NUTRITIONAL AND BIOACTIVE DIFFERENCES BETWEEN HUMAN MILK AND COMMERCIAL INFANT FORMULAS: IMPLICATIONS FOR PUBLIC HEALTH AND THE KNOWLEDGE CHALLENGE IN BRAZIL

Abstract

Human milk is widely recognized as the gold standard of infant nutrition due to its complex, dynamic, and biologically active composition, being fundamental for adequate growth, immunological development, and neurological maturation of the infant. Despite recommendations from the World Health Organization and the Brazilian Ministry of Health for exclusive breastfeeding until six months of age, adherence rates remain below established targets, favoring the early introduction of infant formulas. In this context, this chapter aims to critically analyze the nutritional and bioactive differences between human milk and commercial infant formulas, as well as discuss the implications of these differences for Brazilian public health. Human milk contains highly bioavailable macronutrients and a wide variety of bioactive components, including human milk oligosaccharides, live cells, secretory immunoglobulin A, enzymes, hormones, cytokines, and growth factors, which play an essential role in protection against infections and in modulating the immune system. These elements are not fully reproduced by infant formulas, even with recent technological advances. The absence or limitation of these components in breast milk substitutes is associated with a higher risk of infectious morbidities, alterations in immunological development, and possible impacts on neurocognitive development. Additionally, the chapter addresses the role of infant formula marketing, especially in the digital environment, as a factor contributing to misinformation and weakening confidence in breastfeeding. Although Brazil has a relevant regulatory framework, represented by the Brazilian Standard for the Marketing of Foods for Infants and Young Children (NBCAL), challenges related to oversight and the adaptation of marketing strategies persist. It is concluded that the promotion, protection, and support of breastfeeding should remain a priority in public policies, coupled with the strengthening of scientific information and the effective regulation of the marketing of breast milk substitutes.