Cow and gate organic milk being discontinued

[Jen1978]

HELP!! Have finally found a formula that I am happy with - cow and gate organic and now it is being discontinued!! Can anyone recommend another organic one? Has anyone tried Hipp organic formula - is it as good as the likes of cow and gate, SMA and aptimil?

formula is actually pretty much of a muchness

Hipp organic should be just fine...

how old is your little one?

All 3 of mine had the HiPP organic milk once I had stopped BFing and it was lovely and creamy.

I am a bit that companies discontinue formula when babies are clearly feeding on it.

Thanks, DS is 6 months now and has been on the cow and gate formula for the last 2 months since i stopped b feeding. I agree, companies should not discontinue formula so quickly, it is apparently going to be off the shelves by the end of the month and this is the first I have heard of it! Think I will get some hipp organic now and slowly wean him onto that over the next few weeks whilst I still have the other formula as well.

i bf but my bfriend uses Hipp organic and her LO is brilliant on it

I used HIPP and Aptamil for my last dd and found that she refluxed a lot more with the HIPP it does seem to be fattier and made cleaning the teats and the bottles slightly more difficult. Although I love the organic tag of HIPP the aptamil has more added benefits it terms of prebiotics, nucleotides and other ingredients to help brain eye and nervous development which they advertise as being closer to breastmilk. The other advantage of aptamil was the packaging - Aptamil comes with an integral scoop which attacjes under the lid and a leveller so no searching for a clean knife wheras Hipp was a bag with a clip to close it and I was cleaning it everyday before making bottles as I did not like leving it in the powder - this may have changed however. Aptamil and Hipp were better than SMA on the taste test. SMA was very metallic. With no 2 I am really holding out with the BF though - I hated cleaning bottles before I went to bed at night.

I have just checked the ingredients of hipp organic 1 on Hipp web site. It seems that it doesn't contain LCP's which are important for brain and eye development. I have been thinking that LCP's are the one of the most important ingredient in a formula, isn't that right?

Lara, the advertisers would like you to think that, but there is no independent evidence these are either beneficial or necessary. It may be that they cannot be produced organically, but I am not sure about this - it would be an explanation of why they are not in organic formula.

The Cochrane review on LCPs concluded that claims for LCPs are unsubtantiated:

Simmer K. Longchain polyunsaturated fatty acid supplementation in infants born at term. The Cochrane Database of Systematic Reviews 2001, Issue 4. Art. No.: CD000376. DOI: 10.1002/14651858.CD000376.

"Authors' conclusions: At present there is little evidence from randomised trials of LCPUFA supplementation to support the hypothesis that LCPUFA supplementation confers a benefit for visual or general development of term infants. Minor effects on VEP acuity have been suggested but appear unlikely when all studies are reviewed. A beneficial effect on information processing is possible but larger studies over longer periods are required to conclude that LCPUFA supplementation provides a benefit when compared with standard formula. Data from randomised trials do not suggest that LCPUFA supplements influence the growth of term infants."

It's interesting that mothers have the impression that LCPs are important - this can only come from misleading ads or healthcare professionals who have also been misled

