Baby formula was invented because, for most of human history, infants whose mothers could not breastfeed faced starvation or death from contaminated substitutes. The search for a safe, nutritious replacement for breast milk stretches back centuries, but the first commercially produced formulas appeared in the mid-1800s, driven by a collision of chemistry, industrialization, and desperate need. The story is more tangled than a simple tale of scientific progress, though, woven through with class politics, deadly mistakes, and marketing that sometimes outpaced the science behind it.
Before Formula, There Was Pap
Long before anyone manufactured infant formula in a factory, parents who could not breastfeed had limited and often dangerous options. From the 1600s through the 1800s, most infant-care manuals recommended homemade substitutes. The three most common were pap (flour or bread crumbs cooked in water, sometimes with milk), gruel (a thin porridge made from boiled cereal), and panada (bread or cereal cooked in broth).1PubMed. Pap, gruel, and panada: early approaches to artificial infant feeding These mixtures were nutritionally poor and nearly impossible to keep free of bacteria. Infant mortality rates were staggering when mothers relied on them, and doctors knew it even then.
The other traditional option was wet nursing, where another lactating woman fed the baby. Wet nursing was practiced across cultures for thousands of years, sometimes by choice but often out of economic necessity. Wealthy families hired wet nurses; foundling hospitals relied on them for orphaned infants. But the arrangement carried its own risks. Wet nurses were frequently underpaid, overworked, and sometimes had diseases they could transmit through their milk. Over time, society’s view of wet nursing soured, and as other options emerged, it fell out of favor. The growing negative perception of wet nursing, combined with improvements to feeding bottles and the increasing availability of animal milk, gradually pushed families toward artificial feeding instead.2PubMed Central. A history of infant feeding
The Condensed Milk Breakthrough
The first real leap toward commercial infant feeding came in 1856, when Gail Borden in the United States figured out how to make condensed milk. His process involved heating milk to high temperatures, removing about half its water content, and adding large quantities of sugar. The resulting product was essentially sterile and could be stored safely because its high sugar concentration prevented bacterial growth.3SciELO – Scientific Electronic Library Online. The history of infant nutrition For the first time, parents had access to a milk product that would not spoil within hours and was less likely to kill their baby from infection.
Condensed milk was not formulated for infants, though. It was heavily sweetened and lacked many nutrients babies needed. Still, it became enormously popular as an infant food simply because it was safer than raw cow’s milk, which at the time was a genuine hazard. Borden’s innovation was less about nutrition and more about preservation, but it opened the door for the chemists and entrepreneurs who came next.
Liebig, Nestlé, and the Birth of Commercial Formula
The mid-to-late 1800s saw the first products explicitly designed and marketed as infant food. Industrialized production of infant formula first appeared around 1856, pioneered by Borden in the United States, Justus von Liebig in Germany, Henri Nestlé in Switzerland, and Mellin in the United Kingdom.4Karger. Historic Records on the Commercial Production of Infant Formula Their approaches differed remarkably. Liebig, a renowned chemist, developed a food based on cow’s milk mixed with wheat flour, malt flour, and potassium bicarbonate. He believed he could replicate human milk through chemistry, and his product was one of the earliest attempts to do so on scientific principles. Nestlé’s “Farine Lactée” combined cow’s milk with wheat flour and sugar. Mellin’s Food was a malt-based product dissolved in milk.
None of these early formulas were particularly close to human breast milk in composition. They deviated substantially from both human and cow’s milk, and physicians quickly began debating the importance of getting the ratios of protein, fat, and carbohydrates right.4Karger. Historic Records on the Commercial Production of Infant Formula But these products had one enormous advantage over anything that came before: they were free of bacteria. In an era when milk-borne infections killed thousands of babies every year, sterility alone was a powerful selling point. The companies behind them prospered through mass production, international distribution, and aggressive advertising that sometimes outpaced the actual science of infant nutrition.
The Milk Problem and Why Raw Cow’s Milk Was Deadly
To understand why formula seemed like such a miracle, you have to understand how dangerous ordinary milk was in the 1800s. The germ theory of disease, once it gained acceptance, revealed that cow’s milk could transmit a frightening range of infections, including tuberculosis, brucellosis, salmonellosis, streptococcal infections, diphtheria, and what was then called “summer diarrhea,” a catch-all term for the gastrointestinal infections that killed enormous numbers of infants during warm months.5PubMed. A Brief History of Milk Hygiene and Its Impact on Infant Mortality from 1875 to 1925 and Implications for Today: A Review
Pasteurization eventually helped, but its adoption was slow and fiercely contested. Dairy farmers resisted it, some physicians distrusted it, and even after it became more widespread, infant mortality from milk-borne disease dropped by only about half by the early twentieth century, despite concurrent advances in medical care and dairy hygiene.5PubMed. A Brief History of Milk Hygiene and Its Impact on Infant Mortality from 1875 to 1925 and Implications for Today: A Review The remaining deaths were often caused by bacteria introduced during handling, storage, or preparation at home. This persistent danger kept demand high for any product that could reliably deliver safe milk to an infant’s stomach.
