Currently browsing posts about: Infant-formula

DairyReporter.com has a Special Edition on infant feeding 

Infant formula companies have a problem: the products are virtually identical in nutrient composition (they all have to meet the same FDA standards), babies only need them for the first year, and the number of babies is finite.  From the formula industry’s perspective, the challenge is how to increase sales.  Here’s how this industry is managing this challenge.

Where next for infant nutrition?

In this special edition, we take a look at the infant formula sector, which far from being static is changing through novel ingredients, smart packaging, the explosion in plant-based products, and production of breast milk from cells.

• Making baby formula transparent with Danone’s Track & Connect:  Packaging with QR codes and a new digital platform make up Danone’s Track & Connect service for baby formula products. It is available in China, with launches in France, Germany, Australia and New Zealand soon… Read
• How to trigger a growth spurt in infant nutrition:  Consumers could be forgiven for believing that innovation in infant nutrition is less radical or slower than it is in other parts of the nutrition industry… Read
• Alternatives to traditional infant nutrition hit US market:  Market trends and unique consumer needs in infant nutrition have producers thinking outside the realms of tradition. New launches from Else Nutrition and Biomilq have recently hit the US, forming new categories… Read
• TurtleTree Labs secures funding for production of milk from cells:  TurtleTree Labs, the Singapore-based company working with biotechnology to create the full nutritional content of milk, has announced it has completed its pre-seed funding round… Read
• Stricter EU infant formula marketing rules to come into effect:  New EU food law designed to further restrict the advertising and marketing of infant formula are to come into force on 22 February in a victory for campaigners critical of current guidelines… Read
• Combating cow’s milk protein allergy: Nestlé Health Science China introduces two new FSMPs brands:  Two of Nestlé Health Science China’s infant nutrition products for youngsters with cow’s milk allergies have obtained Food for Special Medical Purposes (FSMPs) status in the country… Read
• Catering for different life stages: What’s next for China’s A2 milk industry in 2020?  China’s A2 milk sector is likely to see the rise of more products catered to different life stages and specific consumers groups, beyond just infant nutrition, as more domestic companies join in the competition… Read

Formula companies must be desperate for sales.  They are spending four times what they used to on advertising of “toddler milk,” formula ostensibly aimed at children who no longer need infant formula and are perfectly capable of eating real food.

So says a new study in the journal Public Health Nutrition.  The study comes from the Rudd Center for Food Policy and Obesity, now at the University of Connecticut in Hartford, a group specializing in research to inform policy.

The report points out that increasing sales of toddler formula come at a time when pediatric authorities specifically recommend against feeding toddler milks to young children.

Why?  Because young kids do not need them and the milks contain unnecessary added sugars.

As the paper points out, “These findings also support the need to regulate marketing of toddler milks in countries that prohibit infant formula marketing to consumers.”

The advertising of toddler milks gets around those policies and should stop.  Right now.

DairyReporter.com is another one of those industry newsletters I so enjoy reading.  This particular article is a roundup of articles on the infant formula industry.

Special Edition: Infant nutrition

The field of infant nutrition is a constantly evolving one, as new ingredients are constantly being added to provide greater benefits, and products are being developed to more closely approximate breast milk for those unable to breast feed. In this special edition, DairyReporter takes a look at some recent innovation in the infant nutrition space.