Tiktok, I don't believe that the Cochrane library is the right place for investigating these kind of things becuase their criteria to make a recomendation are very very strict and difficult to meet. For example if you have a look at their review on exclusively breastfeeding for 6 months, they say as authors' conclusion
"We found no objective evidence of a 'weanling's dilemma'. Infants who are exclusively breastfed for six months experience less morbidity from gastrointestinal infection than those who are mixed breastfed as of three or four months, and no deficits have been demonstrated in growth among infants from either developing or developed countries who are exclusively breastfed for six months or longer. Moreover, the mothers of such infants have more prolonged lactational amenorrhea. Although infants should still be managed individually so that insufficient growth or other adverse outcomes are not ignored and appropriate interventions are provided, the available evidence demonstrates no apparent risks in recommending, as a general policy, exclusive breastfeeding for the first six months of life in both developing and developed-country settings. Large randomized trials are recommended in both types of setting to rule out small effects on growth and to confirm the reported health benefits of exclusive breastfeeding for six months or beyond."
See they even couldn't confirm this recomendation of WHO because there are no enough studies. If you search about comparing breastfeeding and formula, there is no review at all!
So, I am trying to say, there are lots of studies re LCP's and their benefits. I am copying an abstract her as an example, I am not able to give a link because it is on a professional web site.
Title
Effect of providing a formula supplemented with long-chain polyunsaturated fatty acids on immunity in full-term neonates.
Source
British Journal of Nutrition, {Br-J-Nutr}, 19 Jul 2007 (epub: 19 7 2007), p. 1-9, ISSN: 0007-1145.
Author(s)
Field-Catherine-J, Van-Aerde-John-E, Robinson-Lindsay-E, Thomas-Clandinin-M.
Author affiliation
Department of Medicine, University of Alberta, Edmonton, Alberta T6G 2P5, Canada.
"To determine the effect of feeding formula containing long-chain PUFA (LCP) on immune function, healthy term infants were randomised at age 2 weeks to either a standard term formula (Formula; n 14) or the same formula supplemented with the LCP 20 : 4n-6 and 22 : 6n-3 (Formula +LCP; n 16). Peripheral blood was collected at 2 and 6 weeks to measure immune cell response (the rate of (3H)thymidine uptake and cytokine production after stimulation with phytohaemagglutinin (PHA)). Compared with cells from infants receiving only human milk (HM), the rate of (3H)thymidine uptake in response to PHA, but not IL-2 production, was lower for Formula+LCP infants (P < 0.05). Compared with HM-fed infants, Formula-fed infants (but not Formula+LCP infants) produced more TNF-alpha (unstimulated) and had a fewer CD3+CD44+ cells before stimulation and fewer CD11c+ cells post-stimulation (P < 0.05). However, compared with Formula-fed infants, the Formula+LCP infants had an immune cell distribution (higher percentage CD3+CD44+ and CD4+CD28+ cells) and cytokine profile (lower production of TNF-alpha post-stimulation) that did not differ from HM infants. Additionally, it was found that feeding infants formula during the first 10 d of life influenced immune function. These infants had a higher percentage of CD3+, CD4+CD28+, and lower percentage of CD14+ cells and produced more TNF-alpha and interferon-gamma after PHA stimulation than HM-fed infants (P < 0.05). These results demonstrate that early diet influences both the presence of specific cell types and function of infant blood immune cells. Since many diseases have a strong immunological component, these immune changes may be of physiological importance to the developing infant."

Lara, you do understand that Cochrane reviews all the acceptable on an issue and then reports, don't you? You are not reading the Cochrane report of exclusive breastfeeding correctly, sorry. Cochrane on exclusive breastfeeding is (more or less) what current recommendations are based on - that is, there is no growth deficit in babies who have solid foods at six months, and less morbidity from gastrointestinal illness. There is no argument about that. What they say they cannot confirm without further studies is the reported health benefits (ie apart from the uncontroversial gastrointestinal protection. I don't know why this strictness makes Cochrane an unreliable source on infant feeding matters. They are cautious, and rightly so, when it comes to adding anything to an infant's diet, including LCPs.

There are dozens if not scores of studies like the very unimpressive one you have quoted - showing a biochemical difference between babies fed on different formulas. Big Deal - Not. If you are going to cherry pick studies (which Cochrane does not do) then it's notable you picked one that follows babies to 6 weeks only.

To show these differences make a difference, you need to follow the babies for a long time, and you also need to show the differences in the diet do no harm - there may be an adverse impact on another part of health, or growth, or functioning. All that was looked at in that study was one aspect of the babies' biochemistry relating to one aspect of immunity.

As Cochrane says, we do not have the evidence that manufacturers' claims are substantiated. There is concern in Australia and New Zealand sufficient enough not to have approved formulas with these additives, too.

You think LCPS are one of the most important ingredients in formula. Go ahead and think that if you want to - you will find no independent evidence for it, though.

