Pediatric Soy Protein Formula Policy

Australian Pediatric Soy Protein Formula Policy
Policy Statement of Royal College of Australian Physicians
The lack of a suitable diagnostic test for food intolerance has allowed for an exaggeration of the incidence and a tendency for over-diagnosis. The true incidence of milk intolerance in our community is difficult to ascertain but a reasonable working figure would be 2.0% (1).
The number of infants on soy formula outweighs this figure as soy formula accounts for approximately 10% of formula sales in Australia.
There is no evidence that soy formulas are nutritionally better than cow's milk formula for normal infants. The assumption that symptomatic infants who improve on soy formula are therefore intolerant of milk protein is addressed in this statement (2).
There are several well-characterized disorders caused by cow's milk protein intolerance (CMPI), including cow's milk allergy, cow's milk enteropathy and cow's milk colitis. There is also a range of vague signs and symptoms ascribed to CMPI, which includes excessive crying, vomiting, wind, colic, vague ill health, and tension-fatigue syndrome (3).
With the latter symptoms, there is usually no evidence of associated chronic diarrhea or growth failure. Of concern, is that many of these latter symptoms may be the result of parent-child relationship problems, which are inappropriate to treat with soy formula. Controlled trials of cow's milk and soy formulae in colicky infants have not demonstrated a benefit from soy formula (4).
The rationale for the use of soy formula is the assumption that soy protein is less antigenic than cow's milk protein and thus should be used in the treatment of CMPI, or prophylactically in patients at high risk for developing CMPI.
Soy protein can cause intolerance reactions with gastrointestinal symptoms as well as acute anaphylaxis and up to 40% of infants intolerant of cow's milk also develop soy protein intolerance (6).

Glyconutrients may provide health benefits for infants