Monday, August 13, 2007

Which infant formula is the best?

UPDATE 3 February 2010: In response to some of the comments on this post, I have produced a short online film with information which I hope is useful for understanding the differences between brands and I will be maintaining a page on the formulas on the UK market. See:

Now back to the original post....

There has been a lot of discussion about the advertising of infant formula following the Wyeth/SMA promotion with an article on Katie Price (Jordan) and Peter Andre in OK! Magazine. See:

I've seen a couple of comments suggesting that the ban on formula advertising and other measures called for by the Baby Feeding Law Group and Breastfeeding Manifesto coalition in the UK is wrong. Similar bans on company promotion have been called for in recent days in China and Australia.

The comments suggest that advertising is necessary for mothers to gain information on infant formula so they understand which is the best for their baby. Campaigners argue that this information should not come from companies, which profit from a mother's decision, but through independent information from health workers.

Mothers who choose to use formula, for whatever reason, want to know which formula is best, which is closest to breastmilk. The government line is all formulas have to comply with composition standards and so any cow's-milk-based formula that is on the market is suitable for use as a breastmilk substitute (soy formulas and goat's milk formulas are another matter, but more on those another time).

This perhaps does not meet the demand of mothers for information. I read someone describing having to select a brand of formula from a cupboard in the hospital, with nothing to go on from the health workers as to which was the best.

So I am going to attempt to answer the question by looking at the information available from companies, information that would be advertised freely if the present weak marketing restrictions were not in place.

At first sight it seems easy to say which infant formula is the closest to breastmilk. Just read the labels.

Click on the image for a larger version.

Here is the red rectangle at the top right a little larger:

So if you can believe what is on the label, Milupa Aptamil claims it is 'The closest to breastmilk', presumably because 'prebiotics support natural defences'. As this has been sold in the UK for years with this claim, you could be forgiven for assuming that Milupa's claim to be the closest must be true. If it wasn't then surely the authorities would have done something about it.

Well, belatedly they have told Milupa to remove both these claims. Last year the Food Standards Agency wrote to the companies saying that claims such as this are 'non-compliant' with the UK law. See:

If you look around you will see this label is disappearing from the shelves. The new label says: "Inspired by breastmilk" - which again is non-compliant with the regulations. The law is clear. Guidance notes issued to Trading Standards officers set it out. There are only 6 claims which are permitted on labels. Don't take my word. You can download the guidance notes to read for yourself - click here.

Okay, you may say. That is the problem with regulations. If Milupa Aptamil really is the 'closest to breastmilk' then why can't the company say it?

UPDATE 22 July 2009: Since this post, the Aptamil brand has been relaunched with a new ingredient, branded as IMMUNOFORTIS. The Aptamil brand has also been taken over by Danone. An advertisement for Aptamil follow-on formula claimed: "This unique formulation helps to support your baby's natural immune system, making it the best follow on milk." I asked the UK Advertising Standards Authority to investigate whether these claims were true. Although the ASA refuses to even investigate most cases, this time it do and found the claims are not true. The ASA found the company had broken the advertising code clauses on substantiation, truthfulness and comparisons. See:
Even without this ruling there was an immediate problems about the claim that Aptamil is the best formula (as the original posting continues....)

This is a recent image from the Cow & Gate website:

It is also about prebiotics, like the Milupa Aptamil 'closest to breastmilk' claim and shows Cow & Gate is ahead of 'normal infant formula' in the race to be closest to breastmilk.

Again, you may say, well if it is not true that Cow & Gate is closest to breastmilk, they wouldn't be able to say it. Here there is a problem. Baby Milk Action has reported promotions on websites to the authorities many times without any action being taken. This is because the internet falls into a regulatory black hole. The Infant Formula and Follow-on Formula Regulations were introduced in 1995 and the internet wasn't a big route of information then, so doesn't figure. The advertising industry's self-regulatory body, the Advertising Standards Authority (ASA), refuses to examine content on websites. The ASA says it is not advertising. People choose to visit a website, they argue, so it is editorial content and there is no requirement for it to be "legal, decent, honest and truthful" as with other forms of advertising. Most print and television advertisements direct people to a website for information, but still you get nowhere with the ASA.

So there are no grounds for trusting what is on a company website. You might think you will believe the company is being honest.

Well, Cow & Gate has made its claim about prebiotics in a printed advertisement. It claimed: "Our range of follow-on milks all contain a bunch of goodies called prebiotics to help build natural defences."

This was for a follow-on milk, for the simple reason that it is illegal for companies to advertise infant formula. If some of the critics of our campaign have their way, companies would be free to advertise infant formula with claims such as this.

As I said above, there is a requirement that print advertisements must be "legal, decent, honest and truthful" so the Advertising Standards Authority (ASA) did investigate this claim about the formula that 'prebiotics help build natural defences' after a request from a mother. They asked Cow & Gate to provide the scientific proof and they found that the claim was not substantiated. The ASA upheld the complaint and told Cow & Gate it could not repeat this claim in an advertisement and stated: "Because they had not sent evidence to show a direct link between an infant taking their formula and it helping to build defences against a number of everyday illnesses or conditions to which they were susceptible, we considered that Cow & Gate had not substantiated the claim."

