Thanks for the comment on iron in breast milk substitutes. Almost every breast milk substitute is fortified with iron. It has been known for some time that this is essential to avoid anemia and to prevent neurodevelopmental impairment. More and more we are realizing that the old low-iron formulations (including condensed milk and whole milk) are inadequate and should be replaced by high-iron substitutes to protect infants from injury: this is not surprising, it took breastmilk millions of years to evolve, even the most hardworking and industrious formula company would have difficulty competing. The second point is that in blinded (or masked) studies parents have been unable to detect much difference in gastrointestinal symptoms between low- and high-iron formula. Even if there were a proven difference, I am sure if given the choice between loose stools and neurodevelopmental impairment they would choose the former. The issue of supplementing breastmilk is more complicated and I am not sure which way the literature will go. For now I would recommend that low-iron breastmilk substitutes not be routinely stocked by healthcare institutions. In summary, iron deficiency is endemic in Canada and, if mothers choose not to breastfeed, low-iron formulas, condensed milk and whole milk should be strongly discouraged in infancy (as per Canadian Pediatric Society recommendations). We should campaign to ensure that the community and retail trade are aware of this recommendation. Khalid Khalid Aziz Memorial University of Newfoundland