Community Pharmacy

The Market in Baby Formula

Ireland has one of the lowest breastfeeding rates in the world. Rates are increasing steadily but breastfeeding incidence declines steeply in the early weeks after birth. The Institute of Public Health in Ireland reported last year that breastfeeding rates in the Republic and Northern Ireland were slowly growing and that between 2006 and 2015 the percentage of women breastfeeding when discharged from hospital rose from 49% to 58%. Some 35% of babies in the State continue to receive breastmilk at three months, according to the HSE.

The National Maternity Strategy says that in addition to practical supports provided to mothers, such as support to continue breastfeeding on return to the workplace, a broader societal change is required in order to promote a more positive culture around breastfeeding. This should support women to feel confident about their choice to breastfeed. In essence this means that all mothers should be supported to breastfeed at anytime and anywhere.

The National Strategy for Women and Girls 2017-2020 re-affirmed the commitment to advance public support of breastfeeding, and includes an action to extend provision for breastfeeding breaks under employment legislation (currently available to mothers of children under 6 months).

However breastfeeding is frequently not a viable option for all. Some of the main reasons given for not continuing to breastfeed following the first few days and weeks include insufficient milk supply; fatigue; difficulty with breastfeeding technique; nipple pain and poor latch; lack of freedom; return to work; not wanting to breastfeed and embarrassment as a result of negative societal attitudes towards breastfeeding.

Parents welcome the advice of healthcare professionals for infant feeding and the community pharmacy will be the first call when looking for guidance. In this article we look at the latest guidance and ask how you can grow your share of this important category.

Value and Growth

With the highest birth rate amongst the EU Member States and one of the lowest breastfeeding rates in Europe, the Irish market is lucrative for both baby food and milk formula, according to data analyst Euromonitor.

Milk formula use is also strengthened by the high proportion of women aged 20-45 years of age that are both employed and work outside the home.

Prepared baby food continued to be the most dynamic baby food category in 2019, particularly benefitting from greater need for convenience, good economic growth and high employment rates. Its growth also comes from continuous quality improvements and an alignment with current health and wellness trends.

“Other” baby food is doing well thanks to the snacking trend that is spilling over from “adult” food – referring to the grazing trend that has been going on in packaged food for a while in Ireland, where snacks generally are highly demanded. Whereas in the past, parents in transit may have simply brought a packet of plain biscuits or rusks along to give their children something to nibble on, there is a growing number of specific (and value-added/more expensive) products to be consumed on the go that are addressing that need.

Another key characteristic of the global infant nutrition market is the very low penetration of supermarket private labels, at less than 1%, according to Zenith Global. This underlines the high degree of brand loyalty and the opportunities for higher profit margins. High quality and safety credentials are primary criteria for consumers and branded items are more strongly associated with these features.

In many food categories, private label products compete successfully on price against brands. It appears, however, that the last item on which consumers seem to economise is baby food. Higher prices are justified by the perceived better nutritional value for babies from high quality branded products.

It has been said, that there is a belief among pharmacists that much of their baby feeding sales have been lost to grocery, but others think that taking a different approach can make you a centre for feeding advice and win back sales.

Pharmacists and their teams are ideally placed to provide advice and support to mothers when it comes to infant feeding. From giving practical tips and support on breastfeeding to identifying and advising on potential problems, the pharmacy team can make a real difference to young families in those early months. Many community pharmacists have not realised the full extent of the opportunities that exist for them to provide an advice service in their local communities.

The National Childbirth Trust says women can experience unacceptable levels of pressure however they feed their babies – from family and friends, as well as from people they hardly know.

Mothers who breastfeed their babies often feel pressurised and constrained about whether, where, how often, and how long they breastfeed. Similarly, mothers who use formula milk often feel judged or guilty too, particularly – but not only – if they planned to breastfeed. Informed choice must be promoted, many maternity and infant experts advise.

Formula Feeding

The rapid growth of dairy farming in Ireland has led to its position as one of the leading global exporters of infant milk formula.

There is a range of infant formulas available over-the-counter and either a whey or casein based formula is a suitable choice for infants from birth to the age of 12 months. Follow-on formulas, which contain more iron and vitamin D than ordinary formulas, are available for infants over the age of six months.