This ruling does not prevent Cow & Gate making exactly the same claim on its website or in other materials. Only a revised law would do that.

Okay, so the claims about prebiotics don't stand up. The most the ASA will let them say is prebiotics support 'some' natural defences, though this is not a permitted claim for infant formula.

Could it still be possible that Cow & Gate formula really is the closest to breastmilk?

There is another problem.

Heinz/Farley's have distributed a flier to clinics with this graph:

It says on the top: "No. of Nutrients Closest to Breast Milk". Breastmilk is in the red. Farley's is next to it in brown and is clearly better on this graph than the SMA, Milupa and Cow & Gate. So, on the basis of its graph, Farley's claims its formula is the 'Best Formula'.

This was on a flier for health workers, because companies can promote infant formula to health workers. Again you might think they wouldn't be able to say this if it was not true. Strictly speaking that is correct, because information for health workers has to be scientific and factual. However the basis of the claims in such materials does not stand up to much scrutiny and because of the weak state of the current law it is difficult to persuade the authorities to take any action.

If, as some suggest, companies are allowed to advertise infant formula, we would probably see graphs like this appearing in advertisements in parenting magazine and, who knows, OK! Magazine.

Would it mean mothers are better informed? On the basis of the information so far, we have learned that Milupa claims to be the closest to breastmilk, so does Cow & Gate and so does Farley's.

Wyeth/SMA claimed it was 'closer to breastmilk' until the crackdown on illegal claims. Its new slogan is 'love the milk you give' and it claims its formula has a 'new improved protein balance'. So perhaps SMA is the closest to breastmilk?

Looking at what companies say about themselves we are none the wiser.

What about some of the other claims they make? Can that help us decide?

I've already discussed the 'prebiotics help support your baby's natural defences' claim, which the ASA ruled against. Most companies make similar claims.

They are all promoting added LCPs in their formulas. These are Long Chain Polyunsaturated Fatty Acids. For example, Wyeth/SMA formula stated before the crackdown: "Helps brain & eye development." That was 'non-compliant', as the official guidance note to Trading Standards officers states.

You may say that taking this information from labels is denying mothers valuable information. But how reliable is the information Wyeth/SMA put on its labels in breach of the law?

An independent review of the science found: "At present there is little evidence from randomised trials of LCPUFA supplementation to support the hypothesis that LCPUFA supplementation confers a benefit for visual or general development of term infants".

This is from a review by a respected academic institute called The Cochrane Library. Don't take my word for it. You can read it yourself. Find the links here:

Companies love using these claims to promote their products. They know it makes them more attractive to consumers. Even if an ingredient has no proven benefit they will add it to use it in their marketing campaigns, exploiting whatever loopholes in the law they can to put across their message.

This is what market analysts Hambrecht & Quist said about the company Martek, which supplies the LCPs for most of the formula in the world, with its product launched as Formulaid:

"The history of infant formula has shown that virtually all similar examples have led to wide-scale introduction of such additives into infant formula, even if there was no evidence that the additives were important. Infant formula is currently a commodity market with all products being almost identical and marketers competing intensely to differentiate their product. Even if Formulaid had no benefit we think that it would be widely incorporated into most formulas as a marketing tool and to allow companies to promote their formula as 'closest to human milk.'"

So which is the best infant formula? If you try to decide on the basis of what companies tell you, then you get nowhere. They are commercial organisations and aim to convince that their formula is the best.

The official line that there is nothing to choose between the brands comes from the requirement that they comply with compositional standards. See article 8 of:

The logic is that infants should have the best formula possible. So the regulations require all formulas to contain the ingredients that are proven to be necessary and to have a beneficial effect.

A few points to close. I haven't mentioned Hipp formulas above. I am really concerned about their labels. As I wrote recently, powdered infant formula is not a sterile product and so may contain bacteria, which may lead to infection. The good news is there are simple steps to deal with this. The World Health Organisation states: "preparation of Powdered Infant Formula with water at a temperature of no less than 70 °C dramatically reduces the risk." The bad news is that Hipp says on its labels: "Boil water and leave to stand until temperature reaches 50 - 60 Deg. C".

Companies are lax in providing information on the importance of breastfeeding and the difficulty of reversing a decision not to breastfeed and the financial and other costs of using formula. But this is not just about protecting breastfeeding, it is about making formula feeding safer. Companies are required by law to include information on the health hazards of inappropriate foods or feeding methods, and, in particular, the health hazards of improper use of an infant formula.

Other companies do not give the important information on temperature of the water for mixing up powdered infant formula or warn parents that powdered infant formula is not sterile. See:

Another point is there is increasing medicalisation of infant feeding. Companies roll out specialised formulas. The claims for these need close scrutiny. I will go into these another time. It seems to me these confuse health workers as much as they confuse parents. The information companies distribute is not limited to scientific and factual information. Worse than that, companies offer gifts to health workers to try to get them to promote their particular brand.

It seems to me the present situation is highly unsatisfactory. But I don't see that scrapping regulations on formula companies, as some are suggesting, will make it better .

What do you think? Contact me or leave comments here. If you are a mother or carer using formula I particularly want to hear from you.


rosierings said...

