Walmart recalls formula after infant death: Is your baby at risk?

If you haven’t heard the news, you’re about to. I’m sure the Mommy-blogs will be buzzing in the morning about the terrible tragedy that occurred in Missouri, where 10-day-old Avery Cornett died from a bacterial infection. Avery was formula fed, and the family was using Enfamil Newborn which was purchased at their local Walmart. The authorities made it clear that the case is still under investigation; the bacterial infection could have been contracted from the water used to mix the formula (doubtful) or from the way the formula was handled (plausible, and this is not because of any fault of the parents; hardly anyone follows WHO protocol for formula feeding, because a. they are not informed about it and b. typically, it isn’t a problem) – not to mention some other non-formula-related exposure – and not necessarily the powder itself.

Not that these facts make it any less scary.

Look. There’s no doubt about it: it could turn out to be that the bacteria (a particularly dangerous type called Cronobacter sakazakii) was indeed in the powdered formula. This is even more gut-wrenching when you consider that the type of formula affected was one specifically marketed to newborns, who are most susceptible to bacterial infections.

Formula is a manufactured substance, and it is handled by humans in all stages of it’s “life”. This means it is prone to human error. There can be bug parts. There can be bacteria. It can happen.

These things also happen with other manufactured food substances, of course. It’s just that when a food is specifically designed for babies, you are dealing with a whole other can of worms. Sometimes literally…ahem, Similac….

I’ll be awaiting the verdict on whether or not the bacterium was in the powder or not; Enfamil claims that the batch (which has been recalled from all Walmart stores nationwide) was tested prior to its shipment to stores, but who knows. Ultimately, even if a tiny bit of the bacterium made its way into the powder, using extra-vigilant formula prep could reduce the risk of your baby getting sick. Bacteria has to grow and thrive; things like proper sterilization, using distilled or boiled/cooled water, and cleaning bottles, bottle brushes, nipples, etc extremely well can stunt that growth or murder the little buggers outright. This paper on Cronobacter sakazakii explains:

Though the contamination in infant formula has often been attributed to the dried powder, the origin could well be the environment in which the formula is prepared for feeding. Delays between reconstitution of the formula and the actual feeding may allow growth of the contaminants, particularly if the formula is kept warm. Naso-gastric feeding tubes may be left in place for long periods and initially low numbers of C. sakazakii in the formula could attach to feeding tube and reach levels capable of threatening infant health through biofilm growth on the internal bore of the tubes. As the biofilms grow, individual cells or lumps can slough off and re-enter the formula stream. The infant’s digestive tract is thus continuously inoculated with the bacteria. Infection is likely to be exacerbated by the weak immune system and lack of mature competing intestinal microflora in neonates.

For all the talk about the “risks” of formula, I’d say that this risk – the risk of contamination due to human error – is the only one most of us in the developed world truly should worry about. But please, for the love of all things, don’t let anyone berate you about this being yet another reason formula is dangerous, another reason we should all be breastfeeding. There can be risks to breastfeeding too, especially if you’re using women like us as a sample group. Women whose babies were starving due to insufficient milk; women who were withholding vital medications from themselves because they thought breastfeeding was more important than maternal health; women who suffer emotional trauma each time they attempt to bring a baby to their breast. These risks are small; most women who want to breastfeed will be able to do so without suffering any ill effects.

But most women will also be able to formula feed without facing the threat of bacterial contamination from powdered formula sold at Wal-Mart. We can’t mLinkLinkake decisions based on worst-case scenarios. If we did, none of us would be traveling for the holidays, and if the Los Angeles freeways and the cost of my plane ticket to Chicago are any indication, this isn’t the case.

Think of how many millions of babies drink formula every day. Now think about the last time you heard about a formula-related death due to bacterial contamination. Just as it would be ridiculous to use the story about a woman breastfeeding woman smothering her baby to death on a plane (or in the hospital) as an argument for formula feeding, it would be equally stupid to co-opt this tragedy in the name of lactivism. The real attention should be placed on what we could do to safeguard formula manufacturing from these egregious errors, and more importantly, on Avery and his parents, who must be suffering unimaginable grief.

