Saturday, August 10, 2013

Tuesday, April 09, 2013

Danone rationing formula and Nestlé discounts


Campaigners are pointing to new aggressive baby milk marketing practices in the UK as a sign of increased competition with Nestlé entering the UK market, where Danone is currently the largest company.

Nestlé and Danone are respectively the world's biggest and second-biggest manufacturers of breastmilk substitutes. They have been engaged in an increasingly aggressive marketing war, particularly in Asia, since Danone purchased the NUMICO brand in 2007 (Nutricia, Milupa, Aptamil, Cow & Gate etc).

This marketing war has now reached the UK following Nestlé's takeover of Pfizer Nutrition/Wyeth in 2012, manufacture of the SMA brand. Both Danone and Nestlé have launched new strategies to promote their products - the former gaining media coverage by claiming individuals in the UK are buying up formula to send to China thus causing a shortage in the UK, the latter taking advantage of any formula panic buying by putting its follow-on formula on prominent price promotion to increase sales. Nestlé has told the BBC: 'We do not have any evidence of bulk purchase of SMA for export.'


Further details and analysis on the Baby Milk Action press release at:
http://info.babymilkaction.org/pressrelease/pressrelease09apr13

Wednesday, November 14, 2012

WHO regrets PAHO linking with Nestle

As Reuters reported on 19 October 2012, the Pan American Health Organisation (PAHO) has linked with various junk food companies, including Nestlé.

The World Health Organisation (WHO) has today released a statement distancing itself from the decision to accept money from the food and beverage industry, a decision it describes as "unfortunate".


Moves in 2011 by the WHO Director General to set up a multi-stakeholder public health forum were opposed by Member States and public interest organisations such as Baby Milk Action and the International Baby Food Action Network (IBFAN), leading to WHO to take a clearer stand on conflicts of interest.

WHO's statement on PAHO's link to Nestlé and other companies states:

The World Health Organization (WHO) recognizes the importance of working with the private sector. However since part of our work involves setting norms, standards and guidelines for public health, we have very strict guidelines for accepting money from the private sector. 

WHO does not accept funds from the food and beverage industry for its noncommunicable diseases work. 

It is unfortunate that the Pan American Health Organization (PAHO-WHO) has accepted money from the food and beverage industry.

PAHO - while it is a WHO regional office for the Americas – is, unlike the other regional offices, also the health agency of the Organization of American States. Therefore in some areas, PAHO has its own operating guidelines. Not all PAHO guidelines are aligned with WHO. One such area is collaboration with the private sector.

Nestlé systematically undermines public health messages by, for example, claiming its formula 'protects' babies, when babies fed on formula are more likely to become sick than breastfed babies and, in conditions of poverty more likely to die (example below, Nestlé advertising Nan formula on television in Armenia in 2011). It also refuses to bring instructions on preparing formula into line with WHO guidance, so denying parents information on how to reduce the risks from the possible intrinsic contamination of powdered infant formula, which is not a sterile product.


Mike Brady, Campaigns and Networking Coordinator at Baby Milk Action said:

"It is welcome that WHO has come out against PAHO linking with the food and beverage industry. Nestlé is desparate to undermine controls on its marketing practices, which contribute to the unnecessary death and suffering of infants around the world and to the global rise in obesity and non-communicable diseases. As I speak, it is attempting to undermine strong baby milk regulations introduced in the Philippines. Nestlé invests heavily in trying to promote itself as a "health, nutrition and wellness" company to distract from its unethical marketing of baby milks and the high sugar, salt and fat content of many of its junk foods. It also attempts to sponsor civil society organisations, health workers, government programmes and UN initiatives to neutralise them as critics or regulators and to gain kudos by association. Governments should govern and corporations should follow the rules. It is very welcome that WHO Member States rejected a proposal last year to set up a multi-stakeholder forum that the same junk food companies were clamouring to be part of. 

