Infant nutrition is one of the most important factors that not only infl uences immediate child growth and development, but also sets the stage for health outcomes later in life. One of the global challenges that we are faced with today is to fi nd ways to thwart the rise in childhood overweight and obesity rates and their long-lasting negative repercussions.
Breastfeeding is widely recognised as the best way to provide young babies with the nutrients they need for healthy growth and development. However, according to the World Health Organisation (WHO), only about 36 percent of infants aged 0-6 months worldwide were exclusively breastfed over the period of 2007-2014.
WHO recommends exclusive breastfeeding up to six months of age, with continued breastfeeding along with appropriate complementary foods up to two years of age or beyond. Although following these recommendations should be encouraged, when it is not possible or chosen, infant formulas must be designed to properly fulfil the nutritional needs of the child.
This is why “infant formula companies should do their best to make infant formulas that mimic breast milk as closely as possible and come up with affordable options for low and middle income countries without compromising on quality,” said Dr Sandra Einerhand—founder and consultant at Einerhand Science & Innovation. Breastmilk does indeed naturally provide all the essential nutrients for the infant’s development and it also adjusts as the child ages and his/her needs evolve.
Designing Adequate Infant Nutrition Products
Before diving into the specifics of infants’ nutritional needs and how manufacturers can fulfil these requirements, it is important to define the term ‘infant nutrition.’ Infant nutrition can be segmented into two subcategories:
• Infant Formula: food intended for infants from birth to 12 months of age.
• Baby Food: all food intended for children between 12 and 36 months of age.
The infant formula subcategory is under close scrutiny and bears very stringent regulations both on the formulation and the marketing of such products, which limits the number of players involved. In contrast, baby food has fewer restrictions which allows more suppliers to enter the category. In this segment, companies typically rely on advertising to win customers, using scientific studies and data to enhance their product’s credibility and differentiate from the competition.
The infant formula category is made up of two distinct types of products defined by the European Commission: ‘infant formulae’ (0-6 months), which is “foodstuffs used by infants during the first months of life and satisfying by themselves the nutritional requirements of such infants until the introduction of appropriate complementary feeding”; and ‘follow-on formulae’ (6-12 months), which is “foodstuffs used by infants when appropriate complementary feeding is introduced and constituting the principal liquid element in a progressively diversified diet of such infants”.
Growing-up formulae (12-36 months) is the third type of formula pertaining to infant nutrition but it belongs to the more liberal baby food category.
Infant formula and follow-on formula are products designed to satisfy the specific nutritional requirements of healthy infants and are specifically covered by the European Directive and other legislative texts in other geographical areas. This lays down the requirements for the composition, labelling and marketing of both infant formula and follow-on formula. The amount of protein, carbohydrate, fat, mineral substances, vitamins and certain other ingredients in these products are precisely defined and, where necessary, minimum and maximum levels are included.
Another type of product for infant nutrition are pediatric drinks and powders which are classified as products for special medical purposes (FSMP) and are designed to meet the needs of babies with specific illnesses and nutritional requirements. These products are controlled by a distinct set of regulations.
According to Mintel, most infant formulae are made with cow’s milk. However, goat milk is also emerging as an alternative. Given the differences between breast milk and cow’s milk, considerable work is needed for manufacturers to produce a nutritionally complete infant formula mimicking breast milk as closely as possible and matching the mandatory guidelines set by local regulations. This entails a deep understanding of the global regulatory landscape by suppliers as well as a perfectly mastered manufacturing process since, among other things, protein contents need to be adjusted to better compare to breast milk.
For example, unlike cow’s milk, the casein to whey ratio of breast milk is high on the whey side (40:60), which is why whey proteins are commonly used in infant formula to adjust this ratio.
Figure 1: Percentage of global baby formulas (0-6 months and 6-12 months) using protein groups, by region, from Nov 2010-Oct 2015.
Although not very common in baby formulas, vegetable proteins such as soybean proteins are also used, mainly in formulae designed for babies with lactose or dairy intolerance/sensitivity. It is worth noting that vegetable proteins are more common in North America than anywhere else in the world, accounting for 12 percent of infant formulae using protein launched between November 2010 and October 2015 there, when it only adds up to four percent in the Asia-Pacific region and one percent in Europe (see Figure 1).
In order to match breast milk’s composition, missing or low concentration compounds are usually supplemented. Here are some examples of specific nutrients that can be added to infant formulae to comply with infants’ needs at different stages of their development and the benefits associated.
• Lutein: Helps protect the eyes and may also play a role in the development of infant’s brain
• DHA (docosahexaenoic acid) /ARA (arachidonic acid): Essential fatty acids linked to an improvement of cognitive and visual scores in children
• GOS (galactooligosaccharides)/ FOS (fructooligosaccharides)/ inulin: Prebiotic fi bres that may result in positive effects on the composition of the gastro-intestinal microbiota as well as on the immune function in babies
• OPO (oleic and palmitic fatty acid structure oils): A triglyceride structure that has been shown to optimise calcium absorption in infants, resulting in higher bone mass • Nucleotides: Compounds that may play a role in physical growth and neurological development of infants as well as enhance the development of their immune system, resulting in better resistance against infections
• Lactoferrin: A milk protein with known immune health properties • Probiotics: ‘Good bacteria’ intended to promote a healthy balance in infants’ gastro-intestinal tract and to offset the growth of ‘unfriendly’ organisms that could cause infections and inflammation
Targeted Health Benefit
Manufacturers also offer products formulated to target specific health benefits. Here are some of the more popular ones available:
•Preterm formulae: Designed for premature or low birthweight infants, these products are formulated with extra nutrients such as medium chain triglycerides, DHA, etc.
