Most health claims about infant formula have no scientific basis

Infant formula, like many other consumer products, uses science to sell itself. Some of the most frequent attributions are that these products benefit the development of the baby’s brain or immune system or that they promote the child’s growth. However, according to an article published Wednesday in BMJ magazine, most of the health and nutrition claims that are made on the packaging and in ads have little or no scientific evidence to support them.

The researchers analyzed the websites and marketing techniques for breast milk substitutes in 15 countries between 2020 and 2022. Of 608 products that made one or more claims, around 53% said they helped or supported the development of the brain and/or eyes as well as the nervous system. Another 39% claimed to strengthen or support a healthy immune system, and 37% purported to favor growth and development.

However, when the study authors, led by Daniel Munblit of Imperial College London, checked these claims, they found that half of them were made without identifying the beneficial ingredient and 74% of products did not provide scientific references to support claims.

In the case of products that did reference clinical trials, 90% of these had a high risk of being biased and in 88% of the trials, their authors had received funding from companies that produce dairy milk or formula or were themselves employed by these companies.

“These findings support calls for a revised regulatory framework for breast milk substitutes to better protect consumers and avoid the harms associated with aggressive marketing of such products,” the study concludes. However, the regulatory frameworks are not the same in all the countries that took part in the study, which include European countries, India, Russia and Nigeria.

In an opinion piece published alongside the study, Nigel Rollins, a specialist on the matter at the World Health Organization (WHO), states that health authorities “should move to protect infants and parents from commercial interests.” In his view, families and even health professionals do not have the time to analyze the claims of formula marketers, and self-regulation has not worked and does not seem likely to work in the future. “Regulatory authorities must therefore decide whether the use of such apparently misleading evidence is acceptable or hold the formula industry to higher standards, require better products based on high quality evidence, and review standards,” he writes.

Rosaura Leis, coordinator of the Pediatric Nutrition unit of the Hospital Clínico Universitario in Santiago de Compostela, in Spain, believes that advertising can have an influence on the decision to switch from breastfeeding to formula milk. She emphasizes the value of breastfeeding as “the ideal food for the baby, exclusively in the first six months of life, then as a fundamental food until the first year of life, and after that, to the extent that the mother wants and is able to keep on breastfeeding, as part of a balanced diet until possible.”

In the BMJ article, authors warned that the promises may confuse parents about the benefits of the product versus breastfeeding. “Suboptimal breastfeeding is estimated to result in about 600,000 child deaths from pneumonia and diarrhoea and 100,000 maternal deaths from ovarian or breast cancer each year,” they write, although most infant deaths occur in countries with particularly poor sanitary conditions.

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