Today's infant formula has a long history and many years of research and development to thank. Alternatives to breastfeeding are believed to have existed throughout history, with experiments using milk from animals such as cows, goats and donkeys. At the beginning of the 19th century, the first scientific reports appeared that showed poorer chances of survival in children who were not breastfed, but were exclusively fed, for example, cow's milk. In 1838, the German researcher Johann Franz Simonn published the first chemical analysis of the content of breast milk compared to cow's milk, which then formed the basis for 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 breast milk, which led to the understanding that cow's milk was more difficult to digest than breast milk. The first recommendations were to add water, sugar and cream to regular cow's milk to make it more similar to breast milk. 1
In the 1860s, German chemist Justus von Leibig developed powdered infant formula based on wheat flour, cow's milk, malt and potassium bicarbonate. The powder, which was to be mixed with heated cow's milk, was the formula that most closely resembled breast milk up to that point, 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 American market. In 1870, the American company Nestlé Infant Food launched the first infant formula that could be mixed with water instead of milk – the first completely chemical product on the market.
The millennium between 1870 and 1970 revolutionized milk research with the introduction of pasteurization and condensation. In formula, experiments were conducted with added vitamins, sugars, and fatty acids to fine-tune and come even closer to resembling breast milk. In the 1970s in the United States, the use of formula was widespread and more the norm than the exception. Data show that only 25% of new mothers breastfed their babies. A strong contributing factor to the low breastfeeding rates in the United States at this time is believed to have been that hospitals provided formula from birth, which led mothers to believe it was best practice and thus wanted to continue with formula, which was both readily available and inexpensive. 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 accordance with the latest research. The greatest advances that have been made in recent years are in the nutrition of babies born prematurely or with very low birth weight, as well as in formulas for infants with allergies or other problems with processing milk. 4 Another development in this area is the framework of laws and regulations that have been created to ensure the quality and safety of consumers of infant formula. Among other things, the EU regulates the composition of infant formula. In many countries, laws also regulate how infant formula can be marketed, so as not to make it appear as a better alternative to breastfeeding. Especially in developing countries, where access to clean water is not self-evident, it is important not to idealize formula. The World Health Organization (WHO) recommends breastfeeding infants for at least 6 months and opposes inappropriate marketing of formula as it is believed that it generally contributes to lower breastfeeding rates and causes mothers who might otherwise breastfeed to choose formula instead. 5 Most countries follow the WHO's recommendations.
Although the general recommendation is that infants 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 rest assured 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 Pediatric 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. WHO website: https://www.who.int/health-topics/breastfeeding
