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Is it OK to buy imported formulas online?

George J. Fuchs III, MD, FAAP

George J. Fuchs III, MD, FAAP

Answer

To put it simply, no. Here's why. Infant ​formula is one of the most highly regulated foods in the United States. Safety standards, controlled by an act of Congress, ensure that formulas have the proper nutrients for a baby's growth and development. The U.S. Food and Drug Administration (FDA) also monitors all formulas and routinely inspects manufacturers to make sure the products are safe. If there is a safety issue, the formula will be recalled, and consumers will quickly be informed.

In 2018, the American Academy of Pediatrics (AAP) expressed concern over this recent trend of buying imported formulas online for a variety of reasons, including:

  • Lack of FDA regulation means they do not benefit from important consumer protections that ensure safety. These formulas are regulated by their country of origin, but oversight is lost when they are distributed by sellers other than the manufacturer.
  • Shipping & storage concerns. Imported formulas may not be shipped or stored correctly. If transported or stored at incorrect temperatures, for example, the formula can lose some of its nutritional value.
  • Labeling differences can lead to confusion. For example:
    • Language. When labels are not written in English, it might be difficult for some parents to read the expiration date or follow mixing instructions. “Expired" formula may be less healthy for the baby. In addition, mixing a formula incorrectly is unsafe and can lead to electrolyte imbalances, seizures, and poor weight gain.
    • Definitions. The definition of hypoallergenic (HA) formulas in Europe differs from that of the United States. Some imported formulas labeled as hypoallergenic contains proteins that should not be given to a child with cow's milk protein allergy. Therefore, a baby with cow's milk protein allergy who consumes imported European “HA" formulas may not demonstrate an improvement in symptoms.
    • Age-based stages. European formulas, unlike U.S. formulas, come in two age stages: 0 to 6 months and 6 to 12 months. If parents are not aware of these stages, and a baby is fed the wrong stage, they may receive the wrong amount of nutrients for their age.
  • Recall notice delays. There have ​been cases of infants becoming sick or even dying from tainted formulas manufactured outside the United States. In 2016-2017, for example, the FDA received notification of 6 medical adverse events linked to imported European formulas. More importantly, if a formula is recalled in the country where it is produced, news might not reach the U.S. right away.
  • More expensive without proven benefit. These formulas usually cost more than formulas made in the United States. Bottom line: there is no scientific evidence or research showing that imported formulas are better for babies.

All parents want the best for their growing baby. The AAP recommends breastmilk for a baby's sole source of nutrition for about the first 6 months. For parents who can't breastfeed, or choose not to, FDA-regulated infant formula is a healthy alternative. If you choose to use formula, please speak to your pediatrician so together you can decide what is the best and safest option for your child.

Additional Info​rmation:


 
George J. Fuchs III, MD, FAAP

George J. Fuchs III, MD, FAAP

George J. Fuchs III, MD, FAAP, a member of the American Academy of Pediatrics Committee on Nutrition, is a board-certified pediatrician and board-certified pediatric gastroenterologist. He is Professor and Vice Chair for Clinical Affairs, Department of Pediatrics and Chief of Pediatric Gastroenterology, at the University of Kentucky and Kentucky Children’s Hospital. He serves on the Editorial Board of the Journal of Pediatric Gastroenterology and Nutrition and is a member of the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition, as well as the Infectious Diseases Society of America.

Last Updated
3/9/2020
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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