The global infant formula industry is valued at over 50 billion dollars and
it's expected to reach 95 billion by 2026.
At the same time, doctors and health organizations are always reminding
new parents that breast is best.
So how come the formula industry is still thriving?
The biggest driver to the increase in the formula market is the increasing
number of working women.
Honestly, I felt lied to by the world in what it meant to be a working mom
trying to do your best, but also go back and manage your career.
When his weight dropped 12 percent, we had to put him on formula
supplementation. I thought, why is my body failing me?
Why can't I give him what he needs?
Well, breast milk does provide undeniable benefits, strengthening an
infant's immune system, preventing infection and even lowering the risk of
obesity, the reality is a majority of parents will need to turn to formula
at some point.
Many lack the time or appropriate accommodations to breastfeed or pump,
while others may face medical complications.
So there are all of these different factors to overcome.
You know, does your baby have a good latch?
Are you making enough milk?
Are you drinking enough water?
Are you resting enough?
And if any one of them goes, your supply can go down with it.
Entrepreneurs and investors are finally starting to take note of the
business opportunities around infant nutrition.
From high tech breast pumps to apps that track women's periods and peak
fertility, so-called femtech is having a moment.
Now, some entrepreneurs are trying to bring improved formulas to market
and lobbying to update FDA regulations along the way, while others are
engineering solutions to make formula is close to human breast milk as
possible.
Breastfeeding wasn't always so popular.
The world's first commercial infant formula was developed in 1865 and
quickly gained international popularity as well as competition.
In the United States, evaporated milk formulas became widely available
throughout the 1920s and 1930s, and a number of commercial formulas also
rose to prominence in the following decades.
Formula was in vogue, and families of higher socioeconomic status were
more likely to adopt these new feeding methods.
In the nineteen hundreds, the formula industry began marketing both to
mothers but also to physicians.
Formula industries designed our hospitals to optimize formula feeding.
And formula feeding really became the norm.
In the early 1970s, only about 25 percent of babies received any breast
milk at all.
After this time, rates of breast feeding began to tick upwards as the
health benefits became more widely understood.
Wealthy parents once again led the way.
And today, breastfeeding rates in the U.S.
are significantly higher among well-off mothers.
Now, the American Academy of Pediatrics officially recommends that mothers
breastfeed their kids for the first six months of life and continue to
breastfeed, while supplementing with solids, for the remainder of the
first year.
But though breastfeeding rates remain relatively high, the majority of
mothers still can't make it that long.
In the most recent data, 83 percent of babies in this country receive some
breast milk at the time of birth.
But by three months, about 50 percent of those babies are needing breast
milk substitutes and infant formula.
At the one year mark, only about one third of mothers are still
breastfeeding at all.
One reason may be the United States' maternity leave policies.
It's one of the only countries in the world which does not require
businesses and corporations to offer paid leave.
And thus, the majority of U.S.
workers do not receive it as a benefit.
One in every four women goes back to work within two weeks of giving birth.
That's crazy.
Overall, two thirds of mothers report not being able to breastfeed their
children for as long as they initially intended.
But unfortunately, today there's still some stigma around formula feeding.
Parenting can be judgy.
And we're seeing that very specifically when it comes to how you feed your
child.
The majority of U.S.
formulas are provided by one of four large companies: Nestlé, Mead
Johnson, Abbott or Danone.
And some contain ingredients that may give parents pause.
What you see here in the U.S.
to make up their carbs, you often see different types of sugars being used
with corn syrup being a predominant carb.
Concerns like this have helped to spur a thriving and relatively open black
market for European alternatives.
In Europe to make up their carbs, they don't use corn syrup.
Although we're seeing questions around the safety of bringing European
formula over to the U.S.,
we're still seeing pediatricians recommending them.
We did a study with 350 pediatricians to realize 87 percent of them have
recommended European formula in the last six months.
When you see parents coming from transatlantic trips with suitcases packed
full of formula, you know there's a need to evolve.
Laura Modi saw an opportunity.
A mother and entrepreneur, she got a common infection called mastitis when
breastfeeding her first child.
This caused inflammation of her breast tissue and left her unable to
breastfeed for a brief period.
So, I found myself standing in the middle aisle of a pharmacy, choosing a
formula that felt the complete opposite to breast milk.
Riddled with ingredients I couldn't articulate, pharmaceutical
disclaimers, in a way that just didn't feel like food.
She felt guilty that she had to stop breastfeeding and let down by the
alternatives she saw.
I'm a confident woman.
And I have never felt more unconfident as I did when choosing to feed my
daughter formula.
Embarrassingly, I used to hide my product.
I did everything I could to be able to prove that I wasn't feeding her
formula.
So she set out to create one that she could be proud of.
Called Bobbie Baby, it seeks to replicate European formulas.
Grass fed cow's milk is the main ingredient and it contains no artificial
sugar, corn syrup or processed oils.
It raised 2.5
million from investors in 2018, but within weeks of shipping its first
product, Bobbie came under FDA scrutiny.
