Frequently Asked Questions – FAQ's

We have put together some useful information that could help you support parents.

For information on Coronavirus (COVID–19) in pregnancy and advice on breastfeeding please click here.

For tools you could share with parents and answers to frequently asked questions on Coronavirus (COVID–19), please visit the Coronavirus (Covid -19) Frequently Asked Questions page on our SMA Baby website.

The European legislation on infant and follow-on formula has been updated (EU Regulation 2016/127) which means that all infant and follow-on milk products are required to be reformulated in order to ensure the levels of vitamins and minerals and Omega 3 oils are provided at the new levels by 22nd February 2020*.
The key purpose of the legislation is to ensure that baby milks and specialist milks from all manufacturers provide the appropriate nutrition and are safe to use.
The compositional changes in the legislation relate to:

Maximum levels of protein
Levels of vitamins – such as vitamin A, D, E, B vitamins (thiamin, riboflavin, B6), folic acid
Levels of minerals – such as iodine, potassium, chloride, manganese, cooper, selenium
Mandatory addition of Omega 3 (DHA) – until now this addition was on a voluntary basis
*Products containing partially hydrolysed protein have until February 2021 to comply with the new legislation.

EU Legislation Changes
The new EU legislation requires us to make minor vitamin, mineral and other nutrient tweaks across our milks One of the main mandatory changes required by new EU regulation is the levels of DHA* inclusion. DHA (Omega-3 LCPs**) has been recommended by the European Food Safety Authority for use in baby formula and is safe. Omega-3 LCPs form a key part of a healthy diet.

Our current SMA infant and follow on milks already contain DHA* but you may notice an increase in the levels. These changes only apply to infant, follow-on and specialist milks.

Additional Changes
In addition aligned with our most up to date understanding of the key nutrients for babies; we will also be adding the oligosaccharide 2'FL to our SMA PRO range

*DHA: docosahexaenoic acid
**Long chain polyunsaturates

DHA stands for docosahexaenoic acid. DHA is an Omega-3 which is a family of fats that are also referred to as long-chain polyunsaturated fatty acids (LCPs). DHA intake contributes to the normal visual development of infants up to 12 months of age.

Beneficial effect is obtained with a daily intake of 100 mg of DHA.

No, not all formulas are the same. As a result of the updated legislation, the required levels of some specific vitamins, minerals and other nutrients will change in all formulations across all manufacturers. However, manufacturers are permitted to voluntarily add ingredients that reflect their latest scientific understanding in baby nutrition. In short, not all formulas will be the same.

Our products contain fish oil because this is the source of our DHA. Most infant formulas on sale in the UK and Ireland currently use fish oil as a source of DHA.

If you would like more information on the ingredients in our formulas, please contact our Careline team on 0800 081 81 80 or via www.smababy.co.uk/sma-careline/.

Vegetarian:
LITTLE STEPS^® Growing up Milk
SMA^® Comfort Easy to Digest Infant Milk
SMA^® Wysoy Infant Formula
SMA^® PRO Growing up Milk (powders only)

The rest of the SMA^® Nutrition range are not vegetarian because the Omega 3 Docosahexaenoic acid (DHA) (long chain polyunsaturated fatty acid) is derived from fish oil, in line with other formulas in the UK. Because it’s derived from fish oils, this does mean that it is not suitable for vegetarians but is suitable for pescatarian diets.

Most baby milks on sale in the UK and Ireland currently use fish oil as a source of DHA. Previously the addition of DHA to Infant Milk/ Follow-on milk was voluntary. From 2020 changes to legislation mean that it will be mandatory for all infant / follow on formulas to include DHA.

The following SMA^® Nutrition products are Halal Certified:
SMA^® PRO range of milks
LITTLE STEPS^® range of milks
SMA^® ORGANIC range of milks
SMA^® Comfort Easy to Digest Infant Milk
SMA^® LF Lactose Free

If you would like more information on the suitability for use in a Halal diet of any of our other products please contact our Careline team on 0800 081 81 80, or visit the SMA Careline^® page for other ways to get in touch.

