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Comparison of Imported European and US Infant Formulas

Labeling, Nutrient and Safety Concerns

DiMaggio, Dina M.*; Du, Nan; Scherer, Corey; Brodlie, Susan; Shabanova, Veronika; Belamarich, Peter§; Porto, Anthony F.

Journal of Pediatric Gastroenterology and Nutrition: May 9, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/MPG.0000000000002395
Original Article: Nutrition: PDF Only

Objective: Infant formula in the United States is highly regulated. The AAP has reported concerns over the use of non-FDA registered imported infant formulas. The purpose of this study is to identify Internet purchased and recommended imported European infant formulas and compare them to FDA labeling and nutrient requirements.

Study Design: We searched “European infant formulas” in Google and DuckDuckGo to identify vendors of European formulas and blogs discussing these formulas to determine the most frequently purchased and recommended brands. We then compared the identified European formulas’ label and listed nutrients to FDA labeling and nutrient requirements.

Results: Thirteen of eighteen vendors responded to our inquiry of their top selling formula and 17 blogs were reviewed. Sixteen formulas were identified. None met all FDA label requirements. Listed nutrients fell within FDA requirements in 15 of 16 formulas.

Conclusion: Non- FDA registered imported European formulas do not meet all FDA labeling requirements. Although linoleic acid, which was not listed on all of the European formulas, could not be evaluated, all formulas except one met the remaining FDA nutrient requirements. These European infant formulas are being imported into the US via third party vendors and are not FDA regulated, limiting the notable consumer protections set by the FDA that ensure infant formula safety. Pediatric gastroenterologists and health care providers need to understand the composition, labelling and lack of FDA regulation and safety concerns of these formulas in order to better counsel parents.

*Department of Pediatrics, NYU Langone Medical Center, New York, New York

Department of Pediatrics, Yale University, New Haven, Connecticut

Department of Genetics and Metabolism, Montefiore Medical Center, Bronx, New York

§Department of Pediatrics, Children's Hospital at Montefiore Medical Center, Bronx, New York.

Address correspondence and reprint requests to Anthony F. Porto, Department of Pediatrics, Yale University, 333 Cedar St, New Haven, CT (e-mail:

Received 26 December, 2018

Accepted 30 April, 2019

Funding Source: No funding was secured for this study.

Financial Disclosure: Dina DiMaggio and Anthony Porto both are medical consultants for Little Spoon, LLC. The remaining authors have no financial relationships relevant to this article to disclose.

Conflict of Interest: As above. The other authors have no conflicts of interest to disclose.

Role of Authors and Contributors: There are seven authors who contributed to this manuscript and take full responsibility for the manuscript. Drs. Porto and DiMaggio conceptualized and designed the study, collected and verified data, drafted the initial manuscript, and reviewed and revised the manuscript. Dr. Belamarich critically reviewed the manuscript for important intellectual content and revised the manuscript. Dr. Shabanova performed data analysis and critically reviewed the manuscript for important intellectual content. Ms. Brodlie and Drs. Du and Scherer collected and verified data and critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

© 2019 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,