Infant Formula Safety Governance: Systemic Challenges, the Imperative of Prevention, and a Framework for Precautionary Reform

Authors

DOI:

https://doi.org/10.66636/gmj.v1.i1.a11

Keywords:

Infant Formula, Food Safety, Product Recall, Risk Communication, Precautionary Principle, E-commerce, RASFF, Georgia, Infant Formula Governance, INFOSAN, Codex Alimentarius, Foodborne Disease, Consumer Trust, Risk Analysis, Bacillus cereus, Food Recall, Supply Chain Governance

Abstract

Background  Infant formula may constitute the sole source of nutrition during a period of extreme physiologic vulnerability. Recurring safety incidents have exposed systemic governance weaknesses that remain nationally siloed while production and distribution operate globally.

Methods  Policy analysis drawing on peer-reviewed literature, WHO and FAO/WHO framework documents, Codex Alimentarius standards, and INFOSAN operational data to identify structural governance challenges and evaluate the adequacy of existing international frameworks.

Results  Six governance deficits were identified: delayed corporate transparency, regulatory fragmentation, reactive quality paradigms, consumer trust erosion, cross-jurisdictional coordination failures, and a persistent prevention deficit. Current international instruments provide necessary foundations but lack enforceable mechanisms for mandatory early disclosure, globally consolidated recall information, and prevention-first accountability specific to infant formula.

Conclusion  Prevention must be the organizing principle of infant formula governance. A five-pillar framework is proposed: mandatory early public disclosure, prevention-first supply chain governance, a global consolidated recall registry, strengthened INFOSAN operationalization, and formal protection of independent public health actors.

Keywords  infant formula; food safety; governance; prevention; precautionary principle; WHO; INFOSAN; Codex Alimentarius; recall; consumer trust

References

1. Mao Y. Research on corporate public relations strategies in major product quality crises: a case study of Nestlé’s 2008 infant formula incident. Lect Notes Educ Psychol Public Media. 2025;97:153–8. https://doi.org/10.54254/2753-7048/2025.LD25172

2. Sariman SB, Rudi-Polloshka J, Ross RB, Caputo V. US infant formula industry: a qualitative analysis of a major food safety recall and its implications. Q Open. 2025;5(1):qoaf010. https://doi.org/10.1093/qopen/qoaf010

3. Schneider A, Kelly B, Sinha MS. Food inspections: searching for contamination (and solutions) in a haystack. J Food Law Policy. 2025;21(1):30. https://doi.org/10.54119/jflp.rfhd7595

4. Balabin RM, Smirnov SV. Melamine detection by mid- and near-infrared (MIR/NIR) spectroscopy: a quick and sensitive method for dairy products analysis including liquid milk, infant formula, and milk powder. Talanta. 2011;85(1):562–8. https://doi.org/10.1016/j.talanta.2011.04.026

5. Zhang J, Waldron S, Dong X, Dai X. Mediating roles of perceived quality and perceived behaviour control in shaping Chinese consumer’s purchase intention for domestic infant milk formula. Foods. 2024;13(19):3099. https://doi.org/10.3390/foods13193099

6. Li S, Sijtsema SJ, Kornelis M, Liu Y, Li S. Consumer confidence in the safety of milk and infant milk formula in China. J Dairy Sci. 2019;102(10):8807–18. https://doi.org/10.3168/jds.2019-16638

7. Yasuda JK. Response to Henry Thomson’s review of On Feeding the Masses: An Anatomy of Regulatory Failure in China. Perspect Polit. 2020;18(2):570. https://doi.org/10.1017/S1537592720000912

8. World Health Organization. WHO global strategy for food safety 2022–2030: towards stronger food safety systems and global cooperation. Geneva: WHO; 2022. https://www.who.int/publications/i/item/9789240057685

9. World Health Organization. WHO estimates of the global burden of foodborne diseases: Foodborne Disease Burden Epidemiology Reference Group 2007–2015. Geneva: WHO; 2015.

10. Havelaar AH, Kirk MD, Torgerson PR, Gibb HJ, Hald T, Lake RJ, et al. World Health Organization global estimates and regional comparisons of the burden of foodborne disease in 2010. PLoS Med. 2015;12(12):e1001923. https://doi.org/10.1371/journal.pmed.1001923

11. Savelli CJ, Bradshaw A, Ben Embarek P, Mateus C. The FAO/WHO International Food Safety Authorities Network in review, 2004–2018. Foodborne Pathog Dis. 2019;16(7):480–8. https://doi.org/10.1089/fpd.2018.2582

12. Food and Agriculture Organization of the United Nations, World Health Organization. FAO/WHO guide for application of risk analysis principles and procedures during food safety emergencies. Rome: FAO/WHO; 2011.

