'Formula stretching'

Some families that can't afford enough infant formula resort to risky 'formula stretching,' watering down infant formula or skipping feedings, researchers say.

This can have significant health consequences on an infant's developing brain, increasing the risk for learning, behavioral and psychological problems, according to two new studies from Cincinnati Children's Hospital Medical Centre.

In one study, the researchers studied families treated at two paediatric clinics in Cincinnati that see about 45 000 patients from underserved neighborhoods each year. Despite receiving public assistance, about 30% of these families could not afford to meet their basic nutritional needs.

"We were surprised to find one in three families worried about putting food on the table," said study co-author Dr Andrew Beck, a general pediatrician, in a hospital news release.

Food insecurity

The inability to pay for enough food to satisfy basic nutritional needs is called food insecurity. "Food insecurity tends to be an invisible problem, forcing families to make difficult choices between nutrition and other essential needs," Beck said.

The researchers said better screening methods are needed to identify families without enough to eat, they said.

The study was recently published online in Clinical Pediatrics.

In 2009, the federal Special Supplemental Nutrition Program for Women, Infants and Children (WIC), which provides basic nutrition for low-income women with children, decreased the amount of formula it provides to infants older than 6 months. The researchers revealed that two-thirds of the families in the Cincinnati clinics supported by WIC said they often do not receive a full month's supply of formula.

Of the families who cannot meet their basic nutritional needs, 27% admitted to watering down formula or reducing feedings, the study found.

Studies

"We're seeing the effects of those changes in our urban clinics, highlighting that WIC is truly a supplemental program," said study lead author Dr Mary Carol Burkhardt in the news release. "I would venture to say that cities with similar demographics and poverty levels are seeing some of the same behaviours found in our study."

A separate study by these researchers published in Pediatrics found that routine screenings by pediatric residents were not identifying the families unable to meet their nutritional needs.

Residents only recognised the problem in 2% of cases, while preliminary research showed that nearly one-third of families seen at the urban clinics did not have enough to eat.

"Families are sometimes reluctant to report food insecurity because of the stigma," said study co-author Dr Robert Kahn in the hospital news release. "We made a number of improvements, including training our pediatric residents to ask about hunger issues in a more sensitive manner."

The ability of doctors to identify hungry families jumped to 11% following the training program, Kahn's team noted.

(Healthday, January 2012)

(Copyright © 2011 HealthDay. All rights reserved.)