Baby Milk Action helped to set up the Conflicts of Interest (COI) Coalition and invites other concerned organisation to endorse the statement calling on public interest organisations to put the public interest first and maintain their independence from the corporate sector. See:
http://coicoalition.blogspot.co.uk/

The intervention by Patti Rundall, Policy Director of Baby Milk Action, at the World Health Organisation Executive Board meeting in 2011 regarding the proposed multi-stakeholder forum, which has since died a natural death, raises some of the key issues about conflicts of interest with particular reference to infant feeding. See:
http://info.babymilkaction.org/policyblog/speeches

Monday, November 05, 2012

Hipp on BBC Radio 4 You and Yours - ignoring safety guidance on making up formula

A representative of the Hipp baby food company was interviewed on BBC Radio 4 You and Yours programme on 5 November 2012, together with Dr. Helen Crawley of the First Steps Nutrition Trust (click here to listen again).

The discussion was about the refusal of Hipp to provide correct guidance on how to reconstitute its powdered infant formula. The facts, as Dr. Crawley explained, are clear. The Department of Health confirmed its guidance had not changed, despite Hipp claiming in the programme that it had been given permission to flout the guidance.

Infant Formula ExplainedPowdered formula is not sterile and may contain harmful pathogens, such as cronobacter sakazakii (previously known as enterobacter sakazakii) and salmonella. Although studies have found contamination levels as high as 14% of tins (research cited by the US Food and Drugs Administation), ill effects are very rare, but can included meningitis and death.

The risks can be reduced by killing the bacteria by reconstituting the formula with water above 70 deg. C. In practice this temperature can be achieved by boiling a full kettle and allowing it to cool, but for no more than 30 minutes. The formula should then be allowed to cool to a safe temperature before feeding. The following resources provide this information:

The Department of Health Guide to Bottle Feeding booklet includes the instructions - click here.

A clear leaflet to follow if you are using formula (Hipp or any other) or advising parents, can be downloaded from the Department of Health - click here.

The World Health Organisation Guidelines for the safe preparation, storage and handling of powdered infant formula are also clear about using water above 70 deg. C. Its report includes background information on the risks and the reasons for the guidance - click here.

Baby Milk Action produced the Infant Formula Explained DVD on behalf of the Baby Feeding Law Group (consisting of leading UK health professional and mother support groups), which includes a short film for parents on how to reconstitute powdered formula correctly to reduce the risks - click here.

Despite the clear guidance for parents from the Department of Health and WHO, Hipp told Radio 4 that the guidance is unclear.
Why is Hipp putting babies at risk by telling people to use water at a lower temperature on its labels?


It comes down to its own profits and marketing campaigns. Hipp's current advertising and promotion is based on so-called probiotics added to its formula. There is no proven benefit of adding probiotics to formula, despite the impression given by Hipp in advertising such as that shown below (left, advertising to health workers, exposed on Baby Milk Action's Campaign for Ethical Marketing action sheet September 2012).

The First Steps Nutrition Trust guide to Infant Milks in the UK was updated in November 2012 to include information on Hipp's new probiotic formula and states:

A few clinical trials have shown health benefits for specific bacterial strains, however, on the strength of a review of randomised control trials in healthy term infants, the ESPGHAN (European Society of Paediatric Gastroenterology, Hepatology and Nutrition) Committee on Nutrition have found that there is too much uncertainty to draw any reliable conclusions on the efficacy of probiotics in infant milks. They did not recommend their routine use in formula milks for infants.

Water hot enough to kill harmful pathogens will also kill the probiotic bacteria and this is the reason Hipp is trying to hide the risks and ignore the safety guidance.

However, in doing so, Hipp is showing its contempt for the Infant Formula and Follow-on Formula Regulations (2007), adopted by the four countries of the UK. The Guidance Notes from the Food Standards Agency that accompany the Regulations and "shows how the regulations should be interpreted" is also very clear:

Labelling relating to the preparation, storage and disposal of infant formula and follow-on formula

24. Regulation 17 (1)(d) and 18(1)(d) require that instructions are provided for appropriate preparation, storage and disposal of the product. The Agency recommends that these instructions should include information noting that:

• Powdered infant formulae and follow-on formulae are not sterile, and as such can contain harmful bacteria. It is therefore important to be very careful when preparing formula to reduce the risks. Boiled tap water (not bottled water) cooled for no more than 30 minutes should be used to prepare infant feeds.

• All equipment used for feeding and preparing feed must be thoroughly cleaned and sterilised before use, and bottles should be made up fresh for each feed, as storing made-up formula milk may increase the chance of a baby becoming ill.

