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Koletzko, Berthold; Bhutta, Zulfigar A.; Cai, Wei; Cruchet, Sylvia; El Guindi, Mohamed; Fuchs, George J.; Goddard, Elizabeth A.; Goudoever, Johannes B. van; Quak, Seng Hock; Kulkarni, Bharati; Makrides, Maria; Ribeiro, Hugo; Walker, Allan (2013): Compositional Requirements of Follow-Up Formula for Use in Infancy: Recommendations of an International Expert Group Coordinated by the Early Nutrition Academy. In: Annals of Nutrition and Metabolism, Vol. 62, No. 1: pp. 44-54


The follow-up formula (FUF) standard of Codex Alimentarius adopted in1987 does not correspond to the recently updated Codex infant formula(IF) standard and current scientific knowledge. New Zealand proposed arevision of the FUF Codex standard and asked the non-profit EarlyNutrition Academy, in collaboration with the Federation of InternationalSocieties for Paediatric Gastroenterology, Hepatology, and Nutrition(FISPGHAN), for a consultation with paediatric nutrition experts toprovide scientific guidance. This global expert group strongly supportsbreastfeeding. FUF are considered dispensable because IF can substitutefor breastfeeding throughout infancy, but FUF are widely used and thusthe outdated current FUF standard should be revised. Like IF, FUF serveas breast milk substitutes; hence their marketing should respectappropriate standards. The compositional requirements for FUF forinfants from 6 months onwards presented here were unanimously agreedupon. For some nutrients, the compositional requirements for FUF differfrom those of IF due to differing needs with infant maturation as wellas a rising contribution of an increasingly diversified diet withadvancing age. FUF should be fed with adequate complementary feedingthat is also appropriate for partially breastfed infants. FUF could befed also after the age of 1 year without safety concerns, but differentcompositional requirements should be applied for optimal, age-adaptedmilk-based formulations for young children used only after the age of 1year. This has not been considered as part of this review and should bethe subject of further consideration.