all the acceptable = all the acceptable studies

Tiktok, sorry, I haven't been able to reply earlier. I do understand what cochrane does. Actually I work as a clinician who is also interested in research, so I am very familiar with cochrane library reviews. I was trying to say that they review only very reliable research and this make them, of course, reliable (I did not say that cochrane is an unreliable source). However, in practice, there are lots of things we accept without a systematic review. I mean there should be quite a lot randomised control studies done for cochrane to reccomend something. And these evidence should be based on clinical studies. However, in practice we sometimes trust preclinical studies (which are done in labratories)or even expert opinions which have not been proven by research yet. At the end of the review you share with us, they say "The results of most of the well conducted RCTS have not shown beneficial effects of LCPUFA supplementation of formula milk on the physical, visual and neurodevelopmental outcomes of infants born at term. Only one group of researchers have shown some beneficial effects on VEP acuity. Two groups of researchers have shown some beneficial effect on mental development. Routine supplementation of milk formula with LCPUFA to improve the physical, neurodevelopmental or visual outcomes of infants born at term can not be recommended based on the current evidence.Further research is needed to see if the beneficial effects demonstrated by Dallas 2005 trial of Birch et al can be replicated in different settings." They reviewed 14 well established studies and in 3 of them (3 well established studies) there were significant differences (in one VEP and in 2 mental development). This is of course not enough for cochrane to make a recomendation. However, as a mother I would think "why these 3 studies showed differences?". There are also quite good well conducted laboratory studies showing relationship between neurodevelopment and LCPs.
In the review re exclusive breastfeeding, they don't say "less morbidity from gastrointestinal illness", they say "...gastrointestinal infection". These are quite different things. If you don't give an infant nothing but breastmilk of course he will not suffer from any infection. If you give them only sterilized water for example the result would be the same in terms of GI infection (he would suffer from malnutrition but won't have any GI infection). As you said, they cannot confirm this with the current evidence. They reccomended large randomized trials. However, although it cannot be confirmed by cochrane reviews in practice we know that it is beneficial. As a person who works both as a clinician and researcher, this is exactly what I am trying to say.
I am sorry but the study I shared with you is not an unimpressive/unreliable study. It was published in a very well known and respected journal (British Journal of Nutrition). It is a quite invasive study for healthy babies as they did blood tests twice. Do you know how difficult to persuade parents for 2 blood tests twice in 2 months for their healthy babies. It is actually quite a good study which is trying to investigate only one component of the big picture. Besides, we do not know whether cochrane would mention about this study or not because this review was done by searching medline until March 2007 and the research I sent to to you was published in July 2007.
I wanted to read the 14 research included in the cochrane review but could not reach them as the page gives error.
At the end this is my opinion, and giving our current knowledge re the issue, my opinion is as logical as yours.

Also, could you please send me the pages you read that Australia and New Zeland have not approved formulas with LCP's?

Lara, I'll copy and paste your reply and comment on bits of it, as it makes it easier for us both to keep track

" However, in practice, there are lots of things we accept without a systematic review. I mean there should be quite a lot randomised control studies done for cochrane to reccomend something. And these evidence should be based on clinical studies. However, in practice we sometimes trust preclinical studies (which are done in labratories)or even expert opinions which have not been proven by research yet."

True - and of course early studies do tend to be lab based, and then they're taken out into the 'real' world, where hypotheses are tested on (in this case) 'real' babies. Surely, when it comes to a recommendation of what infants are going to eat as their sole source of nutrition in the first months, we need trials that show effects on real babies...lab results won't cut it.

"They reviewed 14 well established studies and in 3 of them (3 well established studies) there were significant differences (in one VEP and in 2 mental development). This is of course not enough for cochrane to make a recomendation. However, as a mother I would think "why these 3 studies showed differences?".

Make up your mind, Lara. You are either a clinician with an interest in research, and rightly cautious and even scepetical about untested claims, or a mother who's cherry-picking studies that show what you want them to show.

As a researcher, you know that sometimes, studies show something anomalous. That's why Cochrane exists! That's why other researchers try to replicate results. Until the results of these 3 studies are replicated, no one can draw any conclusions from them.

"There are also quite good well conducted laboratory studies showing relationship between neurodevelopment and LCPs."

Of course there are. And this is why it's the LCPs in breastmilk are thought to be the 'goodies' when it comes to neurodevelopment. Breastmilk's LCPs are 'packaged' in a safe environment, with other 'ingredients' that enhance their function. It may or may not be the case that the LCPs added to cows milk (artificially harvested LCPs, by the way, from marine algae and from fish, which may or may not make a difference!), are in a safe environment, alongside other ingredients that enhance their function. You could add an ingredient and find it actually works against digestion, or growth, or health in some other unspecified way. Only 'in vivo' research is going to really show you that.

"In the review re exclusive breastfeeding, they don't say "less morbidity from gastrointestinal illness", they say "...gastrointestinal infection". These are quite different things. If you don't give an infant nothing but breastmilk of course he will not suffer from any infection. If you give them only sterilized water for example the result would be the same in terms of GI infection (he would suffer from malnutrition but won't have any GI infection)."