25. Further advice about the preparation and storage of formula can be found at the website below: http://www.breastfeeding.nhs.uk/en/materialforclients/index.asp (advice to consumers) http://www.dh.gov.uk/en/Healthcare/Maternity/Maternalandinfantnutrition/DH_ 4123674 (advice to health professionals)

The links mentioned in the Guidance Notes take you to the Department of Health booklet on formula feeding mentioned above, which states:

Bacteria in infant formula

Even when tins and packets of powdered infant formula are sealed, they can sometimes contain bacteria such as Cronobacter sakazakii (formerly know as Enterobacter sakazakii) and more rarely Salmonella. Although these bacteria are very rare, the infections they cause can be life-threatening.

To reduce the risk of infection, make up each feed as your baby needs it, using boiled water at a temperature of 70oC or above. Water at this temperature will kill any harmful bacteria that may be present.

Unfortunately, the regulatory authorities in the UK are not acting to enforce the regulations.

As Baby Milk Action also recently reported, the Advertising Standards Authority (ASA) is also failing to protect babies and their families in the UK when it comes to misleading claims made in advertisements. For example, it refuses to even investigate advertisments like that shown above. See our 24 October 2012 press release.

What can you do?
  • Direct people using formula to the above guidance so they know how to prepare it correctly.
  • Join Baby Milk Action (or send gift membership to a friend or collague).
  • Support our Campaign for Ethical Marketing.
  • Report examples of questionable promotion to the Baby Feeding Law Group monitoring project, which Baby Milk Action coordinates - click here.

Sunday, November 04, 2012

A message of thanks from Philippines campaigners


Gloria and Miguel
During International Nestle-Free Week 2012 (29 October - 4 November) people have been sending messages to Nestle about its systematic violations of baby milk marketing rules and signing a petition of solidarity with the people of the Philippines. A message of thanks has just been received from campaigners in the Philippines (see below).


Nestle-Free Week is a time for for people who boycott Nestlé over the way it pushes baby milk to do more to promote the boycott - and for those who don't boycott to give it a go.

Above: Gloria joined the successful campaign with her son Miguel in 2007. Mothers and babies need your help again. Please sign the petition of solidarity. This is helping bring attention to this issue - see, for example, this report in the Philippines on 23 October 2012.

In the Philippines Nestle is leading an attempt to bring in a new law to replace regulations introduced in 2007 to stop companies advertising baby milks and targeting pregnant women and new mothers. Campaigners in the Philippines call it Nestle's Monster Bill. The Philippines Department of Health, UNICEF and WHO said in September:

"The draft House Bill... aims to support multinational companies while damaging the Filipino society: families, the mothers and children."

Questions are being asked about the influence Nestle is using to gain support from the Department of Trade and politicians who are facing an election next year.

On 4 September 2012, Baby Milk Action received the following message from MOM CARE - Movement Opposing Milk Code Amendments and Revision, the new name from the Breastfeeding Consortium in the Philippines.

"Thank you for your commitment to the campaign.

Thank you for your kindheartedness.

Nestle never sleeps and greedy Nestle will never stop amassing profits from the poor people in the Philippines who have large families as their consumers.

Nestle leads IPNAP a conglomerate of Nestle-Wyeth, Mead Johnson, Abbott and Fonterra multinational milk companies who dangle gifts of any sorts especially to the lawmakers/lawbreakers in Philippine Congress to weaken the Milk Code law and replace with a pro-Nestle vested interest Monster Bill. Now, it is election time for politicians and the big question how much influence peddling was contributed to the election money bag?

Recently, IPNAP's government ally the Department of Trade and Industry was on the news last week "DTI bucks the amendment Bill in the name of informed choice for lactating mothers". DTI mimics Nestle stand. Nestle style is to sow confusion by letting the Department of Health and DTI fight each other. DOH issued a media statement with UNICEF and WHO, "ban babymilk ads till 36 months old" IPNAP and DTI chorused, "ban babymilk ads till 6 months old" thereafter free wheeling promo lies.

We call on our global partners to defend breastfeeding vigilantly because Nestle creeps in every legislative process to wreck breastfeeding initiatives in every country. Nestle masquerade as pro-breastfeeding but in truth undermines it by pushing policymakers to make a law that will favor their economic interest and not the consumers.

They bleed the consumers to illness, poverty and death.