13. Codex Alimentarius Commission. Code of hygienic practice for powdered formulae for infants and young children (CAC/RCP 66-2008). Rome: FAO/WHO; 2008.

14. Codex Alimentarius Commission. Standard for infant formula and formulas for special medical purposes intended for infants (CXS 72-1981, rev. 2007, amended 2023). Rome: FAO/WHO.

15. European Parliament, Council of the European Union. Regulation (EC) No 178/2002 laying down the general principles and requirements of food law. Off J Eur Communities. 2002;L 31:1–24.

16. Ehling-Schulz M, Filter M, Zinsstag J, Koutsoumanis K, Ellouze M, Teichmann J, et al. Risk negotiation: a framework for One Health risk analysis. Bull World Health Organ. 2024;102(6):453–6. https://doi.org/10.2471/BLT.23.290672

17. Kriebel D, Tickner J, Epstein P, Lemons J, Levins R, Loechler EL, et al. The precautionary principle in environmental science. Environ Health Perspect. 2001;109(9):871–6. https://doi.org/10.1289/ehp.01109871

18. Siegrist M, Zingg A. The role of public trust during pandemics: implications for crisis communication. Eur Psychol. 2014;19(1):23–32. https://doi.org/10.1027/1016-9040/a000169

19. Granum PE, Lund T. Bacillus cereus and its food poisoning toxins. FEMS Microbiol Lett. 1997;157(2):223–8. https://doi.org/10.1111/j.1574-6968.1997.tb12776.x

20. Chan EYY, Griffiths SM, Chan CW. Public-health risks of melamine in milk products. Lancet. 2008;372(9648):1444–5. https://doi.org/10.1016/S0140-6736(08)61604-9

21. Slovic P. Perception of risk. Science. 1987;236(4799):280–5. https://doi.org/10.1126/science.3563507

22. Russ K, Baker P, Byrd M, Kang M, Siregar RN, Zahid H, et al. What you don’t know about the Codex can hurt you: how trade policy trumps global health governance in infant and young child nutrition. Int J Health Policy Manag. 2021;10(12):983–97. https://doi.org/10.34172/ijhpm.2021.109

23. Hull N, Bradley A, Boatwright M, Salmon L, Smith JP, Baker P. Profits before health? New Zealand government rejection of stricter infant formula marketing standards and the lobbying behind it. Matern Child Nutr. 2025;21(4):e70087. https://doi.org/10.1111/mcn.70087

24. Savelli CJ, Mateus C. Looking inside the International Food Safety Authorities Network Community Website. J Food Prot. 2020;83(11):1889–99. https://doi.org/10.4315/JFP-20-193

Cover image for Volume 1, Issue 1 (2026) of the Georgian Medical Journal, titled “A New Voice in Georgian Medicine.” The design features a modern medical visual emphasizing clinical quality, patient safety, and evidence-based healthcare.

Downloads

Published

05/07/2026

How to Cite

Glonti, S., Talakvadze, T., & Pkhakadze, G. (2026). Infant Formula Safety Governance: Systemic Challenges, the Imperative of Prevention, and a Framework for Precautionary Reform. Georgian Medical Journal, 1(1). https://doi.org/10.66636/gmj.v1.i1.a11

Issue

Vol. 1 No. 1 (2026): A new voice in Georgian medicine

Section

Editorial & Policy Forum

License

Copyright (c) 2026 Salome Glonti, Tamari Talakvadze, Giorgi Pkhakadze

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Open Access · CC BY 4.0

This article is published open access under the Creative Commons Attribution 4.0 International (CC BY 4.0) licence.

You are free to: share and adapt the work for any purpose, even commercially.
Conditions: provide appropriate credit to the authors and the Georgian Medical Journal (GMJ), link to the licence, and indicate if changes were made. Do not apply legal terms or technological measures that legally restrict others from doing anything the licence permits.
Licence: creativecommons.org/licenses/by/4.0  ·  Legal code: creativecommons.org/licenses/by/4.0/legalcode

Third-party material. Images or other content credited to a third party are not covered by CC BY 4.0; permission must be obtained from the rights holder for reuse beyond statutory exceptions.

Authors' rights. Authors retain copyright. First publication rights are granted to GMJ.

Data and code. Where provided, datasets or code may carry their own licences; please follow the licence stated in the article or repository record.

Recommended citation
Author(s). Title. Georgian Medical Journal (GMJ) Year;Volume(Issue):Pages. CC BY 4.0. DOI: 10.66636/xxxxx

Similar Articles

1 2 3 4 5 6 7 8 9 10 11 12 > >> 

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)

1 2 3 4 5 6 7 8 9 > >>