This summary is based on ‘The Effect of Goat-Milk-Based Infant Formulas on Growth and Safety Parameters: A Systematic Review and Meta-Analysis’ by Jankiewicz et al. 2023
There is increasing interest in the use of goat milk based infant formula due to potential advantages over cow milk based formula. Goat milk based formulas have received regulatory approval from agencies such as the European Food Safety Authority, indicating their safety as an option for infant feeding. However, further studies on goat milk use have been published since these approvals, providing a greater insight into the advantages and disadvantages associated. The systematic review summarised here aimed to evaluate the available evidence comparing goat milk based formula with cow milk formulas in terms of infant growth and safety measures.
There were four randomised clinical trials that met these criteria identified for inclusion into this analysis1,2,3,4. These studies enrolled a total of 670 infants. Two of the trials recruited new-borns at 14 days of age, one recruited those younger than 72 hours and one recruited those younger than three months. All of the studies measured weight, length, and head circumference and they compared a goat milk-based formula with a cow milk-based formula. In two of the trials there was also a breastfed group for comparison.
When the data from these four trials were combined, there were no differences in weight, length, and head circumference in infants fed goat milk-based formula and cow milk-based formula. Data from two of these trials showed no difference in weight-for-length ratios. When infants fed goat milk-based formula were compared to breast fed infants, there was also no difference in these measures.
Two of the studies compared stool frequency and found no difference between goat milk-based formula and cow milk-based formula, but frequency was lower than in breast fed infants. In terms of stool consistency, results varied between studies therefore no conclusion could be drawn.
In one study that investigated food allergy, there was no difference in occurrences between goat milk based and cow milk-based formula. The incidence was very low (2/92 in the goat milk group and 1/89 in the cow milk group) which means there was most likely not enough infants in the study to detect a difference. A larger study will be necessary for a potential difference to reach significance.
There was no difference in the occurrence of atopic dermatitis (eczema) was not difference between the two infant formula groups and with the breast-fed group. There was also no difference in the incidence of adverse health events between cow milk and goat milk formula.
This systematic review was limited by the small number of studies that were included, which reduced statistical power and generalisability to different populations and scenarios. Outcomes aside from growth parameters varied in what was measured and how they were measured. All of the included studies were also sponsored by industry, and many of the co-authors were employed by manufacturers of goat milk based infant formula. This has the potential to bias results, as industry supported studies are more likely to report positive findings. These limitations should be taken into consideration when interpreting the results.
The results presented here were from randomised controlled trials, meaning infants were allocated goat milk or cow milk-based formula on a random basis. Observational studies, in which parents make the decision which formula to use, have shown an association between goat milk-based formula and improvement of stool characteristics and a reduction in some gastrointestinal symptoms. There have also been some improvements in infant crying and parental satisfaction. These results are yet to be confirmed in a randomised controlled trial, but there are multiple trials ongoing which are expected to address these uncertainties.
In conclusion, the results of published trials comparing goat milk based infant formula and cow milk based infant formula have confirmed that goat milk formula is safe and well tolerated by infants. It is not yet clear whether it is superior to cow milk-based formula, and future larger trials may help provide these answers.
- Grant C., Rotherham B., Sharpe S., Scragg R., Thompson J., Andrews J., Wall C., Murphy J., Lowry D. Randomized, double-blind comparison of growth in infants receiving goat milk formula versus cow milk infant formula. J. Paediatr. Child Health. 2005;41:564–568. doi: 10.1111/j.1440-1754.2005.00722.x.
- Zhou S.J., Sullivan T., Gibson R.A., Lönnerdal B., Prosser C.G., Lowry D.J., Makrides M. Nutritional adequacy of goat milk infant formulas for term infants: A double-blind randomised controlled trial. Br. J. Nutr. 2014;111:1641–1651. doi: 10.1017/S0007114513004212.
- Xu M., Wang Y., Dai Z., Zhang Y., Li Y., Wang J. Comparison of growth and nutritional status in infants receiving goat milk-based formula and cow milk-based formula: A randomized, double-blind study. Food Nutr. Res. 2015;59:28613. doi: 10.3402/fnr.v59.28613.
- He T., Woudstra F., Panzer F., Haandrikman A., Verkade H.J., van Lee L. Goat Milk Based Infant Formula in Newborns: A Double-Blind Randomized Controlled Trial on Growth and Safety. J. Pediatr. Gastroenterol. Nutr. 2022;75:215–220. doi: 10.1097/MPG.0000000000003493.