The dangers of "follow-up" feeds.

Artificial feeds constituted with contaminated water and unclean bottles are the leading cause of diarrhea in infants. Companies market artificial feeds globally as infant formula (a substitute for breast milk) and follow-up formula (a complement to breast milk). Breast milk is best for all 0-12 month old infants. Breast-fed infants do not need any formula even follow-up formula. Indeed >6-month old infants require solid healthful foods and breast milk. Like infant formulas follow-up formula made with contaminated water or bottles can cause the infant to become ill with an infection and offering follow-up formulas to infants impedes weaning and is costly. Follow-up formulas do not complement breast milk but instead tend to replace it. The 1986 WHO World Health Assembly has even declared that in some countries provision of follow-up formula is not necessary. WHO fears mothers could use follow-up formula instead of infant formula because it has a higher protein and mineral content thus increasing the risk of dehydration during diarrhea. Follow-up formula can result in an unbalanced diet. Since the International Code of Marketing of Breastmilk Substitutes does not address formulas marketed as a complement to breast milk formula companies market follow-up formulas in both developed and developing countries. Most mothers do not know the risks of using follow-up formulas however. Governments have several alternatives to stop the marketing of these formulas. They can design and implement a code that defines breast-milk substitutes as any formula perceived and used as a breast milk option even if promoted as a breast-milk complement. They can also amend an existing code. WHO offers technical assistance to any member government who wishes to design implement and monitor such a code.