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Infant formulas with added sugars can be dangerous for some babies

powdered baby formula

Babies with an inherited intolerance of fructose face a risk of acute liver failure if they are fed certain widely available formulas containing fructose.

Emory geneticists Hong Li and Michael Gambello and Assistant Professor of Pediatrics Miriam Vos and colleagues studied four cases of hereditary fructose intolerance (HFI) diagnosed in infants. All of the infants had acute liver failure, which resolved when they were switched to formula without fructose.

This intolerance occurs in about 1 of 20,000 live births and comes from mutations in the aldolase B gene that result in an inability to metabolize fructose. Early symptoms include nausea, vomiting, abdominal pain, and failure of an infant to gain weight. If unrecognized, HFI can result in liver and kidney damage, seizures, or death.

HFI-related problems do not appear if an infant is breastfed exclusively, but may occur when solid foods containing fructose, such as fruits, are introduced into the diet. 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. The label may read “sugar” instead of sucrose.

“In some cases, the treating physician had to call the formula manufacturer to confirm that sucrose was a component,” says Li, Emory assistant professor of human genetics and pediatrics. “This underlines why accurate and explicit labeling is necessary.” In babies with digestive problems or allergies, parents or pediatricians may seek to avoid formulas based on cow’s milk. In alternative formulas, there is a higher chance the manufacturer will add sucrose or fructose as a sweetener and a carbohydrate source.

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