title: Compositional requirements of follow-up formula for use in infancy: recommendations of an international expert group coordinated by the Early Nutrition Academy.
abstract: The follow-up formula (FUF) standard of Codex Alimentarius adopted in 1987 does not correspond to the recently updated Codex infant formula (IF) standard and current scientific knowledge. New Zealand proposed a revision of the FUF Codex standard and asked the non-profit Early Nutrition Academy, in collaboration with the Federation of International Societies for Paediatric Gastroenterology, Hepatology, and Nutrition (FISPGHAN), for a consultation with paediatric nutrition experts to provide scientific guidance. This global expert group strongly supports breastfeeding. FUF are considered dispensable because IF can substitute for breastfeeding throughout infancy, but FUF are widely used and thus the outdated current FUF standard should be revised. Like IF, FUF serve as breast milk substitutes; hence their marketing should respect appropriate standards. The compositional requirements for FUF for infants from 6 months onwards presented here were unanimously agreed upon. For some nutrients, the compositional requirements for FUF differ from those of IF due to differing needs with infant maturation as well as a rising contribution of an increasingly diversified diet with advancing age. FUF should be fed with adequate complementary feeding that is also appropriate for partially breastfed infants. FUF could be fed also after the age of 1 year without safety concerns, but different compositional requirements should be applied for optimal, age-adapted milk-based formulations for young children used only after the age of 1 year. This has not been considered as part of this review and should be the subject of further consideration.
authors.affiliation: Dr. von Hauner Children's Hospital, University of Munich, Munich, Germany. office.koletzko@med.uni-muenchen.de
authors.forename: Berthold
authors.initials: B
authors.lastname: Koletzko
authors.forename: Zulfiqar A
authors.initials: ZA
authors.lastname: Bhutta
authors.forename: Wei
authors.initials: W
authors.lastname: Cai
authors.forename: Sylvia
authors.initials: S
authors.lastname: Cruchet
authors.forename: Mohamed
authors.initials: M
authors.lastname: El Guindi
authors.forename: George J
authors.initials: GJ
authors.lastname: Fuchs
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Goddard
authors.forename: Johannes B
authors.initials: JB
authors.lastname: van Goudoever
authors.forename: Seng Hock
authors.initials: SH
authors.lastname: Quak
authors.forename: Bharati
authors.initials: B
authors.lastname: Kulkarni
authors.forename: Maria
authors.initials: M
authors.lastname: Makrides
authors.forename: Hugo
authors.initials: H
authors.lastname: Ribeiro
authors.forename: Allan
authors.initials: A
authors.lastname: Walker
mesh_terms: D001942:Breast Feeding; D002331:Carnitine; D002794:Choline / Q000032:analysis; D004041:Dietary Fats / Q000032:analysis; D004044:Dietary Proteins / Q000032:analysis; D017408:Guidelines as Topic; D006801:Humans; D007223:Infant; D041943:Infant Formula / Q000737:chemistry* / Q000592:standards*; D007294:Inositol / Q000032:analysis; D007391:International Cooperation; D018977:Micronutrients / Q000032:analysis; D009520:New Zealand; D009711:Nucleotides / Q000032:analysis; D009751:Nutritional Requirements; D009752:Nutritional Status; D009753:Nutritive Value; D009939:Organizations, Nonprofit; D013654:Taurine / Q000032:analysis
chemical_list: D004041:Dietary Fats; D004044:Dietary Proteins; D018977:Micronutrients; D009711:Nucleotides; D013654:Taurine; D007294:Inositol; D002794:Choline; D002331:Carnitine