COMPARING BREASTFEEDING AND FEEDING WITH INFANT FORMULA

Global guidelines for infant formula say the ingredients are supposed to be those “which have been proved to be suitable for infant feeding.” “Proven” has not been defined, so there has not been any authoritative proof of suitability. Assessment of infant formula has focused on its ingredients. Globally, the Codex Alimentarius Commission has set out a list of ingredients that should be in all infant formula, while also giving national governments the option to introduce some variations within that framework. As illustrated by the practice in the United States, infant formula that includes the ingredients specified in the global guidelines and in national law is described as nutritionally adequate. This is not good enough. The gold standard against which infant formula should be compared is optimal breastfeeding. The comparison should be based not on examination of formula’s ingredients but on examination of its performance. Does infant formula do what it is supposed to do? Does feeding with any particular type of infant formula protect the health of infants and their mothers as well as breastfeeding? If not, it is not functionally adequate. Some might argue that while infant formula is not quite as good as breastfeeding for protecting infants’ health, it is not much worse. Families might have their own reasons for feeding their infants with formula. There is a need for serious discussion of the gap between breastfeeding and feeding with formula and about the degree to which considerations other than the infant’s health might play a role. New parents should be supported in making wise, well-informed choices about how they will feed their infants.