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In 2005, the board of directors of the American Academy of Pediatrics (AAP) adopted a policy supporting relationships with companies that, “through their products, activities, and/or their philosophy, enhance the quality of life for children and their families and are aligned with the AAP’s values and mission” (https://www.aap.org /en-us/about-the-aap/aap-leadership/Documents/20 -IndustryRelations.pdf). In doing so, the organization chose to apply a higher standard than simply asking whether corporate funding can be put to good use. Under this policy, the AAP should reassess its engagement with companies that sell infant formula. This relationship traces back more than a century, to the late 1800s, when physicians caring for children expressed alarm about the dangers of “artificial feeding,” including diarrhea, dehydration, and infant mortality.1 To save children who had no access to breastmilk, pediatricians helped to establish the nation’s first safe milk dispensaries. Then, in 1912, with the help of pediatric researchers, Mead Johnson introduced the first modern infant formula at the convention of the American Medical Association to be available by prescription only. This product supported the growth and development of many infants unable to breastfeed. Over the course of the next several decades, for a variety of reasons, formula became seen as modern and scientific and breastfeeding as old-fashioned. According to historian Jacqueline Wolf,1 “older pediatricians...came to believe that their fight for milk reform had been too successful” because “mothers and a new generation of pediatricians mistakenly presumed that breastfeeding was wholly unnecessary.” By 1972, only about 1 in 5 new mothers in the United States were attempting to breastfeed.2 During this period, according to Greer and Apple,3 a “comfortable symbiotic relationship” between physicians and formula companies developed. Formula companies provided research grants, sponsored medical meetings, and supported leading educational series such as the Ross Roundtable. However, tensions developed in the late 1970s and 1980s over allegations of inappropriate marketing in developing countries, where the use of formula was associated with infant mortality, and over a decision by formula companies to begin direct-toconsumer marketing in the United States. As evidence on the health benefits of breastfeeding accumulated— including less diarrheal disease, fewer respiratory infections, less obesity, and a lower risk of breast cancer for the mother4—the AAP and many of its members became engaged in a growing social movement to promote breastfeeding. The most recent data available from the US Centers for Disease Control and Prevention show an improving picture, with 4 in 5 babies breastfeeding after birth and 1 in 2 still breastfeeding at 6 months of age. In recent years, the AAP’s relationship with formula companies has continued to evolve. In 2013, after a column in the New York Times reported that hospitals were distributing to new mothers discharge bags of formula that carried AAP’s logo,5 as well as copies of the AAP’s book on breastfeeding bearing the stamp of a formula company, the AAP canceled the arrangement. The AAP now consults with its Section on Breastfeeding on whether to permit sponsorship by formula companies of specific educational activities and events. Pediatricians in many areas are now advocating for hospitals to adopt evidence-based “baby-friendly” practices that include support for breastfeeding and a ban on formula gift bags. Outside of advertisements and exhibits at its annual meeting, the AAP receives a total of $3.3 million each year from 4 formula companies, accounting for less than 3% of its annual budget. The funding supports the annual meeting and dissemination of initiatives developed by the AAP, including the Institute for Healthy Childhood Weight, Pediatric Care Online, and the Neonatal Resuscitation Program. One approach to relationships with industry is to manage them. In late 2016, members of the Royal College of Paediatrics and Child Health in the United Kingdom voted to keep accepting contributions from formula companies for special projects, as long as there is a review of each individual project and there is no interference with the development of content. The AAP’s handling of its relationships with formula companies today appears to meet this standard. However, corporate relationships are more than the sum of their parts. The board’s policy requires the AAP to ask whether a potential corporate partner is aligned with the organization’s mission to “attain optimal physical, mental, and social health and well-being for all infants, children, adolescents, and young adults.” Such a question recognizes that the reputations and actions of each side of a partnership reflects on the other. This higher standard also respects the fact that pediatricians play a vital role in encouraging breastfeeding, in advocating for policies that support breastfeeding, and in helping parents navigate breastfeeding challenges. So, are formula companies aligned with the health of children? In recent years, the companies have promoted their products with a wide variety of questionable claims, including “supports brain development” and “supports the immune system.” Such claims undermine the evidence base for infant nutrition and may confuse parents about the benefits of infant formula relative to breastfeeding.6 Coincident with the appearance of these claims, the price of formula has been rising. In 2010, the US Department of Agriculture found that increased formula costs VIEWPOINT