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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26 thoughts on “Walmart recalls formula after infant death: Is your baby at risk?

  1. Amen. How sad that my second thought, directly after my first thought of “OMG how tragic” was “And now we wait for the formula bashing to start all over again…”

    I love you and your common sense. x

  2. The REAL story here may indeed be the ludicrously poor education for bottle-feeding out there. Whether it's breastmilk or formula in that bottle. I couldn't get a straight answer out of any doc or lactation consultant on how to bottle-feed exclusively with my own breastmilk, much less formula. I would love to see what will probably become yet another horrible attack on bottle-feeding parents turned around to expose the groupthink that currently exists for infant feeding support (can you tell I've looked at Best for Babes' FB page recently?). That's what's really going to help babies and their families, not beating up on this poor family and other formula feeding families like them.

    Regardless, I am bracing myself for another disgusting diatribe from militants with hearts the size of raisins using this story as if there weren't real people involved with real grief to fearmonger more parents into breastfeeding even when an individualized pro/con analysis would determine BFing wasn't the best option.

  3. Thanks for the update. My thoughts and prayers go out to the Cornett family. I hope nobody is ignorant (in both senses of the word) enough to blame them for FFing and thus causing their child's death. But I'm afraid that will be part of my infant feeding dream world.

    As you pointed out, formula is occaisionally contaminated somewhere along the line. However, there can be problems with BFing, too. In addition to the issues you mentioned, BFing moms might take drugs of questionable safety or pass on some environmental contaminants or communicable diseases in their milk. Suppose a mom has Lyme disease or has been exposed to pesticides, doesn't realize it and BFs. Her child falls ill as a result. This does not mean that BFing is generally bad or dangerous. It means that shtuff happens. I would say the same thing about FFing to poor little Avery's parents, IF indeed her death turns out to be formula-related. While there are measures that reduce the risks of BFing and FFing (getting tested for any diseases you think you might have, wearing protective gear around or avoiding hazardous materials, proper handling, prep and manufacture of formula, proper handling of EBM, proper bottle cleaning, etc.), you can't forsee and prevent every possible issue. Sorry mamas and papas. But there is no risk-free infant feeding method.

  4. Thanks for posting this. I just read the story on CNN (and experienced similar thoughts as Tam mentioned) and came here to check for more information. Of course, there were already comments on the CNN page saying this wouldn't have happened if the poor child had been breastfed and breast is best, etc.

  5. My first thought is that we need more stringent screening for formula and the FDA which has been incredibly weakened since the Bush years ought to prioritize this screening. We need to channel our outrage at contaminated foods for wee ones into positive action – going on about how BFing would have avoided this is not going to change the fact that more than half of American infants rely on formula and the companies bloody well have a responsibility to them, as does the govt.

  6. I have to agree with you Teri. With my last baby (who has been formula fed) I didn't even know you needed to sterilize the bottles after each use. Really, really dumb – I know. My older children were nursed and I never sterilized anything. I remember searching the internet late at night trying to find better information on safe bottle feeding – that is how I found this lovely sight. I can imagine mistakes like mine will continue to occur if the hospitals continue their anti-formula campaign.

  7. You addressed this case very well. My heart goes out to little Avery's family. I'm hugging my baby a bit tighter today. I find the people trying to use this tragedy to prove a point about breastfeeding vs. formula wrongheaded and distasteful. The fact remains that if I'd not given my daughter formula, she would have been dead or dying of dehydration and starvation by 10 days old. There are many others like her.

    Food safety is definitely a big issue, particularly for food fed to our most vulnerable. As we've seen in the past few years, any food can be deadly if proper handling is not practiced – most recently cantaloupe, previously sprouts, tomatoes, cucumbers, lettuce, spinach, etc. Does anybody go around blaming the consumers of these products for their own deaths, or do they rightfully blame the producers for not practicing proper sanitation, and the FDA for not doing the right inspections?

  8. Well addressed, and so awful for the family to lose their child. I do wonder, though, why investigators immediately jumped to the formula as the source of the bacteria. I understand that this particular bug is commonly associated with powdered formula, but testing was negative during production and no other kids in the area are sick. Seems weird.