• DSM puts early childhood nutrition on display at IFT:  DSM Ingredients of the Netherlands showcased its products for all stages of life at the 2019 IFT show in New Orleans last week. Preconception, pregnancy, nursing, infants, toddlers and kids all fit into its portfolio of food and beverage ingredients… Read
• Chicory root fiber in the infant nutrition industry: Functional ingredient supplier BENEO offers products derived from chicory roots, beet sugar, rice and wheat… Read
• Liquid addition for IBC blending: Matcon has launched its Liquid Addition System to expand the range of the Intermediate Bulk Container (IBC) tumble blender for industries that need to be able to add liquids into a wide range of powder recipe mixes in a contained and efficient manner… Read
• Nestlé files patent on age-tailored infant formulas to curb later-life obesity, disease risk: Nestlé has developed six age-tailored infant formulas to prevent sub-optimal body composition in early-life that aim to reduce obesity, cardiovascular disease and metabolic disorder risk later in life… Read
• Awareness of MFGM growing: More pregnant women are familiar with the milk fat globule membrane (MFGM), a nutritional component naturally occurring in breast milk. It’s now being used as an ingredient in infant formula to “close the gap further between breast milk and formula.”.. Read
• Infant formula in India: FSSAI proposes regulations for products with special medical purposes:  The Food Safety and Standards Authority of India (FSSAI) has issued a notification on a draft regulation for infant nutrition safety standards, calling for industry stakeholders to submit their comments… Read
• Nestlé seeks to lower minimum protein content in Australia and New Zealand follow-on formula:  Nestlé has applied to Food Standards Australia New Zealand (FSANZ) to reduce the minimum protein requirement for milk-based follow-on formula in the Australia and New Zealand Food Standards Code… Read
• Dairy Dialog podcast 32: Advanced Lipids, Prinova and Glanbia:  This week’s Dairy Dialog podcast is based around some of the companies attending Vitafoods in Geneva last week… Listen now  
• Moo-ving into udder markets: Bubs to continue goat milk formula innovation amid Fonterra cow milk collaboration:  A supply agreement with Fonterra will see Bubs Australia venture into the cow’s milk infant formula space, though the firm has stressed that it will continue to innovate across its core range of goat’s milk products… Read  
• ESI Nutrition’s infant nutrition powders now approved for export to China:  ESI Nutrition, a division of French dairy cooperative Laïta, has received approval from Chinese authorities (GACG – General Administration of Customs of the People’s Republic of China) allowing it to produce infant formulas in powder for China at its new industrial site, Laiterie Nouvelle de l’Argenon… Read  
• EFSA deem protein isolates safe for extended use in infant formula and supplements:  The European Food and Safety Authority’s (EFSA) Panel on Nutrition, Novel Foods and Food Allergens (NDA) concludes that whey basic protein isolates are safe under new proposed conditions of use… Read

Breastfeeding, anyone?

 

By this time, you have no doubt heard about the Trump Administration’s attempts to stop the World Health Organization from promoting breastfeeding.  Incredible but true.

Here is a brief timeline of how this story got out.

May 25   Lucy Sullivan, executive director o 1000 Days (the first 1000 days of life are critical to an infant’s survival) sent out a tweet warning of a battle brewing over breastfeeding at WHO’s World Health Assembly, where countries are negotiating a resolution on infant and young child feeding.

June 7   Amruta Byatnal writes about “A Moment of Reckoning for Nutrition Advocates at the WHA” [World Health Assembly: “Nutrition advocates have accused the U.S. of siding with private sector interests, sparking a controversy over what they assumed would be a routine effort to provide advice on breastfeeding and the use of breast milk substitutes.”

July 8  The New York Times takes the story national: “Opposition to Breast-Feeding Resolution by U.S. Stuns World Health Officials.”  The Guardian also publishes an account.   These make it clear that the Trump Administration threatened Ecuador to drop its support of breastfeeding.  As the Times put it,

The Americans were blunt: If Ecuador refused to drop the resolution, Washington would unleash punishing trade measures and withdraw crucial military aid. The Ecuadorean government quickly acquiesced….The confrontation was the latest example of the Trump administration siding with corporate interests on numerous public health and environmental issues.

Ironically, Russia stepped in and introduced the measure, which passed despite US attempts to block it.

July 9  President Trump sends out a tweet:

July 9  Alex Azar, Secretary of Health and Human Services, also sends out a tweet, supporting the President: “America has a long history of supporting mothers and breastfeeding around the world and is the largest bilateral donor of such foreign assistance programs. Those unable to breastfeed shouldn’t be stigmatized; they should be equally supported with info and access to alternatives.”

July 9  The New York Times publishes an editorial: “Why Breast-Feeding Scares Donald Trump.”  Its answer: “It comes down to public health abroad could hurt American companies’ profits.”

What this is about

Infant formula works for babies, but breastfeeding is demonstrably better.  This is especially true for women who cannot afford formula, do not have clean water to dilute the powder properly, or lack refrigeration to store formula properly.

But breastfeeding has a serious political problem: it does not make money for formula companies.  As I explained in Waht to Eat:

Infant formulas cause controversy and are endlessly contentious for three important reasons.  Formulas are (1) largely unnecessary (most mothers can breast feed their infants), (2) not as perfect as breast milk for feeding babies, and (3) more expensive than breast feeding.  Breast milk is nutritionally superior to formula, but from a marketing standpoint it has one serious disadvantage: it is free.   Beyond one-time purchases of breast pumps, storage bottles, or special clothing, nobody makes money from it.

