It shows that too often manufacturers add unnecessary ingredients with no proven benefits – so that they can charge a premium price for their products. While it is legal, such practices are unethical and in breach of a voluntary World Health Organization code on the marketing of breastmilk substitutes.

There is no question that exclusively breastfeeding your baby for the first 6 months of life – a practice recommended by every health organisation in the world – provides your baby with everything it needs to grow and thrive. Not just nutrition, but hundreds of non-nutrient factors which cannot be synthesised in the lab and which help protect against illness and promote optimal growth.

Formula you can trust?

Nevertheless there are women who choose not to breastfeed and a very small percentage physically can’t breastfeed. For these women and their babies, being able to trust that infant formula is providing the best possible nutrition is very important.

The new report by non-profit, UK-based Changing Markets Foundation challenges the idea that wide ranges of formula brands, each with different added ingredients do not cater to mothers’ or babies’ needs but instead exist purely to create a fear based market where mothers will pay a premium for certain brands.

Higher prices

The report analysed the retail prices that companies around the world charge for infant formula.

The market, it seems, charges whatever it can get away with and this practice is highlighted by the fact that the same brands that may sell for wildly different prices in different parts of the world.

The most expensive products were found in China and Hong Kong, where families can spend US $286 and US $304 per month to feed a 2-3-month old baby, respectively, based on using the most expensive product in those markets.

Chinese mothers are still reeling from a scandal in which toxic melamine was added to cheap formulas to make them appear as if they had more protein in them than they did. Many infants were made ill and some died from drinking the adulterated formula.

This was in 2008, but many mothers still seek Western brands believing that they are better, or purer, than Chinese brands. Western brands capitalise on this fear by charging exorbitant prices for their products.

As a result, parents in China can spend up to 40% of their average salary on infant formula. In comparison, the most expensive formula in European countries will only cost 1-3% of an average salary.

Closer to breastmilk?

Another industry tactic identified in the report is the creation of different and more expensive varieties of formula with extra ingredients. These formulas with added fats, pre- and probiotics and certain nutrients, claim to make formula closer to breastmilk, to represent the latest developments in nutritional science, to satisfy hungrier babies, promote better digestion, and to aid sleep.

But, says the report, “There is little nutritional science and few beneficial health considerations behind their extensive product ranges.”

Social media spying

The report also highlighted the extent to which formula companies listen in on mothers’ social media posts in order to learn what they hope for – and what they fear – and then tailor their marketing outreach around that.

Infant formula manufacturers are very open about how they use internet platforms such as Facebook, as well as online mother and baby clubs (many of which are financed by formula manufacturers in the first place), to collect vital information on mothers, and to portray themselves as trusted ‘friends’ on the ‘mother’s journey’ in order to sell their products.

“Our report found that instead of nutritional science, companies are basing their selling strategies on market research and consumer preferences,” said Nusa Urbancic from Changing Markets Foundation.

“Product differentials are carefully and deliberately designed to appeal to the tastes and lifestyle preferences of parents, or their natural desire to give their babies the best possible start in life. As such, manufacturers can package these products in ‘premium’ ranges and charge high prices accordingly.”

Changes needed

The report calls for a comprehensive overhaul of global infant milk products and the introduction of stricter regulation, so that only those products based on unequivocal scientific advice and with the highest quality of nutritional ingredients are sold.

It also calls on governments to introduce and enforce national legislation that fully implements the WHO marketing Code and to ensure that the safety and nutritional quality and completeness of products is regularly verified.

• The report, Milking it, along with its executive summary, can be downloaded here.
• To coincide with the report Sum Of Us, the global online campaigning platform, has launched a petition calling for Nestlé to make sure their infant milks are safe, nutritionally complete and based on science. You can sign on and share at this link.

In the past, scientists have concentrated their search for the source of breastmilk’s antibacterial properties on the proteins it contains. But researchers at Vanderbilt University in the US have discovered that some of the carbohydrates in human milk have important antibacterial properties.

“This is the first example of generalised, antimicrobial activity on the part of the carbohydrates in human milk,” said Assistant Professor of Chemistry Steven Townsend, who directed the study. “One of the remarkable properties of these compounds is that they are clearly non-toxic, unlike most antibiotics.”

The results of the investigation were presented at the recent annual meeting of the American Chemical Society in Washington DC and are published in the journal Infectious Diseases.

Antimicrobial properties

What motivated the research was the growing problem of bacterial resistance to antibiotics, which the Centers for Disease Control and Prevention estimates causes 23,000 deaths annually.

