80_FR_35954 80 FR 35834 - Infant Formula: The Addition of Minimum and Maximum Levels of Selenium to Infant Formula and Related Labeling Requirements

80 FR 35834 - Infant Formula: The Addition of Minimum and Maximum Levels of Selenium to Infant Formula and Related Labeling Requirements

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration

Federal Register Volume 80, Issue 120 (June 23, 2015)

Page Range35834-35841
FR Document2015-15394

The Food and Drug Administration (FDA or we) is amending the regulations on nutrient specifications and labeling for infant formula to add the mineral selenium to the list of required nutrients and to establish minimum and maximum levels of selenium in infant formula.

Federal Register, Volume 80 Issue 120 (Tuesday, June 23, 2015)
[Federal Register Volume 80, Number 120 (Tuesday, June 23, 2015)]
[Rules and Regulations]
[Pages 35834-35841]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2015-15394]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Food and Drug Administration

21 CFR Part 107

[Docket No. FDA-2013-N-0067]


Infant Formula: The Addition of Minimum and Maximum Levels of 
Selenium to Infant Formula and Related Labeling Requirements

AGENCY: Food and Drug Administration, HHS.

ACTION: Final rule.

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SUMMARY: The Food and Drug Administration (FDA or we) is amending the 
regulations on nutrient specifications and labeling for infant formula 
to add the mineral selenium to the list of required nutrients and to 
establish minimum and maximum levels of selenium in infant formula.

DATES: This final rule is effective June 22, 2016. See section VII of 
this document for information on the filing of objections. Submit 
either electronic or written objections and requests for a hearing by 
July 23, 2015.

ADDRESSES: You may submit either electronic or written objections and/
or requests for a hearing, identified by Docket No. FDA-2013-N-0067, by 
any of the following methods:

Electronic Submissions

    Submit electronic objections in the following way:
     Federal eRulemaking Portal: http://www.regulations.gov. 
Follow the instructions for submitting comments.

Written Submissions

    Submit written objections in the following ways:
     Mail/Hand delivery/Courier (for paper submissions): 
Division of Dockets Management (HFA-305), Food and Drug Administration, 
5630 Fishers Lane, Rm. 1061, Rockville, MD 20852.
    Instructions: All submissions received must include the Docket No. 
FDA-2013-N-0067 for this rulemaking. All objections received may be 
posted

[[Page 35835]]

without change to http://www.regulations.gov, including any personal 
information provided. For additional information on submitting 
objections, see the ``Objections'' heading of the SUPPLEMENTARY 
INFORMATION section of this document.
    Docket: For access to the docket to read background documents, 
comments, or objections received, go to http://www.regulations.gov and 
insert the docket number, found in brackets in the heading of this 
document, into the ``Search'' box and follow the prompts and/or go to 
the Division of Dockets Management, 5630 Fishers Lane, Rm. 1061, 
Rockville, MD 20852.

FOR FURTHER INFORMATION CONTACT: Leila Beker, Center for Food Safety 
and Applied Nutrition (HFS-850), Food and Drug Administration, 5100 
Paint Branch Pkwy., College Park, MD 20740, 240-402-1451.

SUPPLEMENTARY INFORMATION: 

I. What is the background and legal authority of this final rule?

A. Background

    Section 412(i) of the Federal Food, Drug, and Cosmetic Act (the 
FD&C Act) (21 U.S.C. 350a(i)) establishes requirements for the nutrient 
content of infant formulas. Under section 412(i)(2) of the FD&C Act, 
the Secretary of Health and Human Services (the Secretary) is 
authorized to revise the list of required nutrients and the required 
level for any required nutrient. This authority has been delegated to 
the Commissioner of Food and Drugs (the Commissioner). The table in 
section 412(i) of the FD&C Act, and in FDA regulations at Sec.  
107.100(a) (21 CFR 107.100(a)), specifies that infant formulas must 
contain 29 nutrients; minimum levels for each nutrient and maximum 
levels for 9 of the nutrients are also specified. In 1989, the Food and 
Nutrition Board of the National Research Council established a 
Recommended Dietary Allowance for selenium for infants 0 to 6 months of 
age of 10.0 micrograms per day ([mu]g/day), a level extrapolated from 
adult values on the basis of body weight and with a factor allowed for 
growth (Ref. 1).
    In the Federal Register of April 16, 2013 (78 FR 22442), we 
proposed to amend the nutrient specifications for infant formula to 
include selenium as a required nutrient in Sec.  107.100(a). We also 
proposed to establish minimum and maximum levels for selenium in infant 
formulas because evidence exists for both deficiency and toxicity of 
selenium. We proposed 2.0 [mu]g selenium per 100 kilocalories (/100 
kcal) as the minimum level of selenium in infant formulas and 7.0 
[mu]g/100 kcal as the maximum level of selenium in infant formulas.
    Scientific evidence from multiple sources supported the proposed 
levels. Specifically, for the proposed requirements, we considered 
scientific evidence in: (1) The Institute of Medicine's (IOM) ``Dietary 
Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids'' 
(Ref. 2); (2) the Life Sciences Research Office's ``Assessment of 
Nutrient Requirements for Infant Formulas'' by Raiten et al. (Ref. 3); 
(3) ``Global Standard for the Composition of Infant Formula. 
Recommendations of an ESPGHAN [European Society for Paediatric 
Gastroenterology, Hepatology and Nutrition] Coordinated International 
Expert Group'' by Koletzko et al. (Ref. 4); and (4) ``Selenium Status 
of Term Infants Fed Selenium-Supplemented Formula in a Randomized Dose-
Response Trial'' by Daniels et al. (Ref. 5). We also searched the 
scientific literature from 1998 through 2012 for published studies not 
included in these reports.
    In addition, we proposed to amend the labeling requirements for 
infant formula in Sec.  107.10(a)(2) to add selenium to the list of 
nutrients along with the requirement to list the amount of selenium per 
100 kcal in the formula.

B. Legal Authority

    Section 412(i) of the FD&C Act contains a table of nutrients 
(including minimum and, in some cases, maximum levels for nutrients) 
that are required to be in an infant formula. Section 412(i)(2) of the 
FD&C Act authorizes the Secretary to revise the statutory table of 
nutrients and to revise the level of any required nutrient. The 
Secretary has delegated this authority to the Commissioner. Our 
regulations establishing the table of nutrients are codified at Sec.  
107.100.
    The final rule amends Sec.  107.100 to add selenium to the list of 
nutrients required for infant formula. The legal authority for the 
amendment to Sec.  107.100 comes from section 412(i)(2) of the FD&C 
Act.
    The final rule also requires adding selenium to the statement of 
the amounts of nutrients required for infant formula labeling in Sec.  
107.10(a)(2). ``Infant formula'' is defined as a food for ``special 
dietary use'' under section 201(z) of the FD&C Act (21 U.S.C. 321(z)). 
Under sections 403(j) and 701(e) of the FD&C Act (21 U.S.C. 343(j) and 
21 U.S.C. 371(e)), the Secretary, and by delegation the Commissioner, 
may prescribe regulations concerning the vitamin and mineral content of 
foods for special dietary uses to fully inform purchasers as to the 
value of the food for such uses. As such, FDA has the authority to 
revise the statement of the amounts of nutrients required for infant 
formula labeling in Sec.  107.10(a)(2) under sections 201(z), 403(j), 
412(i), and 701(e) of the FD&C Act.

II. What issues did the comments raise? What are FDA's responses to the 
comments?

    We invited public comment on the proposed rule. The comment period 
closed on July 1, 2013. We received fewer than 20 comments. Overall, 
the comments supported the addition of selenium to infant formula and 
agreed that selenium is an essential nutrient. We summarize and respond 
to the comments on the proposed rule and describe the final rule in 
this section. For ease of reading, we preface each comment discussion 
with a numbered ``Comment,'' and each response by a corresponding 
numbered ``Response.'' We have numbered each comment to help 
distinguish among different topics. The number assigned is for 
organizational purposes only and does not signify the comment's value, 
importance, or the order in which it was received.

A. The Addition of Selenium to the Statement of the Amounts of 
Nutrients (Sec.  107.10(a)(2))

    The proposed rule would amend the infant formula nutrient labeling 
and nutrient specification regulations at Sec. Sec.  107.10 and 
107.100, respectively. Proposed Sec.  107.10(a)(2) would add selenium 
to the statement of the amounts of nutrients required for infant 
formula labeling.
    We did not receive any comments on proposed Sec.  107.10(a)(2). 
However, we note that we have revised Sec.  107.10(a)(2) in this final 
rule to correspond to changes resulting from an interim final rule that 
appeared in the Federal Register on February 10, 2014 (79 FR 7934), and 
later affirmed in a final rule that appeared in the Federal Register on 
June 10, 2014 (79 FR 33057). In brief, Sec.  107.10(a)(2) was reworded 
by replacing ``A statement of the amount of each of the following 
nutrients supplied by 100 kilocalories'' with ``A statement of the 
amount, supplied by 100 kilocalories, of each of the following 
nutrients and of any other nutrient added by the manufacturer.''

B. Minimum and Maximum Levels of Selenium (Sec.  107.100)

    Proposed Sec.  107.100(a) would add selenium to the list of 
required nutrients in infant formula. The proposal also

[[Page 35836]]