SMA^® Growing up Milk powders do not contain vanilla. Only SMA^® PRO Growing up Milk 200ml liquid contains vanilla.

Postbiotics are compounds that are present in some formulas and are made through a process of fermentation. We do not add postbiotics to our milks because they are naturally made in babies tummy and there is no need for an additional supplement.

SMA^® Follow-on milks are tailored for babies from 6 months as part of a varied weaning diet. At 6 months your baby's development progresses quickly and their need for iron increases. SMA^® Follow-on milks are enriched with iron to help support normal cognitive development in baby’s brain.

To see the full list of ingredients and nutrition information for our products please see the label or the information available on our product pages.

SMA^® Growing Up Milks are suitable from 1 year onwards. They are one way to help support your child’s nutrient intake in combination with a healthy balanced diet. They contain unique blends of ingredients tailored to support young children's growth, up until their 4^th birthday. They contains vitamin D and calcium to support the normal growth and development of bones.

To see the full list of ingredients and nutrition information for our products please see the label or the information available on our product pages.

The signs of lactose intolerance or cows’ milk allergy may be immediate or delayed after feeding, and may involve symptoms regarding baby’s digestion, skin or respiratory system. If you believe the baby is showing signs of intolerance, contact your GP for further advice.

The majority of SMA^® Nutrition products are only available in the UK and Republic of Ireland. Therefore, for the duration of your stay, you would be best advised to take enough supplies of your baby’s usual milk with you.

To buy online, for UK please go to the our product page on www.smababy.co.uk and click "Where to buy" to learn where our products can be bought.

SMA^® Nutrition have always used steel tins as they offer the best product protection and protection against humidity. The steel tin is 100% recyclable, however check with your local recycling facility. The cartons and plastic lids of the tins are widely recyclable within the UK and Ireland, but again check with your local recycling facility. SMA^® PRO Growing up Milk 200ml comes with a plastic straw to provide parents with a safe, convenient and easy-to use solution in and out of home. We recommend pushing the straw “back in the pack” as soon as the carton has been finished and before placing the carton in the correct recycling bin.

Yes.  SMA^® Nutrition liquid and powdered products can be used together. 

If you are having difficulties and the powder is not mixing well, check that you are preparing the bottle as recommended on the back of the tin. If you would like some advice, please contact the SMA Careline® team of experts who will be happy to help you.

Yes, SMA^® Follow-on Milks are suitable to use in a baby’s favourite milk-based recipes or on cereals.

Milk will remain a big part of a baby’s daily diet all the way through childhood, providing important energy and nutrients. SMA^® Follow-on Milks contain a tailored combination of nutrients including iron, vitamin D, omega 3 and 6, and GOS/FOS*.

*GOS/FOS = Galacto- and Fructo-oligosaccharides in powder formulation only.

Our SMA^® Follow-on Milks contain iron because it is specifically designed for babies from 6 months of age. At this time, baby’s natural stores of iron have depleted, so SMA^® Follow-on Milks are enriched with iron to help support normal cognitive development in baby’s brain. 

SMA^® Growing Up Milks contain more vitamin D per 100ml than our SMA^® Follow-on Milks, as at 12 months, a toddler will be consuming more iron through the foods they eat as part of their diet. Vitamin D, which helps to support normal growth and development of bones, is a hard to get nutrient in the diet. A contribution to a toddler’s dietary intake of vitamin D can come from foods such as oily fish, supplements and fortified products such as fortified breakfast cereals. SMA^® Growing Up Milks also contain vitamins A, C & D to help support the normal function of a child’s immune system.

Yes, Health Authorities in the UK and Ireland recommend that a toddler has two to three servings of dairy foods a day, including milk. From 12 months, a toddler can be given full fat cows’ milk, Growing Up Milk, or a combination of both. 

To see the full list of ingredients and nutrition information for this product please see the label or the information available on our product pages.

