With the recent debate about breastfeeding vs infant formula (link to NYT article), I want to add some of my own thoughts on the topic. I earlier wrote blogs about the uniqueness of breast milk (link) as well as how infant formula is made from bovine milk (link).
Breast milk is off course the inspiration for the design of infant formula. The more we have learned in the past century about breast milk, the more finetuned infant formula has become. Increasing lactose and reducing protein content have been initial steps, followed by changes in fatty acid and protein composition and mineral composition. In this way, the major nutrients in breast milk are very well mimicked in infant formula.
But breast milk is much more intricate than only these basic nutrients. It for example contains a wide range (100+) of oligosaccharides, all with their own unique properties. Although infant formula also contains oligosaccharides, these are not identical and can only mimic some of the properties of the ones from breast milk. Then we have 100’s of immune-active protein and hormones that are very different between human and bovine milk, and are even more difficult to mimic in infant formula. And finally it becomes even more complicated if we look at the cellular components in breast milk. Breast milk contains, amongst others, live bacteria, white blood cells, and transport vesicles called exosomes. We currently have no way of making or adding such components to infant formula, even though we learn more-and-more each day on their function in the healthy development of infants.
So in the end, I do not believe infant formula will ever match the functionality of breast milk. That’s why I believe we should have very strict rules for infant formula marketing, making clear to parents around the world that breastfeeding has benefits that infant formula cannot match. But that doesn’t mean that we should not try to make the best infant formula possible. My research group focuses on both sides: better understanding the health benefits of breast milk, but also understanding bovine milk to allow designing better infant formula. Because infants that are not breastfed should have the best possible alternative available to them.
Kasper Hettinga, July 2018