would establish minimum and maximum levels for selenium in infant 
formula because evidence exists for both deficiency and toxicity of 
selenium, and there is no room for error in production of a food that 
serves as the sole source of nutrition for infants. We proposed to set 
2.0 [mu]g selenium/100 kcal as the minimum level of selenium in infant 
formulas and 7.0 [mu]g/100 kcal as the maximum level of selenium in 
infant formulas. Since the publication of the proposed rule, we have 
conducted a search of the scientific literature to identify whether 
additional studies on selenium requirements of infants were published 
after we issued our proposal. We did not find any relevant studies in 
our search.
    (Comment 1) One comment suggested we decrease the minimum level of 
selenium to 1.6 [mu]g/100 kcal. The comment pointed to analytical 
variability that can occur between laboratories when testing the levels 
of selenium. According to the comment, due to this analytical 
variability, a minimum selenium level of 1.6 [mu]g/100 kcal will likely 
result in manufacturers' formulating to deliver selenium levels close 
to 2.0 [mu]g/100 kcal to ensure products do not fall below the minimum.
    (Response 1) We decline to lower the minimum level of selenium in 
infant formula to 1.6 [mu]g/100 kcal to accommodate analytical 
variability that can occur between laboratories as the comment 
suggested. The level of any substance (including nutrients, food 
additives, or contaminants) established for regulatory purposes must be 
a value that is based on and true to the available scientific evidence. 
We recognize that analytical variability is always present and manage 
this matter under our compliance program. We also note that lowering 
the minimum level of selenium would not change the analytical 
variability, and the tested level of selenium might fall below whatever 
minimum level is set, due to analytical variability. For example, if 
the minimum level was lowered to 1.6 [mu]g/100 kcal, the tested level 
of selenium might fall below 1.6 [mu]g/100 kcal due to analytical 
variability. However, on our own initiative we have revised proposed 
Sec.  107.100(a) to insert the word ``level'' between the words 
``minimum'' and ``specified'' in light of an inadvertent omission in 
the proposed rule.
    (Comment 2) One comment said that the minimum level of selenium 
should be in the range reported in breast milk and specifically 
recommended the level of 1.6 [mu]g selenium/100 kcal, consistent with 
the mean concentration of selenium in breast milk reported by Daniels 
et al. (2008). The comment continued, saying it was not aware of any 
reports of selenium deficiency in breast-fed infants or at this 
concentration of selenium in infant formula. The comment also stated 
that we did not consider the data from the breast-fed control group in 
the Daniels et al. study.
    (Response 2) With regard to this comment suggesting that the 
selenium concentration in human milk (and more specifically, the level 
of 1.6 [mu]g/100 kcal reported in the Daniels et al. study) be used as 
the basis for the required minimum selenium level in infant formula, 
the scientific evidence we discussed in the proposed rule (78 FR 22442 
at 22444) was more broadly based. The discussion in the proposed rule 
considered the levels of selenium in human milk from the studies used 
to establish the adequate intake (AI) for selenium by the IOM and the 
levels of selenium in infant formulas fed in the randomized and double-
blinded dose-response study in infants by Daniels et al. (2008).
    Specifically, as discussed in the proposed rule (78 FR 22442 at 
22444), the IOM established an AI for selenium of 15.0 [mu]g/day 
(approximately 2.1 [mu]g/kg body weight/day) for infants 0 to 6 months 
of age based on the average concentration of selenium in human milk 
from healthy women from 2 to 6 months of lactation as reported in four 
studies. The study by Daniels et al. was published after the IOM 
established the AI for selenium for infants 0 to 6 months of age, and 
the concentration of selenium in human milk reported in that study was 
not among the studies considered in the establishment of the AI. We 
note that the mean concentration of selenium in human milk in the 
studies included by the IOM in setting the AI for infants 0 to 6 months 
of age was 18 [mu]g/L and that reported by Daniels et al. was 10.7 
[mu]g/L.
    The study by Daniels et al. provides direct evidence of the effect 
of selenium concentration of infant formula on the circulating 
biochemical indicators of selenium status in infants. As described in 
the proposed rule (78 FR 22442 at 22444), this study included a control 
formula that contained 0.9 [mu]g selenium/100 kcal (considered by the 
investigators to be a low-selenium formula) and two test formulas that 
contained 1.9 [mu]g selenium/100 kcal or 3.1 [mu]g selenium/100 kcal. 
The level of selenium in the formula containing 1.9 [mu]g/100 kcal was 
somewhat higher than the level in human milk reported in the Daniels et 
al. study and close to the AI set by the IOM. In our consideration of 
the study by Daniels et al., we regarded the data from the human milk-
fed infants as reference data, with the direct comparators being the 
indicators of selenium status of infants fed the formulas containing 
the three levels of selenium. The plasma and erythrocyte indicators of 
selenium status for both test formulas did not differ from each other 
but differed with statistical significance from the control formula. 
Compared to the infants fed the formula containing 1.9 [mu]g selenium/
100 kcal, infants fed the formula containing 3.1 [mu]g selenium/100 
kcal excreted more selenium in the urine. This increase in urinary 
selenium was found to be statistically significant. Combined with the 
finding of no dose-related changes in the circulating indicators of 
selenium status in infants fed formulas containing 1.9 [mu]g selenium/
100 kcal or 3.1 [mu]g selenium/100 kcal, this dose-related increase in 
urinary selenium suggests that infants fed the formula containing a 
level of 1.9 [mu]g selenium/100 kcal received sufficient selenium to 
meet their nutritional needs. Much of the selenium intake above the 
level of 1.9 [mu]g selenium/100 kcal was apparently eliminated from the 
body through the body's homeostatic mechanisms.
    As effects on indicators of selenium status have not been evaluated 
in infants fed formulas with concentrations of selenium between 0.9 
[mu]g selenium/100 kcal and 1.9 [mu]g selenium/100 kcal, there are no 
data to support lowering the minimum level of selenium in infant 
formula from 2.0 [mu]g/100 kcal to 1.6 [mu]g/100 kcal. The scientific 
evidence discussed previously and in section III.A. of the proposed 
rule (78 FR 22442 at 22443) continues to justify 2.0 [mu]g selenium/100 
kcal as the minimum level for selenium in infant formulas.
    (Comment 3) In support of a lower minimum level for selenium in 
infant formula, one comment pointed out that the Codex Alimentarius 
infant formula standard and the European Union Directive on Infant 
Formulae and Follow-On Formulae recommend a minimum level of selenium 
in infant formula of 1.0 [mu]g selenium/100 kcal.
    (Response 3) The level of 1.0 [mu]g/100 kcal as the minimum level 
for selenium in infant formula was adopted by the Codex Alimentarius in 
2007 for its Standard for Infant Formula and Formulas for Special 
Medical Purposes Intended for Infants (Codex Stan 72-1981) (Ref. 6) 
based on recommendation of this level by an International Expert Group 
(IEG) of the ESPGHAN (Ref. 4). The IEG recommended 1.0 [mu]g selenium/
100 kcal for infant formula based on the median selenium content of 
human milk and an established history of apparent safe use. However, as

[[Page 35837]]

described in the proposed rule (78 FR 22442 at 22444), no information 
was provided regarding the details of how such information was used in 
making the recommendation for 1.0 [mu]g selenium/100 kcal in infant 
formula. In addition, the recommendation of the IEG was made in 2005 
before the dose-response study of Daniels et al. was published in 2008, 
and data from that study suggest that a level of 1.9 [mu]g selenium/100 
kcal in infant formula meets infants' selenium needs. Further, 
although, as noted in the comment, the level of 1.0 [mu]g/100 kcal was 
also adopted as the minimum level for selenium by the European Union in 
2006 for its Directive on Infant Formulae and Follow-On Formulae 
(Commission Directive 2006/141/EC), identification of a scientific 
basis for the selection of 1.0 [mu]g selenium/100 kcal was not included 
in the European Union Commission Directive.
    (Comment 4) One comment suggested raising the maximum level of 
selenium added to infant formula to 9.0 [mu]g/100 kcal. The comment 
said that the 9.0 [mu]g selenium/100 kcal would align the maximum level 
of selenium with the upper levels recommended in the Codex Alimentarius 
Standard for Infant Formula and Formulas for Special Medical Purposes 
Intended for Infants, and with the European Union Directive on Infant 
Formulae and Follow-on Formulae. The comment also stated that 9.0 [mu]g 
selenium/100 kcal is more aligned with the use of 8.0 [mu]g/100 kcal as 
the maximum value for selenium in the FDA Compliance Program Guidance 
Manual (CPGM).
    (Response 4) We decline to increase the maximum level of selenium 
in infant formula to 9.0 [mu]g selenium/100 kcal as the comment 
suggested. As noted in the response to comment 1 concerning the minimum 
level of selenium in infant formula, the maximum level of any substance 
(including nutrients, food additives, or contaminants) established for 
regulatory purposes must also be a value that is based on and true to 
the available scientific evidence.
    The level of 9.0 [mu]g selenium/100 kcal suggested in the comment 
is the maximum level recommended by the ESPGHAN IEG for infant formula. 
The report of the IEG stated that its recommendation was based on a 
history of safe use (not further described) and did not identify 
scientific data or other information relied upon for its recommendation 
for a maximum level of 9.0 [mu]g selenium/100 kcal that was 
subsequently adopted by Codex Alimentarius in 2007 for its Standard for 
Infant Formula and Formulas for Special Medical Purposes Intended for 
Infants (Codex Stan 72-1981). The level of 9.0 [mu]g selenium/100 kcal 
was also listed in the European Union Directive on Infant Formulae and 
Follow-on Formulae. We considered the level of 9.0 [mu]g selenium/100 
kcal; however, we could not determine the scientific basis for this 
level.
    Although we expressly invited comment regarding the proposed 
maximum level in infant formula of 7.0 [mu]g selenium/100 kcal, 
including whether such a maximum level is needed and the scientific 
data or information that form the basis of any comments (78 FR 22442 at 
22445), we did not receive any comments that disagreed with the need 
for a maximum level or that provided a scientific basis that would 
support a change from the proposed level. The report of the IOM, which 
we relied upon to propose the maximum level of 7.0 [mu]g selenium/100 
kcal, identified the data (concentration of selenium in human milk not 
associated with known adverse effects) and the method of calculation 
used to estimate a Tolerable Upper Intake Level (UL) of 7.0 [mu]g/kg 
body weight/day for selenium intake of infants from 0 to 6 months of 
age. (As explained in the proposed rule (78 FR 22442 at 22444), a level 
of intake expressed as [mu]g/kg body weight/day is consistent with an 
infant formula concentration expressed in [mu]g/100 kcal.)
    With regard to the use of 8.0 [mu]g/100 kcal as a maximum in our 
CPGM, this level was incorporated into the CPGM when infant formula 
manufacturers in the United States began adding selenium to infant 
formulas starting as early as 1990 and preceded the establishment of 
the UL for infants 0 to 6 months of age by the IOM. We will update the 
minimum and maximum values for selenium in infant formula in our CPGM 
to align with the final rule.
    (Comment 5) One comment said that setting 7.0 [mu]g selenium/100 
kcal as the maximum level of selenium, which is the amount we proposed, 
would mean some manufacturers would need to reformulate their products 
that currently meet the 8.0 [mu]g selenium/100 kcal level that is 
listed in the FDA CPGM.
    (Response 5) Although the comment said that some manufacturers 
whose products currently meet the 8.0 [mu]g selenium/100 kcal level 
listed in the FDA CPGM would need to reformulate, it did not specify 
how many manufacturers or products would likely be affected or whether 
label changes would be required following any reformulations. It also 
did not provide estimates of possible costs resulting from establishing 
a maximum of 7.0 [mu]g selenium/100 kcal. Other comments indicated that 
any formula changes could be made in a cost effective and timely manner 
with an effective date 12 months after publication of the final rule 
(see comment 7).
    If some manufacturers who currently meet the 8.0 [mu]g selenium/100 
kcal level need to reformulate their products to avoid exceeding a 
selenium level of 7.0 [mu]g/100 kcal, such a reformulation would 
involve only a small reduction in the amount of selenium added to the 
formula. Manufacturers routinely make such small changes in the rates 
of addition of ingredients (which may or may not result in the need for 
label changes) as a fundamental part of their current good 
manufacturing practices and quality control programs to ensure the 
consistent production of infant formulas of high quality. These types 
of changes are generally not considered to be major changes and are 
reported to FDA in a ``before first processing'' submission by the 
manufacturers if the change may adulterate the product, as required by 
section 412(d)(3) of the FD&C Act and our regulations in 21 CFR 
106.140.

C. Allowance for Analytical Variability

    (Comment 6) One comment suggested that, in the absence of setting a 
higher maximum selenium level, FDA would need to establish a specific 
allowance for method bias to ensure that manufacturers can meet both 
the minimum and maximum selenium levels. The comment suggested an 
allowance of 30 percent to account for analytical variability.
    (Response 6) As noted in the response to comment 4, the maximum 
level of any substance must be a value that is based on and true to the 
available scientific evidence. For this reason, we are not setting a 
higher maximum value that would include an allowance for analytical 
variability or method bias. We are not aware of method bias (consistent 
over- or under-measurement of the actual concentration) in the analysis 
of selenium in infant formula. We acknowledge that analytical 
variability occurs between laboratories when testing the levels of 
nutrients in infant formula, and we manage this matter under our 
compliance program as necessary. Further, we decline to set a 30 
percent allowance for analytical variation for the chemical analysis of 
selenium in infant formula. The comment did not provide a reason for 
setting such a high allowance for analytical variation, and 30 percent 
variability is much higher than performance requirements for commonly 
used methods for chemical

[[Page 35838]]

analysis of minerals in infant formula, which typically is about 10 to 
15 percent.

D. Effective Date

    In the Regulatory Impact Analysis of the proposed rule, we analyzed 
three options with respect to an effective date: (1) Take no new 
regulatory action (baseline); (2) require the provisions of this 
proposed rule and make the provisions of the rule effective 180 days 
after publication; and (3) require the provisions of this proposed 
rule, but make the provisions of the rule effective 12 months after 
publication (78 FR 22442 at 22446).
    (Comment 7) Two comments supported FDA's option 3 in the proposed 
rule to make the final rule effective 12 months after publication to 
allow for cost effective and timely changes with no anticipated impact 
on infant health. One comment explained that because there have been no 
reports of full-term, breast-fed infants in the United States with 
evidence of selenium deficiency, there would be no anticipated impact 
to infant health due to a 6-month delay in the rule's effective date 
(from 6 months in option 2 to 12 months in option 3 of the Regulatory 
Impact Analysis of the proposed rule).
    (Response 7) The final rule will be effective 12 months after 
publication of this document (see DATES). This will allow the industry 
to make any needed reformulations and label changes to their infant 
formula products in the 12-month period that the comment identified as 
cost effective and timely for needed changes.