So what do the "breast is best" people recommend if you are physically unable to breast feed...such as a deceased mother.

Mike Brady said...

Everyone, including the formula companies, say 'breast is best'.

If breastmilk is not an option, then infant formula should be used.

In the UK the official government line is all formulas have to comply with composition requirements so none is recommended over any other.

But as you can see from the above and our 'safer formula' campaign, we do not think this is really sufficient and want there to be objective, independent information for parents and carers who use formula on the differences between the products on the market.

There is some information on the UK government's:
eatwell website on formula based on cow's milk, soya and other milks.

We list UK mother support groups on our website (see links section) who may be able to provide some information, but we work with the mother support groups and health professional organisations in the UK and they complain that even the so-called 'scientific and factual' information provided by the companies is generally not very useful. The Royal College of Midwives for one has raised this concern with the government and has produced its own independent guide to formulas on the market and breastmilk in the past.

Anonymous said...

I am late on this one, but great comment Mike. I work for WIC in FL as a nutritionist, and the contract formula here is ...ugh...Nestle....However after 10 months of working here, I have increased my skills as a BF educator, and have evenhad much success of latching babies on well, even at 2 months old!
What people understand that even though we promote breastfeeding, and not formula (no advertising of Formula or even a suggestion of which formula to use or which is better-even if asked), we are not here to make judgement calls or "force" anyone to do anything they don't want to...What we ARE here to do is to present the truth, that breastmilk is better and no formula is not equivalent, but it is a distant...very distant second. What we also promote is actual breastfeeding, not simply pumping and feeding, which is not we are with you....We have plenty of mothers who cannot breastfeed: HIV positive, adopted moms, or even a mom who had her breast removed due to cancer, so we don't bother them about breastfeeding since this population of moms can't really afford donated human milk, nor is a milk bank in this area anyway....But people have to realize we simply want people to not be fooled by these formula companies....Nestle included, nor will we or do we work for Nestle included....usually with education, we are able to get many moms wo do what they thought they were not even able to do!

Anonymous said...


I understand what babymilk action is trying to accomplish, but for me I do not want to breast feed. I have made my choice and if that makes me a bad parent so be it. The problem for me now is 'which formula milk is the best' now I've decided. Due to the blackout on information surronding bottle feeding, how does anyone find out?
I fear that if you got your way formula milk would be banned. Then where does that leave the mothers rights.

Mike Brady said...

In response to anonymous above, there are no grounds for suggesting that 'if you got your way formula milk would be banned'. There are plenty of countries that have introduced the World Health Assembly marketing requirements into legislation and formula and information is available for mothers who want it. The difference is that breastfeeding is not undermined (breastfeeding duration has increased from 3 months to 10 months in Brazil following its action for example) and the information on formula is accurate.

I don't see the UK situation as better. This entry shows how the information from companies cannot be trusted.

Anonymous said...

I breastfed as long as I could, until it was evident that my poor bab wasn't thriving. So I entered into the world you describe, of lack of reliable information. What particularly got my goat was that new regulations state that you must not make feeds up in advance because of risk of bacteria, etc. etc. So if you go out, the advice is to have a bottle of COOLED boiled water to which you add the powder....which of course is not sterile! Devil and the deep blue, much? Cartons are fine but not all the time.

Then when bab went to nursery, they will not make up feeds so you either have to go with cartons (expense) or making up in advance. I hate the whole thing, and to be honest the raging guilt you are made to feel if you are not breastfeeding. Although you can't win, of course - if you bf, then you still get disapproving stares. Having been in both camps, I know what it's like.

Anonymous said...

As a new parent I'm in this mire of confusion as well... Our little guy needs some supplementary milk in the evening (he's a hungry chap), and formula seems the way to go - expressing hasn't worked out - he eats all he can get straight from the tap as it were, leaving nothing to pump...

We've done the research and remain confused about which formula is best. And sadly this site has not helped me much. There is a lot of worthy whining about the evil milk producers putting profit before health, but no useful advice.

I am being exhorted to boycott Nestle; is that because, as an evil capitalist milk producer, their product is harmful to my child? Or not?

The complaint seems more that the baby formula producers are producing misleading advice designed to shift more product than to make our children more healthy.

So Milky Action People, the nasty capitalists are using fear, uncertainty and marketing to sell more product than we need. No great surprises here, given the same happens for more or less every product you can purchase...

We know that 'breast is best' and that formula can be necessary. So which one? Which formulas are unheathly, which ones have too much melamine, soo much salt? Are the HA formulas any better for children at all, or perhaps worse. Are all infant formulas a necessary evil and an acceptable second best to breastfeeding and there is actually little to choose between them?

So please get publishing the recommendations that people you have contact with are making. Then you will make a real difference. Help people make the best choices.

I was frustrated by the misleading advertising before I visited this site, now I'm no better informed and even more irritated by the absence of any information. Perhaps I didn't look hard enough, and it is there, in which case sorry...

Mike Brady said...

In response to Dave above:

Dave, I understand and share your frustration. The official UK Department of Health (DH) line is that there is nothing to choose between formulas as they all have to comply with composition regulations. And, as the links to references show, when you investigate the claims that companies make for their added ingredients, they are found not to be substantiated.

