The skinny on soy: Are soy formulas safe?

Let me preface this post by saying that I am a huge fan of the soybean. Having been a vegetarian (and occasional vegan) for the past 20 years, soy products and I have obviously become BFF.

So when we were trying to figure out my son’s eating issues, I was hoping that soy formula would be the golden ticket. Unfortunately, it turned out that he was allergic to both dairy and soy, and we ended up on hypollergenic formula (Similac Alimemtum). But this had nothing to do with my feelings about soy. Just so we are clear. I still love you, my sweet soybean!

Soy has been in the news a lot lately. Once the golden child of women’s health (it was said to prevent numerous cancers, heart disease, and help alleviate problems associated with menopause), like so many things that have once been exalted for health reasons, the establishment has turned on poor old soy. Now it is being blamed for all sorts of ills, including decreasing metabolism, enlarging thyroids, and killing testicular cells. Yummy.

What does this mean for babies on soy formula? One would think that any problems associated with soy would be exacerbated in its use as an infant formula, since, well, babies are small, and things affect them more strongly than bigger humans (how’s that for a scientific explanation?). In 2008, The AAP came out with a report called “Use of Soy Protein-Based Formulas in Infant Feeding,” which updated it’s 1998 review of soy formulas. Basically, it says the following:

1. Soy formulas have no advantage over cow milk-based formulas.

2. For pre-term infants, soy formulas are not recommended.

3. Soybeans are high in phytoestrogens (estrogen-like compounds found in plant products), but there is no “conclusive evidence” from any study showing that that “eating soy causes problems to human development, reproduction or endocrine function.” (WebMD)

3. If you are vegetarian and do not feel comfortable with milk products (well, actually, the correct term would be “vegan” as vegetarians are fine with dairy products, but hey, semantics…it’s not like the AAP has dieticians on staff or anything….) or your child is lactose intolerant, soy is a safe choice; otherwise stick to milk-based formulas.

4. For kids with food allergies, hypoallergenic formulas are a better bet; many kids who are sensitive to cow’s milk protein are also sensitive to soy. There is no evidence that soy formula confers any protection against the development of allergies over regular formula. (Note: there actually was a recent AAP paper stating that there is possibly an advantage to hydrolysate formulas like Alimentum in this respect; that’s fodder for another post though, so we won’t go into it here.)

Now that we’ve seen what the AAP has to say, let’s look at this from a real-world perspective. Telling a parent that there are “no conclusive studies” on something and then warning him/her to stay away from it isn’t very comforting to that parent. No one wants to be responsible for his/her kid growing breasts at age 8 (especially if that kid is a boy). Why would they warn parents away from soy formula if it were safe?

Here’s one possible answer: the AAP likes to cover it’s bases. These are the same folks who told us to treat peanuts as arsenic for the first few years of a kid’s life; now they are sheepishly (and quietly) admitting that perhaps this policy had a contradictory effect (more kids getting peanut allergies rather than less). Take their statements with a grain of salt – like your mom, they mean well, but can be a little over-dramatic. The truth is that there have simply not been enough studies on the long-term effects of soy formula. I know this won’t put anyone’s mind at ease, but let’s look at it another way – science is discovering new advantages and disadvantages to everything in our world every freaking day. Soy formula has been used for the past 100 years, and while there could obviously be a study that comes out tomorrow saying that it causes all sorts of evils, there could just as easily be a study that proves that potatoes cause cancer. You just never know. All you can do is make an informed decision and weight the pros and cons, and overall, soy formula seems to be a relatively safe choice.

I turned to Dr. Greene, my new favorite pop pediatrician, for some insight. In 2001, he posted the following:

Babies who drink soy formula receive significant amounts of estrogen-like compounds (phytoestrogens) in the form of soy isoflavones. This happens at a developmental time when permanent effects are theoretically possible. Some have speculated that soy formula might be responsible for early puberty in girls or infertility in boys.  The August 15, 2001 issue of The Journal of the American Medical Association (JAMA) contains the results of a study of 811 adults, some of who drank soy formula as children and others who drank milk-based formulas. No statistically significant differences were observed between the groups in either women or men. They followed more than 30 different measures of general health or reproductive health. Breast milk is clearly the ideal food for babies, but this study is quite reassuring that soy formulas are a safe alternative. This is good news for babies who do not tolerate cow’s milk formulas well.

Granted, this was nine years ago; the AAP statement came out seven years later. But reading the AAP statement, it doesn’t seem like much has changed, does it?