E. Miscellaneous Comments

    Several comments addressed matters that were not specific to a 
particular provision in the proposed rule and/or that were not covered 
by the rule. We summarize and address those comments here.
    (Comment 8) One comment suggested that FDA recommend or encourage 
the use of the organic form of selenium, selenomethionine, rather than 
the inorganic forms, sodium selenite or sodium selenate. The comment 
explained that selenomethionine is the selenium compound incorporated 
into body proteins and is available in dietary supplements or from 
brewer's yeast.
    (Response 8) FDA's specifications for infant formula composition in 
Sec.  107.100 identify nutrients that must be included in the formula. 
The regulations do not specify ingredients that can serve as sources of 
the nutrients, except for vitamin K in Sec.  107.100(c). We decline to 
specify the form of selenium in infant formula because we do not have 
information that indicates that any specific source of selenium should 
be used in infant formula. Our recently published current good 
manufacturing practices for infant formulas require that ingredients 
used in infant formulas be safe and suitable for use in infant formula. 
Specifically, under Sec.  106.40(a), the only substances that may be 
used in an infant formula are substances that are safe and suitable for 
use in infant formula under the applicable food safety provisions of 
the FD&C Act; that is, a substance is used in accordance with the 
Agency's food additive regulations, is generally recognized as safe for 
such use, or is authorized by a prior sanction.
    (Comment 9) One comment agreed with the proposed selenium levels 
``unless a pediatrician otherwise recommends an alternative dosage 
because of a peculiar deficiency of selenium.'' The comment did not 
explain the circumstances under which a pediatrician would recommend an 
``alternative dosage.''
    (Response 9) The final rule adds selenium to the list of required 
nutrients in infant formula and establishes minimum and maximum levels 
of selenium in infant formula. Manufacturers will be required to add 
selenium to infant formula within the established bounds as of the 
effective date of this rule. The rule does not apply to what physicians 
may do within the practice of medicine. Thus, matters pertaining to the 
practice of pediatric medicine are outside the scope of this 
rulemaking.
    (Comment 10) Another comment suggested that FDA consider 
establishing a higher maximum for vitamin D based on recent American 
Academy of Pediatrics and IOM recommendations.
    (Response 10) The final rule adds selenium to the list of required 
nutrients in infant formula and establishes minimum and maximum levels 
of selenium in infant formula. With respect to vitamin D and infant 
formula, we may, as resources permit, reevaluate all the minimum and 
maximum required nutrient levels for infant formula in separate 
rulemakings.
    (Comment 11) One comment supported the proposal to require the 
addition of selenium in infant formula. The comment stated that a child 
that does not receive enough selenium in the diet is at risk of 
developing Keshan disease.
    (Response 11) FDA agrees that Keshan disease is linked to selenium 
deficiency. The preamble to the proposed rule discussed the known 
biological functions of selenium and Keshan disease (a cardiomyopathy 
that occurs almost exclusively in children) (see 78 FR 22442 at 22443).

III. What is the environmental impact of this final rule?

    FDA has determined under 21 CFR 25.32(n) that this action is of a 
type that does not individually or cumulatively have a significant 
effect on the human environment. Therefore, neither an environmental 
assessment nor an environmental impact statement is required.

IV. Federalism

    FDA has analyzed this final rule in accordance with the principles 
set forth in Executive Order 13132. We have determined that the rule 
does not contain policies that have substantial direct effects on the 
States, on the relationship between the National Government and the 
States, or on the distribution of power and responsibilities among the 
various levels of government. Accordingly, we have concluded that the 
rule does not contain policies that have federalism implications as 
defined in the Executive order and, consequently, a federalism summary 
impact statement is not required.

V. Executive Order 12866 and Executive Order 13563: Cost Benefit 
Analysis

    On April 16, 2013, we proposed to amend our regulations on nutrient 
specifications and labeling for infant formula to add the mineral 
selenium to the list of required nutrients and to establish minimum and 
maximum levels of selenium in infant formula (78 FR 22442). The 
Economic Impact Analysis in the proposed rule explained the economic 
impact of the changes to regulations at part 107. We did not receive 
any comments on the economic analysis of the proposed rule.
    FDA has examined the impacts of this final rule under Executive 
Order 12866, Executive Order 13563, the Regulatory Flexibility Act (5 
U.S.C. 601-612), and the Unfunded Mandates Reform Act of 1995 (Pub. L. 
104-4). Executive Orders 12866 and 13563 direct Agencies to assess all 
costs and benefits of available regulatory alternatives and, when 
regulation is necessary, to select regulatory approaches that maximize 
net benefits (including potential economic, environmental, public 
health and safety, and other advantages; distributive impacts; and 
equity). FDA has developed a regulatory impact analysis that presents 
the benefits and costs of this proposed rule (Ref. 7). We believe that 
the final rule will not be a

[[Page 35839]]

significant regulatory action as defined by Executive Order 12866.

VI. Paperwork Reduction Act of 1995

    This final rule contains information collection provisions that are 
subject to review by the Office of Management and Budget (OMB) under 
the Paperwork Reduction Act of 1995 (PRA) (44 U.S.C. 3501-3520). The 
title, description, and respondent description of the information 
collection provisions are shown in the following paragraphs with an 
estimate of the annual third-party disclosure burden. Included in the 
estimate is the time for reviewing instructions, searching existing 
data sources, gathering and maintaining the data needed, and completing 
and reviewing each collection of information.
    Title: Third-Party Disclosure Requirements for Selenium in Infant 
Formula
    Description of Respondents: The respondents to this information 
collection are manufacturers of infant formula marketed in the United 
States.
    Description: The final rule revises Sec.  107.10(a)(2) to require 
that selenium be listed in the nutrient list on the label for all 
infant formulas. In particular, in the nutrient list, selenium must be 
listed between iodine and sodium and the amount per 100 calories 
declared; and because selenium is a required ingredient in infant 
formula, selenium is required to be declared in the formula's 
ingredient statement by its common or usual name and positioned 
according to the descending order of its predominance in the formula, 
under Sec.  101.4 (21 CFR 101.4). The present version of Sec.  
107.10(a)(2) is approved by OMB in accordance with the PRA and has been 
assigned OMB control number 0910-0256. This final rule modifies the 
information collection associated with the present version of Sec.  
107.10(a)(2) by adding 23 hours to the burden associated with the 
collection. A manufacturer not in compliance with the new minimum and 
maximum levels for selenium in infant formula would be required to make 
a one-time change to the nutrient list information disclosed to 
consumers on the label of its infant formula, to account for the 
required change in the amount of selenium in its products. The nutrient 
information disclosed by manufacturers on the infant formula label is 
necessary to inform purchasers of the value of the infant formula. As 
discussed previously in this document, FDA has the authority to revise 
the statement of the amounts of nutrients required for infant formula 
labeling in Sec.  107.10(a)(2).
    FDA estimates the burden of this collection of information as 
follows:

                                               Table 1--Estimated Annual Third-Party Disclosure Burden \1\
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                               Number of
              21 CFR section                   Number of      disclosures    Total annual        Average burden per         Total hours    Total capital
                                              respondents   per respondent    disclosures            disclosure                                cost
--------------------------------------------------------------------------------------------------------------------------------------------------------
Sec.   107.10(a)(2)--Nutrient labeling for               1              46              46  0.5 (30 minutes)                          23        $792,439
 infant formula.
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ There are no operating and maintenance costs associated with this collection of information.

    FDA concludes that there will be no additional burden associated 
with the requirement to disclose selenium in the ingredient statement 
as required under Sec.  101.4 because all infant formula manufacturers 
currently add selenium as an ingredient to their infant formula 
products that are sold in the United States, and all manufacturers 
currently disclose selenium in the ingredient statement, as specified 
by Sec.  101.4. Additionally, all manufacturers currently disclose 
selenium in the nutrient list, as required by Sec.  107.10(b)(5). Under 
Sec.  107.10(a)(2), only one manufacturer would need to make a one-time 
labeling change to modify the amount of selenium shown in the nutrient 
list on the labels of its infant formula.
    The third-party disclosure burden consists of the setup time 
required to design a revised label and incorporate it into the 
manufacturing process. Based upon our knowledge of food and dietary 
supplement labeling, we estimate that the affected manufacturer would 
require less than 0.5 hour per product to modify the label's nutrient 
list to reflect the addition of more selenium to the product. We 
estimate that this manufacturer produces 46 separate infant formulas 
that would require relabeling. The one-time third-party disclosure 
burden is estimated in table 1 of this document.
    The final column of table 1 gives the estimated capital cost 
associated with relabeling. This is the cost of designing a revised 
label and incorporating it into the manufacturing process. The cost 
stated in table 1, $792,439, is estimated based on an effective date of 
1 year after publication. These costs are based on the cost model 
estimate that, over a longer period of time, any labeling change is 
more likely to be coordinated with a change in a label that may already 
be scheduled, and will diminish the need to, for example, purchase and 
apply stickers to packages affected by the change.
    The information collection provisions in this final rule have been 
submitted to OMB for review as required by section 3507(d) of the PRA. 
The requirements were approved and assigned OMB control number 0910-
0256. This approval expires on 04/30/2018.
    An Agency may not conduct or sponsor, and a person is not required 
to respond to, a collection of information unless it displays a 
currently valid OMB control number.

VII. Objections

    This rule is effective as shown in the DATES section, except as to 
any provisions that may be stayed by the filing of proper objections. 
If you will be adversely affected by one or more provisions of this 
regulation, you may file with the Division of Dockets Management (see 
ADDRESSES) either electronic or written objections. You must number 
each objection separately, and, within each numbered objection, you 
must specify with particularity the provision(s) to which you object, 
and the grounds for your objection. Within each numbered objection, you 
must specifically state whether you are requesting a hearing on the 
particular provision that you specify in that numbered objection. If 
you do not request a hearing for any particular objection, we will 
consider the absence of such a request as waiving the right to a 
hearing on that objection. If you request a hearing, your objection 
should include a detailed description and analysis of the specific 
factual information you intend to present in support of the objection 
in the event that a hearing is held.
    It is only necessary to send one set of documents. Identify 
documents with the

[[Page 35840]]

docket number found in brackets in the heading of this document. Any 
objections received in response to the regulation may be seen in the 
Division of Dockets Management between 9 a.m. and 4 p.m., Monday 
through Friday, and will be posted to the docket at http://www.regulations.gov. We will publish notice of the objections that we 
have received or lack thereof in the Federal Register.

VIII. References

    The following references have been placed on display in the 
Division of Dockets Management (see ADDRESSES) and may be seen by 
interested persons between 9 a.m. and 4 p.m., Monday through Friday, 
and are available electronically at http://www.regulations.gov.

    1. Food and Nutrition Board, National Research Council, 
``Recommended Dietary Allowances,'' 10th ed., Washington, DC: The 
National Academies Press, p. 221, 1989.
    2. Food and Nutrition Board, Institute of Medicine, ``Dietary 
Reference Intakes for Vitamin C, Vitamin E, Selenium, and 
Carotenoids,'' Washington, DC: The National Academies Press, pp. 21-
33; 292-299; 315-316, 2000.
    3. Raiten, D. J., J. M. Talbot, and J. H. Waters, ``Assessment 
of Nutrient Requirements for Infant Formulas,'' Journal of 
Nutrition, 128:2059S-2249S, 1998.
    4. Koletzko, B., S. Baker, G. Cleghorn, U.F. Neto, et al., 
``Global Standard for the Composition of Infant Formula. 
Recommendations of an ESPGHAN Coordinated International Expert 
Group,'' Journal of Pediatric Gastroenterology and Nutrition, 
41:584-599, 2005.
    5. Daniels, L., R. A. Gibson, K. Simmer, P. Van Dael, and M. 
Makrides, ``Selenium Status of Term Infants Fed Selenium-
Supplemented Formula in a Randomized Dose-Response Trial,'' American 
Journal of Clinical Nutrition, 88:70-76, 2008.
    6. Codex Alimentarius Commission, ``Standard for Infant Formula 
and Formulas for Special Medical Purposes Intended for Infants, 
Codex Stan 72-1981,'' 1981. Revised 2007.
    7. FDA/Center for Food Safety and Applied Nutrition, ``Infant 
Formula: The Addition of Minimum and Maximum Levels of Selenium to 
Infant Formula and Related Labeling Requirements, Final Regulatory 
Impact Analysis and Regulatory Flexibility Analysis,'' 2015. 
Available at: http://www.fda.gov/AboutFDA/ReportsManualsForms/Reports/EconomicAnalyses/.

List of Subjects in 21 CFR Part 107

    Food labeling, Infants and children, Nutrition, Reporting and 
recordkeeping requirements, Signs and symbols.
    For the reasons discussed in the preamble, under the Federal Food, 
Drug, and Cosmetic Act, and under authority delegated to the 
Commissioner of Food and Drugs, the Food and Drug Administration amends 
21 CFR part 107 as follows:

PART 107--INFANT FORMULA

0
1. The authority citation for 21 CFR part 107 continues to read as 
follows:


    Authority: 21 U.S.C. 321, 343, 350a, 371.