“We started to look for different methods to defeat infectious bacteria. For inspiration, we turned to one particular bacteria, Group B Strep. We wondered whether its common host, pregnant women, produces compounds that can either weaken or kill strep, which is a leading cause of infections in newborns worldwide,” Townsend said.

Instead of searching for proteins in human milk with antimicrobial properties, Townsend and his colleagues turned their attention to the sugars, which are considerably more difficult to study.

“For most of the last century, biochemists have argued that proteins are most important and sugars are an afterthought. Most people have bought into that argument, even though there’s no data to support it,” Townsend said. “Far less is known about the function of sugars and, as a trained glycoprotein chemist, I wanted to explore their role.”

Beneficial sugars

To do so, the researchers collected human milk carbohydrates, also called oligosaccharides, from a number of different donor samples and profiled them with a mass spectrometry technique that can identify thousands of large biomolecules simultaneously. Then they added the compounds to strep cultures and observed the result under the microscope. This showed that not only do some of these oligosaccharides kill the bacteria directly but some also physically break down the biofilms that the bacteria form to protect themselves.

“Our results show that these sugars have a one-two punch,” said Townsend. “First, they sensitise the target bacteria and then they kill them. Biologists sometimes call this ‘synthetic lethality’ and there is a major push to develop new antimicrobial drugs with this capability.”

The carbohydrates in breastmilk, say the researchers can act on their own, but also enhance the effectiveness of the antibacterial proteins also present.

The next step, they say is to identify which of these natural sugars is the most effective. It’s a big ask; breastmilk contains over 200 unique sugars.

Head lice infestation, most often seen in children aged 3 to 14 years, causes itching and irritation, as well as parental anxiety. There is also the risk of spreading the infestation to the rest of the family creating an endless cycle of discomfort and embarrassment.

The conventional approach of insecticidal treatments containing neurotoxins raises legitimate safety concerns – as well as concerns about the growing resistance of head lice to these chemicals. This has led to many parents seeking safer and more natural approaches to help get rid of lice.

In a new study from Australia the researchers conducted two separate trial to compare the safety and efficacy of a natural head lice treatment (MOOV Head Lice Solution) made from Australian eucalyptus (Eucalyptus globulus) oil and lemon-scent tea tree (Leptospermum petersonii) oil  with a neurotoxic mousse containing pyrethrins and piperonyl butoxide in children.

A more effective treatment

In the first trial they looked at the efficacy of the two approached when applied several times daily over a 7 day period. In the second they assessed the efficacy of a single application of the essential oil treatment. The scientists also conducted a skin irritation test, involving adults.

Analysis of the first trial which involved 76 children showed a significant difference in cure rate at 7 days. In the natural treatment group 83% of the EO/LP group were cured of their infestation compared with 36% of those using the insecticide. This difference increased from day 1 to day 7 with the biggest difference seen at the end of the trial.

For the second smaller trial 11 children with live lice received a single treatment with the essential oil solution. The authors report that the 1,418 head lice collected were considered dead as they were wet-combed out of the hair. Further examination 30 minutes after combing confirmed that all lice were  dead.

For the skin irritation test the authors report that no erythema, edema, or other adverse effects were observed.

The authors (both of whom work for the company producing the natural formula) conclude that “the EO/LP solution contains a proprietary combination of essential oils that has been shown to be safe and effective in eliminating head lice in Australia,” and because the solution is both volatile and quickly effective, “it is unlikely to cause the development of head lice resistance in the community.”

• For more on this topic see our article Non-toxic ways to get rid of head lice

Women traditionally have been told to avoid eating or drinking during labour due ‘just in case’ they need emergency care with  a general anesthetic – which raises the risk they may aspirate, or inhale liquid or food into their lungs, which can cause pneumonia.

But when researchers reviewed the literature of hundreds of studies on the topic, published in 1990 or later, they determined that withholding food and liquids may be unnecessary for most women in labour.

More than half said they don’t warn about mercury, and hardly any of them give advice about lead, pesticides, air pollution or chemicals in plastics or cosmetics.

Virtually all pregnant women have chemicals in their bodies that might harm fetal development,

For many of these compounds, low-level exposures in the womb can potentially disrupt development of the brain or reproductive systems. Others may raise the risk of birth defects, or lead to cancer, immune problems, asthma, fertility problems or other disorders later in life.

Mothers left in the dark

Yet according to the scientists at University of California, San Francisco’s (UCSF) who conducted the study, that information is not reaching most women who are pregnant or want to become pregnant.

Almost all of the doctors in the nationwide survey said they routinely discussed smoking, alcohol, diet and weight gain; 86% also said they discuss workplace hazards, and 68% warn about second-hand smoke.

