In the UK, the infant formula and follow-on market is worth £165 million a year, but at what price our children's long-term health? Emma Hall investigates

Current UK legislation specifies minimum and maximum levels for the energy, protein, fat, carbohydrate, vitamin and mineral content of formulas. It also specifies which nutritional substances and food additives are approved for small babies.

‘The biggest mass uncontrolled trial ever’
However, some organisations are still very concerned about the use of formula. Baby Milk Action calls infant formula ‘the biggest mass uncontrolled trial ever’ and claims that formula milk is responsible for life-long problems from constipation to high blood pressure. They point out that formula-fed babies forfeit living enzymes and hormones, immune boosters and a custom-made, ever-changing, perfect food.

The safer and closer to breast milk that manufacturers can claim formula milk is, the better it will sell. Nobody wants the kind of bad publicity faced by manufacturer SMA Nutrition last summer, when a case of infant botulism was linked to one of its products.

The organic alternative
Scares like these have sent many mothers (who can afford it) flocking to new ranges of organic baby formulas, such as Hipp or Babynat, which have come on the market recently.

Despite the reassurance of the ‘organic’ tag, these products are no closer to breast milk than ordinary formula. The Department of Health refuses to recommend one formula over another, and takes the official stance that all formulas have a similar composition.

Impressing the medics
Manufacturers, however, are constantly striving to impress the medical profession that their formula is the closest to breast milk, in the hope that their brand will be the one recommended to mothers.

Every innovation in formula milk is designed to bring it closer to breast milk. Recent developments include the addition of taurine (an amino acid found in breast milk); fortification with nucleotides (one of the building blocks of DNA); and an adjustment in mineral levels to emulate more closely the absorption and retention levels seen in breast-fed babies.

There has also been an improvement in the fatty acid content, which plays an important role in an infant’s mental and physical development, particularly the eyes and nervous system. Some parents may be put off to hear that the newer fatty acids come from sources such as fish eyeballs.

The arrival of the 'Frankencow’
Despite the quest to create the perfect copy of human breast milk, formula remains essentially dried cow’s milk with a few added vitamins and minerals, plus adjusted carbohydrate, protein and fat levels. It lacks antibodies, which can protect babies from illness in the first months of life, and the baby digests less of it, leading to more and smellier waste in the nappy.

It couldn’t be long before genetic engineering found its way into breast milk manufacture, and 12 cows in Virginia, USA, have been genetically engineered to produce a human breast milk protein. The resultant milk may also carry the Holy Grail of formula – some antibodies. Although how these would survive the three- or four-year shelf life of the average formula is hard to understand. Besides, the idea of ‘Frankencows’ will be a difficult psychological image for marketers to sell to anxious parents.

New recommendations
In March this year, the World Health Organisation recommended that babies are breastfed exclusively for the first six months of life, up from a previous recommendation of four to six months. Health experts believe that babies should receive at least some breast milk for the first year.

However, the government budget for promoting breastfeeding is a tiny fraction of the promotional budgets of the main baby milk manufacturers. The trouble is no one makes much money out of breastfeeding – you can only sell so many breast pumps, nursing bras and breast pads. Whereas once you have persuaded a mother to use a bottle, she is committed to regular purchases of an expensive product for at least a year.