0
2. In Sec.  107.10, revise paragraph (a)(2) to read as follows:


Sec.  107.10  Nutrient information.

    (a) * * *
    (2) A statement of the amount, supplied by 100 kilocalories, of 
each of the following nutrients and of any other nutrient added by the 
manufacturer:

 
------------------------------------------------------------------------
                 Nutrients                       Unit of measurement
------------------------------------------------------------------------
Protein....................................  Grams
Fat........................................  Do.
Carbohydrate...............................  Do.
Water......................................  Do.
Linoleic acid..............................  Milligrams
------------------------------------------------------------------------
                                Vitamins
------------------------------------------------------------------------
Vitamin A..................................  International Units
Vitamin D..................................  Do.
Vitamin E..................................  Do.
Vitamin K..................................  Micrograms
Thiamine (Vitamin B1)......................  Do.
Riboflavin (Vitamin B2)....................  Do.
Vitamin B6.................................  Do.
Vitamin B12................................  Do.
Niacin.....................................  Do.
Folic acid (Folacin).......................  Do.
Pantothenic acid...........................  Do.
Biotin.....................................  Do.
Vitamin C (Ascorbic acid)..................  Milligrams
Choline....................................  Do.
Inositol...................................  Do.
------------------------------------------------------------------------
                                Minerals
------------------------------------------------------------------------
Calcium....................................  Milligrams
Phosphorus.................................  Do.
Magnesium..................................  Do.
Iron.......................................  Do.
Zinc.......................................  Do.
Manganese..................................  Micrograms
Copper.....................................  Do.
Iodine.....................................  Do.
Selenium...................................  Do.
Sodium.....................................  Milligrams
Potassium..................................  Do.
Chloride...................................  Do.
------------------------------------------------------------------------


[[Page 35841]]

* * * * *

0
3. In Sec.  107.100, revise paragraph (a) to read as follows:


Sec.  107.100  Nutrient specifications.

    (a) An infant formula shall contain the following nutrients at a 
level not less than the minimum level specified and not more than the 
maximum level specified for each 100 kilocalories of the infant formula 
in the form prepared for consumption as directed on the container:

----------------------------------------------------------------------------------------------------------------
                 Nutrients                         Unit of measurement          Minimum level     Maximum level
----------------------------------------------------------------------------------------------------------------
Protein....................................  Grams..........................               1.8               4.5
Fat........................................  Do.............................               3.3               6.0
                                             Percent calories...............                30                54
Linoleic acid..............................  Milligrams.....................               300  ................
                                             Percent calories...............               2.7  ................
----------------------------------------------------------------------------------------------------------------
                                                    Vitamins
----------------------------------------------------------------------------------------------------------------
Vitamin A..................................  International Units............               250               750
Vitamin D..................................  Do.............................                40               100
Vitamin E..................................  Do.............................               0.7  ................
Vitamin K..................................  Micrograms.....................                 4  ................
Thiamine (Vitamin B1)......................  Do.............................                40  ................
Riboflavin (Vitamin B2)....................  Do.............................                60  ................
Vitamin B6.................................  Do.............................                35  ................
Vitamin B12................................  Do.............................              0.15  ................
Niacin \1\.................................  Do.............................               250  ................
Folic acid (Folacin).......................  Do.............................                 4  ................
Pantothenic acid...........................  Do.............................               300  ................
Biotin \2\.................................  Do.............................               1.5  ................
Vitamin C (Ascorbic acid)..................  Milligrams.....................                 8  ................
Choline \2\................................  Do.............................                 7  ................
Inositol \2\...............................  Do.............................                 4  ................
----------------------------------------------------------------------------------------------------------------
                                                    Minerals
----------------------------------------------------------------------------------------------------------------
Calcium....................................  Do.............................                60  ................
Phosphorus.................................  Do.............................                30  ................
Magnesium..................................  Do.............................                 6  ................
Iron.......................................  Do.............................              0.15               3.0
Zinc.......................................  Do.............................               0.5  ................
Manganese..................................  Micrograms.....................                 5  ................
Copper.....................................  Do.............................                60  ................
Iodine.....................................  Do.............................                 5                75
Selenium...................................  Do.............................                 2                 7
Sodium.....................................  Milligrams.....................                20                60
Potassium..................................  Do.............................                80               200
Chloride...................................  Do.............................                55               150
----------------------------------------------------------------------------------------------------------------
\1\ The generic term ``niacin'' includes niacin (nicotinic acid) and niacinamide (nicotinamide).
\2\ Required only for non-milk-based infant formulas.

* * * * *

    Dated: June 17, 2015.
Leslie Kux,
Associate Commissioner for Policy.
[FR Doc. 2015-15394 Filed 6-22-15; 8:45 am]
 BILLING CODE 4164-01-P



                                                35834              Federal Register / Vol. 80, No. 120 / Tuesday, June 23, 2015 / Rules and Regulations

                                                agency’s authority. This rulemaking is                  comments. It, therefore, (1) is not a                    2 miles either side of the 152° radial from the
                                                promulgated under the authority                         ‘‘significant regulatory action’’ under                  3.5-mile radius to 6.3 miles south of the
                                                described in Subtitle VII, Part A,                      Executive Order 12866; (2) is not a                      airport.
                                                Subpart I, Section 40103. Under that                    ‘‘significant rule’’ under DOT                             Issued in Seattle, Washington, on June 15,
                                                section, the FAA is charged with                        Regulatory Policies and Procedures (44                   2015.
                                                prescribing regulations to assign the use               FR 11034; February 26, 1979); and (3)                    Christopher Ramirez,
                                                of airspace necessary to ensure the                     does not warrant preparation of a
                                                                                                                                                                 Acting Manager, Operations Support Group,
                                                safety of aircraft and the efficient use of             Regulatory Evaluation as the anticipated                 Western Service Center.
                                                airspace. This regulation is within the                 impact is so minimal. Since this is a
                                                                                                                                                                 [FR Doc. 2015–15315 Filed 6–22–15; 8:45 am]
                                                scope of that authority as it establishes               routine matter that only affects air traffic
                                                                                                                                                                 BILLING CODE 4910–13–P
                                                controlled airspace at Cloverdale                       procedures and air navigation, it is
                                                Municipal Airport, Cloverdale, CA.                      certified that this rule, when
                                                                                                        promulgated, does not have a significant
                                                History                                                                                                          DEPARTMENT OF HEALTH AND
                                                                                                        economic impact on a substantial
                                                   On September 2, 2014 the FAA                         number of small entities under the                       HUMAN SERVICES
                                                published in the Federal Register a                     criteria of the Regulatory Flexibility Act.
                                                notice of proposed rulemaking (NPRM)                                                                             Food and Drug Administration
                                                to establish Class E airspace extending                 Environmental Review
                                                upward from 700 feet above the surface                    The FAA has determined that this                       21 CFR Part 107
                                                at Cloverdale Municipal Airport,                        action qualifies for categorical exclusion               [Docket No. FDA–2013–N–0067]
                                                Cloverdale, CA. (79 FR 51919).                          under the National Environmental
                                                Interested parties were invited to                      Policy Act in accordance with FAA                        Infant Formula: The Addition of
                                                participate in this rulemaking effort by                Order 1050.1E, ‘‘Environmental                           Minimum and Maximum Levels of
                                                submitting written comments on the                      Impacts: Policies and Procedures,’’                      Selenium to Infant Formula and
                                                proposal to the FAA. No comments                        paragraph 311a. This airspace action is                  Related Labeling Requirements
                                                were received.                                          not expected to cause any potentially
                                                   Class E airspace designations are                                                                             AGENCY:   Food and Drug Administration,
                                                                                                        significant environmental impacts, and                   HHS.
                                                published in paragraph 6005, of FAA                     no extraordinary circumstances exist
                                                Order 7400.9Y, dated August 6, 2014,                    that warrant preparation of an                           ACTION:   Final rule.
                                                and effective September 15, 2014, which                 environmental assessment.                                SUMMARY:    The Food and Drug
                                                is incorporated by reference in 14 CFR                                                                           Administration (FDA or we) is
                                                71.1. The Class E airspace designation                  Lists of Subjects in 14 CFR Part 71:
                                                                                                                                                                 amending the regulations on nutrient
                                                listed in this document will be                          Airspace, Incorporation by reference,
                                                                                                                                                                 specifications and labeling for infant
                                                published subsequently in the Order.                    Navigation (air).
                                                                                                                                                                 formula to add the mineral selenium to
                                                Availability and Summary of                             Adoption of the Amendment:                               the list of required nutrients and to
                                                Documents for Incorporation by                            In consideration of the foregoing, the                 establish minimum and maximum
                                                Reference                                               Federal Aviation Administration                          levels of selenium in infant formula.
                                                   This document amends FAA Order                       amends 14 CFR part 71 as follows:                        DATES: This final rule is effective June
                                                7400.9Y, airspace Designations and                                                                               22, 2016. See section VII of this
                                                Reporting Points, dated August 6, 2014,                 PART 71—DESIGNATION OF CLASS A,                          document for information on the filing
                                                and effective September 15, 2014. FAA                   B, C, D, AND E AIRSPACE AREAS; AIR                       of objections. Submit either electronic
                                                Order 7400.9Y is publicly available as                  TRAFFIC SERVICE ROUTES; AND                              or written objections and requests for a
                                                listed in the ADDRESSES section of this                 REPORTING POINTS                                         hearing by July 23, 2015.
                                                final rule. FAA Order 7400.9Y lists                                                                              ADDRESSES: You may submit either
                                                Class A, B, C, D, and E airspace areas,                 ■ 1. The authority citation for Part 71                  electronic or written objections and/or
                                                air traffic service routes, and reporting               continues to read as follows:                            requests for a hearing, identified by
                                                points.                                                   Authority: 49 U.S.C. 106(f), 106(g); 40103,            Docket No. FDA–2013–N–0067, by any
                                                                                                        40113, 40120; E.O. 10854, 24 FR 9565, 3 CFR,             of the following methods:
                                                The Rule                                                1959–1963 Comp., p. 389.
                                                   This amendment to Title 14, Code of                                                                           Electronic Submissions
                                                                                                        § 71.1       [Amended]
                                                Federal Regulations (14 CFR) part 71                                                                               Submit electronic objections in the
                                                establishes Class E airspace extending                  ■ 2. The incorporation by reference in                   following way:
                                                upward from 700 feet above the surface                  14 CFR 71.1 of FAA Order 7400.9Y,                          • Federal eRulemaking Portal: http://
                                                at Cloverdale, CA, with a segment that                  Airspace Designations and Reporting                      www.regulations.gov. Follow the
                                                extends 6.3 miles south of the airport.                 Points, dated August 6, 2014, and                        instructions for submitting comments.
                                                Controlled airspace is needed for the                   effective September 15, 2014, is
                                                                                                        amended as follows:                                      Written Submissions
                                                RNAV (GPS) standard instrument
                                                approaches and departures at the                                                                                   Submit written objections in the
                                                airport.                                                Paragraph 6005 Class E airspace areas                    following ways:
                                                                                                        extending upward from 700 feet or more                     • Mail/Hand delivery/Courier (for
                                                Regulatory Notices and Analyses                         above the surface of the earth.
                                                                                                                                                                 paper submissions): Division of Dockets
mstockstill on DSK4VPTVN1PROD with RULES




                                                   The FAA has determined that this                     *        *      *       *      *                         Management (HFA–305), Food and Drug
                                                regulation only involves an established                 AWP CA E5 Cloverdale, CA [New]                           Administration, 5630 Fishers Lane, Rm.
                                                body of technical regulations for which                 Cloverdale Municipal Airport, CA                         1061, Rockville, MD 20852.
                                                frequent and routine amendments are                       (lat. 38°46′34″ N., long. 122°59′33″ W.)                 Instructions: All submissions received
                                                necessary to keep them operationally                      That airspace extending upward from 700                must include the Docket No. FDA–
                                                current, is non-controversial and                       feet above the surface within a 3.5-mile                 2013–N–0067 for this rulemaking. All
                                                unlikely to result in adverse or negative               radius of Cloverdale Municipal Airport and               objections received may be posted


                                           VerDate Sep<11>2014   16:21 Jun 22, 2015   Jkt 235001   PO 00000   Frm 00006     Fmt 4700   Sfmt 4700   E:\FR\FM\23JNR1.SGM   23JNR1


