Your baby (probably) doesn’t need ‘probiotic’ or other ‘fancy’ formula: health experts

Wednesday, 24 July 2024

“Standard” - usually cheaper - baby formula without added “extras” is a good source of nutrition for healthy babies, a neonatologist and nutritionist specialist say.

Phrases such as “unique probiotic blend” and “crafted with A2 protein” will have jumped out at many a shopper cruising the baby products aisle, but they could soon disappear from supermarket shelves.

The food giants that produce infant formula are lobbying the Government to block a push by trans-Tasman food regulator Food Standards Australia and New Zealand (FSANZ) to introduce further restrictions on how such products are labelled and sold, as they stand to lose around 400 jobs and $1 billion in exports.

Food Minister Andrew Hoggard will ask for a review of the new labelling requirements when he meets Australian federal and state food ministers on Thursday.

Toddler milk, like this one produced by French food giant Danone, soon won’t be able to be “cross-promoted” on infant formula packaging if the food regulator has its way.

But health experts say the proposal would leave both parents’ wallets and babies’ health better off.

Updated regulations will stop manufacturers from printing information about additional ingredients, including probiotics or Human Milk Oligosaccharides (HMOs), outside of the nutrition panel and “cross-promoting” “follow on” products, such as toddler milk.

They will also require nutritional information tables to be standardised, and specialised medical formula developed for pēpī with allergies or health conditions to only be sold in pharmacies.

The prospective amendments to the Australia New Zealand Food Standards Code are waiting sign off by Australian and New Zealand ministers next month.

Proposed changes to how infant formula is labelled would require manfacturers to display nutritional information in a standardised format.

Infant Nutrition Council chief executive Jonathan Chew said putting the trade implications aside, the sector was also concerned about the removal of information from the label “that helps parents make informed choices, suitable to their individual needs”.

“This information has been on the label for many years without incident, without concern, and now we are going to remove this information from parents.'

He said it was going to cause 'chaos and confusion'.

But Dr Gergely Toldi, a neonatologist and senior lecturer at Auckland Unversity’s Liggins Institute, said the proposed changes made sense and were in line with paediatric practice.

Dr Gergely Toldi, a neonatologist and senior lecturer at the Liggins Institute, says the composition of infant formula is already quite tightly regulated to ensure it meets babies' nutritional needs.

“I think formula milk and formula products do have a place in society. But there are questionable marketing practices that we as a speciality don’t agree with or support.

“When it comes to formula feeding in general, we [doctors] wouldn’t say that this product is better than the other one because it has probiotics or is made of a specific type of milk [like A2].”

That was because the composition of macronutrients and micronutrients in formula was already “quite tightly regulated”, based on how much protein, fat and sugar a baby needed to have from birth to six months old for their growth and development.

However, claims by manufacturers that the inclusion of probiotics or HMOs in their products would improve babies’ health was not backed up with robust scientific evidence, Toldi said, despite these ingredients being used and promoted in more expensive brands of formula.

There’s a lot of confusion and misinformation about baby formula among the general public, says baby and family nutrition specialist Dr Julie Bhosale.

Similarly, while specialised formula was needed for babies with certain health conditions, these products often wouldn’t meet the nutritional needs of healthy babies. These varieties of formulas were also more expensive.

Giving babies specialised – such as low dairy – formula without oversight from a medical practitioner could also lead to some underlying health conditions being missed or delayed because they hadn’t been assessed properly: “I think there’s a risk of self diagnosis and self medication.”

Baby and family nutrition specialist Dr Julie Bhosale said there was already a lot of misinformation about baby formula.

“If we’ve already got this much confusion, what's going to happen next?“

Food Minister Andrew Hoggard will meet with Australian food ministers on Thursday.

In the decade she had been working in the field, the number of new formulas hitting the market had increased. It was big industry with big mark ups, so was highly competitive, she said.

Families she worked with had been told by their primary health carer to put their baby onto goat’s milk formula for an assumed cow’s milk protein allergy, despite the product still containing dairy, and their child not being tested for an allergy.

She “100%” agreed with Toldi that the standard infant formula, without any added extras like probiotics or HMOs and usually at the “cheaper” end of the market, was a good source of nutrition for healthy babies.

Bhosale was particularly pleased to see the proposed restrictions on the “cross-promotion” of toddler milk. Toddler milk is not the same as infant formula.

The vast majority — 80% to 85% — of toddler milk products marketed as being suitable for children over the age of 1 contained added sugar, Bhosale said.

In her view, these products did not serve any nutritional purpose for healthy toddlers. Instead, their purpose was to encourage caregivers to continue to purchase the manufacturer’s products after their child started solids and no longer needed formula.

Despite this, when toddler milks were advertised on the packaging of baby formula as the next “stage” of the product, caregivers might make the inference that they needed to keep buying it to support their child’s health.

Advertising infant formula is banned due to New Zealand health authorities’ staunchly pro-breastfeeding stance. However, there are not the same restrictions on the promotion of toddler milk. Bhosale said the change to the code would help to close this loophole.