This is an extremely familiar issue to anyone who even entertains the briefest and most moderate skepticism regarding seed oils in our food supply, and baby formulas are profound amplifiers of precautionary principles and concern trolling that dominate the industrialized food supply and medicalized food advice. In our everyday food, the seed oils did not have to prove themselves worthy to be present, and the burden of proof to suggest their removal, or to overcome dogmatic fears of other kinds of fats are enormous. I am old, but not that old, and I grew up in a world in which assertions that vegetable-origin trans fats were safer than, say, lard were omnipresent, indeed into my adult life, until they were suddenly and universally banned.
Infant foods are somewhat diverse, but baby formulas are meant to meet the needs of newborns, and with a suitable humility about the chaotic development of human persons, we want to do our best to provide for very good initial conditions that these sensitive beings can use to develop well. So it is that baby formulas must meet profound standards of evidence, and meet established nutritional norms. We know, for instance, that babies depend upon certain essential fatty acids that are used in the development of key neurological structures. The body uses EPA and DHA to build these structures.
Our standards for baby foods emerged out of the fervour and heroic enthusiasm of the industrializing food system at its peak. So it is that we determined that since the body can make EPA and DHA downstream of ALA, and ALA is widely available from seed sources that were already being processed with gusto, we should use industrialized seed oils as a source of ALA in baby formulas. This becomes the baseline against which all evidence must be compared, being rooted in sound mechanistic reasoning of a sort, and nobody else can ever really gather data to counter it, because you'd have to do tests where the risked hard outcomes are unthinkable. So you have a dogmatic incumbent, and no ability to meaningfully challenge it.
This is what's frustrating for the seed oil crowd. You simply can't get a baby formula where you just provide EPA and DHA, likely from a fish source, rather than supplying ALA. It's even mechanistically frustrating, because ALA's conversion into EPA and DHA isn't very efficient, and so you have to either provide an excess or accept something of a lack, and it's kind of weird to be obligated to take an indirect path because of what was justifiable, easy, and profitable for the industrialized food supply. You can pick or choose other things, but not really that.
There are cases beyond breastmilk and baby formulas where we must support our young and vulnerable with necessary nutrition, including parenteral feeding, e.g. IV nutrition. In these cases, the digestive system is bypassed for any number of reasons and the necessities of life are provided directly.
Dr. Kathleen Gura recounts in her article The Power of Networking and Lessons Learned From Omegaven the circumstances around the use of ALA sources in parenteral nutrition for babies. European alternatives were available but unapproved in the US, and patterns of catastrophic liver damage associated with parenteral feeding were found in the US and not in Europe. The key difference is that European sources used fish oils to provide EPA and DHA directly, while US sources used soy. Ultimately, it seems likely that these profound injuries were caused by the soy oils used in the US parenteral preparations to provide ALA, specifically by the linoleic acid content.
This would mean that in some cases, in the service of medical, regulatory, and industrial dogma, parents were forced to allow their babies to be seriously damaged or even killed. These are cases where there was no other alternative to providing parenteral feeding, and where parenteral feeding was doctrinally required to be poisonous.
Can the benefits of industrialization and regulatory deference be so great that we can justify killing babies to uphold its truths? This rigidity also breeds desperate attempts to find alternatives, as we currently see with parents who seek to use alternatives to legal baby formula for enteric use. There are children who experience malnutrition from inadequate formulations, who experience infections caused by the doctrines held by their own protectors, and probably worse horrors, because there is not an alternative and at least equally trustworthy option available.
Anyone who works with ketogenic diets is aware that there are islands of stability across which you cannot translate expectations and results. What is beneficial on a ketogenic diet for optimal performance may not be so for someone not in that metabolic state, and vice versa; fibre is probably a useful buffer and microbial feed for someone who also eats other kinds of carbohydrates, but does not serve a function in and of itself for someone whose energy is already largely in the form of saturated fats. It is good, actually, to have good options within these different islands of stability.
There are doubtless some benefits and some harms unique to each of plant-based and animal-based foods, and where such choices do not obviously cause preventable harms, it's useful to have a set of different options which can be explored at the population level, and which allow for some degree of moral agency, and of responding to the sets of risks that one is not willing to take, or is not willing to take on one's child's behalf. Of course the burden of consciousness is that of accepting bad moral outcomes that may be the result of our choices, and this is not easy. We are not absolved from that burden simply by demanding a regulatory environment which ties our hands. It is not actually better if we are required to allow some children to die than to make choices which cause some children to die. Nobody wants dead babies. We do not yet have such complete and perfect knowledge, nor are we so situated at the end of history, that we can promise that outcome. We need, then, more than just one option on the table.
We have good reason to suspect that linoleic acid in parenteral nutrition for babies can be deadly, and it is not unspeakably unreasonable or conspiratorial for a parent to wish to learn from that example in the set of options available for enteric feeding, too. Metabolism is very different with and without digestion, but the inflammatory potential of linoleic acid is real and sometimes quite amazingly destructive. It may be that it's fine to dump linoleic acid into children's stomachs in order to give them enough ALA to convert in a costly and inefficient manner into the EPA and DHA that they need, even though it seems to have been demonstrably harmful to inject it into their veins. Still, surely there must be some path to just give them what we know them to actually need, and to not take on this cost just because of the profits it allows for industry and the ease it creates for regulators. As bearers of this tremendous burden, we must also be willing to do hard work, and not just to perpetuate a system in which some deaths are shrugged at in the service of status quo dogma.
The worst question may not be whether linoleic acid kills babies, but whether we require parents to ignorantly consent to the stochastic death of their children at the hands of unnecessary but convenient linoleic acid that is fed to their children in order to ensure the political support of industry. I find that question too disturbing to live with, and suspect that at best it can be ignored by those who do not take it seriously, and at worst it is actively denied to protect nothing more noble than profits and corporate and political stability.
