Intended for healthcare professionals


Support for breastfeeding is an environmental imperative

BMJ 2019; 367 doi: (Published 02 October 2019) Cite this as: BMJ 2019;367:l5646

Linked opinion

Conflict of interest and the infant formula industry—a call to action

Editor's Choice

Infant formula, the environment, and The BMJ

  1. Naomi Joffe, technician and environmental lead,
  2. Flic Webster, milk donor,
  3. Natalie Shenker, researcher
  1. Hearts Milk Bank, Rothamsted Institute, Hertfordshire, UK
  1. Correspondence to: N Shenker natalie.shenker09{at}

Formula milk contributes to environmental degradation and climate change

Conversations around the complex subject of infant feeding have invariably focused on health outcomes, but recent studies have highlighted the environmental cost of decades of disinvestment in services to support breastfeeding. Breastfeeding uses few resources and produces minimal or zero waste.12 The associated infant and maternal health outcomes produce healthier populations that use fewer healthcare resources.34 The production of unnecessary infant and toddler formulas exacerbates environmental damage and should be a matter of increasing global concern.125

Water, waste, and methane

The food industry, particularly dairy and meat production, contributes around 30% of global greenhouse gases. Most formulas are based on powdered cows’ milk. The average water footprint of whole cows’ milk is around 940 L/kg: one kilogram of milk gives about 200 g of milk powder, meaning the water footprint of milk powder alone is roughly 4700 L/kg.67

Methane production from livestock is second only to production by the oil and gas industry,8 and methane traps heat in the Earth’s atmosphere 30 times more potently than carbon dioxide.9

A …

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