But only 19% said they talk to their pregnant patients about pesticides and only 12% discuss air pollution; 44% said they routinely discussed mercury and 11% said they mention volatile organic compounds, which are fumes emitted by gasoline, paints and solvents.

Even fewer physicians warned their patients about two chemicals in consumer products that are often in the news: only 8% discussed bisphenol A (BPA), 5%  discussed  phthalates and just 9% of the doctors told their patients about polychlorinated biphenyls (PCBs), industrial compounds often found in fish.

A heavy burden for women

According to on-going monitoring by the US Centers for Disease Control most women carry around 100 different chemicals – including lead, mercury, toluene, perchlorate, bisphenol-A, flame retardants, perfluorinated compounds, organochlorine pesticides and phthalates – 43 of which are in half of all women tested.

In 2011 a study in the journal Environmental Health Perspectives analysed data for a wider range of 163 chemicals and detected polychlorinated biphenyls (PCBs), organochlorine pesticides, perfluorinated compounds (PFCs), phenols, polybrominated diphenyl ethers (PBDEs), phthalates, polycyclic aromatic hydrocarbons (PAHs) and perchlorate in 99-100% of pregnant women.

Among the chemicals found in women’s bodies were highly persistent chemicals such as PBDEs, compounds used as flame retardants now banned in many states including California, and dichlorodiphenyltrichloroethane (DDT), an organochlorine pesticide banned in the United States in 1972.

The majority of chemicals used for commercial purposes have entered the marketplace without testing and standardised information about their potential health effects, including among those most vulnerable amongst us.

Doctors out of their comfort zones ignore the research

The results of the current survey –  which were discussed at a recent American Public Health Association conference but are not yet published – show a disconnect between environmental health research and what the physicians do, and do not, tell their patients, said Patrice Sutton, a research scientist at UCSF’s Program on Reproductive Health and the Environment who helped design the survey.

Many doctors surveyed felt their priority was to protect pregnant women from more immediate dangers, and that warning them about environmental risks may create undue anxiety.

Revealingly, some said they didn’t feel confident in their ability to discuss the topic of environmental toxins. This despite the fact that The American Academy of Pediatrics has had an environmental health committee for over half a century and publishes a clinicians’ handbook for the prevention of childhood diseases linked to environmental exposures.

The human reproductive system is particularly vulnerable to biological changes caused by chemicals in the environment when exposures occur during critical or sensitive periods of development such as in utero, and during infancy, childhood and adolescence. This vulnerability is partly due to extensive changes, such as cellular growth or hormonal shifts.

A previous study by the same team similarly concluded that doctors have an important role to play in the health of future generations by intervening at these critical periods of human development and helping women to understand the impact of environmental toxins

Chemicals not tested, women not questioned

It’s important, say the researchers in the current study, to try to break down obstacles that keep health messages from pregnant women. Acknowledgement of, and familiarity with, the large volume of research is this area is a first step.

Another important step is for doctors to take an accurate history of any potential exposures.

“We recommend that clinicians always ask women of childbearing age about their occupational exposures to chemicals known to negatively impact health,” said Sutton. “Many patients who are pregnant or thinking about becoming pregnant already are interested in their environmental exposures, and at the same time, other women of childbearing age are unaware of the risk of their exposures,”

Clinicians should also provide guidance about avoiding exposures at home, in the community and at work, and for example, it can be incorporated as part of childbirth classes.

She added, however, that society-wide actions are essential for reducing toxic exposures to pregnant women, since individuals cannot control their exposure to many toxins, such as through air pollution.

“As a society, we have a lot of work to do in terms of informing women of the dangers,” said Dr. Naomi Stotland, lead investigator for the survey.

Iron deficiency and iron deficiency anaemia are major public health problems in young children worldwide, and are associated with poor neurodevelopment.

Studies in Africa and South America, where iron deficiency is most common, have shown that delaying umbilical cord clamping improves irons status in infants, but it was unclear whether it is also beneficial countries where malnutrition is less common. Because of this, hospitals have different guidelines and best practices regarding clamping.

In the latest study Swedish researchers tested 400 babies – some who had their umbilical cords clamped after at least three minutes and others who had them clamped immediately,  less than 10 seconds after delivery.

The babies whose umbilical clamping was delayed benefited from higher iron levels at four months.

According to the researchers, for every 20 babies whose cords are clamped three minutes or more after birth, one case of iron deficiency would be prevented. There were also fewer cases of neonatal anaemia in those with delayed clamping.