Even setting aside infection, plain cow’s milk is a poor food for young babies. It can lead to iron deficiency anemia, its high protein and mineral content creates a heavy load on immature kidneys, and early exposure to cow’s milk proteins raises the risk of developing a milk allergy.6PubMed Central. Whole cow’s milk in infancy Healthy infants can usually tolerate the extra kidney workload under normal conditions, but any bout of vomiting or diarrhea that causes dehydration narrows the safety margin considerably. These problems were not well understood in the 1800s, which is part of why so many “hand-fed” babies on diluted cow’s milk still got sick even when the milk itself was free of germs.
Rickets, Scurvy, and the Vitamin Problem
As formula feeding became more common in the late 1800s and early 1900s, new problems emerged that nobody had anticipated. Breast milk contains vitamins C and D in forms that babies can absorb; early formulas did not. The result was a surge in nutritional deficiency diseases. As urban living in the United States increased during this period, infantile rickets, caused by vitamin D deficiency, became widespread.3SciELO – Scientific Electronic Library Online. The history of infant nutrition Scurvy, caused by a lack of vitamin C, was another serious concern. A survey of over two hundred teaching hospitals in the United States found that during the years 1956 to 1960, more than seven hundred infants and children were admitted because of scurvy.3SciELO – Scientific Electronic Library Online. The history of infant nutrition
The solution came piecemeal. Beginning in the early 1920s, pediatricians started recommending orange juice and cod liver oil supplements for formula-fed babies, which dramatically reduced the incidence of both scurvy and rickets. These supplements became standard advice for decades, and many older parents still remember cod liver oil as a childhood staple. Eventually, manufacturers began adding vitamins directly to their formulas, but that process took years. Iron was another gap: an iron-fortified formula was not introduced in the United States until 1959, and by the mid-1960s most manufacturers offered the same base formula with or without substantial iron fortification.3SciELO – Scientific Electronic Library Online. The history of infant nutrition The slow timeline is striking: it took roughly a century from the first commercial formula to one that came reasonably close to covering an infant’s basic nutritional needs.
How Marketing Shaped the Formula Story
Formula did not become dominant in the twentieth century through science alone. Advertising played an enormous role. Companies marketed directly to mothers and, perhaps more effectively, to doctors. Free samples in hospitals, branded educational materials in pediatricians’ offices, and sponsorship of medical conferences all helped normalize formula feeding as modern and scientific. The safety and advertising of formula products increased their popularity and use in society at large.2PubMed Central. A history of infant feeding
By mid-century in many Western countries, formula feeding had become the norm. Breastfeeding rates in the United States hit their lowest point around the early 1970s. The shift was not driven purely by parental choice or medical recommendation. It reflected a broader cultural moment where industrial products were seen as superior to “natural” ones, where women were entering the workforce in larger numbers, and where the medical establishment often presented formula as equivalent or even preferable to breast milk.
The consequences became most visible in the developing world. When formula companies expanded aggressively into low-income countries during the 1960s and 1970s, the results were catastrophic. Families who could not afford adequate formula diluted it to make it last longer. Clean water for mixing was often unavailable. Mothers who stopped breastfeeding found they could not resume it. The dramatic increase in infant mortality, malnutrition, and diarrhea in very young infants in the developing world became closely associated with the aggressive marketing of formula.7Archives of Disease in Childhood. Marketing breast milk substitutes: problems and perils throughout the world This crisis led to international boycotts, most famously against Nestlé, and eventually to the World Health Organization’s International Code of Marketing of Breast-milk Substitutes in 1981. The Code prohibited advertising of baby formula, bottles, and teats, and banned gifts to mothers and financial incentives to health workers.7Archives of Disease in Childhood. Marketing breast milk substitutes: problems and perils throughout the world
Regulation and the Push for Safety Standards
The United States had its own reckoning with formula safety, though the trigger was different. In the late 1970s, a soy-based formula that was deficient in chloride caused a condition called metabolic alkalosis in infants who consumed it. The resulting health damage prompted Congress to act. The Infant Formula Act of 1980 was one of the most specific and detailed pieces of legislation Congress had ever passed. It established minimum nutrient requirements for formula, defined what constituted an adulterated product, required quality control procedures, prescribed recall procedures, and specified inspection requirements.8Journal of AOAC INTERNATIONAL. The Infant Formula Act of 1980
The Act was amended in 1986, and more detailed FDA rules have been created since then, specifying the acceptable ranges or minimum levels of nutrients and providing guidelines for the safe production and evaluation of formulas.9PubMed Central. Perspective: Is It Time to Revise the Current Nutrient Requirements for Infant Formulas Principally Established in 1980? Before 1980, there was no federal law requiring formula to meet any specific nutritional standard. Manufacturers could and did sell products that were missing essential nutrients. The fact that it took until the late twentieth century for the United States to regulate what goes into infant formula tells you something about how the industry’s growth outpaced oversight for most of its history.