At SMA Nutrition we are proud of our 100 year history of baby nutrition research. We are part of the largest food and nutrition research network in the world, with around 30 research and development sites, including one here in the UK. And we hold ourselves to the highest quality research standards. Over the past five years, we published over 1000 studies in peer-reviewed journals, collaborating with leading scientists and universities, including University College London, Southampton University and Imperial College London.

We use our science to constantly feed innovation, and our technology to bring ever better products to families in the UK and Ireland, meeting the specific nutritional needs of our community’s babies. For us it is not enough to know what is in breast milk, we need to be able to create formulas that are ever closer to it. The more we learn about the amazing properties of breast milk, the longer the journey ahead becomes. Even as we commit to making ever better products, we know they will never be equal to breast milk.

SMA Nutrition is part of Nestlé, the world’s largest nutrition, health and wellness company. Our size and scale allow us to invest significant time, money and expertise into research, helping us to achieve our ambition of providing better nutrition that contributes to a healthy start and a healthier future.

We have a diverse team of over 800 people from around the world who give us such a range of expertise at our research site in Switzerland, the Nestlé Research Centre (NRC).

One of the most important things we have done at the NRC is to standardise all the studies we have at Nestle on human milk characterisation. We have more than 10 internal clinical trials ongoing – all of which are working with the same types of methodologies, not only for sampling but also for the analysis across the different studies. This means that in the end we can compare apples to apples.

The formulas we make today are very different to those of a generation ago. This reflects both our better understanding of breast milk and our ability to make better formulas. 

For example, we have not only learnt that breast milk has a much lower level of protein than was previously understood, but we are also now able to create a lower protein formula which has essential amino acid profile similar to that of breast milk.

Once the European Food Standards Agency (EFSA) decides that there is overwhelming evidence either to support the inclusion of a new ingredient, or to change the acceptable levels of an existing ingredient, then the regulations on what must be in infant formula are changed.

One example of this is the decision to include DHA (omega-3) in the list of mandatory ingredients from February 2020. Industry-led clinical research conducted during the past 20 years or so has clearly demonstrated the benefits of DHA for non-breastfed infants.

Nestlé believes in the need for industry and healthcare professionals to work together. We are proud of our long history of collaborative research with leading scientists and universities, work that has led to significant breakthroughs in infant nutrition research.

We also believe that we have a responsibility to share information about our products, and the science behind them, with HCPs. We believe that this should be done in such a way as to minimise and manage any potential conflicts of interest.

This is in line with Article 7 of the International Code of Marketing of Breast-milk Substitutes (the WHO Code), which clearly sets out the ways in which formula companies and healthcare professionals can work together. 

For example, Article 7.5 requires that HCPs disclose to their employer if they are sponsored by formula company to attend a conference. In doing so, it makes it clear that it is not against the Code to accept such sponsorship. Nestlé’s policy on the Sponsorship of Health Workers and Institutions for Professional Development and Scientific Research also requires that HCPs disclose any sponsorship to their employer.

This policy is also echoed in the words of the WHO Director General, Dr Tedros, who said: “Engaging does not mean that there is conflict of interest … It’s the action that comes after that engagement that could be either conflict of interest or not. But engagement is not.”

Human milk contains bioactive components that confer protective effects on the newborn. These include complex carbohydrates called human milk oligosaccharides (HMOs). HMOs are the third most abundant solid component in human milk and have a unique structure. This unique structure results in specific functions within the human body.^1-4
HMOs are unique to human breast milk and are not found in significant amounts in any other mammalian milk.^1-4

References:

1. Kunz C. Historical aspects of human milk oligosaccharides. Adv Nutr 2012; 3(3): 430S–9S.
2. Bode L. Human milk oligosaccharides: every baby needs a sugar mama. Glycobiology 2012; 22(9): 1147–62.
3. Jantscher-Krenn E, Bode L. Human milk oligosaccharides and their potential bene_ ts for the breast-fed neonate. Minerva Pediatr 2012; 64(1): 83–99. 10. Smilowitz JT,
4. et al. Breast milk oligosaccharides: structure-function relationships in the neonate. Annu Rev Nutr 2014; 34: 143–69. 11

