Goat milk for infants: Yes or no?
Published Nov 1, 2005 · L. Baur, J. Allen
Journal of Paediatrics and Child Health
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Abstract
Two articles in this issue of the journal look at very distinct aspects of feeding different forms of goat milk to infants.1,2 The article by Grant et al. presents the results of a carefully conducted randomized controlled trial of goat milk infant formula versus cow milk infant formula which shows that growth at age 6 months was similar in each group. On the other hand, Ziegler et al.2 present a very concerning case history of an 11-monthold boy who was admitted with severe macrocytic anaemia secondary to folate deficiency which arose as a result of longterm feeding of a homemade formula based on goat milk. What messages about goat milk, and infant feeding in general, should clinicians take from these studies? The case history graphically highlights that fact that unmodified goat milk is not suitable as an infant formula as it is a poor source of folic acid.2 It has long been recognized that infants receiving goat milk as a major source of their diet are likely to develop megaloblastic anaemia as an expression of folate deficiency.3 Additional problems with raw goat milk include the potential for infections such as Q fever and toxoplasmosis.4,5 It is for these reasons that it is not recommended to feed unmodified goat milk, especially if unpasteurized, to infants.6 Why do people choose to use goat milk as an infant feeding? Often it appears to be in the mistaken belief that goat milk is more ‘digestible’ and will be less allergenic than cow milk. However, most infants who are allergic to cow milk are also allergic to goat milk.7 There is a safe alternative for those parents who choose to use goat milk, that is, the commercial goat milk infant formula which is supplemented with folic acid and, like all infant formulas, complies with the nutritional standards for infant formula.6 National infant feeding guidelines, such as that produced by the Australian National Health and Medical Research Council6 recommend infant formulas based on cow milk over those based on goat milk, presumably because there have been fewer studies evaluating the safety and efficacy of goat milk formulas, and also because of the lower cost of cow milk-based formulas. It is in this context that the study by Grant et al.1 appears, providing additional information on the safe effect on growth of a goat milk-based infant formula in healthy infants aged up to 6 months. What recommendations on infant feeding should clinicians be giving to pregnant women or mothers of newborns? There is ample evidence to show that exclusive breast-feeding, ideally until 6 months, provides optimal growth and health outcomes for infants, and that breast-feeding should be encouraged until 12 months and thereafter as long as mutually desired.6,8,9 Clinicians dealing with infants, new mothers and pregnant women can play a vital role in supporting and encouraging breast-feeding. In the case report,2 the mother is reported as having stopped breast-feeding at age 2 weeks after she developed mastitis. It is
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