UWr researchers publish in prestigious British Medical Journal

Breast milk is the optimal source of nutrition for infants, providing all the nutrients and bioactives necessary for normal child development. Consistent evidence supports the many short- and long-term health risks to both children and mothers from its substitutes. A range of medical, socio-political and psychological factors can influence infant feeding decisions; however, the marketing of infant formula can significantly undermine the choice to breastfeed. A recent international study by the World Health Organisation and UNICEF highlighted how pervasive and personalised this can be. The industry spends billions of dollars a year promoting breastmilk substitutes, using a range of sales techniques often based on emotions.

Nutrition and health claims about infant formula are controversial, as they may increase the perceived value of breast milk substitutes and thus discourage mothers from breastfeeding. Furthermore, there are doubts about the veracity of common claims.

The objective of the cross-sectional study described here was to review the available health and nutrition claims for infant feeding products in a number of countries and to assess the reliability of the evidence used to substantiate these claims.

A sample of 15 countries identified 757 infant formula products, each with a median of two claims, and 31 claim types for all products. Of the 608 products with ≥1 claim, the most common claim types were for the support of brain and/or eye and/or nervous system development (53%), strengthening/supporting the immune system (39%) and supporting growth and development (37%). 41 ingredient groups were linked to ≥1 claim, but many claims were without reference to a specific ingredient (50% of products). 161/608 (26%) products with ≥ 1 claim had a scientific reference to support the claim (266 unique references). Only 51 claims were based on the results of randomised controlled clinical trials (27 registered RCTs). All cited systematic reviews and pooled analyses, and the majority of RCTs, were at high risk of bias, which biases the estimated outcome in comparisons of interventions. The frequency of health and nutrition claims was similar in low-, middle- and high-income countries.

These claims appear on infant formula products and materials promoting them, despite national laws and international guidelines that prohibit them. They were identified in countries with high, as well as low, regulatory compliance with the ‘International Code of Marketing of Breastmilk Substitutes’. The results of the study confirm the need for changes to the regulatory framework for breastmilk substitutes to better protect consumers and avoid the harms associated with aggressive marketing of such products.

We encourage you to read the full text of the publication: https://www.bmj.com/content/380/bmj-2022-071075

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