You're not making sense, Lara, sorry. It would be perfectly possible for a baby to have a GI infection on sterilised water only - the very fact he was malnourished would lower his immune system and make him more prone to airborne pathogens, or anything he 'picked up' from someone touching him. He could even pick something up from the vessel delivering the sterilised water.

This is the case with breastfed babies, too. They do not live in a germ-free bubble, but their exposure to bugs of all sorts is mediated through an immune system that's boosted, protected and developed by breastfeeding.

:However, although it cannot be confirmed by cochrane reviews in practice we know that it is beneficial.":

How do you know that it is beneficial in practice? Where are the studies?

"I am sorry but the study I shared with you is not an unimpressive/unreliable study. It was published in a very well known and respected journal (British Journal of Nutrition). It is a quite invasive study for healthy babies as they did blood tests twice. Do you know how difficult to persuade parents for 2 blood tests twice in 2 months for their healthy babies. It is actually quite a good study which is trying to investigate only one component of the big picture."

It is very difficult to do tests on babies like this, I agree. I am not saying the journal is not respected. But perforce the study can only look at one component of the big picture, as you say - are you saying that because good, long term research is hard to do with a big cohort of healthy babies, we should just accept the lab studies and recommend LCPs in formula on that basis?

"At the end this is my opinion, and giving our current knowledge re the issue, my opinion is as logical as yours."

Goodness me, I hope not....my opinion is far more logical

The link you asked for is this:

Aus and NZ regs

I am not going to make any more comment on LCPs as it seems you are not open any other opinion in this subject. It is your choice to wait until cochrane reccomends LCPs and I do respect your preferences. However, majority of women prefer formulas with LCPs and not only beacuse these "evil (!) formula companies misleading them". I am using everything in organic for my baby, even tissues, soaps, muslin squares, etc etc etc. However I am convinced that LCPs are good for babies and for that reason preferred a formula which is not organic. This is my choice and I do not agree that your opinion on LCPs is far logical than mine and millions of other women.
I also would like to make it clear that I was not cherry-picking any studies to show anything. I just picked the latest study I saw in medline re the subject. Of course it is a small study and I sent it as just an example. Of course only one small study is not enough to make a decision in such an important issue.
One more thing re the research methodology, there is not such a thing that long term studies are better than short term studies. It depends what you are studying.
Anyway, re the exclusive breastfeeding, The sterilized water example can be little bit extreme. However, I was trying to say that if your GI system does not contact with an infectious agent you will not get GI infection. So it is not a big deal to say that exclusively breastfed infants will have less GI infection. Of course an exclusively breastfed infant do not live in a germ free bubble and they may get loads of infections like respiratory tract infections, urinary tract infecions, flu, and others. However it is very unlikely them to have a GIS infection, independent from their immune system strenght.
"How do you know that it is beneficial in practice? Where are the studies?"
Does this mean that you do not believe exclusive breastfeeding for 6 months is beneficial for babies as it has not been proven by research and cochrane has not reccomended it yet?
I haven't been able to read the link you sent carefully yet, buy I could not see anything re LCPs on that page?? It seems to be related to FOS, isn't it?

Lara, you put 'evil companies' in quotes as if I had said it. I did not.

Women in the UK seem to 'prefer' formula with these added ingredients, but as the vast majority of formulas have them now, they have little choice. I do not think they weigh up the pros and cons - why should they have to? They should be able to trust that what they buy for their infants is safe in every way.

You say, "I also would like to make it clear that I was not cherry-picking any studies to show anything. I just picked the latest study I saw in medline re the subject."

And this from a clinician with an interest in research? That's worse than cherry-picking - that's taking a pin and choosing whichever study comes up and going with that one!

"One more thing re the research methodology, there is not such a thing that long term studies are better than short term studies. It depends what you are studying."

Precisely. And if you are intrerested in the long term health and development and general well-being of infants, wouldn't you want to do a long term study??

I don't understand your counter argument to mine about exlsuive breastfeeding. You seem to be agreeing with me!

" So it is not a big deal to say that exclusively breastfed infants will have less GI infection."

Except if you are sharing information with people who think there are no risks with formula....

"How do you know that it is beneficial in practice? Where are the studies?"

