The Dietitians Association of Australia (DAA) has worked with Pan Macmillan Australia since the end of February 2015 regarding the book -Bubba Yum Yum: The Paleo Way For New Mums, Babies and Toddlers'.
DAA, together with a number of health agencies have provided evidence-based materials to assist the publisher to identify the numerous nutrition and health issues in this book. Problems include:
The use of ingredients that are not recommended for infants within the first 12 months of life due to microbiological risks, for example, honey (botulism risk), runny eggs (salmonella risk) and raw liver
Food safety risks with the preparation of the DIY infant formula
A lack of clear instructions for parents as to the amount of formula to provide the infant on a daily basis.
The DIY infant formula has received media attention because it is based on liver, cod liver oil and a bone broth. This concoction has been independently analysed and provided to Pan Macmillan Australia in order to assist them in making an evidence-based decision to publish the book. We are confident Pan Macmillan will make their decision based on what is in the best interest of Australian infants and their families.
The DIY formula is said to be comparable to breast milk, but the analysis proves this is not the case. It is significantly higher than breast milk in Vitamin A (749% higher), Vitamin B12 (2326% higher) protein (220% higher), iron (1067% higher), sodium (879% higher) and a range of other nutrients. This formula could be very harmful to infants, their immature immune and digestive systems could not cope with this formulation and the levels of these nutrients it contains. In a newborn, the formulation could cause permanent damage and possibly result in death.
DAA supports the Australian Government's Infant Feeding Guidelines developed by the National Health and Medical Research Council which says breastfeeding is the healthiest start for infants, and it is recommended that infants be exclusively breastfed until around six months of age when solid foods are introduced.
It is international consensus that the only suitable replacement for breastfeeding if required is a commercially available infant formula, which is based on significant clinical research and is deemed the only safe alternative when prepared according to product instructions.
Question: Can you talk about why you were assigned to look into the book -Bubba Yum Yum: The Paleo Way For New Mums, Babies and Toddlers'?
Dietitians Association of Australia: The Dietitians Association of Australia (DAA) was made aware of a soon-to-be-released book -Bubba Yum Yum: The Paleo Way for new mums, babies and toddlers' via our routine media monitoring. After looking closer at these articles and the online Bubba Yum Yum blog, it became clear that there were real concerns about some of the recommendations and recipes included in the book.
Question: What are your thoughts on the Paleo diet, for grown adults?
Dietitians Association of Australia: First and foremost, how adults choose what to eat is down to personal preference. If they have access to expert, evidence-based advice from a qualified health professional and still choose to follow a diet that excludes major food groups, that is their choice.
DAA supports eating patterns based on the Australian Dietary Guidelines that were developed using more than 55 000 research papers. There are only a few studies (less than 20) supporting the Paleo diet and these studies are inconclusive and don't prove any substantial benefit to the human race or, more specifically, the Australian population.
While there are some aspects of the Paleo diet that are good, such as eating more vegetables and reducing added sugars, there are also those that do not fit with the Australian Dietary Guidelines such as the elimination of grains, legumes and dairy.
By excluding nutritious core foods such as breads, cereals, legumes and dairy, followers of this diet will be at a greater risk of falling short of important nutrients such as calcium and B vitamins. There is also substantial evidence linking the inclusion of all of these groups with good health.
Question: Can you talk us though the nutrition and health issues you discovered in the recipes of Bubba Yum Yum?
Dietitians Association of Australia: There are a number of issues in the Bubba Yum Yum book that pose a serious threat to the health of infants and children including both food safety risks and unsafe levels of some vitamins and minerals.
Some recipes use ingredients that are not recommended for infants in the first 12 months of life including raw honey (botulism risk) and runny egg (Salmonella risk).
There are also recipes that contain high levels of sodium, Vitamin A, iron and a range of other nutrients.
Question: Will the numerous nutrition and health issues found in Bubba Yum Yum mean the book will not be released?
Dietitians Association of Australia: The authors have decided to publish it online independently.
Question: What is DIY infant formula?
Dietitians Association of Australia: The DIY infant formula is based on bone broth and also includes liver, probiotics, cod liver oil, coconut oil and olive oil.
Question: Why do you not recommend DIY infant formula?
Dietitians Association of Australia: The DIY infant formula is a real focus for us because of the danger it poses to infants. The book claims the formula mimics breastmilk but a closer analysis done independently by the Food Standard Australia and New Zealand (FSANZ) found that this is not the case.
The formula is incredibly high in Vitamin A (749% higher than breastmilk) which could lead to toxicity if consumed in frequent feeds throughout the day.
Very high in sodium (879% higher than breast milk)- infants developing kidney are not equipped to process large amounts of salt.
Low in calcium - needed for appropriate bone and teeth development.
High in protein - while protein is needed for growth and development, to mimic breastmilk the formula needs to contain the right balance of essential amino acids (building blocks of protein). This is not regulated in this recipe.
Question: When should babies be introduced to food?
Dietitians Association of Australia: The Infant Feeding Guidelines recommend that solid food should start to be introduced at around 6 months of age. Prior to that exclusive breastfeeding is recommended, or commercial infant formula feeding if the child is not breastfed.
Question: Can you talk us through the basics of Australian Government's Infant Feeding Guidelines?
Dietitians Association of Australia: Breast is best. The Guidelines encourage exclusive breast feeding to around 6 month of age. At 6 months, mothers need to continue breast feeding while introducing appropriate solid foods until 12 months or for as long as mother and child desires.
If an infant is not breast fed or partially breast fed, commercial infant formulas should be used as an alternative to breast milk until 12 months of age. It is important to make sure feeds are prepared and stored correctly.
First foods need to be rich in iron to prevent deficiency including iron-fortified cereals, pureed meats and poultry. For children under 12 months limit intake of all foods with added sugars, do not add salt to foods, avoid honey to prevent botulism and do not use raw eggs or uncooked product containing raw eggs to prevent salmonella poisoning.
For more info please see the summary of the guidelines
Interview by Brooke Hunter