2’fucosyllactose (2′FL) and lacto-N-neotetraose (LNnT) are among the 10 most abundant oligosaccharides in human breast milk, together they constitute 37% of total HMOs. Interestingly, 2’FL and LNnT are among the most researched HMOs.^1-3 

References:

1. Bode L, Jantscher-Krenn E. Structure-function relationships of human milk oligosaccharides. Adv Nutr Int Rev J. 2012 May;3(3):383S-91S.
2. Austin S, De Castro CA, Bénet T, Hou Y, Sun H, Thakkar SK et al. Temporal change of the content of 10 oligosaccharides in the milk of Chinese urban mothers. Nutrients. 2016 Jun;8(6):346. 
3. Smilowitz J, Lebrilla C, Mills D, German J, Freeman S. Breast milk oligosaccharides: structure-function relationships in the neonate. Ann Rev Nutr. 2014 Jul;34(1):143-69.

Research suggests that HMOs support the infant’s developing immune system in 4 main ways:

1. Selectively feeding good bacteria within the gut, where 70–80% of the human body’s immune cells live¹
2. Preventing pathogens from binding to the intestinal wall, which reduces their ability to infect the infant^1,3 
3. Assisting gut barrier function, which can help prevent pathogen binding to the intestinal cells^1,3 
4. Directly modulating the immune system, which helps in educating the developing immune system^1,4 

References: 

1. Bode L. Human milk oligosaccharides: every baby needs a sugar mama. Glycobiology. 2012 Sep;22(9):1147-62.
2. Sela DA, Mills DA. Nursing our microbiota: molecular linkages between bifidobacteria and milk oligosaccharides. Trends Microbiol. 2010 Jul;18(7):298-307.
3. Jantscher-Krenn E, Bode L. Human milk oligosaccharides and their potential benefits for the breast-fed neonate. Minerva Pediatr. 2012 Feb;64(1):83-99. 
4. Eiwegger T, Stahl B, Schmitt J, Boehm G, Gerstmayr M, Pichler J et al. Human milk-derived oligosaccharides and plant-derived oligosaccharides stimulate cytokine production of cord blood T-cells in vitro. Pediatr Res. 2004 Oct;56(4):536-40.

The structure of HMOs is unique and fundamentally different to GOS/FOS (which are not present in human milk). This unique structure of HMOs allows them to have targeted benefits that are not present with GOS/FOS.

Yes, recent advances in technology have allowed structurally identical HMOs to be synthesized from lactose through a fermentation process.

Yes, there are numerous clinical trials on infant formula supplemented with HMOs. A Randomised, multicentre, double-blind trial to evaluate the effects of infant formula supplemented with two structurally identical HMOs (2’fucosyllactose [2’FL] and lacto-N-neotetraose [LNnT]) on infant growth, tolerance and morbidity was published in 2017. The trial concluded that infant formula supplemented with HMOs  (2’FL and LNnT) is safe, well tolerated, and supports age-appropriate growth. To see a summary of this publication, click here

Our team of nutritionists are always looking to evolve our recipes to reflect our most up-to-date understanding of the key nutrients for babies. The new SMA^® PRO formulas have been updated to incorporate both the new EU legislations and our most up-to-date understanding of the key nutrients for babies.

DHA stands for docosahexaenoic acid. DHA is an Omega-3 which is a family of fats that are also referred to as long-chain polyunsaturated fatty acid (LCP). DHA intake contributes to the normal visual development of infants up to 12 months of age.The beneficial effect is obtained with a daily intake of 100 mg of DHA ( contains at least 0,3 % of the total fatty acids as DHA.)

2’FL is the most abundant human milk oligosaccharide (HMO) found in breast milk. Oligosaccharides are complex carbohydrates and the third largest solid component found in breast milk. There are thought to be 200 oligosaccharides in breast milk. 80% of mums have 2'FL, making it the most abundant oligosaccharide found in breast milk.

