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The Competition and Markets Authority (CMA) has shared the findings of its study into the infant formula and follow-on formula market in the UK, issuing several recommendations to improve outcomes for parents.

The study found that the price difference between brands has a significant impact on parents’ finances. Evidence reviewed by the CMA showed parents could save around £300 over a baby’s first year of life by switching from a popular mid-priced product to a low-priced brand, and around £500 by switching from a premium high-priced brand to a low-priced brand.

The CMA emphasised that many parents choose a brand for the first time in vulnerable circumstances, often in hospital immediately after birth. They frequently feel under pressure and lack the clear, accurate and impartial information needed to make informed decisions, the study found, resulting in many parents actively choosing a more expensive product due to assumptions that this means better quality.

NHS guidance advises parents that all infant formula options on the market will meet babies’ nutritional needs, regardless of brand or price.

Reducing brand influence

The review highlighted that manufacturers place strong emphasis on building brand awareness to secure customers. Examples of this include regularly supplying the NHS with below cost formula to reach new parents, who will rarely switch once they have found a brand that works for their baby.

Manufacturers also use similar branding and labelling – including similar colour palettes, fonts and imagery – across infant and follow-on formulas, despite regulation stating that labelling and presentation should be ‘clearly distinct’. The CMA’s evidence indicates that parents are ‘disproportionately’ influenced by branding practices.

Additionally, parents on lower incomes were found to be more likely to formula feed, so are disproportionately affected by pricing. While government support is available to those eligible, most infant formulas exceed the weekly value of benefits available through schemes such as Healthy Start and Best Start Food.

With these factors in mind, the CMA has called for the removal of brand influence in healthcare settings. It emphasises the importance of parents being provided with clear, accurate and impartial information on nutritional sufficiency of all infant formula products as soon as possible, recommending that labelling in healthcare settings should be standardised to reduce the influence of branding on their decision making. An example of this could be putting branded formula into non-branded containers, or rolling out a white label formula across the NHS.

It also recommends current labelling and advertising rules are strengthened. All packaging should clearly display information on nutritional sufficiency, while claims that are intangible or cannot easily be checked by parents should be banned, the CMA stated.

Pricing and promotion

Currently, advertising and promotion of infant formula – including price reductions or deals – is restricted so as not to discourage parents from breastfeeding. The CMA calls for an additional ban on the promotion of follow-on milks, which are currently not subject to these restrictions. It says the government should clarify what constitutes ‘advertising,’ outlining exactly what shops and manufacturers can and cannot do regarding formula milks.

It also says parents should be allowed to use gift cards, vouchers, loyalty points and coupons to purchase infant formula. But the CMA has not recommended the introduction of a price cap – while it had considered ‘more interventionist measures’ to set a maximum price for infant formula, the regulator said this would involve ‘significant risks,’ including that lower prices in the market could rise to the level of the ceiling, resulting in parents missing out on more affordable options.

However, it noted that government may wish to retain this as a ‘backstop option’ if the CMA’s proposed package of measures does not achieve the desired market outcomes within a ‘reasonable timeframe’. It also said it ‘stands ready to support further consideration’ of the removal of the ban on price promotions, in conjunction with the measures already proposed, if asked.

Other recommendations made include displaying all brands of infant formula together and in a separate cluster from other formula milks in-store, equipping parents with the necessary information to enable easy price comparisons.

Furthermore, it calls for the roles of relevant authorities to be strengthened to effectively enforce current and future rules. While at present, companies can launch products to market before the relevant authorities have reviewed the label, the CMA said all packaging of infant formula products should now be approved before sale.

Pushing for change

Sarah Cardell, chief executive of the CMA, said: “Governments across the UK are committed to the tight regulation of infant formula for public health reasons. So, our proposals are designed to help parents make the best choices for them and their babies, with access to better information, while sharpening the effectiveness of the existing rules.”

She added: “We strongly encourage governments to act on the recommendations to stop well-intended regulation driving poor outcomes for consumers. We’re ready to help implement the changes and support thinking around further measures, including removing the ban on price promotions, should governments consider it necessary at a later stage.”

Public health minister, Ashley Dalton, welcomed the report, commenting: “There are many benefits of breastfeeding but for those families that cannot or choose not to breastfeed, it is vital that they can access formula that is affordable and high-quality. Families should not be paying over the odds to feed their babies because of outdated regulation.”

The UNICEF UK Baby Friendly Initiative – a programme developed by the United Nations Children’s Fund and the World Health Organization, aiming to improve standards of care for babies and mothers in the UK – responded to the CMA’s report, describing the proposed recommendations as a ‘positive step’.

In its statement, it wrote: 'We are pleased to see the report shine a light on the unaffordable prices of infant formula and its impact on families. Findings reveal how high prices and misleading marketing tactics of the infant formula industry add financial strain on family budgets and obscure the impartial information provided by the NHS, which families rely on when navigating important decisions around infant feeding.'

It said the CMA’s recommendations around standardised packaging and removed brand influence are ‘commendable,’ while it described extending the advertising ban to include follow-on formula as a ‘crucial step,’ adding: 'This action addresses the promotion of unnecessary follow-on formula products. We would like this to go further to cover unregulated toddler and growing up milks aimed at children 1-3 years of age. Cows’ milk can be introduced as a main drink for children at 1 year old and is a lower-cost alternative to these products.'

However, the Baby Friendly Initiative called for recommendations to go further than the use of loyalty points, pointing out that families are first required to spend money to earn loyalty points, which is not viable for many families.

'We reiterate our calls for a price cap, which would provide a robust and sustainable solution for all families struggling to afford infant formula and provide equitable, effective and long-term relief,' the statement reads.