                                                                   Federal Register / Vol. 80, No. 120 / Tuesday, June 23, 2015 / Rules and Regulations                                           35835

                                                without change to http://                               formulas and 7.0 mg/100 kcal as the                    special dietary uses to fully inform
                                                www.regulations.gov, including any                      maximum level of selenium in infant                    purchasers as to the value of the food for
                                                personal information provided. For                      formulas.                                              such uses. As such, FDA has the
                                                additional information on submitting                       Scientific evidence from multiple                   authority to revise the statement of the
                                                objections, see the ‘‘Objections’’ heading              sources supported the proposed levels.                 amounts of nutrients required for infant
                                                of the SUPPLEMENTARY INFORMATION                        Specifically, for the proposed                         formula labeling in § 107.10(a)(2) under
                                                section of this document.                               requirements, we considered scientific                 sections 201(z), 403(j), 412(i), and 701(e)
                                                   Docket: For access to the docket to                  evidence in: (1) The Institute of                      of the FD&C Act.
                                                read background documents, comments,                    Medicine’s (IOM) ‘‘Dietary Reference
                                                or objections received, go to http://                   Intakes for Vitamin C, Vitamin E,                      II. What issues did the comments raise?
                                                www.regulations.gov and insert the                      Selenium, and Carotenoids’’ (Ref. 2); (2)              What are FDA’s responses to the
                                                docket number, found in brackets in the                 the Life Sciences Research Office’s                    comments?
                                                heading of this document, into the                      ‘‘Assessment of Nutrient Requirements                     We invited public comment on the
                                                ‘‘Search’’ box and follow the prompts                   for Infant Formulas’’ by Raiten et al.                 proposed rule. The comment period
                                                and/or go to the Division of Dockets                    (Ref. 3); (3) ‘‘Global Standard for the                closed on July 1, 2013. We received
                                                Management, 5630 Fishers Lane, Rm.                      Composition of Infant Formula.                         fewer than 20 comments. Overall, the
                                                1061, Rockville, MD 20852.                              Recommendations of an ESPGHAN                          comments supported the addition of
                                                FOR FURTHER INFORMATION CONTACT:                        [European Society for Paediatric                       selenium to infant formula and agreed
                                                Leila Beker, Center for Food Safety and                 Gastroenterology, Hepatology and                       that selenium is an essential nutrient.
                                                Applied Nutrition (HFS–850), Food and                   Nutrition] Coordinated International                   We summarize and respond to the
                                                Drug Administration, 5100 Paint Branch                  Expert Group’’ by Koletzko et al. (Ref.                comments on the proposed rule and
                                                Pkwy., College Park, MD 20740, 240–                     4); and (4) ‘‘Selenium Status of Term                  describe the final rule in this section.
                                                402–1451.                                               Infants Fed Selenium-Supplemented                      For ease of reading, we preface each
                                                SUPPLEMENTARY INFORMATION:                              Formula in a Randomized Dose-                          comment discussion with a numbered
                                                                                                        Response Trial’’ by Daniels et al. (Ref.               ‘‘Comment,’’ and each response by a
                                                I. What is the background and legal                     5). We also searched the scientific                    corresponding numbered ‘‘Response.’’
                                                authority of this final rule?                           literature from 1998 through 2012 for                  We have numbered each comment to
                                                A. Background                                           published studies not included in these                help distinguish among different topics.
                                                                                                        reports.                                               The number assigned is for
                                                  Section 412(i) of the Federal Food,                      In addition, we proposed to amend                   organizational purposes only and does
                                                Drug, and Cosmetic Act (the FD&C Act)                   the labeling requirements for infant                   not signify the comment’s value,
                                                (21 U.S.C. 350a(i)) establishes                         formula in § 107.10(a)(2) to add                       importance, or the order in which it was
                                                requirements for the nutrient content of                selenium to the list of nutrients along                received.
                                                infant formulas. Under section 412(i)(2)                with the requirement to list the amount
                                                of the FD&C Act, the Secretary of Health                of selenium per 100 kcal in the formula.               A. The Addition of Selenium to the
                                                and Human Services (the Secretary) is                                                                          Statement of the Amounts of Nutrients
                                                authorized to revise the list of required               B. Legal Authority                                     (§ 107.10(a)(2))
                                                nutrients and the required level for any                   Section 412(i) of the FD&C Act                         The proposed rule would amend the
                                                required nutrient. This authority has                   contains a table of nutrients (including               infant formula nutrient labeling and
                                                been delegated to the Commissioner of                   minimum and, in some cases, maximum                    nutrient specification regulations at
                                                Food and Drugs (the Commissioner).                      levels for nutrients) that are required to             §§ 107.10 and 107.100, respectively.
                                                The table in section 412(i) of the FD&C                 be in an infant formula. Section                       Proposed § 107.10(a)(2) would add
                                                Act, and in FDA regulations at                          412(i)(2) of the FD&C Act authorizes the               selenium to the statement of the
                                                § 107.100(a) (21 CFR 107.100(a)),                       Secretary to revise the statutory table of             amounts of nutrients required for infant
                                                specifies that infant formulas must                     nutrients and to revise the level of any               formula labeling.
                                                contain 29 nutrients; minimum levels                    required nutrient. The Secretary has                      We did not receive any comments on
                                                for each nutrient and maximum levels                    delegated this authority to the                        proposed § 107.10(a)(2). However, we
                                                for 9 of the nutrients are also specified.              Commissioner. Our regulations                          note that we have revised § 107.10(a)(2)
                                                In 1989, the Food and Nutrition Board                   establishing the table of nutrients are                in this final rule to correspond to
                                                of the National Research Council                        codified at § 107.100.                                 changes resulting from an interim final
                                                established a Recommended Dietary                          The final rule amends § 107.100 to                  rule that appeared in the Federal
                                                Allowance for selenium for infants 0 to                 add selenium to the list of nutrients                  Register on February 10, 2014 (79 FR
                                                6 months of age of 10.0 micrograms per                  required for infant formula. The legal                 7934), and later affirmed in a final rule
                                                day (mg/day), a level extrapolated from                 authority for the amendment to                         that appeared in the Federal Register on
                                                adult values on the basis of body weight                § 107.100 comes from section 412(i)(2)                 June 10, 2014 (79 FR 33057). In brief,
                                                and with a factor allowed for growth                    of the FD&C Act.                                       § 107.10(a)(2) was reworded by
                                                (Ref. 1).                                                  The final rule also requires adding                 replacing ‘‘A statement of the amount of
                                                  In the Federal Register of April 16,                  selenium to the statement of the                       each of the following nutrients supplied
                                                2013 (78 FR 22442), we proposed to                      amounts of nutrients required for infant               by 100 kilocalories’’ with ‘‘A statement
                                                amend the nutrient specifications for                   formula labeling in § 107.10(a)(2).                    of the amount, supplied by 100
                                                infant formula to include selenium as a                 ‘‘Infant formula’’ is defined as a food for            kilocalories, of each of the following
                                                required nutrient in § 107.100(a). We                   ‘‘special dietary use’’ under section                  nutrients and of any other nutrient
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                                                also proposed to establish minimum                      201(z) of the FD&C Act (21 U.S.C.                      added by the manufacturer.’’
                                                and maximum levels for selenium in                      321(z)). Under sections 403(j) and 701(e)
                                                infant formulas because evidence exists                 of the FD&C Act (21 U.S.C. 343(j) and                  B. Minimum and Maximum Levels of
                                                for both deficiency and toxicity of                     21 U.S.C. 371(e)), the Secretary, and by               Selenium (§ 107.100)
                                                selenium. We proposed 2.0 mg selenium                   delegation the Commissioner, may                         Proposed § 107.100(a) would add
                                                per 100 kilocalories (/100 kcal) as the                 prescribe regulations concerning the                   selenium to the list of required nutrients
                                                minimum level of selenium in infant                     vitamin and mineral content of foods for               in infant formula. The proposal also


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                                                35836              Federal Register / Vol. 80, No. 120 / Tuesday, June 23, 2015 / Rules and Regulations

                                                would establish minimum and                             Daniels et al. (2008). The comment                     the data from the human milk-fed
                                                maximum levels for selenium in infant                   continued, saying it was not aware of                  infants as reference data, with the direct
                                                formula because evidence exists for both                any reports of selenium deficiency in                  comparators being the indicators of
                                                deficiency and toxicity of selenium, and                breast-fed infants or at this                          selenium status of infants fed the
                                                there is no room for error in production                concentration of selenium in infant                    formulas containing the three levels of
                                                of a food that serves as the sole source                formula. The comment also stated that                  selenium. The plasma and erythrocyte
                                                of nutrition for infants. We proposed to                we did not consider the data from the                  indicators of selenium status for both
                                                set 2.0 mg selenium/100 kcal as the                     breast-fed control group in the Daniels                test formulas did not differ from each
                                                minimum level of selenium in infant                     et al. study.                                          other but differed with statistical
                                                formulas and 7.0 mg/100 kcal as the                        (Response 2) With regard to this                    significance from the control formula.
                                                maximum level of selenium in infant                     comment suggesting that the selenium                   Compared to the infants fed the formula
                                                formulas. Since the publication of the                  concentration in human milk (and more                  containing 1.9 mg selenium/100 kcal,
                                                proposed rule, we have conducted a                      specifically, the level of 1.6 mg/100 kcal             infants fed the formula containing 3.1 mg
                                                search of the scientific literature to                  reported in the Daniels et al. study) be               selenium/100 kcal excreted more
                                                identify whether additional studies on                  used as the basis for the required                     selenium in the urine. This increase in
                                                selenium requirements of infants were                   minimum selenium level in infant                       urinary selenium was found to be
                                                published after we issued our proposal.                 formula, the scientific evidence we                    statistically significant. Combined with
                                                We did not find any relevant studies in                 discussed in the proposed rule (78 FR                  the finding of no dose-related changes
                                                our search.                                             22442 at 22444) was more broadly                       in the circulating indicators of selenium
                                                   (Comment 1) One comment suggested                    based. The discussion in the proposed                  status in infants fed formulas containing
                                                we decrease the minimum level of                        rule considered the levels of selenium                 1.9 mg selenium/100 kcal or 3.1 mg
                                                selenium to 1.6 mg/100 kcal. The                        in human milk from the studies used to                 selenium/100 kcal, this dose-related
                                                comment pointed to analytical                           establish the adequate intake (AI) for                 increase in urinary selenium suggests
                                                variability that can occur between                      selenium by the IOM and the levels of                  that infants fed the formula containing
                                                laboratories when testing the levels of                 selenium in infant formulas fed in the                 a level of 1.9 mg selenium/100 kcal
                                                selenium. According to the comment,                     randomized and double-blinded dose-                    received sufficient selenium to meet
                                                due to this analytical variability, a                   response study in infants by Daniels et                their nutritional needs. Much of the
                                                minimum selenium level of 1.6 mg/100                    al. (2008).                                            selenium intake above the level of 1.9 mg
                                                kcal will likely result in manufacturers’                  Specifically, as discussed in the                   selenium/100 kcal was apparently
                                                formulating to deliver selenium levels                  proposed rule (78 FR 22442 at 22444),                  eliminated from the body through the
                                                close to 2.0 mg/100 kcal to ensure                      the IOM established an AI for selenium                 body’s homeostatic mechanisms.
                                                products do not fall below the                          of 15.0 mg/day (approximately 2.1 mg/kg                   As effects on indicators of selenium
                                                minimum.                                                body weight/day) for infants 0 to 6                    status have not been evaluated in
                                                   (Response 1) We decline to lower the                 months of age based on the average                     infants fed formulas with concentrations
                                                minimum level of selenium in infant                     concentration of selenium in human                     of selenium between 0.9 mg selenium/
                                                formula to 1.6 mg/100 kcal to                           milk from healthy women from 2 to 6                    100 kcal and 1.9 mg selenium/100 kcal,
                                                accommodate analytical variability that                 months of lactation as reported in four                there are no data to support lowering
                                                can occur between laboratories as the                   studies. The study by Daniels et al. was               the minimum level of selenium in infant
                                                comment suggested. The level of any                     published after the IOM established the                formula from 2.0 mg/100 kcal to 1.6 mg/
                                                substance (including nutrients, food                    AI for selenium for infants 0 to 6                     100 kcal. The scientific evidence
                                                additives, or contaminants) established                 months of age, and the concentration of                discussed previously and in section
                                                for regulatory purposes must be a value                 selenium in human milk reported in                     III.A. of the proposed rule (78 FR 22442
                                                that is based on and true to the available              that study was not among the studies                   at 22443) continues to justify 2.0 mg
                                                scientific evidence. We recognize that                  considered in the establishment of the                 selenium/100 kcal as the minimum
                                                analytical variability is always present                AI. We note that the mean concentration                level for selenium in infant formulas.
                                                and manage this matter under our                        of selenium in human milk in the                          (Comment 3) In support of a lower
                                                compliance program. We also note that                   studies included by the IOM in setting                 minimum level for selenium in infant
                                                lowering the minimum level of                           the AI for infants 0 to 6 months of age                formula, one comment pointed out that
                                                selenium would not change the                           was 18 mg/L and that reported by                       the Codex Alimentarius infant formula
                                                analytical variability, and the tested                  Daniels et al. was 10.7 mg/L.                          standard and the European Union
                                                level of selenium might fall below                         The study by Daniels et al. provides                Directive on Infant Formulae and
                                                whatever minimum level is set, due to                   direct evidence of the effect of selenium              Follow-On Formulae recommend a
                                                analytical variability. For example, if                 concentration of infant formula on the                 minimum level of selenium in infant
                                                the minimum level was lowered to 1.6                    circulating biochemical indicators of                  formula of 1.0 mg selenium/100 kcal.
                                                mg/100 kcal, the tested level of selenium               selenium status in infants. As described                  (Response 3) The level of 1.0 mg/100
                                                might fall below 1.6 mg/100 kcal due to                 in the proposed rule (78 FR 22442 at                   kcal as the minimum level for selenium
                                                analytical variability. However, on our                 22444), this study included a control                  in infant formula was adopted by the
                                                own initiative we have revised proposed                 formula that contained 0.9 mg selenium/                Codex Alimentarius in 2007 for its
                                                § 107.100(a) to insert the word ‘‘level’’               100 kcal (considered by the                            Standard for Infant Formula and
                                                between the words ‘‘minimum’’ and                       investigators to be a low-selenium                     Formulas for Special Medical Purposes
                                                ‘‘specified’’ in light of an inadvertent                formula) and two test formulas that                    Intended for Infants (Codex Stan 72–
                                                omission in the proposed rule.                          contained 1.9 mg selenium/100 kcal or                  1981) (Ref. 6) based on recommendation
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                                                   (Comment 2) One comment said that                    3.1 mg selenium/100 kcal. The level of                 of this level by an International Expert
                                                the minimum level of selenium should                    selenium in the formula containing 1.9                 Group (IEG) of the ESPGHAN (Ref. 4).
                                                be in the range reported in breast milk                 mg/100 kcal was somewhat higher than                   The IEG recommended 1.0 mg selenium/
                                                and specifically recommended the level                  the level in human milk reported in the                100 kcal for infant formula based on the
                                                of 1.6 mg selenium/100 kcal, consistent                 Daniels et al. study and close to the AI               median selenium content of human
                                                with the mean concentration of                          set by the IOM. In our consideration of                milk and an established history of
                                                selenium in breast milk reported by                     the study by Daniels et al., we regarded               apparent safe use. However, as