We cannot give health advice and so direct people to their health worker, but if they follow the DH line it doesn't provide any recommendation for one formula over another. If they are recommending a formula, then it is not because of health benefits (except in exceptional circumstances where a specialist formula has a medical indication). It is more likely they have been lobbied by company reps. Many health trusts try to filter this information so only that found to be scientific is passed on - so companies invite midwives to a meal instead outside office hours to gain influence.

On the basis of the DH position, it could be argued to go for the cheapest formula. On the other hand it could be argued as formulas have different ingredients and any positive/negative effects of these differences will only be known years down the line, if at all, then it may be best to rotate formulas.

Which adds no more clarity, I know.

We have a 'safer formula' campaign and would like to see objective, science-based analysis on the differences between formulas.

It would certainly be useful to have parents who are using formula involved in this so the information is in a useful form. Please contact me if you are interested.

Regarding the specific case you refer to of a 'hungry baby' I would suggest calling one of the mother support groups about this. There are numbers on the Baby Milk Action website at:

Anonymous said...

i agree with dave - forget the debate about breastfeeding or not breastfeeding, the decision has been taken to use formula. what i want to know is which brand of formula is best. no one can tell me. which in turn makes me believe that they all must be of the same quality and that in the end it doesnt matter what brand you use your baby will be fine. i too was looking for some advise on formula brands when visiting this site but all it seemed to contain was the push to continue to breast feed. not much help at all. and regardless if you breast feed or formula feed your baby will turn out just fine. my husband was formula fed from day one. i was breastfed. there is no physical or mental difference in how we have turned out. what is more important is the environment you are bought up in and the parents you have.

Anonymous said...

Further to Dave's comments about a hungry baby, I'm with you on this, I am currently breastfeeding and my son is now 4months, he has only ever put on the minimum amount of weight, I have a very slow flow so often he gets frustrated and when I express more often than not I can only express 1 to 2ozs. My son is still feeding every 2 to 3 hours probably because he is not getting enough and I'm absolutely exhausted. I wanted to supplement him with formula and used Mike Brady's link about hungry babies, which I was disappointed to see that it was just breast feeding support groups. They are not allowed to advise you to use formula but surely if a child is still hungry and you are clearly not producing enough milk, advice should be available for alternatives.

Mike Brady said...

In response to 'anonymous' on 3 April, the link to mother support groups includes groups such as the National Childbirth Trust that have information and articles in their newsletter for mothers who have decided to use formula.

It is indeed likely that independent experts will first try to assist a mother who is experiencing difficulty in breastfeeding in overcoming those difficulties, but I am not sure why that should be unwelcome.

We and others are investigating producing independent guides on the differences between formulas, but as the above article shows, the companies are dishonest in the information they provide, all claiming to be superior to their competitors. I know of one Primary Care Trust in the UK that invites company reps. to attend meetings to present their evidence regarding the claims they make. They are reluctant to do so. Instead reps. prefer to invite health workers to off site meetings with refreshments and gifts to tell them their products are superior.

We have pressed and continue to press health authorities to conduct the necessary research in this area, but so far they are reluctant to do so, and stick to the line that there is nothing to choose between formulas as they have to comply with composition standards.

Anonymous said...

Surely, as we live in a democracy, everyone is allowed to have a choice and that choice should be an informed one! Having spent the last two days talking to very frustrated midwives and health visitors who are desperate to be able to give mums who are bottle feeding for whatever reason an informed choice, I think that it is an absolute digrace that you should be demonising all companies that make formula milk. My challenge to you is to come up with an alternative product to breast milk and market it to everyone operating within the ridiculous guidelines in place!

Mike Brady said...

To the anonymous comment on 22 May above, firstly in countries such as Brazil companies are able to market breastmilk substitutes under far stricter marketing requirements than in the UK.

The standards adopted by the World Health Assembly do not prevent formula being sold, they are intended to protect breastfeeding and reduce the risks from formula feeding. That, in my view, is not ridiculous.

I would be interested to know what information it is that you refer to, which you would like to see distributed. As this blog shows with reference to independent studies, the claims made by formula companies are not accurate. How does it help anyone to have inaccurate information distribute?

Anonymous said...

Are you sure that you are not a politician as you seem to have answered my comment without answering any questions within it.
So tell me, if a mother cannot, for whatever reason, breastfeed, what should she feed her baby? Cows milk? Don't get me wrong, I know that breast is best and am thoroughly proud of my wife who has breast fed our son, but if she couldn't then he would have needed a substitute. Mums and Dads need to be able to make an informed choice. As for me asking for information to be distributed, I don't believe that I asked for that. What I believe is that Health Care Professionals should be allowed to advise mums and mums to be about formula milk and which one IS the best, based on hard facts.It is easy for you to sit and write your blog and make judgements, but why don't you get out into the poorer communities and talk to mums, midwives, health visitors etc, then you may understand the struggle that they have on a daily basis! Not everyone wants to be told what to do, most people want to have a choice and do what they consider to be best for them and their baby.
I do not believe that formula companies are misleading anyone with their marketing as it all has to be carried out within guidelines set down by the 'authorities' who do their very best to tell us how we should lead our lives.
The problem is, no-one is officially allowed to advise women who choose bottle over breast.