Since it was made in Germany and not an approved domestic facility, it did
not meet U.S.
regulations. It also didn't contain a complete list of nutrients on its
label. But Bobbie says its formula does meet the European Commission's
regulations, which differ in some specific ways.
In the E.C.,
there's a limitation on how much table sugar you can use in infant
formula. Where in the U.S.,
you can make up 100 percent of your carbs with table sugar.
The European Commission also requires that at least 30 percent of carbs
come from lactose and bans certain additives that are common in U.S.
formulas.
American formulas would not meet the criteria for the EU were they to be
sold there.
So it tells you a little bit about how strict the EU is and also, you
know, the differences between the food science in the two countries.
For its part, Nestlé says it's actually committed to removing all added
sugars from its formulas, except for those meant for babies that are
allergic to lactose.
We intend to by the end of 2019, no longer make any of our infant formulas
that would contain sucrose or glucose syrup solids, particularly for all
routine and starter infant formulas.
And Abbott emphasizes that all its ingredients are closely vetted and that
its extensive research and experience means consumers can always trust its
products.
We've spent almost a hundred years developing infant formulas at the
forefront of nutrition.
We have over 600 scientists worldwide studying breast milk components with
the goal to advance infant formula innovation and bring infant formulas
closer to breast milk.
But Modi has been frustrated by the dominance of the major formula
companies and her own run-ins with the FDA.
She says it's too difficult for new players to enter into this space.
It's hard.
And it should be, because we're developing products for a vulnerable
audience that should be extraordinarily safe.
But it shouldn't be impossible.
But for now, Bobbie's products have been recalled and won't be back on the
market until the company can fall in line with U.S.
regulations.
So for the time being, it seems we can't really replicate European recipes
here in the U.S.,
so why can't we just replicate breastmilk itself?
That would be the best solution, but it turns out it's pretty much
impossible. Breast milk is a highly specialized and variable substance
personalized for each specific mother and each specific environment.
We know that breast milk is a living substance.
If a mom is in an environment where she's exposed to a certain infection,
that her breast milk will make antibodies specific to that exposure.
The hormones in breast milk even change depending on time of day.
And the fat content changes throughout a single feed.
Even the formula giants themselves acknowledge that they can never quite
measure up.
To mimic and replicate breast milk is not possible.
But what is possible is to study all of these components in breast milk
and wherever possible we add them to infant formula.
Companies big and small are beginning to replicate some of the special
sugars found exclusively in breast milk, called human milk
oligosaccharides or HMOs.
After fats and carbs, HMOs are the third most prevalent ingredient in
breast milk.
And unlike corn syrup or table sugar, they play a vital role in an
infant's nutrition and gut health.
So in human breast milk, there are over 180 different types of sugars that
the mother makes.
They're there to help the microbiome, for example, and help the baby's
health in those kinds of ways.
The major sugar that's missing is 2'-Fucosyllactose, or 2'-FL it's often
called.
In 2016, formula maker Abbott released the first formula containing 2'-FL.
And in 2018, Nestlé followed suit with a 2'-FL formula of its own.
Until we launched in 2016, only breastfed babies could benefit from this
molecule. Now human milk oligosaccharide 2'-FL has been clinically shown
to strengthen the developing immune system of formula fed babies to be
more like breastfed.
Sugar logix, a Berkeley-based startup, is also working to synthesize 2'-FL
and other HMOs in its lab through yeast fermentation, a method it said it
pioneered. Sugarlogix says that currently, major formula companies are
synthesizing 2'-FL from E.
coli bacteria, a process that requires rigorous quality control testing
since E.
coli contains dangerous toxins that must be removed.
Sugar logix believes its method of yeast fermentation will be simpler and
cheaper. The startup is backed by biotech accelerator IndieBio as well as
venture capital firm SOSV and has raised about two million dollars.
By 2021, it hopes to hit the market, partnering with major formula
companies to supply them with 2'-FL as well as other each HMOs.
Companies like Bobbie Baby and Sugar logix will likely enter the premium
market first.
For comparison, Abbott's Similac Pro-Advance formula with 2'-FL as well as
its organic formula, are about 13 percent to 15 percent more expensive
than the company's basic offerings.
We believe that at first, it will enter into a smaller space of premium
infant formulas, but that eventually there is no reason not to choose
these ingredients.
So we envision a future where it becomes the next must have ingredient for
infant formula.
This sounds ideal to families who not only care deeply about their infant's
nutrition, but feel that the messaging around breastfeeding has
unintentionally put pressure and even judgment on mothers who formula
feed.
If you can breastfeed your baby, you should.
Breast milk is good.
But if you can't, you shouldn't be made to feel like a failure.
Consumer tastes are changing and companies are beginning to catch up to it.
For the first time, consumers are reading labels and they're questioning
what's in their products.
Eighty percent of all health care decisions in the home are made by women.
And I think venture is finally starting to realize that that's true and
just how big the pregnancy market is.
But change is hard and the FDA is no exception.
And no regulatory body is an exception.
It will take time.
And I think as we start to see consumers and parents raise their hands
looking for change, we will see regulation change to.