category. And, and I certainly see this in Vermont, with some unexplained halos around certain types of Foods that are actually end up being deadly. In some cases, as you just explained with your experience,
Katie Ferraro (14m 45s):
We see it in Infant feeding. A lot of times with protein, this, you know, undeserved health halo, that protein gets in the adult population, adults don't understand. There is no storage form of protein in the human body. And that for infants, when they're prioritizing protein and promoting keto diets, it's like, do you understand the way the physiology of the developing Kidney works and the renal solute load and their inability to remove the nitrogenous waste part. It's like, no, because you're getting nutrition advice from social media.
Faryyl Bertmann (15m 10s):
Exactly. And that's exactly what we're seeing with the Kidney damage. That's coming from the Homemade Infant formula. So If you don't mind, I'm gonna share with you another published set of case studies that when they came across my desk, I saw these after we published this article or at least after we submitted the final version of this article and it just really reiterated the importance of messaging around the safety with Homemade Infant formula. And I'm happy to send you a, a PDF.
Katie Ferraro (15m 40s):
Yeah, we'll get a copy of those If you don't mind. And then we'll link to them in the Shownotes for this episode on BLW podcast.com.
Faryyl Bertmann (15m 46s):
So this is coming from the CDC morbidity and mortality weekly report. This was published on August 20th, 2021, and the author was Calliou and colleagues. And so what I've done is I, I looked through this and I've kind of broken it down so that it's more accessible for your audience. So they looked at between August, 2020 and February, 2021. They looked at cases, emergency room emergency department cases where an Infant was fed Homemade Infant formula. And there was an adverse reaction. So they say that this happened in New Jersey, Pennsylvania, and Delaware, and it was directly linked to nutritional deficiency of Homemade Infant Formulas.
Faryyl Bertmann (16m 31s):
And in case one, it was a four month old. This Infant was unresponsive with cardiac arrest. The Infant survived, but experienced brain injury. And the bone loss was so much because of those low calcium levels that there are now irregularities in that infant's long bones. So that's case one case two is a five month old. The Infant became stiff, turned blue, stopped breathing. And that is when emergency medical professionals were called. They found that the bones had lost so much calcium, that there are also irregularities in the bones and it's similar to rickets.
Faryyl Bertmann (17m 12s):
So we would think of that as, although they didn't talk about bowlegedness in the Infant. That that was also the case, both of the first two infants recovered with the exception of the brain injury in case one now case three is a nine month old. And in case three, this Infant was not growing properly. The forehead bone was protruding again, directly linked to Homemade Infant formula. So now we have a facial irregularity and when it's a change in, in the growth of the bone, that is very hard to overcome.
Katie Ferraro (17m 49s):
Is that due to the underlying, like irregular brain development, what would cause a forehead bone to protrude?
Faryyl Bertmann (17m 55s):
You know, they were saying in this case, again, that it's hypocolemia. So I just think that, I mean, I am completely guessing here, but thinking about in these cases where the body was low on calcium, so it was seeking calcium wherever it could get. I'm wondering if part of that calcium, the blood calcium levels were taken from the facial structure leading to an irregularity. This is, is this, I don't know for sure, but that would potentially be a connection there.
Katie Ferraro (18m 28s):
So where do the case studies come from? Dr. Bertmann?
Faryyl Bertmann (18m 31s):
So these were identified by the CDC. So this most likely the doctors within the emergency room saw these irregularities and reported them to the CDC. And then the CDC took these cases and, and published them. I just wanted to also mention that this case three, the nine month old has also irregularities in their long bones. And they mentioned the bowing, this child was discharged to a long-term care facility
Katie Ferraro (19m 0s):
At nine months
Faryyl Bertmann (19m 1s):
At nine months. So that's implying that they're, it looks like permanent damage.
Katie Ferraro (19m 5s):
They're not able to go home. Yeah. Oh my gosh. Again, this is what you don't see on social media, the consequences of messing with nutrition, what would be the circumstances where someone would be considering making a Homemade Infant formula?
