Breast milk is widely recognised as the best source of nutrition for infants, providing a range of essential nutrients that support growth and development. In many parts of the world, however, mothers are unable to breastfeed, either due to medical conditions, cultural practices, or lack of support. In these cases, breast milk substitutes, such as infant formula, are often used as a replacement. While formula can provide adequate nutrition, recent research suggests that many of the health claims made by formula manufacturers are not supported by scientific evidence. This raises concerns about the impact of breast milk substitutes on child malnutrition in Africa, a region where rates of child malnutrition are among the highest in the world.
According to the World Health Organization (WHO), malnutrition is a major contributor to the global burden of disease, affecting millions of children around the world. In Africa, the situation is particularly dire, with an estimated 58 million children under the age of 5 suffering from malnutrition. This is due to a range of factors, including poverty, poor access to healthcare, and inadequate diets. Breastfeeding has been identified as a key strategy for reducing the risk of malnutrition, with studies showing that breastfed children have lower rates of both acute and chronic malnutrition.
However, as the recent study by Imperial College researchers, Dr. Ka Yan Cheung and Loukia Petrou, highlights, many of the health claims made by formula manufacturers are not supported by scientific evidence. The study analyzed over 100 health claims made by 814 formula manufacturers in 15 countries and found that only a small fraction were backed up by rigorous scientific research. A careful study of how formula products were marketed in South Africa, Australia, Nigeria, Canada, Italy, Germany, India, Japan, Norway, Saudi Arabia, Pakistan, Russia, Spain, the UK, and the US; showed that an average of 2 non-evidence-based health claims were included in marketing content.
This raises concerns about the impact of formula on child health and nutrition, particularly in regions where breastfeeding rates are low. The WHO and the United Nations Children’s Fund (UNICEF) recommend exclusive breastfeeding for the first 6 months of a child’s life, followed by continued breastfeeding along with appropriate complementary foods for up to 2 years or beyond. However, in Africa, only 37% of infants under 6 months of age are exclusively breastfed. This means that the majority of infants are at risk of not receiving the optimal nutrition and immune protection provided by breast milk.
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In situations where breastfeeding is not possible, formula can provide an alternative source of nutrition. However, a recent study suggests that many of the health claims made by formula manufacturers, such as improved brain development, reduced risk of allergies, strengthened immune system, and supports overall growth are not supported by scientific evidence. This raises concerns about the profit-oriented landscape of formula marketing even at the expense of the youngest and most vulnerable population of the world.
The WHO and UNICEF recommend that formula should only be used when it is medically necessary and that mothers should be supported to breastfeed whenever possible. However, in many African countries, formula is marketed as a desirable alternative to breast milk, and aggressive marketing practices by formula manufacturers are misdirecting. For instance, certain ingredients were claimed to offer multiple health or nutrition effects without any scientific references to back up these claims. Dr. Ka Yan Cheung and Loukia Petrou maintain that these claims need to be supported by robust clinical trial evidence. The cons of unfounded claims can be potentially harmful to toddlers. Senior co-researchers, Dr. Daniel Munblit and Dr. Robert Boyle, both from Imperial College, London have called for greater regulation of formula marketing in order to protect infant health and promote optimal nutrition.
In addition to concerns about the health impact of formula, there are also broader economic and social implications of relying on breast milk substitutes. Formula can be expensive, making it unaffordable for many families in Africa. This can lead to a situation where children are fed inadequate diets, increasing the risk of malnutrition and other health problems. Hence, while breast milk substitutes, such as formula, can provide an alternative source of nutrition when breastfeeding is not possible, regulating bodies need to ensure health claims made by formula manufacturers are clinically proven, and supported by unbiased scientific evidence.
In Africa, where rates of malnutrition are among the highest in the world, it is important to prioritize breastfeeding as a key strategy for reducing the risk of malnutrition and improving child health.
Ehi-kowoicho Ogwiji is a storyteller and science writer who advocates for a science-literate Africa. She aspires to be a science development communicator and leader of important conversations around gender imbalances in STEMM (Science, Technology, Engineering, Mathematics, Medicine) in Africa and around the world. She writes from Abuja, Nigeria. Connect with her on social media @ogwijiehi or email her at ehikowoicho.ogwiji@gmail.com