Supporting breastfeeding is important, but many parents need advice on alternatives, write Dr Esther Lau and Professor Lisa Nissen

As a profession, pharmacists encourage and support breastfeeding. However, for whatever reason, breastfeeding may not be possible for some women.

In these instances, pharmacists have an important role to play in providing support, and assisting in choosing an alternative – and infant formula is the only suitable and safe alternative to meeting primary nutritional needs.

While pharmacists have positive attitudes towards breastfeeding, research has shown we have poor knowledge in this area – practice is variable, and often guided by personal experience.

This finding is certainly not surprising and not unexpected – little about breastfeeding per se is often covered in the pharmacy degree – and where it is, the focus is on medicines and lactation rather than choosing an appropriate formula, or how to support distressed parents having trouble with breastfeeding.

For those of us who are not parents ourselves or have not had experience with infant formula, the section of the pharmacy housing the baby formula, bottles, and teats can often seem like a wall of wonder – we often need to defer to staff members who are parents!

The NHMRC Eat for Health Infant Feeding Guidelines: information for health workers (2012) is the current guidelines aimed to help health workers provide correct and consistent advice. Some recommendations and information about infant formula include:-

  • Infant formula requires accurate reconstitution and hygienic preparation to ensure its safety, so it is important that health workers know how to demonstrate the preparation of infant formula and how to feed an infant with a bottle. (
  • Cow’s milk-based formula is suitable for the first 12 months of life unless the infant cannot take cow’s milk-based products for specific medical, cultural or religious reasons, in which case special formulas may be used under medical supervision.
  • In Australia, a range of cow’s milk and goat’s milk formulas that meet the Australia New Zealand Food Standards Code for infant formula are available. There is little evidence that, if breastfeeding is discontinued for any reason, one formula is better than another for healthy full-term infants.

Pharmacists as the most accessible healthcare professional are often the first point of call for sleep-deprived and tired parents – who can also be anxious and distressed if they are experiencing trouble with breastfeeding, or cannot breastfeed and are struggling with choosing infant formula.

Aside from helping patients navigate how to manage medicines during breastfeeding, we have an important role to play in reassuring and supporting these parents. Pointing them in the direction of reputable resources, or where they can seek support can also be incredibly helpful e.g. Australian Breastfeeding Association (

Dr Esther Lau and Prof Lisa Nissen are from the School of Clinical Sciences, Queensland University of Technology.