Faryyl Bertmann (19m 20s):
When we wrote this practice paper, we could not have imagined the Infant formula shortage that we experienced recently at the time of writing the paper, just a categorical. No, absolutely not. I still stand by that statement. When I explain to you the ramifications of Homemade Infant formula, that sort of cost benefit of long-term renal failure of cardiac arrests of changes in sort of the, the shaping of the bone of the Infant Infant. If Infant formula is not available, this is when you tap into your community, you work with nutrition assistance programs, you get on a list, serve and ask, can somebody help source you go to a food bank?
Faryyl Bertmann (20m 8s):
The cost of Homemade Infant formula is such that there are mechanisms to access commercial Infant formula. If you are sort of in that the broader feeding population, If you have an Infant that requires a very specialized formula, that is when you get on the phone with your primary care physician and you explain to them the urgency and they will work with their network to get the Infant Formulas.
Katie Ferraro (20m 37s):
And those are for this again, guys, that's the specialty Formulas. We are talking about medically fragile children who are already requiring a special Infant formula that they cannot be on, on your traditional cows milk or soy based formula because of either allergies or severe illness. And to be honest, we've done a lot of coverage on this. They are the most severely impact by the Infant formula shortage. And so taking the shortage out of it, cuz again, your paper, you guys started, you proposed this in April 2020, right? Like month two of the pandemic, long before the Infant formula shortage was a quote unquote known problem in reality. So outside of the shortage, what are other reasons why people are on TikTok making their own Infant formula recipes?
Faryyl Bertmann (21m 18s):
Yeah, so we really looking at the literature and speaking with professionals in the field, we dialed into the three key reasons why people would use how made Infant formula. The first is what I refer to as healthism and healthism, it's sort of a, a modern interest in the pursuit of specific Foods and beverages that reduce disease risk and people believe will enhance physiological function. However, we find that with healthism, it takes such a, a sort of reductionist specific sort of minuscule, like losing the forest for the trees approach that you start to ignore the holistic approach to health.
Faryyl Bertmann (22m 3s):
And there is a whole suite of Considerations when we are feeding an Infant. So I mentioned a moment ago about raw milk, raw milk would be an example of healthism where somebody at some point gave somebody the impression that raw milk has this health halo. And I want to believe that people are coming from the best that they can do for their Infant. Because they are not working with a Registered dietician or their primary care physician. That person who shared with them that health halo has led them to believe that this reductionist view, this type, this ingredient is better for infants.
Faryyl Bertmann (22m 43s):
As I've already mentioned, this ingredient can lead to long term and possibly deadly health consequences. So as a Registered Dietitian, what I need to work on is creating a conversation with my client in a way that I'm reducing barriers. So people can share with me why they have these health beliefs, where they're getting their information and how we can without putting somebody on the defensive leads to what I think is the ultimate goal, which is providing the best nutrients for their Infant. And as a Registered dietician, of course that's gonna be evidence-based. So that's one, the next is food insecurity and food access.
Faryyl Bertmann (23m 26s):
And it is incredibly complicated with our current economic situation. We recognize that Infant formula can be expensive. So coming up with ways to connect people with nutrition assistance programs, with support, with their primary care physician, we also recognized that in 2019, there was some concern around some legislation, as it relates to immigration status, we call it the public charge and concerns around sort of this public charge law that is not in effect that has, there was an executive order that stopped the public charge, but we recognize that some people might worry about using public assistance, whether it's WIC or snap or other support systems.
Katie Ferraro (24m 13s):
That's dependent upon their immigration status because of their, so we're talking about 2019 Trump era policies currently, not in effect because Biden shut them down, whatever the official terminology is. And you guys, you covered this in the article, which I was like, heck yeah. I mean, that's reality. Like we're talking about a massive government program, the WIC program, which is, you know, it serves half of the babies born in this country, the largest purchaser. I mean, every time I hear that statistic, that's the one that just blows my mind. We do so much WIC content. We have so many wonderful WIC moms and educators in our community. And it's like, this is half of all babies born in the us. We can't pretend like politics doesn't play a role in this. And especially with the shortage, we've kind of talked a lot about the different state contracts and we don't have time to get into it, but I appreciate you guys addressing the political realities that trickle down and affect Parents.