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                                                                   Federal Register / Vol. 80, No. 120 / Tuesday, June 23, 2015 / Rules and Regulations                                         35837

                                                described in the proposed rule (78 FR                   Special Medical Purposes Intended for                  selenium/100 kcal. Other comments
                                                22442 at 22444), no information was                     Infants (Codex Stan 72–1981). The level                indicated that any formula changes
                                                provided regarding the details of how                   of 9.0 mg selenium/100 kcal was also                   could be made in a cost effective and
                                                such information was used in making                     listed in the European Union Directive                 timely manner with an effective date 12
                                                the recommendation for 1.0 mg                           on Infant Formulae and Follow-on                       months after publication of the final
                                                selenium/100 kcal in infant formula. In                 Formulae. We considered the level of                   rule (see comment 7).
                                                addition, the recommendation of the                     9.0 mg selenium/100 kcal; however, we                    If some manufacturers who currently
                                                IEG was made in 2005 before the dose-                   could not determine the scientific basis               meet the 8.0 mg selenium/100 kcal level
                                                response study of Daniels et al. was                    for this level.                                        need to reformulate their products to
                                                published in 2008, and data from that                      Although we expressly invited                       avoid exceeding a selenium level of 7.0
                                                study suggest that a level of 1.9 mg                    comment regarding the proposed                         mg/100 kcal, such a reformulation would
                                                selenium/100 kcal in infant formula                     maximum level in infant formula of 7.0                 involve only a small reduction in the
                                                meets infants’ selenium needs. Further,                 mg selenium/100 kcal, including                        amount of selenium added to the
                                                although, as noted in the comment, the                  whether such a maximum level is                        formula. Manufacturers routinely make
                                                level of 1.0 mg/100 kcal was also                       needed and the scientific data or                      such small changes in the rates of
                                                adopted as the minimum level for                        information that form the basis of any                 addition of ingredients (which may or
                                                selenium by the European Union in                       comments (78 FR 22442 at 22445), we                    may not result in the need for label
                                                2006 for its Directive on Infant                        did not receive any comments that                      changes) as a fundamental part of their
                                                Formulae and Follow-On Formulae                         disagreed with the need for a maximum                  current good manufacturing practices
                                                (Commission Directive 2006/141/EC),                     level or that provided a scientific basis              and quality control programs to ensure
                                                identification of a scientific basis for the            that would support a change from the                   the consistent production of infant
                                                selection of 1.0 mg selenium/100 kcal                   proposed level. The report of the IOM,                 formulas of high quality. These types of
                                                was not included in the European                        which we relied upon to propose the                    changes are generally not considered to
                                                Union Commission Directive.                             maximum level of 7.0 mg selenium/100                   be major changes and are reported to
                                                   (Comment 4) One comment suggested                    kcal, identified the data (concentration               FDA in a ‘‘before first processing’’
                                                raising the maximum level of selenium                   of selenium in human milk not                          submission by the manufacturers if the
                                                added to infant formula to 9.0 mg/100                   associated with known adverse effects)                 change may adulterate the product, as
                                                kcal. The comment said that the 9.0 mg                  and the method of calculation used to                  required by section 412(d)(3) of the
                                                selenium/100 kcal would align the                       estimate a Tolerable Upper Intake Level                FD&C Act and our regulations in 21 CFR
                                                maximum level of selenium with the                      (UL) of 7.0 mg/kg body weight/day for                  106.140.
                                                upper levels recommended in the Codex                   selenium intake of infants from 0 to 6
                                                                                                                                                               C. Allowance for Analytical Variability
                                                Alimentarius Standard for Infant                        months of age. (As explained in the
                                                Formula and Formulas for Special                        proposed rule (78 FR 22442 at 22444),                     (Comment 6) One comment suggested
                                                Medical Purposes Intended for Infants,                  a level of intake expressed as mg/kg body              that, in the absence of setting a higher
                                                and with the European Union Directive                   weight/day is consistent with an infant                maximum selenium level, FDA would
                                                on Infant Formulae and Follow-on                        formula concentration expressed in mg/                 need to establish a specific allowance
                                                Formulae. The comment also stated that                  100 kcal.)                                             for method bias to ensure that
                                                9.0 mg selenium/100 kcal is more                           With regard to the use of 8.0 mg/100                manufacturers can meet both the
                                                aligned with the use of 8.0 mg/100 kcal                 kcal as a maximum in our CPGM, this                    minimum and maximum selenium
                                                as the maximum value for selenium in                    level was incorporated into the CPGM                   levels. The comment suggested an
                                                the FDA Compliance Program Guidance                     when infant formula manufacturers in                   allowance of 30 percent to account for
                                                Manual (CPGM).                                          the United States began adding                         analytical variability.
                                                   (Response 4) We decline to increase                  selenium to infant formulas starting as                   (Response 6) As noted in the response
                                                the maximum level of selenium in                        early as 1990 and preceded the                         to comment 4, the maximum level of
                                                infant formula to 9.0 mg selenium/100                   establishment of the UL for infants 0 to               any substance must be a value that is
                                                kcal as the comment suggested. As                       6 months of age by the IOM. We will                    based on and true to the available
                                                noted in the response to comment 1                      update the minimum and maximum                         scientific evidence. For this reason, we
                                                concerning the minimum level of                         values for selenium in infant formula in               are not setting a higher maximum value
                                                selenium in infant formula, the                         our CPGM to align with the final rule.                 that would include an allowance for
                                                maximum level of any substance                             (Comment 5) One comment said that                   analytical variability or method bias. We
                                                (including nutrients, food additives, or                setting 7.0 mg selenium/100 kcal as the                are not aware of method bias (consistent
                                                contaminants) established for regulatory                maximum level of selenium, which is                    over- or under-measurement of the
                                                purposes must also be a value that is                   the amount we proposed, would mean                     actual concentration) in the analysis of
                                                based on and true to the available                      some manufacturers would need to                       selenium in infant formula. We
                                                scientific evidence.                                    reformulate their products that currently              acknowledge that analytical variability
                                                   The level of 9.0 mg selenium/100 kcal                meet the 8.0 mg selenium/100 kcal level                occurs between laboratories when
                                                suggested in the comment is the                         that is listed in the FDA CPGM.                        testing the levels of nutrients in infant
                                                maximum level recommended by the                           (Response 5) Although the comment                   formula, and we manage this matter
                                                ESPGHAN IEG for infant formula. The                     said that some manufacturers whose                     under our compliance program as
                                                report of the IEG stated that its                       products currently meet the 8.0 mg                     necessary. Further, we decline to set a
                                                recommendation was based on a history                   selenium/100 kcal level listed in the                  30 percent allowance for analytical
                                                of safe use (not further described) and                 FDA CPGM would need to reformulate,                    variation for the chemical analysis of
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                                                did not identify scientific data or other               it did not specify how many                            selenium in infant formula. The
                                                information relied upon for its                         manufacturers or products would likely                 comment did not provide a reason for
                                                recommendation for a maximum level                      be affected or whether label changes                   setting such a high allowance for
                                                of 9.0 mg selenium/100 kcal that was                    would be required following any                        analytical variation, and 30 percent
                                                subsequently adopted by Codex                           reformulations. It also did not provide                variability is much higher than
                                                Alimentarius in 2007 for its Standard                   estimates of possible costs resulting                  performance requirements for
                                                for Infant Formula and Formulas for                     from establishing a maximum of 7.0 mg                  commonly used methods for chemical


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                                                35838              Federal Register / Vol. 80, No. 120 / Tuesday, June 23, 2015 / Rules and Regulations