2'FL is a Human Milk Oligosaccharide which benefits baby in four main ways:

1. HMOs block bad bacteria from attaching to the gut and doing harm ^1,2
2. Strengthening the developing gut barrier^1,2
3. Helping to balance the immune system ¹
4. Feeding good bacteria within the gut, where 70–80% of the body’s immune cells live ¹

REFERENCES

1. Bode L. Human milk oligosaccharides: every baby needs a sugar mama. Glycobiology 2012; 22(9): 1147–62. 6. Jantscher-Krenn E, Bode L. Human milk oligosaccharides and their potential benefits for the breast-fed neonate. Minerva Pediatr 2012; 64(1): 83–99.
2. Smilowitz JT, Lebrilla CB, Mills DA, et al. Breast milk oligosaccharides: structure-function relationships in the neonate. Annu Rev Nutr 2014; 34:143–69)

2’FL has been assessed by the EFSA (European Food Safety Authority) as safe for use in baby milks and has been present in our SMA Advanced Milks since May 2019. There are 50 research studies over 24 years that support the role of oligosaccharides in infant nutrition. 2'FL is the most clinically studied of these oligosaccharides. Even though there are 200 oligosaccharides in breast milk, we will only add those that have been studied and accepted by EFSA (European Food Safety Assosiation).

No, the 2'FL present in our SMA^® PRO range are structurally identical to the oligosaccharides found in breast milk. The 2'FL in SMA^® PRO range are made by fermentation of lactose.

GOS & FOS are not found in breast milk. We will therefore stop adding GOS & FOS to our products from 2020.

The preparation instructions for our new SMA^® Nutrition milks have not changed. When making up a feed, it is always important to follow the on-pack instructions closely.

Our updated milks will be gradually replacing our current packs in all retailers from February 2020, the availability of our current and updated milks will vary depending on the retailer.

For the first few months in market the new milks will have a lid sticker on to highlight that it is the new updated formulation and the ready to feed liquids will have a flash on the bottles.

The UK will continue to comply to EU Regulation for the foresable future, until further guidance is issued from the UK Government.

We believe that it is important to ensure that parents have choices in the formula that they give to their baby. Which is why we have a variety of milks to suit the different needs of parents and babies. 

The European legislation on infant and follow-on formula has been updated (EU Regulation 2016/127) which means that all infant and follow-on milk products are required to ensure the levels of vitamins and minerals and Omega 3 oils are provided at the new levels set out in the legislation by 22nd February 2020. 

*Products containing partially hydrolysed protein have until February 2021 to comply with the new legislation.

LITTLE STEPS First Infant Milk Scoop size 4.5g
LITTLE STEPS Follow-on Milk Scoop size: 4.5 g

LITTLE STEPS First Infant milk contains 1.5g protein per 100ml of prepared feed
LITTLE STEPS Follow-on milk contains 1.5g protein per 100ml of prepared feed

LITTLE STEPS First Infant Milk 60:40 (whey:casein)
LITTLE STEPS Follow-on Milk 23:77 (whey:casein)

EU regulations (Commission Delegated Regulation (EU) 2016/127) specify mandatory ingredients of Infant and Follow-on formulae. It is now mandatory for all Infant and Follow-on formulae to contain Docosahexaenoic acid (DHA), however supplementation with arachidonic acid (AA) is not a necessity. 

The Omega 3 Docosahexaenoic acid (DHA) (long chain polyunsaturated fatty acids) used in Little Steps First Infant Milk/Little Steps Follow-on Milk, is derived from fish oil, in line with other formulas in the UK. Because it’s derived from fish oils, this does mean that it is not suitable for vegetarians but is suitable for pescatarian diets. 

Most baby milks on sale in the UK and Ireland currently use fish oil as a source of DHA. Previously the addition of DHA to Infant Milk/ Follow-on milk was voluntary.  From 2020 changes to legislation means that it will be mandatory for all infant / follow on formulas to include DHA. The mandatory addition of docosahexaenoic acid (DHA) to infant formula/follow-on formula is a new requirement introduced by this Regulation, as a result of recent scientific research.

