title: Global trends and patterns of commercial milk-based formula sales: is an unprecedented infant and young child feeding transition underway?
abstract: The marketing of infant/child milk-based formulas (MF) contributes to suboptimal breast-feeding and adversely affects child and maternal health outcomes globally. However, little is known about recent changes in MF markets. The present study describes contemporary trends and patterns of MF sales at the global, regional and country levels.
  
  
  
  Descriptive statistics of trends and patterns in MF sales volume per infant/child for the years 2008-2013 and projections to 2018, using industry-sourced data.
  
  
  
  Eighty countries categorized by country income bracket, for developing countries by region, and in countries with the largest infant/child populations.
  
  
  
  MF categories included total (for ages 0-36 months), infant (0-6 months), follow-up (7-12 months), toddler (13-36 months) and special (0-6 months).
  
  
  
  In 2008-2013 world total MF sales grew by 40·8 % from 5·5 to 7·8 kg per infant/child/year, a figure predicted to increase to 10·8 kg by 2018. Growth was most rapid in East Asia particularly in China, Indonesia, Thailand and Vietnam and was led by the infant and follow-up formula categories. Sales volume per infant/child was positively associated with country income level although with wide variability between countries.
  
  
  
  A global infant and young child feeding (IYCF) transition towards diets higher in MF is underway and is expected to continue apace. The observed increase in MF sales raises serious concern for global child and maternal health, particularly in East Asia, and calls into question the efficacy of current regulatory regimes designed to protect and promote optimal IYCF. The observed changes have not been captured by existing IYCF monitoring systems.
authors.affiliation: 1Health Equity and Governance Group,RegNet School of Regulation and Global Governance,H.C. Coombs Extension Building #8,Fellows Road,Australian National University,Canberra,ACT 0200,Australia.
authors.forename: Phillip
authors.identifier: 0000-0002-0802-2349
authors.initials: P
authors.lastname: Baker
authors.affiliation: 1Health Equity and Governance Group,RegNet School of Regulation and Global Governance,H.C. Coombs Extension Building #8,Fellows Road,Australian National University,Canberra,ACT 0200,Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Smith
authors.affiliation: 1Health Equity and Governance Group,RegNet School of Regulation and Global Governance,H.C. Coombs Extension Building #8,Fellows Road,Australian National University,Canberra,ACT 0200,Australia.
authors.forename: Libby
authors.initials: L
authors.lastname: Salmon
authors.affiliation: 1Health Equity and Governance Group,RegNet School of Regulation and Global Governance,H.C. Coombs Extension Building #8,Fellows Road,Australian National University,Canberra,ACT 0200,Australia.
authors.forename: Sharon
authors.initials: S
authors.lastname: Friel
authors.affiliation: 2Department of Political Science,University of Hawai'i, Honolulu,HI,USA.
authors.forename: George
authors.initials: G
authors.lastname: Kent
authors.affiliation: 3Independent,Manilla,Philippines.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Iellamo
authors.affiliation: 4Breastfeeding Promotion Network of India,Delhi,India.
authors.forename: J P
authors.initials: JP
authors.lastname: Dadhich
authors.affiliation: 5Mother and Infant Research Unit,School of Nursing and Health Sciences,University of Dundee,Dundee,UK.
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Renfrew
mesh_terms: D000818:Animals; D001942:Breast Feeding; D002675:Child, Preschool; D004032:Diet / Q000639:trends*; D014943:Global Health; D006801:Humans; D007223:Infant; D041943:Infant Formula / Q000191:economics*; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D008892:Milk
keywords: Breast-milk substitutes; Formula; Infant and young child feeding; Nutrition transition