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The history of infant formula

The quest to find a complete alternative to mother's milk has been around for ages. Centuries of development and research are the basis for the safe substitutes available today.

Today’s infant formula has a long history and many years of research and development to thank. Alternatives to breastfeeding are thought to have existed throughout history, with experiments using milk from animals such as cows, goats and donkeys. In the early 19th century, the first scientific reports showed poorer survival rates for children who were not breastfed, but exclusively fed cow’s milk, for example. In 1838, the German scientist Johann Franz Simonn published the first chemical analysis of the content of mother’s milk compared to cow’s milk, which then formed the basis of research on infant formula in the following decades. Among other things, the analysis showed that cow’s milk has a significantly higher protein content and lower carbohydrate content than mother’s milk, which led to the understanding that cow’s milk was more difficult to digest than mother’s milk. The first recommendations were to add water, sugar and cream to regular cow’s milk to make it more like mother’s milk.1

In the 1860s, the German chemist Justus von Leibig developed powdered infant formula based on wheat flour, cow’s milk, malt and potassium hydrogen carbonate. The powder, to be mixed with heated cow’s milk, was the formula most similar to mother’s milk to date, and became the first infant formula to be commercialized. The formula soon became popular across Europe and a few years later it was also available on the US market. In 1870, American NestlĂ© Infant Food launched the first infant formula that could be mixed with water instead of milk – the first fully chemical product on the market.

The millennium between 1870 and 1970, pasteurization and condensation revolutionized milk research. In substitution, experiments were carried out with added vitamins, sugars and fatty acids to fine-tune and come even closer to resembling mother’s milk. In the 1970s in the US, the use of infant formula was widespread and the norm rather than the exception. Data shows that only 25% of new mothers breastfed their babies. A major contributing factor to the low breastfeeding rates in the US at this time is believed to have been the fact that hospitals provided formula from birth, which led mothers to believe it was best practice and so wanted to continue with formula, which was both readily available and cheap. Breastfeeding was also not recommended in the same way as it is today.3

In modern times, manufacturers have continued to develop and fine-tune their formulas in line with the latest research. The biggest advances in recent years have been in nutrition for babies born prematurely or with very low birth weight, and in formulas for babies with allergies or other difficulties in processing milk.4 Another development in this area is the framework of laws and regulations established to ensure the quality and safety of infant formula for consumers. For example, the composition of breast milk is regulated in the EU. In many countries, the marketing of infant formula is also regulated by law so as not to make it seem like a better option than breastfeeding. Especially in developing countries, where access to clean water is not self-evident, it is important that compensation is not idealized. The World Health Organization (WHO) recommends breastfeeding infants for at least 6 months and opposes inappropriate marketing of substitutes, arguing that it generally contributes to lower breastfeeding rates, leading mothers who might have been able to breastfeed to choose substitutes instead.5 Most countries follow the WHO recommendations.

Although the general recommendation is that babies should be breastfed for at least six months, today’s babies and parents can benefit from the results of many years of research and development of infant formula. Those who do not breastfeed can be confident that the substitutes available are the best that medical research has to offer.4

References:

1: Spaulding M: Nurturing Yesterday’s Child: A Portrayal of the Drake Collection of Paediatric History. Philadelphia, BC Decker, 1991

2: Apple RD: Mothers and Medicine: A Social History of Infant Feeding. Madison, Wis, University of Wisconsin Press, 1987.

3 Fomon SJ: Infant feeding in the 20th century: Formula and beikost. J Nutr 2001;131:409S

4 Schuman, A: A concise history of infant formula (twists and turns included) Contemporary Pediatrics 2003;2:91.

5. the WHO website: https://www.who.int/health-topics/breastfeeding

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