The term infant means a person not more than 12 months of age (1 year old or less). Infant formula means a breast-milk substitute specially manufactured to satisfy, by itself, the nutritional requirements of infants during the first months of life up to the introduction of appropriate complementary feeding, while Formula for Special Medical Purposes Intended for Infants also means a substitute for human milk or infant formula, but is specially manufactured to satisfy, by itself, the special nutritional requirements of infants with specific disorders, diseases or medical conditions during the first months of life up to the introduction of appropriate complementary feeding (CODEX STAN 72-1981). In Indonesia, they are included in BPOM Food Category 13 (Food Products for Special Nutritional Requirements). Here are the details of some infant formula and other special formulas belongs to this category.
13.1 Infant Formula and Follow on Formula, and Formulas for Special Medical Purposes Intended for Infants
13.1.1 Infant Formula
– Infant Formula
Breastmilk formulas for babies (up to 6 months of age) specifically formulated to be the only source of nutrition in the first months of life until the baby is introduced to the appropriate complementary foods. Its use can be continued until the baby is born 12 (twelve) months. Formulas can be made from cow’s milk or other animal milk and or edible parts of animals including fish, and or can from plants which have all been proven suitable for use as baby food for 6 (six) months; with vitamins, minerals and other nutrients in breast milk. This product is in the form of liquid, both in the form of ready-to-eat and powder reconstituted.
– Standard Milk Based Formula
Formula made from cow’s milk with modifications to get a number of nutrients (protein, fat, lactose, vitamins, minerals) that are compatible with breast milk. Protein is converted into a form that is easier to digest and the fat content is lowered or eliminated and added vegetable fat to obtain more essential fatty acids and is easily digested.
13.1.2 Follow-on Formula
Products obtained from cow’s milk or other animal milk and or edible parts from animals including fish, and / or from plants which have all been proven suitable for use as food for infants aged 6 (six) months until the child is 3 (three) year; by adding vitamins, minerals and other nutrients commonly found in breast milk; can be in the form of powder that needs to be added to water before use, or in the form of liquid that can be used directly or after being diluted with water.
Based on Permenkes RI no. 49/2014, there are two types of follow-on formula, which are milk formula for 1-3 years old (obtained from milk ingredients or materials derived from animals have all been proven suitable for children aged 1-3 years) and formula for 1-3 years old (obtained from basic ingredients from plants which have all been proven suitable for children aged 1-3 years).
13.1.3 Formulas for Special Medical Purposes Intended for Infants
13.3 Special Diet Foods for Health Purposes, Including for Infants and Children (Except Food Category Products 13.1)
Some of Infants Formulas included in this category are:
– Special Formula
Milk is specially formulated to deal with some specific nutritional problems that occur in infants. Some of these products include formula milk for premature babies, formula milk for babies with digestive problems, and formula milk for babies with metabolic problems.
– Soy Proteins Formula
Formula for babies who are intolerant of lactose or cow’s milk protein or who suffer from galactosemia.
– Formula for Preterm Infants
Formulas specifically made for premature babies, made from cow’s milk ingredients.
– Formula for Infants with Low Birth Weight
Formulas specifically made for babies with low birth weight (less than 2.5 kg)
However, breast feeding should be encouraged, while infant formula and formulas for special medical purposes intended for infants should only be given under certain circumstances and under medical supervision. According to Permenkes RI No. 39/2013, every mother who gives birth must give exclusive breastfeeding to the baby born, except in circumstances:
a. medical indication;
b. no mother; or
c. mother separated from baby.
Provision of Infant Formula Milk based on Medical Indications is carried out in terms of:
a. Babies who can only receive milk with a special formula;
b. Babies who need food other than breast milk for a limited period of time;
c. medical conditions of mothers who cannot provide exclusive breastfeeding because they must get treatment in accordance with medical service standards;
d. medical conditions of mothers with HBsAg (+), in the case of infants who have not been given passive and active hepatitis vaccination within 12 hours; and
e. other conditions in accordance with the development of science and technology.
References:
CODEX STAN 72-1981. Infant Formula and Formulas for Special Medical Purposes Intended for Infants.Formerly CAC/RS 72-1972. Adopted as a worldwide Standard in 1981. Amendment: 1983, 1985, 1987, 2011, 2015 and 2016. Revision: 2007.
Peraturan Menteri Kesehatan RI Nomor 39 Tahun 2013 Tentang Susu Formula Bayi dan Produk Bayi Lainnya (Permenkes RI No. 39/2013)
Peraturan Menteri Kesehatan RI Nomor 49 Tahun 2014 Tentang Standar Mutu Gizi, Pelabelan dan Periklanan Susu Formula Pertumbuhan dan Formula Pertumbuhan Anak Usia 1-3 tahun (Permenkes RI No. 49/2014)
Surat Keputusan Kepala BPOM RI No. HK 00.05.52.4040 tanggal 9 Oktober 2006 tentang Kategori Pangan (BPOM Food Categories).
Zulkarnain, MR. 2016. Mengetahui Jenis dan Nama Lain Susu dalam Label Pangan. Food For Kids Indonesia, June 2016 edition.