Playing with national legislation is their new trick in Vietnam, Kenya, Hongkong, Philippines etc.

Keep Nestle away from your home, away from your life, away from your generation's future.

It is not good food, good life as Nestle promise, it is in fact Bad life after all."

Thursday, October 18, 2012

Comment on UNICEF breastfeeding report: Preventing disease and saving resources

UNICEF has published a report today called: "Preventing Disease and Saving Resources: the potential contribution of increasing breastfeeding rates in the UK". 

UNICEF'S press release states: "The report findings show that for just five illnesses, moderate increases in breastfeeding would translate into cost savings for the NHS of £40 million and tens of thousands of fewer hospital admissions and GP consultations."
See:
http://www.unicef.org.uk/BabyFriendly/News-and-Research/News/Breastfeeding-could-save-the-NHS-millions/

Here's a quick response from me, Mike Brady, Campaigns and Networking Coordinator at Baby Milk Action:

"This report is very welcome. The finding that babies who are not breastfed are more likely to become ill and require hospital and other medical treatment is neither surprising or new. The big question is will the present Government act when others have failed to do so in the past? Unfortunately, the current administration has taken steps backwards by, for example, scrapping the Infant Feeding Coordinator posts at the Department of Health despite these being one of the initiatives included in the Global Strategy on Infant and Young Child Feeding, which the UK claims to support. Some of the countries that have followed the strategy, including prohibiting the promotion of breastmilk substitutes in line with internationally agreed minimum marketing standards, have seen marked increases in breastfeeding rates, Brazil being a particularly good example. Of course, in parts of the world without the same level of health service support babies who are not breastfed are not only more likely to become ill, but more likely to die.

"Stopping baby milk company promotion has to be part of the public health policy response to this unnecessary illness and suffering. That is not to say that mothers who use formula should be made to feel guilty for doing so. Formula should be available for those who need it and everyone benefits if there is accurate independent information on infant feeding, instead of promotion from baby milk companies with a vested interest in selling their products. Don't forget, the millions companies spend on their promotion campaigns ultimately goes onto the price they charge for formula."

The following advertisements all appeared in the same health worker journal showing how each of the companies claims its formula is closer to breastmilk than the other brands. They cannot all be telling the truth. Unfortunately, the Advertising Standards Authority (ASA) refuses to investigate advertising in health journals. When Baby Milk Action has brought complaints about follow-on formula advertising to the public, the ASA has ruled against the claims that Aptamil and SMA are the best formulas. The claims do not stand up to scrutiny. Baby milk companies have shown they cannot be trusted to provide accurate information to parents or health workers. See: http://info.babymilkaction.org/cem/cemsep12


The Government has known about the health and financial impact for years of course. For example, in 2006 the National Institute for Clinical Excellence costed the savings to the NHS from a modest increase in breastfeeding rates (a 10% increase in initiation) and found many thousands of babies would not suffer illness and millions would be saved.

As UNICEF points out, the National Infant Feeding Survey tells us that 90% of mothers who stopped breastfeeding their babies by the time they were 6 weeks old wanted to breastfeed for longer. With greater support, many would have been able to do so, fewer babies would have become sick or even died and there would have been cost savings.

It is not just about support, of course. Breastfeeding is the normal way to feed a child. Denying a child breastmilk and giving it an alternative type of milk, even one processed to the best of current knowledge, is inevitably not going to be as beneficial. Breastmilk is a living substance and is a continuation of the nurture a mother has provided to her child through the placenta.

Formula is sometimes described a fourth best after breastfeeding, the mother's expressed breastmilk and donor breastmilk. Formula can save lives when breastmilk is unavailable either from the mother or donors, but modified cow's milk will always have limitations. In the UK, composition of formula is closely regulated so that those on the market have the ingredients known to be necessary. As scientific knowledge changes, the regulations are updated to change the composition. Mothers who do not breastfeed, or carers without access to breastmilk, can base their choice on their baby's preference and/or cost. Every company tries to claim its formula is better than the other brands, but this is marketing hype designed to inflate prices.

So aside from the short and long-term health impacts, financially the public is suffering a double whammy. As more tax money goes to paying for the care of babies who are not breastfed, parents who use formula are paying over the odds as prices are inflated to pay for the multi-million pound marketing campaigns run by the baby milk companies.