What I think has changed is the perception of soy in general. The issue with soy is that it is in practically everything. Read any label in your kitchen cupboard – I guarantee you’ll see some terms like soy protein isolate, soy lecithin, soy isoflavens. Even if nary a cube of tofu should ever pass your lips, you’ll still be consuming a fair amount of soy in your lifetime. The problems we are seeing now that are associated with soy are most likely from an overabundance of it in our diets – a real conundrum for vegetarians like me. Once I started looking into it, I realized I was eating soy cheese, soy yogurt, soy milk, tofu, and a myriad of veggie-friendly products all made from soy. Rather than freaking out completely, I opted to switch to almond milk, coconut milk yogurt, and decided to eat dairy cheese or no cheese at all. I still eat tofu and veggie meat (made with soy) nearly every day, but at least it’s not the main ingedient in everything I eat. Moderation, people, moderation.

Back to the babies… If your child can’t tolerate dairy, you basically have two choices in formula – soy or hypoallergenic. It comes down to preference – for those who don’t like the idea of processed, chemical food, then soy formula will probably be a better bet. You can get it in organic variants, and at least you can prononce the majority of the ingredients. The hydrolysate formulas tend to fare better in studies, but they are completely manufactured, not available organic, and extremely cost prohibitive. Plus, a lot of kids won’t drink them, because they taste like crap. Weight the pros and cons and realize that no matter what, you’ll be able to switch them off the stuff in a few short months. (At which point, if you are concerned about an overabundance of soy, I would recommend weaning to regular milk, or a substitute other than soy, like rice, oat or hemp).

Take away message? Go for the soy if it works for your family – my hubbie was raised on the stuff and he doesn’t have boobs. I promise.

Suzanne Barston is a blogger and author of BOTTLED UP. Fearless Formula Feeder is a blog – and community – dedicated to infant feeding choice, and committed to providing non-judgmental support for all new parents. It exists to protect women from misleading or misrepresented “facts”; essentialist ideals about what mothers should think, feel, or do; government and health authorities who form policy statements based on ambivalent research; and the insidious beast known as Internetus Trolliamus, Mommy Blog Varietal.

Suzanne Barston – who has written posts on Fearless Formula Feeder.

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15 thoughts on “The skinny on soy: Are soy formulas safe?

  1. Thanks for sifting through fact and fear-mongering to deliver a balanced post on this. I think that when it comes to choosing between soy and hypoallergenic, it helps to know which of the two types of “dairy issues” you're dealing with: protein or lactose. A lot of babies whose issue is protein intolerance can't do cow's milk or soy proteins. (I was emphatically told to give up both in my attempt to continue breastfeeding.) If it's just an issue with lactose, you probably have more choices.

    Quick question: why is hypoallergenic more chemical? That sounds scary. I know Elecare is “broken down”… but that is a claim a lot of milk-based formulas are now making (though they are not “broken down” as much). So “broken down” could translate to “more processed”–after all, that's the entire point of hypoallergenic formula. Is that also why it's more chemical? Are there more chemicals detected in it? I compared ingredient lists from a popular Similac soy formula and Elecare. They are astoundingly similar, heavily based on corn syrup solids. Elecare has more ingredients, but the extras are amino acids, due to the fact that the bigger nutritional components are broken down into the smaller pieces for easy digestion.

    Note: Baby's Only Organic Soy Formula does have a slightly simpler ingredient list, so that may mean it's less complex and less processed. It also focuses on the claim that it's the only soy formula with corn syrup. I would've LOVED to have been able to use an organic formula! That's awesome! But putting that aside, I'm not sure I really see how another syrup (brown rice) is significantly better than another (corn syrup). The formulas all wind up with around the same amount of carbs/sugars/fat/etc.

    The Baby's Only copy (on the official site) seems sneaky–they talk about brown rice syrup as a quality carb source right after they proudly state that they are the only choice without corn syrup, but they talk about this “quality” only in relation to lactose and cane juice, not corn syrup. Makes me wonder if they didn't say it because they legally could not make that claim (I'm a copywriter so I've faced such situations and know sneaky when I see it).

    Bottom line–I'm not sure there is a huge difference but then again, I'm not a nutritionist! Just a neurotic mom.

    Why am I doing all this lengthy commenting? I am wanting to have another baby (I hope to be so lucky), so I want to be prepared for the possibility that he or she may have the same issues as my daughter. I'll want to have an idea of what formula I'd turn to if breastfeeding doesn't work out again.

    Thanks again.