Mike Brady said...

In response to the anonymous post on 26 May:

You asked: "So tell me, if a mother cannot, for whatever reason, breastfeed, what should she feed her baby? Cows milk?"

As I said: "The standards adopted by the World Health Assembly do not prevent formula being sold."

As we say repeatedly, we are not calling for formula to be banned. Our campaign slogan is: "Protecting breastfeeding - Protecting babies fed on formula."

We work for appropriate marketing. That includes campaigning for improvements to composition and to a reduction in the price of formula: it is one of the products, if not the product, on the supermarket shelves with the biggest percentage markup on it. See our 'safer formula' campaign at: write: "What I believe is that Health Care Professionals should be allowed to advise mums and mums to be about formula milk and which one IS the best, based on hard facts."

I agree.

But look at what the companies are saying: they all claim to be the best. Those are not hard facts, they are marketing strategies, so why defend their right to mislead people?

You write: "Not everyone wants to be told what to do, most people want to have a choice and do what they consider to be best for them and their baby. "

To quote what we have said many times: "Baby Milk Action believes it is a mother's choice how she feeds her child and no-one should attempt to make her feel guilty over the decision she takes."

You write: "I do not believe that formula companies are misleading anyone with their marketing as it all has to be carried out within guidelines set down by the 'authorities' who do their very best to tell us how we should lead our lives."

Sorry, but you are wrong - read the above blog and see the evidence in the monitoring reports available at: can follow the link in the above blog to the ruling by the Advertising Standards Authority that found that claims about Cow & Gate formula were not true.

In the latest monitoring report (March 2009) you can read responses from Trading Standards officers who have either raised practices they believe to be illegal with the company concerned, with little impact, or have stated that practices are against their Guidance Notes, but the law isn't written in a way that enables them to take companies to court.

The last time a company was taken to court, the judge accused it of a 'cynical and deliberate breach of the regulations' and criticised it for stringing the case out over 8 days. Local authorities have to be brave if they are going to put public money into taking legal action, even when they know they have a strong case.

Anonymous said...

Of course they are marketing strategies, how else are they meant to sell their products? There are no blatant lies on the packaging and of course they will all say that they are the best!
Does this justify these companies being demonised by yourselves and all of these other do gooding action groups?
As I previously said, you tell me how you would market such a product.
Do you not think that the pressure that is being bought to bear on new mums to breast feed is also a little like a 'cynical marketing strategy'?
Are these companies really 'misleading' people? Or are they doi ng what they can to sell their products to people who need/want them? Considering that no-one these days is 'allowed' to educate mums to be about formula milk, I don't think that they have an awful lot of choice.
Isn't marketing all about pushing the boundaries to sell as much of your product as possible?

Mike Brady said...

To the anonymous post on 1 June.

You write: "Isn't marketing all about pushing the boundaries to sell as much of your product as possible?"

Well, that sums up the approach of the formula companies.

While you suggest that is acceptable. I take the view that companies should abide by the marketing requirements adopted by the World Health Assembly, the world's highest health policy setting body, which sets out what is and is not appropriate. 'Pushing the boundaries to sell more products' is not what they allow; they allow companies to put products on the market, with accurate information and warnings on labels and limit them to providing scientific and factual information to health workers who have responsibility for advising parents. As I have said, in some countries these requirements are in law and companies can comply when forced to do so. No child that requires formula is prevented from having it because of these regulations.

I agree there is a shortage of objective information. But I am sorry to have to state this once again, but companies do make untrue claims. I don't know why you put faith in regulations stopping them from doing so when every organisation that is expert on this issue is saying the regulations are failing to provide the necessary protection.

For example, allowing companies to claim their formula with LCPs aids 'brain and eye development' and builds intelligence - claims that the independent Cochrane Library says are not supported by the evidence (see links above) is surely not the a solution. But it seems we will have to agree to disagree on this point.

We receive many horror stories of mothers who were not helped with breastfeeding when they had difficulties or received awful comments from health workers telling them to give up and use formula and it is impossible to ignore this. Indeed, 9 out of 10 mothers who stopped breastfeeding in the UK before their child was 6 months old said they wanted to breastfeed for longer.

That is not to disregard those who felt lack of support when using formula - both these shortcomings are addressed by our work if you would only just take an objective look at it.

RG said...

My comment about marketing pushing the boundaries, was not a comment about formula milk marketing but marketing in general. Although it did bring out your true feelings about formula milk companies didn't it??
You know what...I think we will agree to disagree on all points. I have searched your site for support and information for those wishing to bottle feed and couldn't find an awful lot that helps.
Maybe, you should try to work with some formula milk companies to make things better? Or better still get a job as a marketeer and try and change things from the inside out.
The reason that I am defending formula milk is that I work for a company that supplies it to the market.
I know which product is the 'best' one but due to the laws, mums and dads don't.(not ours by the way)
I don't think that mums or dads are going to be influenced by any 'cartoon' animals. I think you will find that it is circumstance, recommendation and what friends use that are the biggest influencers to purchase.
There are many many more food stuffs out there aimed at kids that flout the laws and rules and pose a bigger risk to health than formula milk.
Try working with these companies rather than making them out to be the sons of satan and boycotting them. You might find more sympathy to your cause that way. Just a thought!

