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Follow-up formula and “picky-eating” formula are not covered under the proposed Hong Kong Code on Marketing of Breastmilk Substitutes.

Professor Tony Nelson, who chairs the Department of Paediatrics at the Chinese University of Hong Kong, suggests there is a strong commercial reason why breastfeeding is undermined. “It [milk formula] is a US$11.5 billion industry, it’s big, big money,” says Nelson. “Promoting milk formula makes shareholders really wealthy.”

The price of a can of milk formula ranges from around HK$100 to a few hundred dollars. Normally, a baby finishes one tin of infant formula a week, and parents can spend between around HK$600 to HK$2,000 a month.

Given that mother’s milk is the best nutrition a baby can have and costs nothing, Nelson says formula producers have to launch aggressive advertisements to persuade mothers to buy the inferior milk formulas.

“Breastfeeding has advantages no matter if it’s intelligence, protection for infection, protection from obesity and protection from long-term illnesses,” says Nelson. “The medical evidence is so strong that there should be no debate.”

Nelson says it is a shame that even though the evidence-based benefits of breast milk are so clear, Hong Kong people do not seem to recognise them. “They [parents] will spend a vast amount of money on extra piano lessons, mathematics lessons, anything else to give the baby the best chance in life,” sighs Nelson. “And yet, surprisingly, one of the very best things that they could do, they don’t see it as important.”

Nelson says many mothers give up nursing because of the misconception that they do not have enough milk, but research shows that this is not true for more than 90 per cent of cases. In fact, insufficient supply is caused by supplementing breast milk with formula.

He explains that breastfeeding is a self-fulfilling process. The supply of breast milk depends on the baby’s demand, which creates a biological feedback. “Milk companies know that, so they just persuade mothers to take a little bit of formula, even a bottle in the ward or one bottle at night,” says Nelson. “In many cases, the supply [of breast milk] will really come down.”

“We have the duty to let mothers know that they have been misled by the companies to buy and waste their money on what they don’t need when there is a much cheaper better alternative,” says Nelson

 Edited by Kris Lee


  1. Congratulations, Jeff and Tracy, on your careful and thoughtful exploration of an important topic! As the medical experts you quoted said, breast really is best – but like most biologically-based behaviour, breastfeeding involves some learning and a supportive community. Since a lot of the traditional networks are no longer present in Hong Kong (as you explained) maybe the internet and online social networks could be used to “show and tell”, share experience, and help build support for breastfeeding – and university students, like yourselves, can lead the way in campaigning for effective breastfeeding education – not just “how to” for new mums but public education on the value of breastfeeding, workplace support for lactating mothers, and a public health code with strong backing for breast-milk over formula. I breastfed my children (now grown up) for a year each, and weaned them on to cow’s milk and solid food bit by bit – I’m so glad I did, and would be happy to think that the young women I teach in Hong Kong can have the same experience – and yes, without putting their careers on hold. Go, go, Jeff and Tracy – hope your article starts a debate, and a movement for change!

  2. In this information explosion era, for the same strong commercial reason, I hope the baby formula company will shift their business in breast feeding equipment and accessaries. Similar to the cloth diaper business which might be more sustainable and profitable in a long run. It is a freedom of choice which is important to all the parents. New parents should have the right to understand the pros and cons for both choices. (Mother of two, breastfeed til 1 year / 7 months)

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