Formula companies are happy to pay lip service to “breast is best,” as long as policies do not promote breastfeeding over formula.

This is not the first time the US has taken this position.  In 1981, when the United Nations developed the International Code of Marketing of Breast-Milk Substitutes, all of its member countries agreed to abide by the Code except for the United States and South Africa.  Eventually, South Africa signed on.  The U.S. was the last hold out and did not agree to abide by the Code until 1994.  Why not?  Because the Code could set a precedent that might adversely affect U.S. corporations.

The Washington Post (“US efforts”) and The Atlantic (“epic battle”) review this history.

The formula industry’s problem

As I also explained in What to Eat, only about 4 million babies are born in the US each year, meaning that the formula market is limited and static.  That is why formula companies work so hard to convince mothers that breastfeeding is too difficult, unsanitary, inefficient, and ineffective to continue, and that they would be better off switching to formulas and staying on formulas long past the time when babies should be eating solid foods.

The reactions

My favorites are from

• Georges Benjamin, executive director of the American Public Health Association (in an interview with Food Chemical News).

• From the American Public Health Association
• From medical experts interviewed in the New York Times
• From Vox

Add this to the growing list of ways the Trump Administration favors corporate interests over public health. Alas.

Additions

Maplight reports:

Three of the largest infant formula companies — U.S.-based Abbott Laboratories, Swiss-based Nestle, and U.K.-based Reckitt Benckiser — have spent $60.7 million lobbying U.S. lawmakers and officials during the last decade….While the New York Times reported that the formula manufacturers didn’t play a visible role in the debate over the WHO resolution, lobbying records show they have a significant Capitol Hill presence that often extends beyond infant nutrition.

Stephen Colbert’s take

 

The Rudd Center for Food Policy & Obesity at the Univeristy of Connecticut  produces terrific reports.  The latest is Baby Food FACTS: Nutrition and marketing of baby and toddler foods and drinks:

 

Infant formula companies have a marketing problem: breast milk is a better option, all formulas have the same nutrient composition by FDA regulation, and babies only need to use formula for a few months.

Baby food companies also have a marketing problem: babies can eat table foods (suitably ground or cut) and don’t really need the stuff in jars (convenient thought they may be).

The Rudd Center report takes a good hard look at the

• Contents of food and drink products marketed to parents for their babies and toddlers (up to age 3)
• The marketing messages used to promote these products
• Degree to which marketing messages correspond with expert advice on feeding young children

The findings: The nutritional quality is pretty much as advertised but nearly 60 percent of advertising dollars go for products that are not recommended for young children such as sugar-sweetened toddler milk, nutritionally poor snack food, and Pediasure, a high-calorie liquid nutrition supplement.

Here’s the full report 

And here’s a summary

The FDA wants to tighten up the rules for labels and advertising of “structure/function” claims on infant formulas.  It has proposed “guidance” and asks for comments on it.

This is a good proposal and needs all the support it can get.

Background

“Structure/function” claims were allowed by the Dietary Supplement Health and Education Act of 1994.  These are pseudo health claims that are really about marketing, not health.  Example: this brand of infant formula “supports digestion.”

All infant formulas must meet FDA nutritional requirements and there is no meaningful difference in any of them.  Structure/function claims market one brand over another.  Worse, they make infant formulas seem better than breast milk and help to discourage women from breastfeeding.

In September, the FDA announced that it was proposing draft guidance for industry, entitled “Substantiation for Structure/Function Claims Made in Infant Formula Labels and Labeling.”  This says that the infant formula industry must actually produce evidence that the claims do what they say.  Formula makers must substantiate structure/function claims with “competent and reliable evidence,” preferably from clinical research.

Infant formula makers would much rather not bother.

This proposal deserves enthusiastic support.  If you agree with it, please write the FDA and say so.

ChangeLab Solutions has filed a position paper on this topic with the FDA—excellent background reading.

It also has developed a template letter, which you can adapt and send.

But even a shorter statement that you think structure/function claims should not be used to market infant formulas without real science behind them would help.

Here’s the quick one I sent in.  Feel free to copy.  But individual letters carry more weight.

How to do this?