Mike Brady said...

In response to RG's comment of 1 June.

Thank you for indicating your connection to the formula industry. So I take you accept that companies are not telling the truth when they all claim their formula is the best (with reference to 'research' which does not stand up to scrutiny). You see no contradiction between the dishonest strategies used to increase sales and your suggestion that less regulation would somehow result in more objective information to parents?

Our assessment of company marketing strategies is based on the evidence. We do not demonise companies - we provide evidence of their practices, including the fact that they do indeed make untrue claims on labels and fail to provide information that would help parents to reduce the risks from possible intrinsic contamination of formula with bacteria (information that is available from independent sources and which we do highlight for the benefit of those who use formula).

Regarding working with companies, we report cases of violations of the Code as we are called on to do under Article 11.4 of the International Code of Marketing of Breastmilk Substitutes.

We have also worked with companies that have been open to changing practices to bring them into line with the Code and Resolutions. See, for example:

We also publicly welcomed Danone's statement that it would conduct a 'root and branch' review of NUMCO brand marketing when it bought this company and offered to meet with them to move this forward. We asked for a statement of commitment to complying with the World Health Assembly marketing requirements - we have to take these as the baseline, not invent something ourselves. This they have refused to do even though they are called on to abide by them independently of government measures. Indeed, marketing appears to have got worse since Danone's takeover. If they have thrown our approach back in our faces and stepped up aggressive marketing, principally to compete with Nestlé, should we let that be the end of it, or continue to campaign for changes? See:

Forgive me if I feel it is our campaign that is being demonised! Your portrayal of our work and approach is neither fair nor accurate.

RG said...

As I said, I think that it's best that we agree to disagree. At no point have I asked for less regulation.My point is that there should be more advice and support for those who choose to bottle feed rather than trying to force all mums to breastfeed. We all know that breast is best, but it is a choice at the end of the day!

Of course every company is going to say that their product is the best, although we do not.That is just sales and marketing surely!
There is one product on the market that is recognised by the industry and midwives to be the best and closest to breast milk.

As I said, I have looked hard through your site for support and advice for those that bottle feed and cannot find much that helps as other people have commented. Four other people have left comments here asking for help, guidance, advice and none has been forthcoming.

If you truly to aim to support bottle feeders as well as breast feeders then a balanced approach is called for??

Mike Brady said...

In response to RG on 4 June.

If you are saying that we should assume the role of producing materials for parents who use formula that is a valid request. However, we do not produce guidance materials for parents on breastfeeding, so it would be a departure to become a front-line health information service.

I would much prefer the information is available to all parents who need it, not just those who happen to visit our website.

We have been actively campaigning for years for better information for parents who use formula - and partly as a result of this materials have been produced by the Department of Health, though these fall short of giving guidance on specific formulas. Some of our partners in the Baby Feeding Law Group - which we convened - are mother support groups and have produced materials for parents.

In our submission to the government consultation on regulations for formula marketing, Protecting breastfeeding - Protecting babies fed on formula, the BFLG stated as a principal point: "Formula companies do not provide accurate information on differences between brands and essential information on how to reduce risks. Those who use formula need protection and independent information."

And: "the Government must provide objective information on infant feeding, avoiding conflicts of interest in funding infant feeding programmes." The full report is available at:

We'll do what we can and will try to do more, but surely independent, objective information should be available to all parents who require it? That means through the Department of Health.

In parallel with that, the misleading information from companies should be stopped. You may say: "That is just sales and marketing surely!" But we are not talking about chocolate bars. Infant formula is a nutritional medicine, which is why it should be marketed appropriately.

As for you saying you know which is 'the best' formula, it sounds to me like you have been taken in by someone's marketing department. The claims companies make about optional ingredients they add do not stand up to scrutiny.

However, from this I understand that you are continuing to market formula which is going to be the sole food for a child in the most critical phase of its development outside the womb while believing it is inferior. Is that something you tell parents I wonder?

Our position is that if any ingredient is essential for the health of infants then it should be a requirement for all formulas AND we actively campaign at Codex Alimentarius which sets the composition standards for formula to ensure this is the case (while also working for reduction in contaminants, such as pesticides and bacteria). Another aspect of our work in defense of babies fed on formula which is not appreciated.

RG said...

Formula milk is not a medicine, it is a food.
A nutritional replacement for breast milk.
Ours is by no means an 'inferior' product.
Stop trying to protect people and help to inform them by putting pressure on the government to make information and advice on formula milk more freely available.
I have not been taken in by anyone's marketing, but was simply pointing out that there is an industry 'best' out there that is recognised by HCP's. Does this mean that they are ill informed and have been taken in by marketing too?
I would think that they are very probably better informed than you are as they are in the front line dealing with mums who want to bottle feed.
The link to this page is 'Which infant formula is the best?'
Misleading? I think so.
Stop banging the drum about how you need to 'protect' babies from infant formula and do some research, find which one is the 'best' and publish your findings.
We are not harming babies with formula milk, in fact the exact opposite, babies live and grow thanks to the availbility of formula milk!