Faryyl Bertmann (24m 58s):
And it goes back to misinformation, just like with healthism. There is some misinformation, the fact that there might be a documentation issue using WIC is not, not accurate. And So I would recommend in that case, utilize nutrition assistance programs. If you are in doubt, use a free legal aids program. We have one right down the street here in Vermont, check in, make sure that any of the programs that you wanna utilize are okay, but WIC is not going to have ramifications using the food bank is not gonna have ramifications even if in the future, for whatever reason that law is reinstated.
Faryyl Bertmann (25m 39s):
There's some cultural beliefs that have to do with just sort of heritage practices that we we have we're aware of. And so again, just being mindful of what people are bringing to the conversation and just making sure that there is a way to keep that conversation going and not being stigmatizing.
Katie Ferraro (26m 1s):
And I know you teach college level nutrition, you that run the dietetics program in the master's program. I'm I teach in the undergraduate nutrition program at San Diego state university, and I teach our cultural Foods class, which I would love to learn more because, you know, we have the students actually do a whole assignment on Infant feeding practices around the world in different cultures. And we've talked a lot about the introduction of solid Foods yet. We've never addressed the use of Homemade Infant Formulas and situations where that might be a cultural belief or a heritage practice. So I'd love to learn more about what you guys have found as a way to possibly incorporate that because it is true, you know, just cuz this is the way we feed babies in North America doesn't necessarily mean it applies around the world.
Katie Ferraro (26m 41s):
Although I should add that the benefits of human milk being perfectly matched to a developing infant's needs is well established in the literature around the world and accepted by every major health organization around the world.
Faryyl Bertmann (26m 53s):
Yeah, absolutely. And it's such an interesting balance, Katie, because I came into this paper with my lactation management training and I strongly support human milk for human babies, but I recognize that sometimes that also creates a barrier. If I am talking to a client about breastfeeding being the ideal human milk for an Infant, I might create a situation where my client has different beliefs would like to use commercial Infant formula, but doesn't feel like they can talk to me about that. And so in writing this paper, I recognize the need to create a conversation where there multiple feeding relationships can be discussed, whether it's breastfeeding, where it's partially breastfeeding, where it's feeding with commercial Infant formula and doing it in a way that's not stigmatizing, that's not adding to what we sometimes call mommy wars.
Faryyl Bertmann (27m 50s):
And so in doing that, I have heard of anecdotal cultural practices around complimentary Foods earlier than would be appropriate using recipes that were passed down by generation and generation. And it is recognizing and supporting one's cultural heritage, but also discussing some of these practices around pasteurization and the use of commercial Infant formula. That includes, you know, those 29 micro macronutrients that the infants need to thrive.
Katie Ferraro (28m 28s):
So you've written a lot about the history of human milk alternatives or alternatives to maternal breastfeeding, such as wet nurses, especially in addition the commercial efforts over decades to modify cow or goat milk to feed the babies, but in today's environment, knowing the advances that we know like you are a nutrition and science professional background in lactation, expertise in food safety, just curious, does the threat that Homemade Infant Formulas present today, is that different or how does it differ compared to decades or even centuries ago? Like I just can't believe we're having this conversation. If you take the shortage out of it, like how are people still like messing around with the components of the milk that they feed their baby? Like that's mind blowing to me and that might sound insensitive, but I don't research this all day every day.
Faryyl Bertmann (29m 8s):
Yeah. And, and I actually have a similar reaction is we, there are so many components along this continuum of alternative Infant feeding over, you know, hundreds of years. How are we in some cases back to where we were in the 1800s, it is also mind blowing for me. And I mentioned the food insecurity. I mentioned the healthism. I mentioned that there are recipes that have been passed down, but what we're not taking into account is that the regulation and the protection and the acts that have gone that have been put into place in particular, I'll talk about one, which is Congress enacted the Infant formula act of 1980.
Faryyl Bertmann (29m 53s):
And in this act they established a minimum requirement of those 29 nutrients with maximum amounts. Remember we talked about Kidney health of nine of those nutrients. And then most recently in 2016, they did also add selenium to bring it up to 30 nutrients. And so when I'm saying this list of 30 Katie, it's not just that these are necessary, but if we think of, sometimes I like to think about poison that poison has a dose response, right? If we're thinking about how much a body can handle when it comes to poison, I like to think of that as the same analogy, like how many micro macronutrients can a developing Infant handle at a certain period that they're thriving and they're not having a toxic overload and leading to, you know, being significantly ill, having heart issues, having breathing issues and all of those things.