"Does this mean that you do not believe exclusive breastfeeding for 6 months is beneficial for babies as it has not been proven by research and cochrane has not reccomended it yet? "

Cochrane certainly does support excl bf to 6 mths, while sensibly calling for more research for some aspects of this. Again, I am surprised that someone with an interest in research does not get this point. Breastfeeding is not 'beneficial' - it is the physiological way to feed infants. We do not need research to 'prove' the physiological, just as we don't need research to 'prove' it is better to breathe than use an oxygen mask, or walk rather than use a wheelchair, insert your own analogy here. Use of formula is the intervention.

Yes, sorry about the link - it was about prebiotics. LCPs are used in Australia and NZ, I have just checked.

I have thought this so many times and now I just have to say it...tiktok..Mumsnet are so lucky to have you

I really like the cow and gate organic. I found the hipp made their poos really white and runny .
Discontinuing eh? Bloody typical.

I agree with charlielegal - mumsnet is lucky to have tiktok and her excellent advice for breastfeeding mums.

However, I have to say that Lara's points seemed pretty logical to me. If there are current studies showing that LCP's in formula have beneficial effects, surely these are worth considering.

The conclusion in the Cochrane review seemed to be saying that that further studies were required - the study Lara quoted showing beneficial effects of LCP's was subsequent to the Cochrane review. I understand that some studies are better than others of course, but is there any reason to suppose that there are serious flaws in this one?

If I had to use formula, I think this would definitely affect my decision as to which one to choose, even if currently the evidence only suggests rather than proves the benefits of LCP's in formula.

Some good questions

Mother, you asked: "is it patronising to 'withhold' this information unless specifically requested or is it confusing/unhelpful to bring it up????"

I think you need to be questioning about what that research is teling you, mother. 'Extra' LCPs in the milk of organically-eating mothers - so what? 'Extra' doesn't mean 'better' necessarily....maybe babies get what they need by way of LCPs without the mother eating more of them. Do the increased levels translate as significantly better for the baby? Do we have evidence that babies of mothers not on an organic diet do worse? Maybe not, but of course it hasn't been looked at so we have to use common sense, and common sense would indicate that breastfeeding is the physiological way to feed babies, no matter what the mother's diet.

As we know, maternal diet varies throughout history, across cultures, and across socio-economic levels, but we can trust it to be consistently more appropriate for a human infant than another species' milk....even if we are going to be concerned about the grass, feed, rain water, hormones, medications, lifestyle of the cows whose milk goes to make formula, and the artificially-added extras such as LCPs which are from sources such as fish and marine algae.

We know mothers do not need to have a special diet to breastfeed perfectly well, so it's not withholding information, IMO, to omit mention of increasing LCPs unless the mothers ask.

Iorek, Lara's study was after Cochrane, and when Cochrane looks at this issue again, if the study is worthy, it will be assessed alongside other studies. I objected to this study somehow 'trumping' Cochrane, because all it looked at was one aspect of infant biochemistry at the age of 10 days and 6 weeks. How unimpressive is that??

There's nothing especially flawed in the study, but it is limited, necessarily, to looking at this very small aspect of physiology, over a short time. I'd be more impressed if they looked at the same babies at 18 months, and then maybe several times later on, too.

Choose formula with LCPs if you like - I think it's a reasonable decision. But my original comment was in response to Lara's speculation that LCPs are one of the most important ingredients in formula, and to me, there is no evidence at all for that.

Iorek - that was Tiktoks point really - there have been 3 studies that show benefits, but not all the same benefits and some showed benefits in one study and not others.

This isnt conclusive enough to make recommendations from.

I blardy love tiktok. I have to say - it has been nice to see a somewhat more intelligent debate for a change though - thank you Lara

Thanks for your response Tiktok. I think (as usual) we're all agreed that more research is what's needed.

To me, erring on the side of caution on this issue would mean a preference for supplementing formula with LCP's since they are a crucial element in breastmilk and while the evidence for their benefits in formula may be limited, as far as I know there is no evidence at all that they might be harmful.

Motherhurdicure - I would love to see more research on breastfeeding and diet too. I worried a lot in my early days of bf about whether I was eating enough of the right sort of fats for the sake of my breastmilk (made more anxious still by fears about mercury levels in oily fish!).

Am confused though by the idea that "the media does seem to pick up on bf studies and use them to portray formula in a positive light somehow." - have never seen this. What newspapers have you been reading?!