Specialised 
                         infant milks 
                         in the UK:  
                         Infants 0-6 months 
                         Information for health 
                         professionals 
                          
                         March 2017 
                                   
                     Specialised Infant Milks in the UK • March 2017 • page 1 
            Specialised Infant Milks in the UK: Infants 0-6 Months. Information for health 
            professionals.  March 2017.  
             
            Authors: Helen Crawley, Susan Westland and Sarah Weston 
             
            ISBN 978-1-908924-08-7  
             
            This resource is provided for information only and individual advice on diet and health 
            should always be sought from appropriate health professionals. We have attempted to 
            provide accurate information on the current composition of specialised infant milks sold in the 
            UK in this report, and do so in good faith. However, composition, names and claims may 
            change, so please refer to the specific manufacturers for up-to-date information. 
             
            Acknowledgements 
             
            Thanks are due to Debra Davidson, Alison Holmes, Caroline King, Anita MacDonald, June 
            McMahon, Colin Michie and the Royal College of Paediatrics and Child Health, Jessica Williams 
            and the BDA Paediatric Group, and the Unicef UK Baby Friendly Initiative, who all commented 
            on the first edition of this report. We would like to thank all those working for infant milk 
            companies who provided information about their specialised milk products for this edition. 
             
            First Steps Nutrition Trust  
             
            First Steps Nutrition Trust is a charity which provides evidence-based and independent 
            information and support for good nutrition from pre-conception to five years of age. 
             
            Also available from First Steps Nutrition Trust (www.firststepsnutrition.org) 
             
            Breastmilk and Breastfeeding: A simple guide 
            Fortified Milks for Children: A worldwide review of fortified milks marketed for children over 1 
            year of age 
            ‘I Just Want to Find the Right Formula for My Baby’: Discussions around infant feeding 
            among formula feeding parents 
            Infant Milks in the UK: A practical guide for health professionals 
            Infant formula: An overview 
            Infant Milks: A simple guide to infant formula, follow-on formula and other infant milks 
            Scientific and Factual: A review of breastmilk substitute advertising to healthcare professionals 
            Websites and Organisations that are Funded by the Formula Milk Industry 
             
            Author conflict of interest statement 
             
            Helen Crawley, Registered Dietitian and Registered Nutritionist (public health). Director 
            First Steps Nutrition Trust. No conflicts of interest.  
            Susan Westland, Registered Nutritionist (public health). No conflicts of interest. 
            Sarah Weston, Registered Dietitian, Breastfeeding Network Registered Breastfeeding 
            Supporter, and board member of East London Food Access. No conflicts of interest. 
             
                                                  
                              Specialised Infant Milks in the UK • March 2017 • page 2 
                 Contents 
                  
                 Acronyms                                                                                                  7 
                  
                                                                                                                              
                 1        Introduction                                                                                     9 
                 1.1      Why have we written this report?                                                                 9 
                 1.2      Current infant feeding guidance                                                                 10 
                 1.3      What does this report contain?                                                                  12 
                  
                                                                                                                              
                 2        Infant feeding                                                                                  13 
                 2.1      Supporting all new mums to exclusively breastfeed                                               13 
                 2.2      Working within the WHO Code to protect breastfeeding and infant and young                       15 
                          child health 
                 2.3      Critical appraisal of infant feeding marketing information                                      16 
                 2.4      Medications and breastfeeding                                                                   18 
                 2.5      Donor milk and milk banks in the UK                                                             18 
                 2.6      Supplementing the intake of breastmilk                                                          19 
                 2.7      Growth monitoring                                                                               19 
                 2.8      Breastmilk fortifiers                                                                           21 
                 2.9      Concentration of powdered infant milk to increase energy and nutrient content                   27 
                 2.10   Foods for special medical purposes (FSMP)                                                         28 
                 2.11   Indications for specialised infant milk                                                           28 
                 2.12     Appropriate prescribing                                                                         29 
                 2.13   Current cost of specialised infant milks                                                          30 
                 2.14   Long-term consequences of using specialised infant milk                                           33 
                 2.15     How much milk to use and how to make up milk safely                                             34 
                 2.16    Making up feeds marketed as foods for special medical purposes                                   34 
                 2.17   Current compositional regulations relating to foods for special medical                           38 
                          purposes  
                  
                                                    
                                                                       
                                            Specialised Infant Milks in the UK • March 2017 • page 3 
                 3       Specialised infant milks available in the UK                                                 41 
                 3.1     The composition of infant milks                                                               41 
                 3.2     The specialised infant milk market in the UK                                                  41 
                 3.3     Types of specialised infant milks available in the UK                                         42 
                 3.4     Infant milks suitable for specific population groups                                          45 
                 3.5     Infant milks for preterm and low-birthweight infants                                          48 
                 3.6     Infant milks for preterm infants post-discharge                                               56 
                 3.7     High-energy infant milks suitable for term infants from birth                                 60 
                 3.8     Thickened (anti-reflux) infant milks suitable from birth                                      67 
                 3.9     Lactose-free infant milks suitable from birth                                                 72 
                 3.10   Soy protein based infant formula suitable from birth                                           76 
                 3.11   Partially hydrolysed infant milks suitable from birth                                          80 
                 3.12   Extensively hydrolysed peptide-based infant milks suitable from birth                          88 
                 3.13   Amino-acid based infant milks for non-metabolic disorders, suitable from birth               100 
                 3.14   Infant milks for disorders of protein metabolism, suitable from birth                        107 
                 3.15   Modified-fat infant milks for disorders of fatty acid metabolism, suitable from              114 
                         birth 
                 3.16   Modified-carbohydrate infant milks suitable from birth                                       119 
                 3.17   Infant milk for the dietary management of calcium intolerance, suitable from                 124 
                         birth 
                 3.18    Infant milk for the dietary management of liver failure, suitable from birth                127 
                 3.19   Infant milks for the dietary management of renal disease, suitable from birth                131 
                 3.20   Infant milk for the dietary management of epilepsy, suitable from birth                      135 
                  
                 4       Foods for special medical purposes                                                          138 
                 5       Instructions for making up breastmilk fortifier                                            140 
                 6       Infant feeding support and information                                                     141 
                 7       Specialised infant milk companies                                                          144 
                 References                                                                                         146 
                  
                  
                                                                     
                                          Specialised Infant Milks in the UK • March 2017 • page 4