Some researchers have argued that the nutrient requirements established in 1980 are now overdue for a comprehensive update. Our understanding of infant nutritional needs has advanced considerably in four decades, and questions have been raised about whether the current standards fully reflect modern science.9PubMed Central. Perspective: Is It Time to Revise the Current Nutrient Requirements for Infant Formulas Principally Established in 1980?
What Modern Formula Still Cannot Replicate
Today’s infant formulas are incomparably better than the pap and gruel of the 1700s or the sweetened condensed milk of the 1860s. They contain carefully calibrated ratios of protein, fat, carbohydrates, vitamins, and minerals. But breast milk remains a fundamentally different substance, and some of its properties have proven extremely difficult to reproduce.
Human milk oligosaccharides, or HMOs, are a good example. These are complex sugars that are the third most abundant solid component of breast milk, after lactose and fat. They do not nourish the baby directly. Instead, they feed beneficial gut bacteria, help train the infant immune system, and may protect against infections. Breast milk also contains immunoglobulins, hormones, and other bioactive components that formula simply does not have.10PubMed Central. Human Milk Oligosaccharides: Health Benefits, Potential Applications in Infant Formulas, and Pharmacology In recent years, a few individual HMOs have been synthesized and added to some premium formulas, but the full diversity of these sugars in human milk numbers in the hundreds, and replicating that complexity at scale remains well beyond current manufacturing capability.
This gap does not mean formula is harmful. Modern formula supports healthy growth and development in millions of babies worldwide. But the persistent distance between formula and breast milk helps explain why research into formula composition continues to be an active field, and why the history of formula is really a history of trying to close a gap that keeps proving wider than the last generation of scientists thought.
A Fifty-Five Billion Dollar Industry
Whatever its origins in nineteenth-century chemistry labs, infant formula is now a massive global business. Global milk formula sales grew from roughly $1.5 billion in 1978 to $55.6 billion in 2019.11PubMed Central. Globalization, first-foods systems transformations and corporate power: a synthesis of literature and data on the market and political practices of the transnational baby food industry That growth has been driven by two forces. First, the geographical expansion of the industry, particularly into Asia, Africa, and Latin America, where corporations have pursued new markets aggressively. Second, the broadening of product lines beyond standard infant formula to include follow-up formulas, toddler milks, and specialized products for various conditions and age groups, widening the range of families being marketed to.11PubMed Central. Globalization, first-foods systems transformations and corporate power: a synthesis of literature and data on the market and political practices of the transnational baby food industry
The toddler milk category deserves particular scrutiny because it exists in a regulatory gray area. The WHO Code and most national regulations focus on infant formula marketed for babies under six or twelve months. Toddler milks, which are nutritionally unnecessary for children eating solid food, often escape these marketing restrictions entirely. This has allowed companies to build brand recognition through toddler-milk advertising that effectively promotes their infant formula lines as well. It is a strategy that the original nineteenth-century formula pioneers would have recognized instantly.
Contamination Risks That Persist
Even with modern manufacturing, powdered infant formula carries microbiological risks that liquid formula and breast milk do not. Powdered formula is not a sterile product. Cronobacter sakazakii, a bacterium found widely in the environment, has been repeatedly linked to serious infections in infants through contaminated powdered formula and breast pump equipment. Investigations have found the organism in opened powdered formula, breast pump parts, home environmental surfaces, and, on rare occasions, in unopened powdered formula and manufacturing facilities themselves.12PubMed Central. Cronobacter sakazakii Infections in Two Infants Linked to Powdered Infant Formula and Breast Pump Equipment – United States, 2021 and 2022
Cronobacter infections are rare, but they are devastating when they occur, particularly in premature or immunocompromised newborns. A high-profile contamination incident in the United States in 2022 led to a major product recall and a nationwide formula shortage that exposed just how concentrated and fragile the formula supply chain had become. Only a handful of manufacturers produce the vast majority of formula sold in the country, and when one facility shut down, parents across the nation found empty store shelves for months. The episode was a sharp reminder that the formula story is not just about chemistry. It is about infrastructure, regulation, supply chains, and the practical question of how a society feeds its most vulnerable members when something goes wrong.
Why Families Used Formula Then and Now
It is tempting to frame the history of formula as a story about corporate greed versus breastfeeding, but that misses the reality of why formula was invented in the first place. Babies have always needed to be fed when breastfeeding was not possible. Mothers died in childbirth. Mothers became too ill to nurse. Some mothers simply did not produce enough milk. Adoption, abandonment, and orphanhood meant that many babies had no access to a lactating woman at all. Before formula, those babies were fed contaminated pap or diluted animal milk and died at appalling rates. Formula, for all its limitations and the ethical failures in its marketing history, represented a genuine lifeline for infants who had no other option.
Today the reasons families use formula are broader but no less real. Many parents combine breastfeeding with formula. Some mothers face medical conditions that make breastfeeding impossible or unsafe. Same-sex male couples and adoptive families rely on formula entirely. Workplace demands, lack of parental leave, and insufficient lactation support push many families toward formula earlier than they planned. The invention of formula did not create these needs. It responded to them, imperfectly and sometimes exploitatively, but in ways that have saved countless lives over the past century and a half.