  2. @Amber-

    Once again, I am so happy that you come here and comment because you always add so much, on a personal and topical level. Plus, I love the copywriter side of you- keeps me on my toes. 😉

    I probably chose the wrong words for the section on hydrolysates. What I meant to say is that I know some people are skeeved out by the “space food” aspect of formula, and if you're one of those people, I can see how the hypoallegenics might scare you. However- and this is what I alluded to that I am saving for a future post – I personally believe the hydrolysates are the wave of the future. It is pretty amazing how well they do in studies. If one is to argue that cow's milk can be difficult for babies to process, then the advantage of these special formulas are clear – they are chemically altered to be the most sensitive, perfectly hypoallergenic food a lab can create.

    I always hesitate to talk them up though, b/c at present, they are just so cost-prohibitive for many people. And in terms of relative risk, I still think you're talking tiny statistical bumps here, so even if cow's milk- and soy-based formulas are associated with some health concerns, the risks are really tiny. For most babies, these formulas will be fine. I do have some “pet” theories on how regular formulas might be associated with higher rates of diarrhea, which leads me to believe it's not that breastmilk has protective effects on these issues, per se, but perhaps the wrong formula – but these are total speculation on my part!

    Anyway- what was your question? Kidding. 🙂 Your point was well taken – if you look at the ingredients, pretty much all formulas are basically the same. (And I agree with you about the corn syrup issue, incidentally.) I know that some people feel more comfortable with the organic companies like Earth's Best b/c they aren't part of the “Big Formula” machine, and that was more what I was referring to in my comments. But I see how that could be misconstrued.

    In terms of which formula to turn to for future children – I think about this a lot. (You know, that would also be a great future post – what are we all going to do with the next kid?) I think if we can afford it, I will stick to Alimentum from the get-go. That is if my kid will take it. We lucked out with this one, but I've heard the taste is pretty offensive to most babies. I honestly believe that hypoallergenics are the best bet if you can afford them – at least for the first 3-4 months until their systems develop. But that is probably more of a recommendation for people like you and I who know that there is a possibility of similar dietetic issues in future siblings…why risk any possible discomfort or confusion, you know?

  3. I love your deep research on soy! I hadn't read the JAMA study. Good to know! A few years ago soy was the buzz word, now it's been downgraded. Although it's been a couple years since I've read up on it, I think most of the studies showing harmful effects were with adults, particularly a breast cancer scare, no? The Japanese, who eat a lot of soy products, refined and otherwise, don't seem to show negative effects, in fact, they have rather low breast cancer rates. Never heard about a man-boob problem among Japanese men either. Anyhow, again, thanks for the great post!

  4. Choosing formula can be so confusing. I was afraid to use soy because I have a major allergy to it, even skin contact causes a rash. I always heard that early uses with soy formula can be attributed to allergies later on in life. In fact I had found out my mom had used soy formula for me. I also heard it can be very constipating so again that made me unsure about it. My brother though doesn't have a soy allergy and was also on soy formula. Was there anything in your research about allergies and constipation from soy formula?

    I do agree with using a hypoallergenic formula or a sensitive formula for young babies though. I started out with a regular formula and he seemed fine, but then started spitting up a ton, developed a rash on his cheeks, and was having tummy problems. Lactose free formula for us was a life saver.

  5. Oh yes, also, thanks for putting the AAP recommendations/statements into perspective! We don't see this enough! I think of them as overprotective elders. And often, they're going by gut instinct and CYA as much as scientific evidence – be it food allergies, breastfeeding, extracirricular activities/play, circumcision, television, you name it!! Is there a kernel of evidence for many positions, yes, but it's always exaggerated. I'm suprised they haven't crafting a formal bisphenol-a policy statment yet.

  6. I'm not sure I understood the comment completely, but I think there are a lot of people who are very concerned about the corn intake and believe it to be a part of the obesity epidemic, Michael Pollan not the least of them. So I can see why they would make that claim and why some parents would be drawn toward a formula without corn anything.

  7. Brooke, that's because corn syrup is adding more sugar and calories to foods. But in the case of the formulas, whether it has brown rice syrup or corn syrup, the amount of calories/sugar/carbs is the same. So I don't think you can throw this in with other foods. I consulted with our Children's Hospital about my concern when I realized her formula was corn syrup based, and a nutritionist did talk me through it and I was reassured. I read “In Defense of Food” recently and loved it. But again, if you think about it on a deeper level, and I think Pollan would agree, it's more complicated than just demonizing corn syrup.