Faryyl Bertmann (30m 50s):
So with this regulation and it's actually interestingly, part of why there was a little pause in bringing in more commercial Infant formula, as we were bringing new Infant Formulas in or outsource Infant Formulas into the United States. They also had to meet these regulations for the Infant formula act.
Katie Ferraro (31m 13s):
Which are different in Europe, slightly different, different. Yeah, but we agree on the major components like this is not just corn syrup with some other stuff you bought on Amazon mixed in. And So I think when we, again, that the health is in action. When we simplify it down, we lose the forest for the trees. Like we are talking about lots and lots of micronutrients and macronutrients in play at a really important time in your baby's life. I get parents, Hey, I don't love the idea that the two, three major brands of formula United States have corn syrup in them or whatever it may be. Like, there certainly are areas for improvement, but like literally throwing the baby out with the bath water and making it from scratch is not the solution,
Faryyl Bertmann (31m 50s):
Not the solution at all. And I'm really glad that you just brought up the corn syrup because in, in my article, I'm a little, I turn into a history nerd and I'm really fascinated at this relationship between breastfeeding and alternatives to breastfeeding over time. And in the 1940s, this Homemade Infant formula was a mixture of plain animal milk. So they included water, corn syrup, fruit juice to deal with vitamin C. And then there was some vitamin D added later on. And I just, you know, in the context of this conversation, if we were to ask moms that are even considering Homemade Infant formula, how do you feel about feeding your Infant water, corn syrup, fruit juice, and vitamin D I'm hoping for the most part they're like, like, heck no, if it's a heck no.
Faryyl Bertmann (32m 42s):
And we've come so far. Why would you veer off of all of this research, all of these ingredients, all of these studies to just go at it on your own, based on a TikTok or a website. I think that's, what's most baffling. Just like you said, dismissing all of this research and all of these Considerations for sort of this, this strange..
Katie Ferraro (33m 6s):
Which for something that honestly just appears to be trendy, I'm like, sorry, I don't care if it's trendy. It's your developing infant's brain irreversible brain damage. Like those three case studies that you shared were chilling. Like I still feel my blood pressure high. Do you know Amy Bentley in her book Inventing Baby Food?
Faryyl Bertmann (33m 22s):
I don't
Katie Ferraro (33m 23s):
She's out of NYU. Oh my gosh. She's fabulous. So she was on the podcast it's for those of you who might be here for a while, episode 144 was called, What Did Babies Eat Before Baby Food was Invented? And it's Amy Bentley. She's a PhD outta NYU. And her book is called Inventing Baby Food. And it's fascinating, but she goes through the history of the advent of commercial baby food. And that like why you said it very nicely, but like inappropriate recommendations of starting solids at four months of age, when we know nutritionally, they don't need it. And developmentally they're not prepared to safely swallow anything except Infant milk. Well, well, why do we sell it? Well, because it's to sell more baby food, she kind of goes through a lot of the history of that, but she also talks a little bit about the commercial infant formula market as well. Again, not a Registered Dietitian, not from a nutrition standpoint, but almost purely from a marketing standpoint yet.
Katie Ferraro (34m 3s):
That's so important to acknowledge that that's what's happening here is a lot of the misinformation is coming out of the same people who are trying to sell you the products that, you know, we talk about toddler milk and I have no qualms. I speak regular to our state WIC associations around the country about the detrimental effects of toddler milk for toddlers, who should be drinking cows milk and how it's an economic situation, how it's misinformation and it's marketing. And only in very, very rare medical conditions when a child is already being followed by a pediatric dietician, would toddler milk even play a role. And I think there's not a lot of professionals sometimes who are willing to stick their neck out and say that, cuz obviously then you're going up against the formula company and everyone knows what happens then. But I do think it is important to address not just nutrition, but dieticians, especially to also be aware of the other economic factors at play here in addition to just the micronutrients and the macronutrients.
