Milk Formula: A Substitute for Breast Milk- Part 1

Last month, I have discussed the mythical mechanism of breast milk. This month, I would like to talk about milk formula, as a substitute for breast milk.

When there is not sufficient breast milk, we must find a way to feed the baby with a substitute so s/he can develop normally. In the past, we had such a practice as "gifted milk". This is the practice of women, who themselves have just given birth, becoming nurses to give breast milk to other babies who have just been born. The so-called "wet nurse" is a good example of this practice. However, encountering the many limitations of this practice, man turned to what had always been a close companion and part of their living, their livestock. From this process, the use of cow milk for the baby was born. Pediatricians, with the help and collaboration of nutritional scientists, veterinary scientists, and biochemists, came up with a solution to produce milk formula to take place of cow milk. This invention can be marked in the history annals of pediatrics.

History of cow milk as a substitute for mother's milk

The cow had always had the deepest relation with man. Thus, it is not surprising that researchers came up with the thought of substituting cow milk for mother's milk. Furthermore, it happened in the prosperous European and American cultures where livestock and farming were abounding aspects of everyday life. It is thought that in the beginning, they just milked the cows in the farm and given them to the baby. However, when we think about it now, this type of nutrition is extremely inappropriate for the baby.

Firstly, during those days, sanitary conditions were not so good, and if the baby drank contaminated or sour cow milk, it would cause many bacterial infections, especially diarrhea which led to death in many cases. Such cases became a big motivational factor for advancement of the study of diarrhea, in the history of pediatrics. The second problem was the problem of the components of cow milk. When we compare cow milk to breast milk, we find cow milk to have higher protein content and electrolytes (e.g. sodium, potassium, etc.) and less sugar. For a baby whose kidney functions are still trying to develop, it is not only inappropriate, but it becomes a burden on the system, thickening the blood and causing dehydration. These observations developed into extensive research of nutrition and metabolism on the baby. It led further to the study of metabolism and its relation to electrolytes (e.g. sodium and potassium, etc.) (note 1), the study of the relationship between vitamin D and rickets (note 2), and finally the study of the relationship between vitamin C and scurvy (note 3).

The solution to the first problem is solved, if one can obtain fresh cow milk. There is even evidence that when industrialization began, some people kept their dairy cows in the basement and milked them there. However, the cows became sick because they were not exposed to any sunlight, and thus, their milk soon made the babies sick also. Even tuberculosis was passed on to the baby. Through the many illnesses encountered with the cow milk, pediatricians came to understand many of the problems it bore, and began to solve them as they arose. Thus, began the 100 years of research that produced what is known today as baby formula.

Until safe dairy products are made...

In order to give cow milk to the baby, we must be able to keep the milk as fresh as possible for as long as possible. Let's look into the progress made throughout history. We needed a way to preserve cow milk without changing its components and in order to do that, we needed to sterilize the milk. With that in mind, in 1856, an American named Borden made condensed milk. Condensed milk is milk brought to its highest possible density, so that it becomes difficult for bacteria and microorganisms to exist. In 1876, Pasteur developed a low temperature sterilization procedure (note 4), which was a huge leap in the progress of converting cow's milk for babies, and this process later become known as "pasteurization".

This is how we were able to give babies condensed milk, which was easier to keep. In Japan, condensed milk first began production in 1872 (Meiji year 5). Artificial nourishment for the baby began with condensed milk and continued for fifty years. However, there is a limit to the period of preservation for even condensed milk. Without a refrigerator, once you open the condensed milk, it spoiled rather quickly. To eliminate this problem, powdered milk was developed. Soon after its introduction, it became widely distributed and used due to the high preservation threshold of powdered milk. In the United States and Europe, condensed milk (formula) is still used quite frequently, but in Japan, when we think of baby's milk, it is in a powdered form. This powdered milk began production in Japan, in 1917 (Taisho year 6).

Note 1: Metabolism and its relation to electrolytes and water
Sodium, potassium, calcium and chlorine are elements running through the blood stream and in other body fluids that help metabolism stabilize. There is an especially deep relationship with the kidney and hormones.

Note 2: Rickets
A disease of the skeletal system, mainly of children, resulting from vitamin D deficiency in the body. Vitamin D is needed to deposit calcium salts in the bone, and the disease is characterized by a softening and, often, bending of the bones. It is also said to be caused by insufficient exposure to sunlight. It can cause dwarfism, delay in standing and walking, delayed growth in tooth and bone development, and a bone or bone transformation.

Note 3: Scurvy
A disease caused by a lack of Vitamin C in the body. It can cause weakness in the veins, bones, and joints. Bleeding of the gums is also a characteristic. Scurvy in little children shows symptoms similar to that of the anesthesia of the lower limbs.

Note 4: Low temperature sterilization (pasteurization)
A method that sterilizes products that has a high risk of spoiling, by applying temperatures of less than 100 degrees Celsius. In the sterilization of milk, it allows for the important elements, such as vitamins and lactobacillus to remain in its original structure, and sterilizes on the pathogenic microorganisms. This method was first developed by Pasteur, thus the labeling of "pasteurization".
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