Cows’ milk is not suitable as a main drink for children under the age of 12 months. It contains little iron and vitamin D and may lead to intestinal blood loss in some children. Skimmed and semi-skimmed milks should not be used in infancy because of their low energy content. Semiskimmed milk may be used from the age of 2 years where it is the milk used in the household and the infant’s diet is varied. However, skimmed milk should not be used under the age of 5 years. Fruit juice is not necessary, but helps the absorption of iron from fruit, vegetables and cereals.

It is important to remember that many parents do not receive instruction on appropriate technique for making up bottles; if formula preparation is not done properly, the baby may be at risk of dehydration and over or under-nutrition.

Parents who bottle-feed can feel that they are not given enough impartial information about formula milks. Recent position statements recommended that balanced and relevant information is given to parents choosing to formula feed their babies, whether exclusively or partially, to enable them to do so safely and with support to encourage good bonding. This includes instructions on cleaning and sterilising equipment and the correct method for making up formula feeds.

Pharmacy teams should know the differences between the different types of milks, as this can be bewildering for new parents. While leaflets on bottle feeding are essential, so are one-to-one discussions. Pharmacists must make sure customers understand about good hygiene, washing, sterilising and making up feeds. Signpost to other healthcare professionals if customers need extra help.

Whey Based Formulae – The first group are whey based formulae. These are similar to breastmilk because the protein content is made up of more whey than casein. However, the total protein content of infant formulae is higher than breastmilk and as a result, infant formulae are not as digestible as breastmilk. These formulae are the most suitable for newborn and older infants.

Casein Based Formulae – The second group are casein based formulae. Babies fed casein based formulae may have to work harder to digest each feed. This means that baby may sleep more – All babies need time every day to be awake and alert, in order for them to grow and develop.

“Follow-on” Milks – These are made from modified cow’s milk with extra iron and vitamins.

Soya Based Formulae – Soya based formulae and other specialised formulae should not be used without the advice of a dietician or doctor. All infant formulae on the Irish market must conform to the same EU standards and provide the same nutritional value. There should be no reason to change a baby from one “type” of formula to another.

Specialist Formula

Specialist infant formula is one area where pharmacists could provide a valuable service to those mothers who are unable to breastfeed and whose babies have an intolerance or a sensitivity to regular formula milk, or for those women whose baby has a problem such as reflux, colic or constipation.

Many pharmacies can benefit from adopting a merchandising approach, with clear signposting to ‘Ask the pharmacist for advice.’ There has been an increase in the number of babies who do not thrive on standard formulas, which is why much of the growth in the infant formula market over the past year has been driven by an increase in purchases of specialist milks, aimed at addressing feeding problems.

This offers a genuine opportunity for pharmacists because such products sit well with the pharmacy’s role as a provider of healthcare advice and remedies. By stocking one or two of these products, the pharmacy would be in a position to provide a possible solution.

Hence it is vitally important all pharmacy staff understand the difference between formula types. It is important to stock some alternatives. Some parents may experience various feeding problems with their baby such as reflux, lactose intolerance or allergies. Make sure mums know they can get these specialist formulas on prescription if their baby has a diagnosis, so it’s also important they see their GP.

Baby Food Natural Alternatives

One of the main trends driving growth in the baby food sector is a continued interest in natural and organic baby and childspecific products, reflecting higher awareness of ingredients such as parabens.

With environmental conditions deteriorating globally, there is a rising anxiety as to the safety of the products we use and, even more so, the food we consume. There is a growing trend towards organic products, which stems from a concern for our health and general wellbeing and, even more so, that of our children. Organic baby products, food in particular, have therefore garnered much attention in recent years.

Organic baby food has witnessed rapid adoption due to factors such as rise in parental concerns over baby’s nutrition, growing awareness about the benefits of organic products, improved distribution channels, and ecofriendly farming techniques.

Link Sales

New parents tend to seek out baby products that help to make their lives easier. Well-stocked shelves will ensure footfall, and encourage cross-category purchases, ensuring the pharmacy is a chosen destination for future family healthcare purchases. There is a great opportunity to have a strong “best for baby” message. Whether online or in-store, pharmacies have that great position of trust.

More so in the early years, when information and advice for new parents can feel overwhelming and confusing, community pharmacies have an essential role in offering advice and education on lifestyle issues and product selections, which will encourage a drive to the pharmacy instead of the GP or supermarket.

The infant feeding market prospects are strong, proving recession-proof, despite falling birth rates. Nevertheless, the industry is dealing with a highly sensitive consumer. The importance of safety cannot be underestimated.

Consumer confidence is key.

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