Faryyl Bertmann (34m 50s):
Absolutely. And it's interesting that you say this and gosh, back when I was working on my post doc, I actually wrote a paper it's dated now, but I wrote a paper on the commoditization of Infant formula. And like how, why is it that there's so much marketing attached to Infant formula versus breastfeeding? And So I make an argument that when we're thinking about sustainable food systems, that breastfeeding should be part of the conversation and why isn't it. Now I mentioned earlier in our conversation that I'm really, I think that I was such a strong advocate of breastfeeding and breast milk that I didn't recognize that there needs to be a concerted effort to talk about the role of commercial Infant formula, because I don't want the alternative to be Homemade Infant Formula.
Katie Ferraro (35m 43s):
I a hundred percent agree. And the, we talked about kind of the mommy wars and one unfortunate turn of events with the, you know, mainstream media, fine only starting to cover the Infant formula shortages now. Well, well now I feel shamed for choosing formula and that's not actually the issue here. We need to not turn this into a mom versus mom formula versus breastfeeding. We need to look more at why our parents getting information about Infant feeding from TikTok. No one cares. If you're eating, drinking, feeding, regular formula, regular formula has some science behind it. You might not like the marketing practices. You might not like the way that the WIC state associations get the contracts for the formula. And those are definitely issues to discuss. But at the end of the day, this is a safe product for babies to have until it's not when we find the contamination, et cetera, and the Sturgis plant, and then there's that whole conversation.
Katie Ferraro (36m 24s):
So it is such a multi, you know, very, very layered conversation. But what's so interesting about your article. It came out before all of this stuff, all of the formula shortage stuff. This is an article that you guys started writing two years ago, and I promise you the concerns about Homemade Infant formula will last even after the formula shortage is quote unquote resolved. Even if a stockpile is achieved, there will still be people getting this information and messing with a very, very important part of their infant's nutrition because they saw it as a trend on social media. And that's unfortunate.
Faryyl Bertmann (36m 51s):
And there will be people who are earning clicks, likes influencing based on misinformation. And in this case, as, as we've talked about, there can be long-term permanent repercussions for Infant. And at the end of the day, that is what we need to elevate above all outs.
Katie Ferraro (37m 8s):
Yeah, the TikTok trend is gonna go away, but the irreversible brain damage in that five month old case study that you shared is not, I would imagine Dr. Bertmann that data on homeade infant Formulas pretty hard to obtain parents are probably unlikely to be readily admitting or disclosing that they're in a situation to either have to resort to making Homemade Infant formula. And I'm just curious, is there any good national data on these practices versus what we're hearing, or this is just like strictly TikTok and other social media anecdotes. And like this seems to be a trend.
Faryyl Bertmann (37m 36s):
So when we were writing our paper, we worked with professionals in, in pediatrics, in the national WIC association, in the Infant nutrition council of America, there is some data available, but the argument is it's not robust because it's under recorded. So that folks are less likely to disclose that they fully formula feed, which is unfortunate. I would like people to feel like they can disclose and, and share that this is the choice that they've made for their family. Even more. So people are not disclosing that they're using Homemade Infant formula to a point where it is our anecdotal conversations are not aligning at all with the surveys it's very under reported.
Katie Ferraro (38m 21s):
It's also not aligning with all the likes and comments on social media posts about this. Like someone out there's watching this stuff and some of them are doing it. And you see the comments in some of these posts online, like people are actually doing this. This is not just like, oh, that's interesting enough for me.
Faryyl Bertmann (38m 35s):
So when, when we, we first were sort of workshopping this article and as I mentioned, we took it to these different organizations to say is what we're discovering, aligning with what you're seeing, because we want to be evidence-based. We want to partner with all of these different organizations. And they kept saying like, there just isn't data capturing it. So our team, just like you were saying, like, what is happening? Are people researching this? We went to Google trends and we saw in April, 2020 a huge increase in the search for Homemade Infant formula. My team, we still are in touch just the other day.
Faryyl Bertmann (39m 15s):
One of our members sent us a snapshot of a screenshot of Google trends. Again, and people are not only searching Homemade Infant Formulas in the way that they did in April 2020, but even more so now. And so do we have an exact number for you, Katie? No, but we do see that when people are going on Google they're actively searching Homemade Infant formula.