  9. That is an excellent point, Antigone and is a great response if someone says “it wouldn't have happened if the child was BFed.” Even if a child is breastfed, if that child eats contaminated solids (at the appropriate age of course), he will still get sick. Bottom line: contaminated food is bad. It doesn't matter which food we are discussing.

  10. I am with Antigone on this one. If I'd witheld formula from my first daughter she would have either a) died or b) been taken by the state because she was dying. No ifs ands or buts about it.

    For my second daughter (born 13 months after the first) breastfeeding has been easy and I suddenly understand everything all the *lucky* women who don't have problems were talking about. With my first it was NOT easier, it was a nightmare. We did not bond, it was a nightmare. 4 months of constant stress, guilt, and misery. 2nd baby? Wasn't interested for the first 6 hours after birth, sent her to the nursery so I could nap (horror of horrors I know), but this kid GOT IT and it was an absolute breeze in those early weeks and months. Now she's 5 months and yes, I have some supply issues. She gets 1 bottle a day on most days, sometimes we'll go a week without. No guilt (largely due to this site) about our combo feeding and 'failure' to exclusively BF.

    I will say though, that with my first I meticulously sterilized everything, the bottles, nipples, rings, and water. Washed my hands before handling the powder. With 2nd baby…well…I have not been. I boil the water when we go to the inlaw's cabin because it is well water, but I unscientifically and/or ignorantly assumed the water in town was “fine” due to being chlorinated. I never gave her any formula before she was 3 months, so I guess I assumed she was 'old enough' but what I was basing that on I have no idea. This post has given me food for thought.

    And let me add that I know a great many women that do NOT safely pump, store, and sterilize their breastmilk because they think it has magic powers. That take illicit drugs or drink considerable quantities of alcohol and BF, that fail to wash their hands after changing a diaper before placing them around the infant's mouth and on the nipple…this could happen just as easily to a BFer if the death is truly due to formula or formula handling.

    In the end even if this death turns out to be no kind of related to the formula, rather than viewing enfamil's rapid and voluntary recall response as indicative of proactive safety efforts, people will just bleat on about teh ebil formula companies running rampant without safety checks…and it will be republicans faults…or something.

  11. I just saw this today and sadly my first thought was “oh no, here come the anti formula crusaders with their pitch forks and fire torches.” First off-we don't even KNOW that the death was caused by the formula (the batch used tested negative for this bacteria). I'm curious to hear the final results of the investigation. Even if it was, from what I've read/heard about formula preparation, boil the water and sterilize the bottles to avoid the risk, OR when your baby is a wee newborn, you have the option use sterile ready to feed. From my purely ignorant, non-mother opinion, seems like simple solutions to mitigate an extremely small risk.

    I will admit, this whole thing has made me think twice about using powder when I have a baby (I might spring more money for the RTF, at least for the first few months). But it has NOT scared me away from formula as I've learned from reading on this forum breastfeeding is far from risk/problem free. Also, isn't breastmilk full of chemicals and pollutants, and the long term effects on babies not currently known? Seems the lactivists love to keep that under hush hush wraps.

  12. That's exactly what I've been thinking today as well. I have to say that I am still struggling more than I expected to be about the decision to formula feed number 2. It is unlikely that I still have an active Lyme infection, though I still have residual nerve issues. But if I do still have an infection and gave it to my child as a result of breastfeeding, I could make him very, very sick. But that story wouldn't be in the news. And there would be no recall. And there would be no big company to blame. Ignoring the reality that there are risks to breastfeeding as well is naive.

  13. How absolutely terrible for the family of Avery Cornett. It makes me heartsick just thinking about it. I'm sure they'll second guess the formula decision for years, whether or not it ultimately turns out that the formula was to blame. And I'm certain there will be people in their lives who will be very uncharitable in their response to Avery's death.

    Having just downloaded the WHO guidelines on safe formula preparation, I have to say that anyone who thinks mothers choose formula because it's the “easy” infant feeding solution is crazy. At least for myself, the decision has been wrought with difficulty and anxiety. I'm fortunate in that I don't really have a choice (so I don't blame myself or feel guilty), but even so, the preparation of the formula itself looks intimidating. Breastfeeding, when it goes well, looks much easier.