There were no adverse health effects from delayed clamping and the researchers concluded that delayed cord clamping should be considered as standard care for full-term deliveries after uncomplicated pregnancies, even in developed countries.

Early cord clamping has become controversial in the last decade or so because some hospitals ‘harvest’ umbilical cord blood for stem cell research. Women are often approached antenatally and asked if they would like to donate their cord blood and told there is no risk to the baby.

The amount of blood taken varies but is usually around 150-20oml – out of the potential 600mls in the baby’s body.

There is conflicting data on whether depriving the baby of cord blood also deprives babies the baby of essential stem cells. In addition to possible iron deficiency found in this study, parents should consider all the facts and potential risks, before agreeing to donate cord blood.

A selection of publications can be found here.

This physiological response to fatherhood, say researchers at Northwestern University in Illinois in the US, is consistent with what is observed in many other species in which males help take care of dependent offspring.

Testosterone boosts behaviours and other traits that help a male compete for a mate. But after they succeed and become fathers, “mating-related” activities may conflict with the responsibilities of fatherhood – and so the body adapts to reduce production of the hormone.

“Humans are unusual among mammals in that our offspring are dependent upon older individuals for feeding and protection for more than a decade,” said Christopher W. Kuzawa, co-author of the study and associate professor of anthropology in the Weinberg College of Arts and Sciences.

“Raising human offspring is such an effort that it is cooperative by necessity, and our study shows that human fathers are biologically wired to help with the job.”

Past studies showing that fathers tend to have lower testosterone levels were small and not conclusive regarding whether fatherhood diminished testosterone or whether men with low testosterone in the first place were more likely to become fathers.

This most recent study which followed a group of 624 males aged 21.5 to 26 years old for 4.5 years in the Philippines, took takes a novel approach by following a large group of men who were not fathers and seeing whether their hormones changed after becoming fathers.

It found that the men who started with high testosterone were more likely to become fathers, but once they did, levels of this hormone dropped substantially. What is more the findings suggested that this is especially true for fathers who become the most involved with child care.

The new study’s findings also suggest that fathers may experience an especially large, but temporary, decline in testosterone when they first bring home a newborn baby.

Fatherhood and the demands of having a newborn baby require many emotional, psychological and physical adjustments and these results suggest that a man’s biology can change substantially to help meet those demands.

The authors also suggest that their findings may provide insight into one reason why single men often have poorer health than married men and fathers.

“If fathers have lower testosterone levels, this might protect them against certain chronic diseases as they age,” Kuzawa said.

The researchers at Stanford University, in California, USA used data from the National Birth Defects Prevention Study to identify pregnant women from 10 US states with estimated due dates from October 1997 through December 2005.

Information about their babies’ health was collected via telephone interviews. Included in the analysis were 936 cases with neural tube defects, 2,475 with orofacial clefts, and these were compared to 6,147 other babies without birth defects.

This was compared to data on the mothers’ diets which was collected via a questionnaire. A good diet was defined as either one which was based on the Mediterranean Diet (Mediterranean Diet Score or MDS) or on the US Department of Agriculture Food Guide Pyramid.

A higher quality diet was associated with a lower risk of both neural tube defect and orofacial clefts.

Interestingly this held true even though 19% of the women smoked, 38% drank alcohol, and 16% were obese – all potential risk factors for reproductive abnormalities.

Around 78% percent took folic-acid-containing supplements during early pregnancy. However the authors state in that while folic acid supplementation and food fortification has been effective in preventing neural tube defects, folic acid does not prevent all birth defects.

“Nutrition research on birth defects has tended to focus on one nutrient (or nutritional factor) at a time,” they write. “However, the reality of nutrition is much more complex.”

“These results” say the authors, “suggest that dietary approaches could lead to further reduction in risks of major birth defects and complement

In an accompanying editorial in the same journal, David R. Jacobs, Jr, PhD, from the University of Minnesota, Minneapolis, and colleagues note that while maternal intake of folate is important for fetal development, recent studies suggest the supplemental folic acid may have adverse health effects on older adults.

He notes also that the impact of the study may have implications for the controversial requirement of blanket fortification of certain foods, which risks over supplying some individuals with certain nutrients and thereby negatively affecting their health.

“The importance of the findings of this particular study, he notes ”…lies in showing that women obtain benefit from the consumption of a high-quality diet, beyond the benefits derived through grain fortification.

This raises the question of whether a high-quality diet alone may be sufficient to prevent NTDs (neural tube defects) – a strategy that would also remove the potential harm from fortification.”

“Reduction of NTDs may be achievable by diet alone, at the same time reducing potential risk for other chronic diseases in the rest of the population.”