Katie Ferraro (39m 38s):
Well, at least the AAP is finally putting on their website. Don't make Homemade Infant formula. Like that's a start. So Dr. Bertmann for families struggling to afford or obtain Commercially prepared Infant formula, what resources do you recommend so that they don't have to resort to Homemade Infant formula recipes that they find online or on social media.
Faryyl Bertmann (39m 57s):
Number one, engage a Registered Dietitian nutritionist. We here in Vermont at our community health center, we have free access to dieticians. So that can be a wonderful cost effective way to connect with somebody who's practicing evidence based nutrition and is a nutrition expert. Next, I would suggest that you seek referrals, that you seek referrals to specialists. You can work potentially with lactation support with social services to connect you with, to address perhaps the economic side of the situation, but also connect you with these, this national emergency supply of Infant formula, the, the national stockpiling.
Faryyl Bertmann (40m 42s):
And I mentioned before that If you have any concerns around the public charge rule, for whatever reason, maybe directly or within your family, there is a local legal aid that can be available. And again, that is free legal aid. I think I also mentioned tapping into your charitable food system. So that could be a food pantry, a food bank prepared boxes, let them know your need. And for most infants that do not need a specialized diet. You should be able to access free, readily accessible commercial Infant formula.
Katie Ferraro (41m 20s):
And for the 44.46% of babies born in the country in the WIC program, If you are not in the WIC program and you qualify economically for nutrition assistance from the WIC program in the United States, please seek out how you can get enrolled in WIC. We have lots of WIC content on our podcast, and we'll also share links in the Shownotes for this episode for how you can become enrolled in this program that can help you by providing free Infant formula. And I loved in your paper, Dr. Bertmann that you guys did the breakdown on the cost of how many canisters of formula WIC provides for free. It was about at about $18 a canister, which I was like choking on my mouth. Cause it's like $32 right now at my local grocery store. But when you did the papers, $18, a canister, it's like upwards of $2,000 per baby of formula in the event that you choose not to, or can't breastfeed, these resources are out there and WIC is still meeting the needs of parents, even in the throws of the formula shortage.
Faryyl Bertmann (42m 13s):
And I think we should normalize WIC and using these these services. Heck yeah. When I was a doctoral student and I mentioned to you that I was working on WIC, I went to a conference FENCE and under secretary, Kevin Khan was speaking about WIC and I was so excited about WIC and the policy and advocating for WIC. I stuck around and I talked to him and I said, I'm researching on WIC. And he looked at me and he goes, I participated in WIC. And so when you have somebody at one of the highest levels of US government that is destigmatizing WIC and utilizing WIC, this is the type of message that I want to share..And normalize,
Katie Ferraro (42m 57s):
Half of all babies guys, half of all babies, half of all babies, why isn't this normal yet? You know, we actually just had Sunny Rudd on the podcast. So she's a mom, she's an also NYU grad student, single mom on WIC. She does these WIC grocery hauls on TikTok. She's JustSunny on TikTok. They're so awesome because she's showing in real life how she uses just the Foods she gets from WIC and works them into like delicious looking, amazing recipes, like any other TikToker but it's all coming from WIC and she's blowing up. Her Baby's just about to start solid Foods with BABYLED Weaning. So we've been like watching, like with anticipation and glee, but again, normalizing utilizing this program, that's there for you. And she said, you know, I deal with the backlash and people calling me a welfare queen and all that just, but you know what, I'm on this platform TikTok where there's a lot of misinformation about the program and I'm here living it and sharing about it and trying to normalize it because it is my reality.
Katie Ferraro (43m 49s):
And it's providing me with Foods to help fuel my family. And it's really cool just to see her doing that in the social media space. I think it's cool that high level policy people are, but like your average mom is not gonna be at FENCE talking to the director of whatever, but they're gonna be on TikTok. And that's where moms are sharing their content too. So I think we, all we can do is to continue on our platforms with our communities to talk about resources so that we don't have to default to making Homemade Infant formula because as you very eloquently, but also sadly put it like there are real life consequences to this. And I wanna thank you for sharing this and also for being willing to address this because it's volatile. And I think it's controversial in many regards. And I'm interested to hear our audience's thoughts about this as well, because we do need to be getting our feeding information from credentialed experts.
