Chapter 4: Nutrition and Food Service
4.3 Requirements for Special Groups or Ages of Children
4.3.1 Nutrition for Infants
220.127.116.11: Use of Soy-Based Formula and Soy Milk
Soy-based formula or soy milk should be provided to a child whose parents/guardians present a written request because of family or religious dietary restrictions on foods produced from animals (ie, cow’s milk and other dairy products). Both soy-based formula and soy milk should be labeled with the infant’s or child’s full name and date and stored properly.
Soy milk should be available for the children of parents/guardians participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); Child and Adult Care Food Program; or Supplemental Nutrition Assistance Program (SNAP). Caregivers/teachers should encourage parents/guardians of children with primary health care provider–documented indications for soy formula, who are participating in WIC and/or SNAP, to learn how they can obtain soy-based infant formula or soy milk products.
RATIONALEThe American Academy of Pediatrics recommends use of hypoallergenic or soy formula for infants who are allergic to cow’s milk proteins (1). Soy-based formula and soy milk are plant-based alternatives to cow’s milk, often chosen by parents/guardians due to dietary or religious reasons. Soy-based formulas are appropriate for children with galactosemia or congenital lactose intolerance (2). Soy-based formulas are made from soy protein isolate with added methionine, carbohydrates, and oils (soy or vegetable) and are fortified with vitamins and minerals (3). In the United States, all soy-based formula is fortified with iron. Soy-based formula does not contain lactose, so it is used for feeding infants with documented congenital lactose intolerance. There are known differences between allergies to cow’s milk proteins and intolerance to lactose. The child’s specific health concerns (allergy versus intolerance) should be documented by the child’s primary health care provider and not based on possible parental/guardian misinterpretation of symptoms.
TYPE OF FACILITYCenter, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS18.104.22.168 Care for Children with Food Allergies
22.214.171.124 Vegetarian/Vegan Diets
126.96.36.199 Preparing, Feeding, and Storing Infant Formula
Greer FR, Sicherer SH, Burks AW; American Academy of Pediatrics Committee on Nutrition and Section on Allergy and Immunology. Effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas. Pediatrics. 2008;121(1):183–191
American Academy of Pediatrics. Where we stand: soy formulas. HealthyChildren.org Web site. https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Where-We-Stand-Soy-Formulas.aspx. Updated November 21, 2015. Accessed November 14, 2017
US Department of Agriculture. Infant feeding guide. WIC Works Web site. https://wicworks.fns.usda.gov/infants/infant-feeding-guide. Modified October 31, 2017. Accessed November 14, 2017
Content in the STANDARD was modified on 05/30/2018.