                                                analysis of minerals in infant formula,                 information that indicates that any                    almost exclusively in children) (see 78
                                                which typically is about 10 to 15                       specific source of selenium should be                  FR 22442 at 22443).
                                                percent.                                                used in infant formula. Our recently
                                                                                                                                                               III. What is the environmental impact
                                                                                                        published current good manufacturing
                                                D. Effective Date                                                                                              of this final rule?
                                                                                                        practices for infant formulas require that
                                                   In the Regulatory Impact Analysis of                 ingredients used in infant formulas be                   FDA has determined under 21 CFR
                                                the proposed rule, we analyzed three                    safe and suitable for use in infant                    25.32(n) that this action is of a type that
                                                options with respect to an effective date:              formula. Specifically, under § 106.40(a),              does not individually or cumulatively
                                                (1) Take no new regulatory action                       the only substances that may be used in                have a significant effect on the human
                                                (baseline); (2) require the provisions of               an infant formula are substances that are              environment. Therefore, neither an
                                                this proposed rule and make the                         safe and suitable for use in infant                    environmental assessment nor an
                                                provisions of the rule effective 180 days               formula under the applicable food safety               environmental impact statement is
                                                after publication; and (3) require the                  provisions of the FD&C Act; that is, a                 required.
                                                provisions of this proposed rule, but                   substance is used in accordance with
                                                make the provisions of the rule effective               the Agency’s food additive regulations,                IV. Federalism
                                                12 months after publication (78 FR                      is generally recognized as safe for such                 FDA has analyzed this final rule in
                                                22442 at 22446).                                        use, or is authorized by a prior sanction.             accordance with the principles set forth
                                                   (Comment 7) Two comments                                (Comment 9) One comment agreed                      in Executive Order 13132. We have
                                                supported FDA’s option 3 in the                         with the proposed selenium levels                      determined that the rule does not
                                                proposed rule to make the final rule                    ‘‘unless a pediatrician otherwise                      contain policies that have substantial
                                                effective 12 months after publication to                recommends an alternative dosage                       direct effects on the States, on the
                                                allow for cost effective and timely                     because of a peculiar deficiency of                    relationship between the National
                                                changes with no anticipated impact on                   selenium.’’ The comment did not                        Government and the States, or on the
                                                infant health. One comment explained                    explain the circumstances under which                  distribution of power and
                                                that because there have been no reports                 a pediatrician would recommend an                      responsibilities among the various
                                                of full-term, breast-fed infants in the                 ‘‘alternative dosage.’’                                levels of government. Accordingly, we
                                                United States with evidence of selenium                    (Response 9) The final rule adds
                                                                                                                                                               have concluded that the rule does not
                                                deficiency, there would be no                           selenium to the list of required nutrients
                                                                                                                                                               contain policies that have federalism
                                                anticipated impact to infant health due                 in infant formula and establishes
                                                                                                                                                               implications as defined in the Executive
                                                to a 6-month delay in the rule’s effective              minimum and maximum levels of
                                                                                                                                                               order and, consequently, a federalism
                                                date (from 6 months in option 2 to 12                   selenium in infant formula.
                                                                                                                                                               summary impact statement is not
                                                months in option 3 of the Regulatory                    Manufacturers will be required to add
                                                                                                                                                               required.
                                                Impact Analysis of the proposed rule).                  selenium to infant formula within the
                                                   (Response 7) The final rule will be                  established bounds as of the effective                 V. Executive Order 12866 and
                                                effective 12 months after publication of                date of this rule. The rule does not                   Executive Order 13563: Cost Benefit
                                                this document (see DATES). This will                    apply to what physicians may do within                 Analysis
                                                allow the industry to make any needed                   the practice of medicine. Thus, matters
                                                                                                        pertaining to the practice of pediatric                   On April 16, 2013, we proposed to
                                                reformulations and label changes to
                                                                                                        medicine are outside the scope of this                 amend our regulations on nutrient
                                                their infant formula products in the 12-
                                                                                                        rulemaking.                                            specifications and labeling for infant
                                                month period that the comment
                                                                                                           (Comment 10) Another comment                        formula to add the mineral selenium to
                                                identified as cost effective and timely
                                                                                                        suggested that FDA consider                            the list of required nutrients and to
                                                for needed changes.
                                                                                                        establishing a higher maximum for                      establish minimum and maximum
                                                E. Miscellaneous Comments                               vitamin D based on recent American                     levels of selenium in infant formula (78
                                                  Several comments addressed matters                    Academy of Pediatrics and IOM                          FR 22442). The Economic Impact
                                                that were not specific to a particular                  recommendations.                                       Analysis in the proposed rule explained
                                                provision in the proposed rule and/or                      (Response 10) The final rule adds                   the economic impact of the changes to
                                                that were not covered by the rule. We                   selenium to the list of required nutrients             regulations at part 107. We did not
                                                summarize and address those comments                    in infant formula and establishes                      receive any comments on the economic
                                                here.                                                   minimum and maximum levels of                          analysis of the proposed rule.
                                                  (Comment 8) One comment suggested                     selenium in infant formula. With                          FDA has examined the impacts of this
                                                that FDA recommend or encourage the                     respect to vitamin D and infant formula,               final rule under Executive Order 12866,
                                                use of the organic form of selenium,                    we may, as resources permit, reevaluate                Executive Order 13563, the Regulatory
                                                selenomethionine, rather than the                       all the minimum and maximum                            Flexibility Act (5 U.S.C. 601–612), and
                                                inorganic forms, sodium selenite or                     required nutrient levels for infant                    the Unfunded Mandates Reform Act of
                                                sodium selenate. The comment                            formula in separate rulemakings.                       1995 (Pub. L. 104–4). Executive Orders
                                                explained that selenomethionine is the                     (Comment 11) One comment                            12866 and 13563 direct Agencies to
                                                selenium compound incorporated into                     supported the proposal to require the                  assess all costs and benefits of available
                                                body proteins and is available in dietary               addition of selenium in infant formula.                regulatory alternatives and, when
                                                supplements or from brewer’s yeast.                     The comment stated that a child that                   regulation is necessary, to select
                                                  (Response 8) FDA’s specifications for                 does not receive enough selenium in the                regulatory approaches that maximize
                                                infant formula composition in § 107.100                 diet is at risk of developing Keshan                   net benefits (including potential
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                                                identify nutrients that must be included                disease.                                               economic, environmental, public health
                                                in the formula. The regulations do not                     (Response 11) FDA agrees that Keshan                and safety, and other advantages;
                                                specify ingredients that can serve as                   disease is linked to selenium deficiency.              distributive impacts; and equity). FDA
                                                sources of the nutrients, except for                    The preamble to the proposed rule                      has developed a regulatory impact
                                                vitamin K in § 107.100(c). We decline to                discussed the known biological                         analysis that presents the benefits and
                                                specify the form of selenium in infant                  functions of selenium and Keshan                       costs of this proposed rule (Ref. 7). We
                                                formula because we do not have                          disease (a cardiomyopathy that occurs                  believe that the final rule will not be a


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                                                                    Federal Register / Vol. 80, No. 120 / Tuesday, June 23, 2015 / Rules and Regulations                                             35839

                                                significant regulatory action as defined                   Description of Respondents: The                      information collection associated with
                                                by Executive Order 12866.                                respondents to this information                        the present version of § 107.10(a)(2) by
                                                VI. Paperwork Reduction Act of 1995                      collection are manufacturers of infant                 adding 23 hours to the burden
                                                                                                         formula marketed in the United States.                 associated with the collection. A
                                                  This final rule contains information                                                                          manufacturer not in compliance with
                                                collection provisions that are subject to                  Description: The final rule revises
                                                                                                         § 107.10(a)(2) to require that selenium                the new minimum and maximum levels
                                                review by the Office of Management and                                                                          for selenium in infant formula would be
                                                Budget (OMB) under the Paperwork                         be listed in the nutrient list on the label
                                                                                                         for all infant formulas. In particular, in             required to make a one-time change to
                                                Reduction Act of 1995 (PRA) (44 U.S.C.                                                                          the nutrient list information disclosed to
                                                3501–3520). The title, description, and                  the nutrient list, selenium must be listed
                                                                                                         between iodine and sodium and the                      consumers on the label of its infant
                                                respondent description of the                                                                                   formula, to account for the required
                                                information collection provisions are                    amount per 100 calories declared; and
                                                                                                         because selenium is a required                         change in the amount of selenium in its
                                                shown in the following paragraphs with                                                                          products. The nutrient information
                                                an estimate of the annual third-party                    ingredient in infant formula, selenium is
                                                                                                         required to be declared in the formula’s               disclosed by manufacturers on the
                                                disclosure burden. Included in the
                                                                                                         ingredient statement by its common or                  infant formula label is necessary to
                                                estimate is the time for reviewing
                                                                                                         usual name and positioned according to                 inform purchasers of the value of the
                                                instructions, searching existing data
                                                                                                         the descending order of its                            infant formula. As discussed previously
                                                sources, gathering and maintaining the
                                                                                                         predominance in the formula, under                     in this document, FDA has the authority
                                                data needed, and completing and
                                                reviewing each collection of                             § 101.4 (21 CFR 101.4). The present                    to revise the statement of the amounts
                                                information.                                             version of § 107.10(a)(2) is approved by               of nutrients required for infant formula
                                                  Title: Third-Party Disclosure                          OMB in accordance with the PRA and                     labeling in § 107.10(a)(2).
                                                Requirements for Selenium in Infant                      has been assigned OMB control number                     FDA estimates the burden of this
                                                Formula                                                  0910–0256. This final rule modifies the                collection of information as follows:

                                                                                       TABLE 1—ESTIMATED ANNUAL THIRD-PARTY DISCLOSURE BURDEN 1
                                                                                                                    Number of
                                                                                                 Number of          disclosures         Total annual      Average burden                        Total capital
                                                             21 CFR section                                                                                                      Total hours
                                                                                                respondents             per             disclosures        per disclosure                           cost
                                                                                                                    respondent

                                                § 107.10(a)(2)—Nutrient labeling for                           1                46                  46   0.5 (30 minutes)                  23       $792,439
                                                   infant formula.
                                                   1 There   are no operating and maintenance costs associated with this collection of information.


                                                  FDA concludes that there will be no                    relabeling. The one-time third-party                   VII. Objections
                                                additional burden associated with the                    disclosure burden is estimated in table
                                                requirement to disclose selenium in the                                                                            This rule is effective as shown in the
                                                                                                         1 of this document.
                                                ingredient statement as required under                                                                          DATES    section, except as to any
                                                                                                            The final column of table 1 gives the               provisions that may be stayed by the
                                                § 101.4 because all infant formula                       estimated capital cost associated with
                                                manufacturers currently add selenium                                                                            filing of proper objections. If you will be
                                                                                                         relabeling. This is the cost of designing              adversely affected by one or more
                                                as an ingredient to their infant formula
                                                                                                         a revised label and incorporating it into              provisions of this regulation, you may
                                                products that are sold in the United
                                                States, and all manufacturers currently                  the manufacturing process. The cost                    file with the Division of Dockets
                                                disclose selenium in the ingredient                      stated in table 1, $792,439, is estimated              Management (see ADDRESSES) either
                                                statement, as specified by § 101.4.                      based on an effective date of 1 year after             electronic or written objections. You
                                                Additionally, all manufacturers                          publication. These costs are based on                  must number each objection separately,
                                                currently disclose selenium in the                       the cost model estimate that, over a                   and, within each numbered objection,
                                                nutrient list, as required by                            longer period of time, any labeling                    you must specify with particularity the
                                                § 107.10(b)(5). Under § 107.10(a)(2),                    change is more likely to be coordinated                provision(s) to which you object, and
                                                only one manufacturer would need to                      with a change in a label that may                      the grounds for your objection. Within
                                                make a one-time labeling change to                       already be scheduled, and will diminish                each numbered objection, you must
                                                modify the amount of selenium shown                      the need to, for example, purchase and                 specifically state whether you are
                                                in the nutrient list on the labels of its                apply stickers to packages affected by                 requesting a hearing on the particular
                                                infant formula.                                          the change.                                            provision that you specify in that
                                                  The third-party disclosure burden                                                                             numbered objection. If you do not
                                                                                                            The information collection provisions               request a hearing for any particular
                                                consists of the setup time required to
                                                                                                         in this final rule have been submitted to              objection, we will consider the absence
                                                design a revised label and incorporate it
                                                                                                         OMB for review as required by section                  of such a request as waiving the right to
                                                into the manufacturing process. Based
                                                                                                         3507(d) of the PRA. The requirements                   a hearing on that objection. If you
                                                upon our knowledge of food and dietary
                                                supplement labeling, we estimate that                    were approved and assigned OMB                         request a hearing, your objection should
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                                                the affected manufacturer would require                  control number 0910–0256. This                         include a detailed description and
                                                less than 0.5 hour per product to modify                 approval expires on 04/30/2018.                        analysis of the specific factual
                                                the label’s nutrient list to reflect the                    An Agency may not conduct or                        information you intend to present in
                                                addition of more selenium to the                         sponsor, and a person is not required to               support of the objection in the event
                                                product. We estimate that this                           respond to, a collection of information                that a hearing is held.
                                                manufacturer produces 46 separate                        unless it displays a currently valid OMB                  It is only necessary to send one set of
                                                infant formulas that would require                       control number.                                        documents. Identify documents with the


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                                                35840                       Federal Register / Vol. 80, No. 120 / Tuesday, June 23, 2015 / Rules and Regulations

