Intended for healthcare professionals


Health and nutrition claims for infant formula are poorly substantiated and potentially harmful

BMJ 2020; 369 doi: (Published 06 May 2020) Cite this as: BMJ 2020;369:m875
  1. Daniel Munblit, associate professor of paediatrics12,
  2. Helen Crawley, director3,
  3. Richard Hyde, professor of law4,
  4. Robert J Boyle, reader in paediatric allergy25
  1. 1Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child’s Health, Sechenov First Moscow State Medical University, Moscow, Russian Federation
  2. 2Section of Inflammation, Repair and Development, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
  3. 3First Steps Nutrition Trust, London, UK
  4. 4School of Law, University of Nottingham, University Park, Nottingham, UK
  5. 5Centre of Evidence-based Dermatology, University of Nottingham, Nottingham, UK
  1. Correspondence to: R J Boyle r.boyle{at}

Marketing claims for infant formula should be banned, argue Daniel Munblit and colleagues

Despite improvements in infant formula over its 150 year history, it is still associated with health risks for mother and infant compared with breastfeeding. Manufacturers try to limit these risks through changes to formula composition, which are often accompanied by health or nutrition claims that aid product differentiation or increase market value. Academics and regulators have raised concerns, however, that these claims are often unfounded and may undermine efforts to support breastfeeding.123456 The current regulatory environment allows claims to be made for food products with low levels of evidence, but the potential harms associated with claims are higher for infant formula than for other foods. How can we prevent the harms associated with infant formula claims while ensuring formula fed infants can benefit from improvements in formula composition?

Potential harms of health and nutrition claims

Health and nutrition claims are commonly made for a wide variety of food products, and the level of evidence supporting such claims is variable. However, special consideration is needed for claims related to infant formula products, which we define as breastmilk substitutes for use in the first year of life, including follow-on formula and foods for special medical purposes. Infant formula is consumed by a substantial proportion of the world’s infants, often in large volumes in relation to their body weight—typically 150-200 mL/kg/day for a young infant fed solely on formula milk, the equivalent of 11-14 L/day for a 70 kg adult. The developmental status of infants means that any potential harms associated with infant formula claims may have a high cumulative impact over their life.7

Mothers are also vulnerable during the period when they make infant feeding choices, with up to 20% experiencing a mental illness during pregnancy or the first …

View Full Text

Log in

Log in through your institution


* For online subscription