Yes, both Little Steps First Infant Milk and Little Steps Follow-on Milk are halal certified.

No, LITTLE STEPS does not contain GOS/FOS. 
EU Regulations set out the criteria for the mandatory nutritional composition of Infant and Follow-on milks. These regulations state that it is not a necessity to add GOS/FOS (non-digestible oligosaccharides) to Infant formula and Follow-on milks, so we have chosen not to in our LITTLE STEPS milks. 

Non-digestible (non-glycaemic) carbohydrates

In the absence of convincing evidence of any beneficial effects of non-digestible oligosaccharides on infant health, the Panel considers that there is no necessity to add non-digestible oligosaccharides to IF or FOF. The Panel considers that there is no evidence to change the previous conclusions of the SCF (2001d) that a mixture of 90 % GOS and 10 % of high-molecular-weight FOS is safe under the current conditions of use (i.e. < 0.8 g/ 100mL) in IF and FOF. The safety of any other non-digestible oligosaccharides or any new mixture of non-digestible oligosaccharides in IF and FOF should be established by clinical evaluation.

As per EFSA opinion 2014 on the essential composition of IF and FoF (and consequently the new European Delegated Regulation), nucleotides are not compulsory. If they are added (on a voluntary basis) then the amount should not exceed 5mg/100kcal. Nucleotides are not compulsory in a product like Little Steps and are therefore not added. 

LITTLE STEPS First Infant Milk/ Follow-on milk is currently only available in the UK & Ireland. To ensure sufficient consistent milk supply for such babies, whilst away we recommend that parents take LITTLE STEPS First Infant Milk/ Follow-on Milk with them.

LITTLE STEPS^® First Infant Milk and Follow-on Milk are available in ready to drink format. We do not currently have a LITTLE STEPS^® Growing up milk readymade liquid format, however this may be something we look to introduce in the future.

Little Steps Growing up milk - 4.6g

1.5g/100ml

23/73

We have made some changes to the front of the tin to more clearly show the key ingredients of our range.

Yes, SMA^® ORGANIC First, Follow-on and Growing Up milks are certified organic and meet strict EU Organic requirements. You will see that on our labels we have the EU green leaf which indicates that we are certified Organic. The cows that produce our high quality organic milk spend time outside where they can graze on green pastures and are fed organic feed.

The SMA^® ORGANIC range does not currently come in liquid format however; this may be something we look to introduce in the future.

SMA LF^® Lactose Free Infant Milk only.

SMA^® LF infant milk complies with new EU legislation regulations. Now contains Omega 3 DHA from fish oil, a natural source which is commonly used in baby milks in the UK & I.

There has been a slight revision to the preparation instructions for SMA LF^® Lactose Free Infant Milk. Stage 5: Place the sterilised teat and cap on the bottle and immediately shake vigorously until the powder is fully dissolved. Cool bottle under cold running water or in a bowl or jug of cool water until lukewarm, do not immerse the teat. Test temperature by shaking a few drops onto the inside of your wrist. Upon preparation there may be a noticeable foam, this is quite normal. For more information on the preparation instructions please contact the SMA Careline^® .

SMA^® Anti-Reflux formula complies with new EU legislation regulations. Now contains Omega 3 DHA from fish oil, a natural source which is commonly used in baby milks in the UK & I.

SMA Gold Prem^® 1 & SMA Gold Prem^® 2.There has been no change to SMA^® Breast Milk Fortifier.

SMA Gold Prem^® 1 as a result of EUDA was updated:
There has been a change in the fat source of the DHA fatty acid, and these are now sourced from fish oils. Also, changes to the levels of some of the fatty acids (increase in DHA fatty acid) and the triglyceride levels (decrease in the Medium Chain triglyceride levels).
Increase in the level of milk carbohydrate (lactose).

SMA Gold Prem^® 2 as a result of EUDA was updated:
There has been a change in the fat source of the DHA fatty acid, and these are now sourced from fish oils. Changes to the levels of the triglycerides (increase in the Medium Chain triglyceride levels).
Increase in the level of Vitamin D