PEN® eNews 15(11) November 2025 - Controversies Surrounding Infant Formula

Safe Handling of Infant Formula

What are the recommendations for the preparation, use, handling and storage of infant formula?

While health care professionals should encourage breastfeeding, parents and caregivers need instruction on the safe preparation, use, handling and storage and handling of infant formula if formula is chosen. Gaps in parent/caregiver education exist and safe practices are not always followed. It is important that education and support be provided in a non-judgmental manner. 

The full practice question makes additional Recommendations regarding Chemicals in Water, Water-Borne Pathogens, Cleaning and Disinfecting Equipment, Mixing and Storage of Formula, and Warming Feeds.

Blenderized Tube Feeds: Are They Safe?

How does blenderized tube feeding compare to commercial enteral formula in adults and children?

There appears to be variability in nutritional content of blenderized tube feedings (BTF) that may have implications for nutritional status and health outcomes; however, the effect on clinical outcomes has not been well studied.  

For adults, limited evidence suggests a trend toward lower nutrient intake in those receiving BTF compared to commercial enteral formula (CEF).  

For children, BTF may be associated with improved gastrointestinal symptoms and increased family satisfaction.  

BTF may not be appropriate for adults or children who are malnourished or medically complex at risk of malnutrition. For other individuals, a shared decision-making process with the client in the choice of BTF or CEF could consider psychosocial, cultural and socioeconomic issues, nutrition needs, tolerance, food safety issues and costs.

Remarks

In the included studies, adults who were identified as malnourished or medically complex at risk of malnutrition included individuals with head and neck cancer, gastrointestinal cancer, those who were immunocompromised, with a malabsorptive disorder or disease or presenting with a critical illness.

To see the full practice question, click here.

New Search Function Updates!

You may be used to seeing our search bar when you log into your PEN System homepage. But did you know that our search function has recently been improved?

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We hope this makes it easier for you to use the PEN System. Happy searching!

Consumer Reports on Infant Formulas: Are They Really Contaminated, and Is This Cause For Concern?

In March 2025, Consumer Reports published the results of their independent investigation into toxic chemicals (including arsenic, lead, perfluoroalkyl and polyfluoroalkyl substances (PFAS), bisphenol A (BPA), acrylamide) in 41 powdered infant formulas. When the expert panel measured the amounts of contaminants found in infant formula against American safety standards, about half of the infant formulas sold in the USA exceeded the maximum safe limits.

Whether Consumer Reports’ results are good or bad depends on your perspective: as the team at Consumer Reports stated, “there are many good options on the market”, but it can be worrying to imagine that an American consumer has as good a chance of choosing an infant formula with potentially harmful contaminants than as not. Given this, the PEN Team wondered: are these results applicable to markets in other countries, too? 

To find out whether infant formulas sold in Canada and Australia have the same levels of contaminants, and whether these data are cause for alarm, read the Trending Topic here!