  8. @Andrea-

    Regarding soy and constipation – in the more alarmists texts, soy is blamed for pretty much everything, constipation being one of them. However, Dr. Greene, BabyCenter, and a few other more moderate sources suggested that sometimes soy formula can HELP constipation in cases where babies are reacting poorly to milk-based formula (like with lactose or protein intolerance). However, a baby can also be sensitive to soy, and if he is, then constipation can be one of the side effects of this sensitivity. Also, when switching from breastmilk to formula, or one type of formula to another, constipation can definitely occur, but should subside once the baby gets used to the new formula.

    So the simple answer to your question? No, I don't think soy is normally associated with constipation. The more complex answer? People react differently to everything, and soy is one of those foods that a lot of people are sensitive to. And since food sensitivity can manifest as constipation, then… you see where I am going with this! 😉

  9. Thanks for this post on Soy. It was also good to get some more info about those hypoallergenic formulas. But it is really too bad they don't come in organic and at a more affordable price. Also, I have to say I am one of those ones who is freaked out a bit by the “space food” aspect of it as you say.

    Also, on the corn syrup front- it was good to see that discussion in the comments. I am also a Pollan fan and when I saw corn syrup as the first ingrident on my soy formula I didn't really feel great about it. But I think that is a good point that it is not added unneccessarily, the way it is in most foods. I hadn't thought about it like that.

  10. @FFF — thanks so much for your reply. a couple thoughts in response to your response.

    a well informed friend told me that breastmilk has something in it that provides a laxative effect… i haven't looked into it though. makes sense, i suppose. so it's not some super magical protection but some component that just makes it easier to pass through. it is a really cool system when you think about it, and when it works (didn't for me of course), i gotta admit.

    we spent $1,000 a month on elecare. granted we were tube feeding and trying to help her take the bottle so there was more waste than normal. and i think it ferments quicker due to the fact that it's already broken down. if it sat out before she had it, it would come back up. yuck!

    i didn't know that hydrolysates did so well in studies! that's encouraging. i'd always wondered if it was sub-par, you know, because it's perceived currently as a last-ditch option (again, cost probably has a lot to do with that).

    ii totally, totally understand why you'd want to go with what clearly worked if you have another baby. maybe it's because i'm stubborn, but if i have another kid, i'm going to try to breastfeed. after my experience with stella, i know what red flags to look for, so i can nip any issue in the bud and be confident and not despondent about a switch to formula. with her, the discomfort built up gradually over the early weeks and increased slowly, so i don't feel dissuaded from trying breastfeeding. her aversion took many weeks to take root (breastfeed-at-all-costs messages helped bring the need for the feeding tube, definitely, because it was hard to believe that something could go so terribly wrong… yet if i'd tried soy or dairy formula, it wouldn't have helped… but i would've been able to troubleshoot faster and more effectively without the boob mandate.) so i feel that i could adjust my plan if needed based on the cues i get from the baby. because who knows, the next one might really love to nurse and thrive on my milk. or not! and that's easy to address if caught early on, which can happen if you take off the insane breastfeeding-is-always-best-and-perfect blinders. i want to thank you for being one of the few women who helped me get to this place so that if #2 ever arrives, i'll be on much more solid ground! it's huge, really.

    sorry for another rambler of a comment 🙂

  11. We used formula to supplement and our boy was dairy-sensitive in his early months. So we used Similac Alimentum. I threw away three cans (and those cans are EXPENSIVE) thinking they had gone bad before I realized that that stuff just tastes like death.

  12. @Accidents-

    Tell me about it. I couldn't believe my son drank it so easily – I've heard that most parents need to cut it with something else for a bit to get kids used to the taste. But he took it down, no problem, and it has been a FIGHT to get him off the stuff. He LOVES it. I guess that when you've been in horrible discomfort for your whole life, something that finally makes you feel okay is such a relief that you'll take it, even if it does taste like death!

  13. My first baby drank soy formula for about a month and then soy milk for about 8 months because my breast milk dried up and we discovered he was allergic to cows milk.

    Since then, I've read countless suggestions that soy formula is risky for babies in families with a history of thyroid disease, something I've had since I was 18 and which definitely runs in my family.

    Soy, being a goitrogen, can affect the thyroid gland, but doctors don't even recommend those with thyroid disease avoid all goitrogens, which also include foods like strawberries, peaches and broccoli. I can handle all those foods ok, but soy puts me into autoimmune crisis. So I'll alwas wonder if my son gets thyroid disease later in life, if it's his genes or if it was the soy formula.

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