• Go to the FDA docket website: look for ID: FDA-2016-D-2241.
• Go to the first of the two FDA documents listed there.
• Click on “Comment Now!”
• Fill in the Comment box by saying you are commenting on FDA-2016-D-2241.
• Upload your letter
• Following the instructions for the required items (the others are voluntary)

The FDA documents

• FDA announcement
  Draft Guidance for Industry: Substantiation for Structure/Function Claims Made in Infant Formula Labels and Labeling
• Federal Register Notice

Jennifer Grayson.  Unlatched: The Evolution of Breastfeeding and the Making of a Controversy.  Harper. 2016.

I thought this book had plenty to say and said it well (and has a great cover).  I did a blurb for it:

Unlatched is a deeply engaging, highly personal, well researched, and thoughtfully balanced account of how modern society has denormalized breastfeeding.  Jennifer Grayson does not expect every mother to follow her example and breastfeed babies for three or four years.  Instead, she asks us to consider how formula feeding became the norm and how government policies perpetuate it as the norm (see especially the stunning chapter on the Women, Infants, and Children program).  She argues compellingly that our challenge as a society is to restore breastfeeding as the default for feeding babies, and to provide the support—political as well as emotional–that mothers need to breastfeed successfully.

Mead Johnson Nutrition says it has tested additional samples of its Enfamil baby formula and still does not find the bacteria responsible for the death of one newborn infant and the illness of another.

The bacteria at fault are Cronobacter sakazakii, formerly known as Enterobacter sakazakii (bacterial taxonomists proposed this reclassification in 2007).

Last week several retailers pulled Enfamil infant formula from their shelves because of fears that Enfamil was contaminated with this organism.

Walmart was the first to issue a recall.

The retailers actions were unusually cautious.  Neither Mead Johnson nor federal investigators had evidence that the formula caused the illnesses.  Federal agencies had not asked for a recall.

But the retailers must have connected the dots:

• The most likely source of C. sakazakii is powdered infant formula.

• The two infants ill with C. sakazakii were fed Enfamil powdered formula (although the second ill infant drank several kinds of formulas).

In the chapter on infant feeding in my book, What to Eat, I noted that the main difference between one kind of infant formula and another is its cost.  Powdered formula is much cheaper than the already reconstituted kinds.  I asked:

Beyond the difference in cost, does it matter which level of convenience you choose?

It might.   Powdered formulas are not sterile.  In this, they differ from concentrate and ready-to-serve formulas, which have been heated to sterilize them.

In 2002, the FDA warned pediatricians that powdered milk formulas could be contaminated with Enterobacter sakazakii, a type of bacteria that causes rare but terrible and sometimes fatal infections in infants, especially those who are premature, weak, or in hospitals.

The FDA says it is not aware of any E. sakazakii infections in healthy full-term infants in home settings.

Reports from other countries, however, suggest that even healthy babies may sometimes acquire such infections [see Kwan Kew Lai, “Enterobacter sakazakii infections among neonates, infants, children, and adults: case reports and a review of the literatur,”(see:  Medicine, Vol. 80, pp. 113-122, March 2001.]

In 2001, the CDC published a case report on this type of infection.  It pointed out that “…in 50-80 % of cases, powdered infant formula is both the vehicle and the source (direct or indirect) of E. sakazakii-induced illness.”

The CDC’s conclusion:

Clinicians should be aware of the potential risk for infection from use of nonsterile enteral formula in the neonatal health-care setting.

The World Health Organization has a Q and A:

3. How does infant formula get contaminated with Enterobacter sakazakii? Can other foods also be contaminated?

Basically there are three routes by which Enterobacter sakazakii can enter infant formula:

a) through the raw material used for producing the formula;

b) through contamination of the formula or other dry ingredients after pasteurization; and

c) through contamination of the formula as it is being reconstituted by the caregiver just prior to

feeding.

Enterobacter sakazakii has been detected in other types of food, but only powdered infant formula has been linked to outbreaks of disease.

So the recalls were precautionary.  It’s hard to argue with that—unless you are a stockholder; Mead Johnson stocks declined by 5% as a result.

At the moment, the source of these particular C. sakazakii infections is unknown.  Let’s give the retailers credit for taking precautions to protect the public.

As for infant feeding in general: Breastfeeding is best, of course.  If you are using formulas to feed your infant, the liquid ones are safer—but much more expensive.