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Population-based study of the developmental outcome of children exposed to chloride-deficient infant formula
A Willoughby1, B I Graubard, A Hocker
1National Institute of Child Health and Human Development, Bethesda, Maryland 20892.
Insights
Children fed chloride-deficient infant formula showed slightly lower cognitive development scores. This study suggests a potential long-term impact on developmental outcomes for infants exposed to this formula.
Area of Science:
- Pediatric Nutrition
- Developmental Psychology
- Environmental Health
Background:
- Infant formula composition is critical for healthy development.
- Chloride deficiency in soy-based infant formula was a concern in the late 1970s.
- Long-term developmental effects of such deficiencies require investigation.
Purpose of the Study:
- To assess the long-term cognitive development of children exposed to chloride-deficient soy-based infant formula.
- To compare developmental outcomes between children who consumed deficient formula and a matched control group.
- To identify specific areas of cognitive function potentially affected by early-life nutritional deficits.
Main Methods:
- A cohort of children exposed to chloride-deficient formula was identified through school records.
- Matched controls who consumed other soy formulas were selected based on demographic and feeding history.
- Developmental testing was conducted using the McCarthy Scales of Children's Abilities, with blinded examiners.
Main Results:
- Children exposed to chloride-deficient formula had a mean General Cognitive Index 4.9 points lower than controls.
- This difference was statistically significant (P = .04, 1-tailed).
- The most pronounced effect was observed in the Quantitative subscale (P = .005).
Conclusions:
- Chloride-deficient infant formula exposure is associated with a statistically significant, albeit small, negative effect on long-term cognitive development.
- The quantitative aspect of cognitive function appears particularly vulnerable to this nutritional deficiency.
- Further research is warranted to fully confirm these findings and understand the underlying mechanisms.
Abstract:
In 1978 and 1979 a large number of US children were fed chloride-deficient soy-based infant formula. A representative sample of such children was identified in a southern county through a mailing to the homes of 3639 first- and second-grade children in the public schools. Of the 2329 (64%) who responded, 56 reported use of deficient formula and were invited to have developmental testing by one of four study psychologists at their school. Of the 310 users of other soy formulas, 112 were selected for testing as matched controls on the basis of their sex, feeding history, age, birth weight, and socioeconomic status (as indicated by school attended). After exclusions and refusals, 42 children who used deficient formula and 66 control children were tested using the McCarthy Scales of Children's Abilities. Examiners were unaware of the child's history of formula use. The mean General Cognitive Index was 102.8 in those using deficient formula and 105.4 in controls. After adjustment for demographic differences the children who used chloride-deficient formula were found to average 4.9 points less than the controls (P = .04, 1-tailed). The largest difference was in the Quantitative subscale (P = .005). These data show a statistically significant although small effect of chloride-deficient formula on the long-term developmental outcome of exposed children; however, further study of these results is needed for full confirmation.