How good is infant formula?

Jun 19th 2026|3 min read

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BABY MILK has come a long way since a patented “soup for infants” made with cow’s milk, potassium bicarbonate, and wheat and malt flour was introduced in Prussia in 1865. Today the Food and Drug Administration (FDA), an American regulator, requires baby formulas to have minimum levels of 30 nutrients including iron, iodine and vitamin D.

Formula-makers these days are just as keen to tell people about the extras they add to their products, too. In 2023 the BMJ, a journal, published a study of 757 formula products in 15 rich and poor countries. Many trumpeted additives such as prebiotics, probiotics and long-chain polyunsaturated fatty acids (LCPUFAs; some of which must be included in formula sold in Britain and the EU). The benefits claimed included supporting “growth and development” and “a healthy immune system”. The most common claim, appearing on just over half the formulas that claimed benefits, was that they helped develop the brain, eyes or nervous system.

Do they? Infant formulas are usually classified as food rather than medicines, which leaves them freer to make claims about benefits without the backing of rigorous trials. Three-quarters of the products evaluated did not cite scientific references. Of the references that were cited, only half were clinical trials. Of those trials, fewer than a third were registered. Among the small group of registered trials that used a randomised comparison, nine in ten claims relied on evidence the study’s authors deemed to have a high risk of bias. Industry funding and affiliations were common.

The risk of bias might give some parents pause for thought. But it does not, in itself, prove that their claims are wrong. Only the evidence can do that, and as best as scientists can tell, it is equivocal. A review of 15 randomised trials involving 1,889 infants, last updated in 2017, found that those given formulas supplemented with LCPUFAs had no better brain development or visual acuity than those fed less-fortified formulations. A study in published in 2021 examined 1,607 British adolescents and found that those who had been fed supplemented formula as babies had not gained an academic edge.

On the other hand, a meta-analysis of nine randomised controlled trials involving 1,039 babies was published in the journal Nutrients in 2025. It found a slight, but statistically significant, improvement in cognitive development among infants fed formulas supplemented with two LCPUFAs, ARA and DHA. The FDA notes that other studies have suggested that babies born prematurely may especially benefit.

Artificial formulas have generally proved safe in trials. Experts worry, though, that breast-feeding is undermined by slick, emotive marketing of formulas with an aura of scientific superiority.

The benefits of breast-feeding vis-à-vis any type of formula are well established. Many studies link breast-feeding with lower rates of infection for infants; several recent ones have linked it to lower rates of asthma and allergies. It is also much cheaper than buying formula milk, even accounting for the extra calories that a breast-feeding mother must consume. The FDA, and many other rich-country health bodies, advise that breast-feeding is optimal. But mothers who cannot breast-feed, or who find that they must top up with formula, should not worry. Today’s infant formulas are safe and nutritious, even if some of the marketing runs ahead of the science. ■