Questioning the ethics of international research on formula milk supplementation in low-income African countries: response

Abstract

We thank Nankabirwa and colleagues for their response1 to our commentary.2 We concur that well-supported early, exclusive breast feeding (EBF) has important health benefits for infants. We also agree that strategies to prevent infant growth impairment are urgently needed. However, we are concerned that supplementing all low birthweight newborns with commercial milk formula, during the first 30 days, is ill considered as a possible solution and has potential for harm in these two countries where 40% of families lack access to basic drinking water services. Introducing commercial milk formula in the first 3 days, when frequent breast feeding is so critical to establish lactation and breast feeding, may also have a negative impact on these processes.