Thanks for sending this link, Nina.

I found it an interesting read, and clearly written.

The author has a good handle on what can happen when parents ask about formula:

"There are those who would prefer parents didn't use it; they don't 
like to talk for fear of promoting formula."

I see this often in the UK - some midwives and health visitors, asked 
directly about formula, tell parents (totally erroneously), 'we 
aren't allowed to talk to you about it'.

This also happens:

" Others openly promote it, offering vague and sometimes misleading 
marketing info but few details. Still others try to be more balanced, 
but in an attempt to avoid guilt trips, they soft-pedal the 
differences between formula and human milk."

However, there are gaps in the information in the article and things 
the author gets a bit wrong -

"In recent years new formulas, called follow-up formulas, have been 
designed to more closely match some of the nutritional needs of an 
older baby. "

No....this description of follow-on formulas (do they really call 
them 'follow up' formulas in Canada?) is not correct. There is no 
evidence  that follow ons are a 'closer match' than regular formulas 
for older babies. Follow ons have more iron than regular cows milk, 
so, arguably, they are 'better' for older infants than regular cows 
milk -  but in practice, research that looks at whether routine iron 
supplementation benefits growth and development appears to reveal no 
difference in healthy kids.  They are casein-dominant - that can't be 
'a closer match'. They were created for marketing, not nutritional, 
purposes.

The author also says, " Although formula is still fundamentally 
different from human milk, several significant improvements have been 
made in the past 30 years, including fine-tuning to improve the 
balance of proteins and the blend of fats." But he provides *no* 
evidence for this improvement, and indeed, gives an example 
(nucleotides) of an 'improvement' that turned out to be meaningless.

I do think this is a reasonable conclusion, nevertheless, though it 
is an opinion, a judgement, rather than anything more scientific, and 
it should have been clear it was an opinion : " If we look at formula 
as a medical intervention, a way to nourish a baby when breastmilk is 
not available, it stands up fairly well. The problem is that this 
substitute became a competitor."

And this is where the author fails to deliver - a few lines on the 
way the 'substitute became a competitor' would have been helpful. 
The marketing of the formula industry is, as we know, ethically 
suspect all over the world and is only ever regulated when laws force 
changes in practices - voluntary agreements never work. The collusion 
between the industry and health care professionals is a major part of 
this, and he should have included this in his analysis.

I think a few clear references would have helped, too.

Heather Welford Neil
NCT bfc, tutor, UK

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