Margot Bertelsmann checks out baby formula – or tries to, anyway …
Look, we all know breast is best. Thanks to an actively implemented campaign by the Department of Health, which mirrors the advice of the World Health Organisation (WHO), more and more South African mothers are being taught every day that exclusively feeding breast milk to newborn babies is the best possible nutrition choice you can make for your baby.
After about six months, you start to introduce supplementary solid foods and water, but continue breastfeeding to two years and beyond, depending on the individual circumstances of the mother and baby.
Part of the reason the message has been successful is because the new feeding regulations introduced by Health Minister Aaron Motsoaledi in 2012 severely limit how companies can market or advertise baby food. In other words, the government is “walking its talk” by making access to baby formula less convenient and tempting.
Regulation 991, the Regulations Relating to Foodstuffs for Infants and Young Children, falls under the Foodstuffs, Cosmetics and Disinfectants Act 54 of 1972, and it is strict: baby formula manufacturers may not show pictures on their tins other than how to constitute the formula. They may not make any claims about their nutritional benefits, especially in comparison with human breast milk. They may not show babies or teddies or anything that could appeal to children on their packaging.
They must, however, list their ingredients in accordance with law. They must also state on their tins that breast milk is best for babies, and that their product does not contain breast milk.
And here’s the rub: manufacturers also may not promote or advertise their product, and – and this is the bit that presumably frightens formula sales reps and media relations officers – they may not distribute information or educational material about the nutrition or feeding of infants.
What this means in practice is that getting information on the contents of the infant formulas available on our shelves can be surprisingly difficult.
The hunt for formula information
We tried to find information on the ingredients in the following brands of baby formula on sale in large stores in South Africa for infants younger than six months:
- Nestle NAN Optipro Gold 1
- Nestle NAN Supreme 1
- Wyeth S-26
- Wyeth S-26 Gold
- Novalac AC
- Novalac Premium
- Aspen Infacare
All the brands except Infacare have ingredients listed online on their websites, but in several cases the information is hidden many pages into the site in pdf or jpeg format, meaning a mother who needs information has to have both internet access as well as enough data to download image files.
Phone calls and email messages about the content of their formulas to the media liaison representatives of Nestle, Wyeth, and Aspen went unanswered.
Aspen Group declined to comment, saying: “As your article is intended for the public domain and given that we are governed by and uphold the National Department of Health’s Regulations relating to Foodstuffs for Infants and Young Children (R991 of December 2012), we are not able to provide comment as requested.”
Novolac’s product manager, Almarene Mocke, had a similar response: “Novolac follows the R991 guidelines, which means we cannot speak to the consumer at all and we cannot promote our formula. Our only contact is with healthcare professionals. Novalac as a company supports breastfeeding; we only provide an alternative to breastfeeding for moms who cannot breastfeed for some reason – and our product is in preference to unhealthy food choices for infants, such as cows’ milk or other unsuitable baby food.”
“All the brands on the market are acceptable food for your baby if you can’t breastfeed, whether it’s an entry-level formula or a more expensive premium brand.”
Whether this was the intention of the regulations or not, company representatives seem to consider speaking to journalists as setting off alarm bells that they may be trying to “speak to the consumer”.
Where to from here for a mother seeking nutritional information?
To the nearest Pick n Pay, armed with a phone camera, of course! We managed to obtain photos of the first four listed brands’ ingredients lists on the backs of the tins. We were about to photograph Infacare, when a security guard stepped in and told us photographs were not permitted inside the store.
“We do have a policy restricting photography in stores from a security point of view,” admits Pick n Pay media liaison Janine Caradonna.
The only alternative seems to be to purchase, at up to R200 per tin, one tin of each formula – a total financial outlay of up to R1 500 – before you can even make up your mind about which formula to use for your baby.
Imagine these five scenarios
- Imagine an unemployed new mother who finds work as a char once or twice a week, but who is not allowed to bring her baby to work with her. She must choose: income or breastfeeding?
- Imagine the woman employed in a front-of-house position greeting and directing visitors in a medium-sized company. She asks for two half-hour breaks to express breast milk per day, as mandated by employment legislation, but her boss refuses, saying she must be at her desk at all times.
- Imagine the mother undergoing potentially lifesaving chemotherapy or emergency surgery, for whom the decision to feed her infant formula is filled with regret and a sense of urgency to find a suitable alternative.
- Imagine the mother, trying to avoid dipping into postnatal depression, whose history of sexual abuse makes her unwilling to breastfeed.
- And imagine the corporate high-flyer who doesn’t have the time or inclination to breastfeed, and who thinks it is none of your or my business what choices she makes over her own body.
Whatever the reason mothers have for not breastfeeding, or not exclusively breastfeeding, access to information should not be this difficult. Whether you choose or need to bottle-feed sometimes or always, you should be able to at least learn about the replacement food you are giving your precious baby, so that you can make an informed decision.
If you do formula-feed, what extras are worth paying for?
“In order to be labelled as an infant formula, a product has to meet certain basic criteria. It must contain a certain number of vitamins and minerals in certain quantities, and be made up of an acceptable blend of proteins, carbohydrates and fats,” says registered dietitian Claire McHugh.
“All the brands on the market meet those criteria and are an acceptable food for your baby if you can’t breastfeed, whether it’s an entry-level formula such as Infacare or a more expensive premium brand.”
Nestle’s Zweli Mnisi agrees. “Standard infant starter formulas are designed to offer optimal nutrition to infants whose mothers chose or opted not to breastfeed, after consultation with a healthcare professional. They meet all the nutritional requirements, as dictated by the relevant bodies, such as CODEX. Premium starter infant formulas contain additional ingredients, or undergo special technological processes, for increased nutritional benefits. The cost of the additional raw materials, at times imported, then leads to the increase in price.”
But Claire says it’s best for formula to resemble breast milk as closely as science has so far made possible. Therefore, manufacturers add ingredients – at an added cost. “The prebiotics GOS (galacto-oligosaccharides) and FOS (fructooligosaccharides) are saccharides, carbohydrates on which the natural good bacteria of the gut can feed.
Omega-3 fatty acids such as DHA and AHA (or AA) are good for infant eye and brain development, and these are often added to the formulation, adding to the cost,” says Claire. “Some brands use a blend of fats rather than exclusively the cheaper palm oil, which has a cost implication. Many brands add a probiotic – the good bacteria that can help gut health.”
“In my opinion, if you can afford to buy a brand with added omega acids and probiotics, you should,” says Claire. “But you can be sure that your standard brand meets the baseline requirements.”