Katie Ferraro (44m 31s):
And those who do not study history are doomed to repeat it. This is like my life goal at the end of my career, when I don't have to worry about making money and feeding my family, I wanna put together a nutrition history course that every student in an accredited ascend program who's studying to be a dietician, has to take. We need to understand the history of commercial, Infant formula and vitamin discovery so that we don't come full circle. And that people just like on TikTok, deciding that they want to take some of those nutrients out and you end up with babies with irreversible brain damage
Faryyl Bertmann (44m 59s):
And you're dialing right into it. I am such a history buff around Infant feeding, and I'm just so pleased that my team tolerated the fact that I was like, I just think that this needs to be part of the story and part of dietetic education. So we understand where we were and how far we've come.
Katie Ferraro (45m 16s):
Absolutely. And I'm gonna link to your article I'm so just again, I work in an era of social media and we, at this point, the average attention span on an Instagram reel is about six seconds and the months and years of expertise and the research and the experts you guys talk to to publish this article is so important. I'm like parents need to know about this, cuz it's the anecdote to the six, second evaporated or condensed milk TikTok for making Infant formula. Like we need to see the research and the science that's gone into creating Infant formula. And yes, it is a controversial topic for some things, but at the end of the day, if, or If you can, or you choose not to breastfeed commercial, Infant formula is prepared in such a way that's safe for your baby and Homemade Infant formula is not.
Faryyl Bertmann (45m 58s):
And in my recommendation to go see a Registered dietician nutritionist, this paper is written for rising dieticians or practicing dieticians.
Katie Ferraro (46m 9s):
Well, I'm making it mandatory reading in my nutrition throughout the lifecycle course. I'm serious. It's also the practice applications are a lot easier to read than some of the other articles, especially if you're teaching at the undergraduate level. Like I am. Well, thank you so much. This was such a wonderful conversation. And then could you just tell our audience, where would they go to learn more about your team's work? And I will link the article, but if there's anything else we should be reading. If there's a place where we can go get it from you,
Faryyl Bertmann (46m 31s):
Katie, we are an ad hoc team. We are from four different universities. And the way that we came together is we right when COVID was hitting, we got together in a working group looking at potential problems that can arise from COVID. I am part of a research team called InFact, and you can find more about the research that I'm doing with my UVM team through infactresearch.org. Our work is on the food insecurity of COVID. But through that work, I discovered my co-authors and independent of that research. We recognize that this practice paper was important.
Katie Ferraro (47m 6s):
You have to get in touch with Amy Bentley because she's doing food insecurity stuff related to COVID in the New York area now, but historically did the inventing baby food book. I think you guys would like maybe she can join the ad hoc team.
Faryyl Bertmann (47m 19s):
That would be amazing. These are such incredible people. I'm so lucky.
Katie Ferraro (47m 22s):
Well thank you for the incredible work you guys are doing. And I really appreciate your time in taking the time to explain to us in the background, cuz we really appreciate the work you do, especially as a Registered dietician and someone who educates future Registered dieticians. We have a lot of feeding professionals who listen to the podcast and I know they'll be very interested in your article as well because we're all dealing with parents, you know, asking these questions instead of just saying no it's bad. Well, here's the actual results of what happened. So thank you for bringing that to light.
Faryyl Bertmann (47m 48s):
You're welcome. Well, it was my pleasure
Katie Ferraro (47m 50s):
Definitely much longer interview than we normally do, but I just think the conversation about where we are getting our advice and our information from, and then just hearing those chilling case studies of the real life trickle down effect of a very dangerous social media trend is just, it literally broke my heart. I had to take a pause at the end of our interview and come back and record the outro. It might have been upsetting to some of you, If you you're still listening, I hope you had some value or took away some value from that conversation with Dr. Bertmann, I'm very grateful to her and her team for doing that. Like If you are a dietician, you know that we don't generally tackle topics of that nature in our journal. And I think it is important that we do, especially as credentialed feeding professionals in speaking to some of these harmful practices that we're seeing on social media.
Katie Ferraro (48m 32s):
So of Dr. Bertmann's resources will be linked up in the Shownotes for this episode, which you can find at BLW podcast.com/252. Thank you for listening.

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