1. General Practitioners medibus™ October 2014

2.  A generally low familiarity with NHRMC Infant Feeding Guidelines 2013 is seen among general practitioners, with a majority of them being vaguely familiar or not at all familiar with it.  GPs are not strongly convinced that excessive protein intake is associated with obesity – only 6% completely agree while half of the doctors take a neutral standpoint.  A protein level of 2.2 g per 100 kcal is perceived to be a moderate level.  A protein level of 1.9 g per 100 kcal is thought to be lower than or same as mature breast milk. Moreover, a quarter of GPs think this level may not meet the infant’s protein needs.  The majority of GPs are unsure of the decrease in protein levels in breast milk over time and the discrepancies between reference of breastmilk and the current norms for infant formula. Key Findings

3. Familiarity with NHRMC guidelines is generally low, the majority are vaguely familiar or not at all familiar Q1: How familiar are you with the NHRMC Infant Feeding Guidelines 2013? Familiarity with the NHRMC Infant Feeding Guidelines 2013 Base: 200 General Practitioners Extremely familiar Very familiar Moderately familiar Slightly familiar Not at all familiar Male ( n = 125)0%2%22%33%43% Female (n = 75)1%5%40%31%23% Less than 1%  Significantly higher vs. Female GPs

4. GPs are not strongly convinced that excessive protein intake is associated with obesity, 50% are on the fence Q2: The updated NHRMC Infant Feeding Guidelines 2013 recommend using a lower protein formula for infants that are not breastfed, as there is mounting evidence that excessive protein intake in early infancy is associated with later obesity. To what extent do you agree that excessive protein intake in early infancy is associated with later obesity? Excessive protein intake in early infancy is associated with later obesity Base: 200 General Practitioners Less than 1%

5. Q5: If a follow-on formula had a protein level of 2.2g per 100 kcal, would you say that is: Follow-on formula with a protein level of 2.2 g per 100 kcal is: Base: 200 General Practitioners Follow-on formula with a protein level of 1.9 g per 100 kcal is: Q6: If a follow-on formula had a protein level of 1.9g per100kcal, would you say that is: A protein level of 2.2 g per 100 kcal is seen as medium while 1.9 g is lower than or same as mature breast milk Base: 200 General Practitioners

6. Q7: Protein levels in breast milk decrease over time from the first to 12th month of breast feeding. Protein levels in breast milk decrease over time from the first to 12th month of breast feeding There is no discrepancy between the reference of breastmilk and the current norms for infant formula Q8: There is no discrepancy between the reference of breastmilk and the current norms for infant formula The majority of GPs are unsure of protein level decrease over time and discrepancy between references Base: 200 General Practitioners

7. Discrepancies between the reference breastmilk and the current norms for infant formula Q9: Please specify the discrepancies between the reference of breastmilk and the current norms for infant formula: Base: 59 General Practitioners who think there are discrepancies between the reference of breast milk and the current norms for infant formula “Breastmilk varies in composition over time so this will be a discrepancy to fixed protein level formula” “More natural proteins in breast milk” “More fat and less protein on breast milk” “Breastmilk concentrations will change over time and depending on mothers health/diet. The formula will not.” “Breast milk contains less protein than normal formula milk, perhaps half the amount. Breast milk has more oligosaccharides, omega-3 fats, immune and growth factors.” Protein levels and fat content “Breast milk has specific protein easily digestible” “Human milk - soft, easily-digestible whey - more completely absorbed” “Breast milk's components are easily digested by a newborn's immature system” “Breastmilk has protein that is easier to digest. It also has probiotics and other vitamins that not in formula.” Easy to digest “Breastmilk is superior.” “Formula is not equivalent to breast milk” “No formula is identical to breast milk” “Breast milk is better, always give breast milk if possible” “Breastmilk is best” Breastmilk is best “Breast milk has mother's antibodies present” “Maternal antibodies” “Infant formulas may have all the components in various entities of the protein, fat and carbohydrate but miss the breast milk antibodies.” “In breastmilk besides carbohydrates, proteins and other essentials there are antibodies, whereas in infant formula there are none.” “Immune protection” Antibodies

8. Sample of 200 GPs from Cegedim’s panel of healthcare professionals. All interviews completed between 06/10/2014 and 13/10/2014. Statistically significant differences calculated at 95% confidence level, indicated with  or . Methodology and demographics QuotaSample #Sample %Population % Male12562%67% Female7538%33% ≤ 50 years10552%43% > 50 years9548%57% NSW / ACT6935% VIC / TAS5728%27% QLD / NT4120%19% WA / SA3316%19% ≤ 100 patients per week5728%19% ≥ 101 – 200 patients per week12462%63% ≥ 201 patients per week1910%18% Total200100%

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