Based on figures from dairy farmers, the proportion of the selling price of formula that goes towards promotion and profit is between 53% and 80%. That means parents who use formula for 12 months are paying anything between about £231 and £884 towards promotion and profit. See:
http://info.babymilkaction.org/news/campaignblog310712

The latest marketing strategy of the baby milk companies is to claim they are friends of breastfeeding, wanting to offer advice and support to mothers. Danone claims that 3,000 mothers are signing up to its Cow & Gate branded baby club every week.

We have seen that companies have ostensibly given up on the first 6 months period, promoting their follow-on milk for use after breastfeeding for six months. This follows campaigns exposing their misleading claims and public health messages about the importance of breastfeeding. But companies ignore the fact that it is exclusive breastfeeding that is recommended for 6 months, with breastfeeding continuing beyond this age with the introduction of complementary foods. Companies also break the UK Infant Formula and Follow-on Formula Regulations (2007) and associated Guidance Notes by using the same brand names for follow-on milks and infant formula for use from birth and making the brand the focus of the advertising. See examples in the Baby Feeding Law Group monitoring project:
http://www.babyfeedinglawgroup.org.uk/reports/bflgreports
Involving baby milk companies in breastfeeding promotion is like putting the fox in charge of the chicken coop. We receive complaints about the outrageous emails mothers have received from companies. For example, Pfizer/Wyeth has promoted its SMA brand in an email headed: "How is feeding going?". It then plants seeds of doubt about breastfeeding:

"If you’re breastfeeding, do you sometimes wonder if your baby is getting enough milk?"

Although purporting to offer supportive advice, it highlights negatives:

"Feeling sore? .... If the pain continues or your nipples start to crack or bleed...."

Wyeth suggests people contact their midwife or public health nurse, "or call the SMA Careline".

After all that comes the closing punch: "Thinking of bottle feeding?" This is accompanied by an advertisement for SMA infant formula (which it is illegal to advertise) and the idealising claim (also prohibited) boasting the formula has "a new fat blend closer to that of breast milk".

The information that babies fed on the formula are more likely to become sick, be hospitalised and cost the NHS money treat is missing. As is the fact that these email marketing campaigns, the Careline, the cuddly toys, free gifts, free lunches for health workers and so on all go onto the price of formula.


What do parents really need? A free bear from Danone branded with its Aptamil formula name and logo (left) paid for by premiums on the price of formula - or accurate independent information on infant feeding from the health care system, no company promotion and cheaper formula?

Not for nothing are mothers supporting Baby Milk Action's "No promotion, cheaper formula" campaign. It doesn't matter if they are breastfeeding or using formula.
Everyone benefits by stopping baby milk company promotion:
http://www.change.org/petitions/baby-milk-companies-no-promotion-cheaper-formula

So why doesn't the Government act?

Why didn't it act in 2006 when the law was last revised and all health professional organisations, mother support groups and its own Scientific Advisory Committee on Nutrition called on it to prohibit company advertising, promotion and claims?

Why does it ignore the repeated calls from the UN Committee on the Rights of the Child to implement the internationally agreed minimum marketing standards, which companies should already be abiding by in the UK?

These are very good questions. Ask your Member of Parliament.

Tuesday, October 09, 2012

Infant Sleep Information Source

The September 2012 issue of Breastfeeding Briefs from the International Baby Food Action Network (IBFAN) is on the theme of "Sleeping with the baby". It is guest edited by Dr Helen Ball who has researched and written extensively on this theme.

Dr Ball explains:
Over the past year, my colleague Dr Charlotte Russell and I have been working with several organisations in the UK (La Leche League, National Childbirth Trust, UNICEF Baby Friendly Initiative) to produce an infant sleep information website (ISIS) that aims to inform parents and health care providers about the research evidence available on where and how babies sleep (www.isisonline.org.uk). This editorial will summarise some of the issues we discuss on the site, and consider how the latest research is informing parents and healthcare providers.
The editorial is a fascinating overview of questions relating to co-sleeping, possible positive and negative impacts on breastfeeding and Sudden Infant Death Syndrome and the latest evidence and advice.

You can download the issue of Breastfeeding Briefs below from the IBFAN site (where you will also find past issues) - click here.

There is information for health workers and resources for parents and carers on the ISIS site:
http://www.isisonline.org.uk/