Heavy Metal Index

Prescription Infant Formulas Are Contaminated with Aluminium

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Publication
International Journal of Environmental Research and Public Health 16(5):899
Year
2019
Authors
James Redgrove; Isabel Rodriguez; Subramanian Mahadevan-Bava; Christopher Exley
Source type
peer reviewed
License
cc by

Redgrove, Rodriguez, Mahadevan-Bava, Exley 2019 — Prescription infant formulas are contaminated with aluminium

This International Journal of Environmental Research and Public Health article from the Birchall Centre at Keele University and Russells Hall Hospital, Dudley, is the first systematic survey of aluminium in prescription infant formulas. 24 specialised UK formulas (ready-to-drink and powdered) were obtained from a paediatric clinic and analysed by transversely heated graphite furnace atomic absorption spectrometry (TH GFAAS) following microwave-assisted acid/peroxide digestion. The headline finding: ready-to-drink concentrations range from 49.9 µg/L (Cow & Gate Nutriprem 1, preterm) to 1956.3 µg/L (Abbott PediaSure Plus Juice Apple, weight-gain supplement), a roughly 40-fold range. PediaSure Plus Juice Apple delivers 391 µg Al per 200 mL serving. Some prescription formulas (SMA Alfamino 41.4 µg/L, Neocate LCP 44.4 µg/L) were the lowest-Al formulas measured in the Keele group’s accumulated experience, demonstrating that the contamination of infant formulas with aluminium is not inevitable. Powdered formulas were generally less contaminated than ready-to-drink products, which inverts the pattern seen for off-the-shelf formulas in their prior work.

Key numbers

Ready-to-drink formulas for preterm/IUGR infants (Table 1, n=5 measurements per product)

Brand[Al] µg/L mean (SD)Al µg/serving (volume)
Cow & Gate Nutriprem 149.9 (33.7)3.5 (70 mL)
Cow & Gate Nutriprem 2139.3 (143.6)27.9 (200 mL)
Cow & Gate Nutriprem Hydrolysed167.1 (10.6)15.0 (90 mL)
Danone Nutricia Infatrini Peptisorb228.5 (48.3)45.7 (200 mL)
SMA Pro First Infant Milk249.4 (64.0)17.5 (70 mL)

Ready-to-drink formulas as supplements for weight gain (Table 2)

Brand[Al] µg/L mean (SD)Al µg/serving
Abbott PediaSure Plus Juice Apple1956.3 (111.0)391.3 (200 mL)
Danone Nutricia Fortini Compact Multi Fibre Neutral784.5 (121.7)98.1 (125 mL)
Danone Nutricia Fortini Smoothie709.6 (180.3)141.9 (200 mL)
Danone Nutricia Fortini Multi Fibre703.4 (53.7)140.7 (200 mL)
Nutrinovo ProSource TF Unflavoured569.2 (18.1)25.6 (45 mL)
Danone Nutricia Fortini Compact Multi Fibre Strawberry568.2 (65.4)71.0 (125 mL)
Nestlé Health Sciences Resource Fruit180.2 (62.5)36.0 (200 mL)
Abbott PediaSure Plus Juice Strawberry153.5 (161.3)30.7 (200 mL)

Powdered formulas for allergies and intolerance (Table 3)

Brand[Al] µg/g mean (SD)Al µg/day (birth/6mo)
Nutramigen Pregestimil Lipil3.27 (0.19)231/367
Abbott Similac Alimentum1.65 (0.76)na/na
Nestlé Peptamen Junior1.48 (0.24)na/na
SMA Lactose Free1.07 (0.15)77/106
Cow & Gate Pepti Junior0.53 (0.40)35/59
SMA Althera0.46 (0.14)53/69
Danone Aptamil Pepti 10.35 (0.03)26/47

Powdered formulas with additional amino acids (Table 4)

Brand[Al] µg/g mean (SD)Al µg/day (birth/6mo)
Nutramigen Puramino2.23 (1.23)167/256
Danone Nutricia Neocate Junior0.61 (0.11)na/na
Danone Nutricia Neocate LCP0.29 (0.12)24/47
SMA Nutrition Alfamino0.27 (0.04)21/24

Cross-formula synthesis (Table 5)

The full 24-product distribution as prepared per manufacturer instructions ranges from 41.4 µg/L (SMA Alfamino, the lowest-Al formula in the Keele group’s accumulated literature) to over 1900 µg/L (Abbott PediaSure Plus Juice Apple). Powdered formulas were generally lower than ready-to-drink products. The 40x range across this small dataset establishes both that high-Al contamination is common in prescription infant formulas and that low-Al formulas are technically achievable.

Methods (brief)

24 prescription infant formulas obtained pristine and unopened from the Paediatric Clinic of Russells Hall Hospital, Dudley, UK. Each product mixed manually before sampling. Total Al measured by transversely heated graphite furnace atomic absorption spectrometry (TH GFAAS) following microwave-assisted acid/peroxide digestion. n=5 per product. Analytical methods identical to Burrell & Exley 2010 and Yokel & Florence 2008 (cited as references 1, 2, 9 in the paper). Comparison provided across ready-to-drink and powdered formulations (Table 5).

Implications

  • Certification: HMTc Al-threshold development for infant formula must account for the 40x range documented here. The product-page CC candidate framework should distinguish ready-to-drink from powdered formats (format-axis row-fit per CLAUDE.md Part 6). SMA Alfamino at 41.4 µg/L and Neocate LCP at 44.4 µg/L represent achievable clean-platform values; PediaSure Plus Juice Apple at 1956 µg/L is a dirty-platform outlier.
  • Microbiome / clinical: Vulnerable population (preterm and IUGR infants, infants with allergies, infants requiring amino-acid-based or peptide-based formulas) is exposed via a single feeding modality and cannot diversify exposure. No safety margin via dietary variation.
  • App: Powder vs ready-to-drink Al differential should be a query input. Fruit-flavored RTDs (PediaSure Plus Juice Apple) are an outlier category warranting separate flag.
  • Courses: Foundational primary occurrence-data reference for infant formula Al; supersedes regulatory-only synthesis.

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