Health assessment of infant nutrition

BfR advises the Federal Government on matters of infant nutrition, particularly with regard to the scientific basis for statutory regulations for dietary foods for infants and small children including labeling and advertising (§§22 and 25 of Diet Regulation).

Infant nutrition consists of two phases:
1. Diet solely of breast milk or breast milk substitutes (first 6 months)
2. Diet with breast milk or breast milk substitutes supplemented with complementary food (at the earliest from 5 months, at the latest from 7 months.

Since 1999 BfR has been the headquarters of the National Committee for the Promotion of Breastfeeding (established in 1994). It advises the Federal Government on matters relating to the promotion of breastfeeding and overcoming obstacles to breastfeeding. The National Committee for the Promotion of Breastfeeding has formulated recommendations on breastfeeding. The Research Institute for Children's Nutrition (FKE) in Dortmund publishes recommendations on the nutrition of infants and small children.

If a mother is unable to or does not breastfeed, breast milk substitutes can be given to healthy, full-term infants (cf. also the practical proposals from FKE):

• Infant formula can replace breast milk from birth onwards and like breast milk is suitable as the sole source of food for the first four to six months. After that infant formula plus weaning food can be given throughout the first year of life. In Germany and in the European Union there are four types of infant formula:
  
  • based on cow's milk protein with lactose as the sole carbohydrate
  • based on cow's milk protein with other carbohydrates besides lactose
  • based on soy bean protein isolate (N.B.: this food is only lactose-free in Germany)
  • based on partially hydrolysed (cleaved) protein (name HA). This initial food is intended for non-breast fed infants from families with a history of allergies.
• Follow-on formula can replace breast milk at the earliest from the fifth month onwards. It is not suitable from birth onwards as it is not adapted to the needs of the very young infant. There is no compelling reason to switch from infant formula to follow-on formula.
• Complementary food is the name given to all foods fed to infants in the second six months of their lives in addition to breast milk or infant formula/follow-on formula. Complementary food can be prepared from the basic ingredients or purchased ready for use. Complementary food products available commercially in Germany are classified as dietetic foods which must satisfy the requirements of the "Dietetic Foods Ordinance" (Diet Regulation). It is recommended when introducing complementary food to follow the recommendations of the Research Institute of Child Nutrition in Dortmund.

Both for infant bottle formula and complementary food products there are especially stiff statutory provisions concerning the composition, the use of additives (colouring agents, flavourings, preservatives are banned), the bacteriological requirements and the limit values for residues and contaminants which are uniform throughout the European Union.