  14. ^^^ THIS.

    as a breastfeeding mama, i have nothing but utter sympathy for you guys! How gut wrenching especially if YOUR brand is the one contaminated? Like you guys need more BS guilt! We need more checks and balances to make sure ALL babies are safe, and ESPECIALLY with newborns! I mean for heavens' sake, isn't it like, “old” wisdom that you're not supposed to take them out for the first few weeks to limit their exposure to germs? And then after all that BS and worry, having to hear preachy idiots yammer on about “breast is best” dude, I wish everyone would stop worrying so hard about how other people parent and take care of their own.

  15. You have such a good way of stating something so that it is succinct and compassionate at the same time. I used Enfamil and then Similac with my girl so at one point or another I used affected products. (My Similac use was well after the recall) It's scary because there is so little true standardization of formula protocol, and we really do need it, and not just another round of “everyone needs to BF”. It would be lovely if everyone could BF, but it just doesn't work that way…

  16. Well, that is not entirely true. Certain pollutants are stored in human bodies, typically in fat. These come through in measurable amounts in breastmilk. There are pollutants that come through in formula as well, but to a much more controllable and predictable amount. In this specific and isolated case, formula does trump breastmilk. Of course this does not meant women shouldn't nurse, but it is a fallacy to state that pollutants are not an issue in breastmilk or that formula is equivalent in regards to this risk.

  17. I hadn't thought about toxins that are contained within our bodies. However, the pollutants that are stored in my body came from somewhere. In my environment – something I ate, breathed, etc. So it's logical to assume that my child may encounter the same thing at some point or another.

  18. Thanks FFF-that pretty much summed up my understanding of that issue. Not saying at all that I think it's a reason that moms shouldn't breastfeed. But just shows that breastfeeding/milk is not the pristine, perfect, risk-free food source that it's so often touted to be. The levels in formula are low enough that they are proven safe (as per the FDA) for consumption by infants. However, I've read (scientists words, not mine) that if women attempted to bottle up and sell their breastmilk, it would never make it onto store shelves due to the significant amount of pollutants and chemicals that are pulled from the mother's fat stores. Long term effects of this phenomenon are not yet known. It could very well be that the risks associated with this are extremely small-but then again, I believe the risks associated with formula are also extremely small. Call me crazy but doesn't it seem that for all the formula bashing you hear in the media/online, this subject so rarely comes up?

  19. Correct-BUT-my understanding of this scenario at least in terms of breastmilk is that the level of toxins/chemicals/pollutants that is pulled from the mother's fat stores into the breastmilk is of a far greater concentration than exposure in other food/the environment. The more exclusive the breastfeeding is, the more the fat stores are taxed and thus the worse this scenario becomes.

    Again-not saying at all this is a reason not to nurse or nurse exclusively. I just think it's ridiculous that so many people advocate for moms to have all of the information they need to make “informed” choices about risks/benefits with infant feeding, yet the discussion is centered entirely around the benefits of breastmilk and the “risks” of formula. No one ever talks about this potential risk with breastmilk. It's most likely miniscule since so far we're not seeing exclusively breastfed kids with 3 heads, but then again, the “risks” of formula are also miniscule in my opinion (caveat, developed world, clean water, etc.) but they are being totally blown out of proportion. I think that's one of the root motivations for this blog, as well as a source of agnst and frustration for the FFF and many of the other moms on here.

  20. One of the biggest fallacies of the breastfeeding-first movement is that there are no risks to breastfeeding. Yes, there bloody well are, everything from Lyme disease exposure to chemicals in breastmilk. Until people get their heads out of the sand and realize that NO decision in life is without risks, one way or another, we will go round for round with militants, well-meaning moms, and breastfeeding promotion organizations with no real solutions.

    For some people, the chemicals/pollutants/toxins in breastmilk ARE a very valid reason not to nurse. And for her and her family, that's fine. It's not good from the standpoint of needing to get chemicals like these out of the environment, but as usual, someone who makes that decision doesn't fit the “stupid, ill-informed, booby trapped, perpetual victim of the formula companies, selfish mom” stereotype perpetuated by the militant lactivists out there.

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