• Lactose-free formulae: Intended for lactose-intolerant/ sensitive babies, these products are usually formulated with maltodextrin or glucose syrup as a replacement for lactose
• Anti-regurgitation formulae: Developed for infants suffering from severe regurgitation issues, these powders usually contain added carob bean or rice starch to reduce spit-up
• Hypo-allergenic formulae: Intended for infants at risk of allergies, these products are formulated with hydrolysed proteins that prove to be easier to digest
• Comfort formulae: Designed to reduce the digestive discomfort experienced by some children, these products offer a reduced lactose content and added starch.
What Drives The Market
The global infant nutrition market was estimated to be worth about US$50 billion in 2014 and is forecast to be the fastest growing packaged food category through 2019, according to Zenith International. In fact, the market is expected to record an compound annual growth rate (CAGR) of over seven percent each year until then.
US, Europe and Japan will continue to represent steady demand for infant nutrition but, being more mature markets, they will display lower growth rates, reported Nielsen in 2015. In comparison, emerging markets such as China, India, Brazil and also the Middle-East and Africa, are projected to exhibit double-digit growth over the same period thanks to high birth rates, increasing purchasing power of middleclass consumers and the growing number of women working outside of home.
Two-thirds of the global infant nutrition market is concentrated among four major global players. Abbott and Mead Johnson account for 80 percent of sales in the US, whereas Nestlé and Danone (Numico) are leading the Western Europe market. In Asia, these players tend to form joint ventures with local operations to help develop local offerings.
Trends driving the infant nutrition market vary greatly depending on the regions. In China, for example, the infant formula safety issues of the past decade still weigh on the market, creating heightened consumer concerns over food safety and hygiene. In this context, they are willing to pay more for quality products. Also, because ingredients imported from Europe are perceived to be of higher quality than local offerings, these unlock tremendous potential for European suppliers.
Figure 2: Based on a survey by 2,859 female internet users aged 20-39 with babies under 36 months in December 2014, this depicts the desired health improvements from milk formula products.
Other major trends in the Asia-Pacific region are the reason for emphasis on added ingredients and on the targeted health benefits offered. For example, products formulated to provide a specific health benefit, such as relief of gas discomfort, lactose intolerance, etc. (see Figure 2), are preferred by 47 percent of Chinese mothers aged 20-39 with a baby under the age of 36 months who uses infant formula. Organic and goat milk alternatives are also emerging there as additions to existing ranges.
In Europe, the primary focus is to communicate on the ‘premium’ status of one’s products and, interestingly, we have observed an increasing presence of infant nutrition companies on TV. Manufacturers create strong marketing campaigns to strengthen their brand and reassert their commitment to quality, in an effort to reassure consumers.
The organic market of infant nutrition is still on the rise although it is not a new segment in this area. Overall, innovation is slower in Europe than it is in Asia, which makes sense considering that the market is more mature.
As far as US is concerned, a growing demand is seen for organic baby food as well as eco-friendly packaging. Infant formulae targeting a specific health issue are popular and so those with added ingredients (e.g. immune health ingredients which are particularly trendy) and that are backed up by scientific data gain consumers’ trust.
Globally, the baby food market is driven by a quest for convenience with innovative, on-the-go packaging options; healthier choices with clean labels and organic options which are believed to be healthier and safer than their conventional counterparts; and targeted health benefits with products focusing for example on toddler’s cognitive development.
What Does The Future Hold?
As the world population continues to grow, so does the demand for infant nutrition products. The challenges ahead lie in deepening our understanding of biological mechanisms and breast milk compositions as they evolve throughout the beginning of a child’s life.
This will help manufacturers mimic breast milk’s nutritional features more closely in an effort to create a healthier future by improving our children’s food supply. Hopefully, it will in turn help reduce the prevalence of noncommunicable diseases such as obesity, diabetes, etc.
However, it might be useful to note that some aspects of breastfeeding such as the skin-on-skin contact between a mother and her baby are also believed to play an important role in an infant development; this can never be replicated if infant formula was used instead.
In the near future, there will be an ever increasing demand in quality for infant nutrition products by consumers. This will allow companies with superior commitment to quality, traceability and control, from raw materials to finished products, to stand out.
Yet, it needs to be understood that there is a fine line between food safety and nutritional quality. Manufacturers need to balance these two components very carefully in order to produce safe products with preserved nutritional properties. For example, liquid formulae (using ultra-high temperature processing) is currently growing at a very fast pace and, although they are extremely safe thanks to the heat treatment they go through, this same treatment might decrease the nutritional quality of the end-product by altering the nutrients’ content. This is something manufacturers need look into when aiming to create the best products positioned for infants.
Infant nutrition brands are looking for reliable long-term partners to help them fulfi l their moral obligation to design products that come as close as possible to breast milk and to market these products responsibly and in compliance with regulations. Suppliers with established expertise in manufacturing processes as well as a deep understanding of the global regulatory landscape will have the upper hand as they can offer full support to these companies, from idea to formulation, implementation and even claims substantiation.