As I previously mentioned, there are many more products marketed for kids that manage to escape the rigid guidelines...maybe you should concentrate some of your efforts on these products that could actually do harm to kids due to their salt, sugar content??

Mike Brady said...

In response to RG's comment on 11 June:

I don't think this needs a response as the points have already been addressed.

Many thanks for your input. I am sure readers of this post will find the industry position illuminating.

Mike Brady said...

The Advertising Standards Authority has today ruled against the claim made by Danone/Milupa that Aptamil is the 'best follow-on formula'.

It also found that the company's claim about 'immunofortis' supporting the immune system is not substantiated by the evidence.


Anonymous said...

A lot of you are confused about why there is no conclusive evidence available as to which formula is best and how exactly it rates compared with breast milk.

Well the reason is very simple: In order to find such information, tests would need to be performed on hundreds or even thousands of babies over many years, and as we all know, such testing is unethical and not practised. We can only go by statistics gathered from mothers who often have used different formulas or breastfed for different amounts of time. Therefore it is not possible to know which formula is the best and it never will be. Formula companies can only assume that new ingredients in their formula MIGHT be absorbed by your baby's system and MIGHT have certain positive effects. All it takes is a few experts to come up with a credible theory supporting it. The newer the formula, the closer we are to being guinea pigs by buying it.

Mike Brady said...

In response to anonymous on 25 July.

To an extent you are right. However, studies are done where mothers do use formula with new ingredients in a trial. There are ethical complications with these, of course, and we have been critical of the way some of them have been designed. But as explained above, the Cochrane Library has reviewed studies on LCPs and found the evidence does not support the claim about adding them to formula improves brain and eye development.

A serious concern, which we raised in the UK law consultation (see our report 'Protecting breastfeeding - Protecting babies fed on formula') is that there is little in the way of controls on adding new ingredients to formula. In the UK law that was introduced, companies simply have to file a copy of the label they intend to use with the Food Standards Agency. We argued that there should be a requirement to present scientific evidence regarding a new ingredient, and a significant part of it coming from non-company sources, showing the safety and need for it. The government rejected this.

So what we have is, as you suggest, mass uncontrolled trials on the population of new babies whose parents use the new composition, perhaps persuaded by claims such as 'new improved protein balance', 'IMMUNOFORTIS' etc.

There needs to be careful tracking of these new ingredients and openness about possible ill effects. However, it took use of the Freedom of Information Act in the US to find that the US Food and Drug Administration had received many public reports of adverse actions to formula containing LCPs. See:

Some health experts suggest it is best to rotate formulas rather than stick to one brand, so that any risk from these new ingredients is minimised and any benefit - should it exist - is not totally missed.

It remains true that companies continue adding new ingredients not because of proven - or even perceived - benefits, but because they can be used in marketing strategies, as the Humbrecht and Quist analysis of LCPs above makes clear.

That is not to say that formula should not be improved. Discoveries continue to be made about breastmilk and how it is absorbed by the child. Improvements to formula to reduce its adverse health effects can only be a good thing, but all aspects must be conducted in the child's interest, not the company's thirst for boosting profits.

Anonymous said...

Dear All,

I was looking for the information about the quality of the baby formulas available on the market. However, the only thing I found here was the arguments in favor of breastfeeding. I would argue, that vast majority of mothers able to breastfeed will do so; however, if the mother is not able to do so, then baby formulas are the only solution; therefore it would make sense to focus on providing accurate information on the risks and benefits associated with specific brands of baby formulas, rather engaging in discussion about the benefits of breastfeeding, marketing strategies, etc. For the mother, who is not able to breastfeed, this information is less important.

Mike Brady said...

The anonymous comment on 3rd January says that 'the only thing I found here was the arguments in favor of breastfeeding'. However, if you read the article, I've only referred to breastfeeding when necessary to examine claims made by the companies regarding formula and tried genuinely to answer the question 'which infant formula is the best?' by examining company claims.

Clearly the companies do not provide accurate information about their products.

Part of the reason we have a safer formula campaign is we believe parents who use formula should have access to accurate, independent information. We are calling on health authorities to do a better job than the advice I reference above.

Please do support our campaign for accurate information and for an end to the misinformation put out by companies.

Anonymous said...

Geez, are the people who are leaving comments actually reading this website? Or are they all just pro-formula folks looking for a fight? This site makes an excellent point - there is no standard or measure regarding which formula is the "best" amongst them all. Try to do an internet search on "formula ingredients" and see how much luck you have. Every company adds their own secret ingredient and markets it as the "best". You can't have the "best" if there is no comparison to be had. I think breastmilk needs to be completely removed from the formula marketing equation. Compare formulas to formulas for providing infant nutrition. Formula will never be near as good as breastmilk, everyone knows it, so any comparison is moot. All the pro-formula people should get together and form a group to create an information/rating system for formulas, and promote the "best" inferior product as they see fit, and stop complaining about people who promote breastfeeding!

Unknown said...

We are awaiting our first child and it would appear that there are many radical individuals (Possibly anti-capitalists) jumping onto this important issue. I come from a healthcare background and whilst I wish to breast-feed I know that LCP's, prebiotics and nucleotides, that are present in breast milk are also components in some brands of formula milk. Why cant someone just have the guts to have an open debate, let information flow and let us have informed choice?