                                                docket number found in brackets in the                                        Academies Press, pp. 21–33; 292–299; 315–                                     ReportsManualsForms/Reports/
                                                heading of this document. Any                                                 316, 2000.                                                                    EconomicAnalyses/.
                                                objections received in response to the                                           3. Raiten, D. J., J. M. Talbot, and J. H.
                                                                                                                              Waters, ‘‘Assessment of Nutrient                                              List of Subjects in 21 CFR Part 107
                                                regulation may be seen in the Division
                                                                                                                              Requirements for Infant Formulas,’’ Journal                                     Food labeling, Infants and children,
                                                of Dockets Management between 9 a.m.                                          of Nutrition, 128:2059S–2249S, 1998.
                                                and 4 p.m., Monday through Friday, and                                                                                                                      Nutrition, Reporting and recordkeeping
                                                                                                                                 4. Koletzko, B., S. Baker, G. Cleghorn, U.F.                               requirements, Signs and symbols.
                                                will be posted to the docket at http://                                       Neto, et al., ‘‘Global Standard for the
                                                www.regulations.gov. We will publish                                                                                                                          For the reasons discussed in the
                                                                                                                              Composition of Infant Formula.
                                                notice of the objections that we have                                         Recommendations of an ESPGHAN                                                 preamble, under the Federal Food, Drug,
                                                received or lack thereof in the Federal                                       Coordinated International Expert Group,’’                                     and Cosmetic Act, and under authority
                                                Register.                                                                     Journal of Pediatric Gastroenterology and                                     delegated to the Commissioner of Food
                                                                                                                              Nutrition, 41:584–599, 2005.                                                  and Drugs, the Food and Drug
                                                VIII. References                                                                 5. Daniels, L., R. A. Gibson, K. Simmer, P.                                Administration amends 21 CFR part 107
                                                                                                                              Van Dael, and M. Makrides, ‘‘Selenium                                         as follows:
                                                  The following references have been                                          Status of Term Infants Fed Selenium-
                                                placed on display in the Division of                                          Supplemented Formula in a Randomized                                          PART 107—INFANT FORMULA
                                                Dockets Management (see ADDRESSES)                                            Dose-Response Trial,’’ American Journal of
                                                and may be seen by interested persons                                         Clinical Nutrition, 88:70–76, 2008.                                           ■ 1. The authority citation for 21 CFR
                                                between 9 a.m. and 4 p.m., Monday                                                6. Codex Alimentarius Commission,                                          part 107 continues to read as follows:
                                                through Friday, and are available                                             ‘‘Standard for Infant Formula and Formulas
                                                                                                                              for Special Medical Purposes Intended for                                         Authority: 21 U.S.C. 321, 343, 350a, 371.
                                                electronically at http://
                                                www.regulations.gov.                                                          Infants, Codex Stan 72–1981,’’ 1981. Revised                                  ■ 2. In § 107.10, revise paragraph (a)(2)
                                                                                                                              2007.
                                                  1. Food and Nutrition Board, National                                                                                                                     to read as follows:
                                                                                                                                 7. FDA/Center for Food Safety and Applied
                                                Research Council, ‘‘Recommended Dietary                                       Nutrition, ‘‘Infant Formula: The Addition of                                  § 107.10         Nutrient information.
                                                Allowances,’’ 10th ed., Washington, DC: The                                   Minimum and Maximum Levels of Selenium
                                                National Academies Press, p. 221, 1989.                                       to Infant Formula and Related Labeling                                          (a) * * *
                                                  2. Food and Nutrition Board, Institute of                                   Requirements, Final Regulatory Impact                                           (2) A statement of the amount,
                                                Medicine, ‘‘Dietary Reference Intakes for                                     Analysis and Regulatory Flexibility                                           supplied by 100 kilocalories, of each of
                                                Vitamin C, Vitamin E, Selenium, and                                           Analysis,’’ 2015. Available at: http://                                       the following nutrients and of any other
                                                Carotenoids,’’ Washington, DC: The National                                   www.fda.gov/AboutFDA/                                                         nutrient added by the manufacturer:



                                                                                                                             Nutrients                                                                                              Unit of measurement

                                                Protein ................................................................................................................................................................     Grams
                                                Fat ......................................................................................................................................................................   Do.
                                                Carbohydrate ......................................................................................................................................................          Do.
                                                Water ..................................................................................................................................................................     Do.
                                                Linoleic acid .......................................................................................................................................................        Milligrams

                                                                                                                                                           Vitamins

                                                Vitamin A ............................................................................................................................................................       International Units
                                                Vitamin D ............................................................................................................................................................       Do.
                                                Vitamin E ............................................................................................................................................................       Do.
                                                Vitamin K ............................................................................................................................................................       Micrograms
                                                Thiamine (Vitamin B1) ........................................................................................................................................               Do.
                                                Riboflavin (Vitamin B2) .......................................................................................................................................              Do.
                                                Vitamin B6 ..........................................................................................................................................................        Do.
                                                Vitamin B12 .........................................................................................................................................................        Do.
                                                Niacin .................................................................................................................................................................     Do.
                                                Folic acid (Folacin) .............................................................................................................................................           Do.
                                                Pantothenic acid .................................................................................................................................................           Do.
                                                Biotin ..................................................................................................................................................................    Do.
                                                Vitamin C (Ascorbic acid) ..................................................................................................................................                 Milligrams
                                                Choline ...............................................................................................................................................................      Do.
                                                Inositol ................................................................................................................................................................    Do.

                                                                                                                                                            Minerals

                                                Calcium ..............................................................................................................................................................       Milligrams
                                                Phosphorus ........................................................................................................................................................          Do.
                                                Magnesium .........................................................................................................................................................          Do.
                                                Iron .....................................................................................................................................................................   Do.
                                                Zinc .....................................................................................................................................................................   Do.
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                                                Manganese .........................................................................................................................................................          Micrograms
                                                Copper ................................................................................................................................................................      Do.
                                                Iodine ..................................................................................................................................................................    Do.
                                                Selenium ............................................................................................................................................................        Do.
                                                Sodium ...............................................................................................................................................................       Milligrams
                                                Potassium ...........................................................................................................................................................        Do.
                                                Chloride ..............................................................................................................................................................      Do.



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                                                                           Federal Register / Vol. 80, No. 120 / Tuesday, June 23, 2015 / Rules and Regulations                                                                                           35841

                                                *        *         *         *         *                                    § 107.100          Nutrient specifications.                                 specified for each 100 kilocalories of the
                                                                                                                              (a) An infant formula shall contain the                                   infant formula in the form prepared for
                                                ■ 3. In § 107.100, revise paragraph (a) to
                                                                                                                            following nutrients at a level not less                                     consumption as directed on the
                                                read as follows:                                                            than the minimum level specified and                                        container:
                                                                                                                            not more than the maximum level

                                                                                     Nutrients                                                                  Unit of measurement                                     Minimum level        Maximum level

                                                Protein ................................................................................      Grams .............................................................                    1.8                           4.5
                                                Fat ......................................................................................    Do. ..................................................................                 3.3                           6.0
                                                                                                                                              Percent calories ..............................................                          30                           54
                                                Linoleic acid ........................................................................        Milligrams ........................................................                    300    ............................
                                                                                                                                              Percent calories ..............................................                         2.7   ............................

                                                                                                                                                          Vitamins

                                                Vitamin A ............................................................................        International Units ...........................................                         250                         750
                                                Vitamin D ............................................................................        Do. ..................................................................                   40                         100
                                                Vitamin E ............................................................................        Do. ..................................................................                  0.7   ............................
                                                Vitamin K ............................................................................        Micrograms .....................................................                          4   ............................
                                                Thiamine (Vitamin B1) ........................................................                Do. ..................................................................                   40   ............................
                                                Riboflavin (Vitamin B2) .......................................................               Do. ..................................................................                   60   ............................
                                                Vitamin B6 ...........................................................................        Do. ..................................................................                   35   ............................
                                                Vitamin B12 .........................................................................         Do. ..................................................................                 0.15   ............................
                                                Niacin 1 ...............................................................................      Do. ..................................................................                 250    ............................
                                                Folic acid (Folacin) .............................................................            Do. ..................................................................                    4   ............................
                                                Pantothenic acid .................................................................            Do. ..................................................................                 300    ............................
                                                Biotin 2 ................................................................................     Do. ..................................................................                  1.5   ............................
                                                Vitamin C (Ascorbic acid) ...................................................                 Milligrams ........................................................                       8   ............................
                                                Choline 2 .............................................................................       Do. ..................................................................                    7   ............................
                                                Inositol 2 ..............................................................................     Do. ..................................................................                    4   ............................

                                                                                                                                                          Minerals

                                                Calcium ...............................................................................       Do. ..................................................................                   60   ............................
                                                Phosphorus ........................................................................           Do. ..................................................................                   30   ............................
                                                Magnesium .........................................................................           Do. ..................................................................                    6   ............................
                                                Iron .....................................................................................    Do. ..................................................................                 0.15                          3.0
                                                Zinc .....................................................................................    Do. ..................................................................                  0.5   ............................
                                                Manganese .........................................................................           Micrograms .....................................................                          5   ............................
                                                Copper ................................................................................       Do. ..................................................................                   60   ............................
                                                Iodine ..................................................................................     Do. ..................................................................                    5                           75
                                                Selenium .............................................................................        Do. ..................................................................                    2                             7
                                                Sodium ...............................................................................        Milligrams ........................................................                      20                           60
                                                Potassium ...........................................................................         Do. ..................................................................                   80                         200
                                                Chloride ..............................................................................       Do. ..................................................................                   55                         150
                                                    1 The    generic term ‘‘niacin’’ includes niacin (nicotinic acid) and niacinamide (nicotinamide).
                                                    2 Required   only for non-milk-based infant formulas.


                                                *        *         *         *         *                                    ACTION:          Final rule; correction.                                    in the Federal Register of Wednesday,
                                                  Dated: June 17, 2015.                                                                                                                                 June 3, 2015, the following corrections
                                                                                                                            SUMMARY:   The Food and Drug                                                are made:
                                                Leslie Kux,                                                                 Administration (FDA) is correcting a
                                                Associate Commissioner for Policy.                                          final rule entitled ‘‘Veterinary Feed                                       § 558.6        [Corrected]
                                                [FR Doc. 2015–15394 Filed 6–22–15; 8:45 am]                                 Directive’’ that appeared in the Federal
                                                BILLING CODE 4164–01–P                                                      Register of June 3, 2015 (80 FR 31708).                                     ■  1. On page 31734, in the second
                                                                                                                            The rule amended FDA’s animal drug                                          column, in § 558.6 Veterinary feed
                                                                                                                            regulations regarding veterinary feed                                       directive drugs, in paragraph (b)(5),
                                                DEPARTMENT OF HEALTH AND                                                    directive (VFD) drugs. The document                                         remove ‘‘(b)(2)(vi),’’ and add in its place
                                                HUMAN SERVICES                                                              published with typographical and                                            ‘‘(b)(3)(vi),’’.
                                                                                                                            formatting errors. This document                                            ■ 2. On page 31734, in the third column,
                                                Food and Drug Administration                                                corrects those errors.                                                      in § 558.6 Veterinary feed directive
                                                21 CFR Part 558                                                             DATES: Effective: October 1, 2015.                                          drugs, the introductory text of paragraph
                                                                                                                            FOR FURTHER INFORMATION CONTACT:                                            (c) ‘‘Responsibilities of any person who
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                                                [Docket No. FDA–2010–N–0155]                                                Sharon Benz, Center for Veterinary                                          distributes an animal feed containing a
                                                                                                                            Medicine (HFV–220), Food and Drug                                           VFD drug or a combination VFD drug:’’
                                                RIN 0910–AG95                                                               Administration, 7519 Standish Pl.,                                          is corrected as a paragraph heading to
                                                                                                                            Rockville, MD 20855, 240–402–5939,                                          read ‘‘Responsibilities of any person
                                                Veterinary Feed Directive; Correction                                       email: Sharon.Benz@fda.hhs.gov.                                             who distributes an animal feed
                                                AGENCY:        Food and Drug Administration,                                SUPPLEMENTARY INFORMATION: In FR Doc.                                       containing a VFD drug or a combination
                                                HHS.                                                                        2015–13393, appearing on page 31708                                         VFD drug.’’


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Document Created: 2018-02-22 11:15:01
Document Modified: 2018-02-22 11:15:01
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionRules and Regulations
ActionFinal rule.
DatesThis final rule is effective June 22, 2016. See section VII of this document for information on the filing of objections. Submit either electronic or written objections and requests for a hearing by July 23, 2015.
ContactLeila Beker, Center for Food Safety and Applied Nutrition (HFS-850), Food and Drug Administration, 5100 Paint Branch Pkwy., College Park, MD 20740, 240-402-1451.
FR Citation80 FR 35834 
CFR AssociatedFood Labeling; Infants and Children; Nutrition; Reporting and Recordkeeping Requirements and Signs and Symbols

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