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Development of infant formulas can be traced to the late 19th century. In 1867, Liebig developed and marketed a product for infant feeding that contained cow milk, wheat flour, malt flour, and potassium bicarbonate. In 1915, Gerstenberger reported a 3-year experience using “synthetic milk, adapted” that contained nonfat cow milk, lactose, oleo oils, and vegetable oils. This product represented early understanding that cow milk required alteration to improve its acceptability for human consumption and is considered the precursor to modern infant formulas. (1)

Government regulation of infant formula composition in the United States began in 1941 and underwent significant expansion with passage of the Infant Formula Act of 1980, a direct and prompt response to an epidemic of a Bartterlike syndrome (hypochloremic, hypokalemic metabolic alkalosis). Most cases were later attributed to consumption of a chloride-deficient soy infant formula. The...

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