Mike Brady said...

I am sorry Shelley, but from you comment I can only conclude that you have neither read the above post nor looked at the film. These look at whether there is any equivalence between LCPs and oligosaccharides (marketed as 'prebiotics') in breastmilk and formula.

Aside from the independent evidence cited above, in the film, I quote from a company that was censured over its claims by the Advertising Standards Authority and tried to argue that it was not claiming that the ingredients added to its formula act in the same way as similar constituents of breastmilk.

So before using the 'anti-capitalist' attack, you might actually like to consider the efforts we are making to bring objective information to people's attention.

Anonymous said...

Ah Mike, I really feel for you, you just seem to be banging your head against a brick wall because clearly the majority of people who have commented haven't seem to have actually read or understood the information you have supplied.

In effect people, it doesn't matter which company you choose to throw your money at, their milk is basically, on a fundamental level because of regulations is exactly the same, none are close to breastmilk because that is an impossible goal, formula has and never will be close to human milk because it is lacking in hundreds if not thousnads of ingredients. This is no fault of the formula companies or anyone else, this is purely because sceintists can not analyse human milk enough and so the properties of human milk are still a 'mystery'
You can't promote imuno properties in formula because they contain absoloutly no imuno properties because they can't replicate them, prebiotics are not imuno properties. The claim milupa had on their aptimil cans 'imunofortis' was the equivelent of every manufacturer of vitamin c claiming vitamin c can cure a cold. We all know that is untrue. You need to have a level of immunity in the first place to be resistant to illnesses, new born have very little immunity to a common cold or chicken pox etc but the colostrum in a mothers milk provides antibodies from illnesses she has suffered with ie-glandular fever. You can't support the bodies immune system if there isn't an immune system to support that is why a lot of artificially fed babies are much more ill than breastfed babies. It is a fact.

It's a little silly to even assume that any formula milk could be as good as/closer to human milk, scientists aren't that good!

No where in this article did Mike promote breastfeeding, he tried to offer some insight into the pure and simple fact of 'it doesn't matter what formula you use, they are all the same, by law' It just seems a lot of people who have responded feel attacked for their decision to use formula the reality is, no one is attacking you, they're attacking the unfair, agressive and manipulating marketing of profiteiring formula companies.

also, for the ones with hungry babies, you can still ebf a 'hungry' baby as human milk production is a supply and demand thing. Cluster feeding on an evening and into the night is quite normal (from areound 5pm until 12am is NORMAL), it stimulates milk production and helps a baby sleep longer at night. you introduce a bottle of formula/expressed milk at that time, you tell your body you don't need to produce that milk therefore you won't and the result is a hungry baby. Look at it this way, the human race has survived hundreds of years without aretificial milk and most likely they had 'hungry' babies as well, we're still here though aren't we?

We've gotta admit, we're privaleged that there is an alternative for the people who choose not to/can't breastfeed.

Anonymous said...

Both my sons were fed Milupa for hungry babies from birth, both are healthy and have never been overweight.One is 23 and 6ft the other has just turned 18 and is 6ft 2".
It makes me really angry to see the pressure put on new mothers to breast feed.
A happy mother makes for a happy baby.

Unknown said...

I trawled this and many other websites and asked my health professionals for advice about formula, as my baby was in a neonatal unit for a while (2 wks) after birth and I was unable to express milk due to severe illness (related to preg and birth) all I have been able to find is 'BF is best, expressed milk is better than alternative' - I am a smart woman, I KNOW BF IS THE BEST! But unless my husband and myself read every ingredients label on formula, there was no info available - the midwives said, and i quote, "we are not allowed to help you choose a formula as it goes against Government guidelines" (this was after NN unit where my son was fed a special milk)
parents should be able to access EASILY all the info required to help them make an informed choice about how to feed our babies - the majority of parents are not idiots and know that 'breast is best' but if it doesn't work there is virtually no help available! I finally got an auxiliary to help me!
Also, when I was a baby, my mother passed on a staph infection through her breast milk, which resulted in me (only 2 weeks old) having to be rushed into hospital - why is there no info on the possible (if unlikely) risks of breastfeeding?
Thanks to websites like this and others - I am regularly made to feel like a bad mother because my son never had any breast milk - why can't people campaign for freedom of information on this subject?

Mike Brady said...

Paula, I am sorry to hear of your experience and lack of information, but I can't help wondering if you have actually read the information on our sites? We ARE campaigning for parents to have access to accurate, independent information - and as the Government is not doing enough are doing what we can.

The trouble with the information provided by companies is that it is dishonest. The suggestion that health workers cannot provide information due to government regulations is simply wrong - the fact is that all formula has to comply with composition requirements that specify the ingredients known to be important in baby milk - any additional ingredients added by companies have no proven benefit, otherwise it would be a legal requirement for all baby milks to include them. They are used for marketing purposes by companies.

Accordingly, there is no scientific basis for recommending any baby milk over any other. In Australia they are clear that price is as good a reason as any for choosing between products. The reaction of the child is also relevant, of course, though as formulas taste different (give them a try), it may take time for a baby to adjust to one over another.

You can find additional information in our short film on this topic at: