Friday, November 30, 2007
The labels introduced since the crackdown are highlighted in the report Breaking the Rules, Stretching the Rules 2007 from the International Baby Food Action Network (IBFAN), launched at a meeting in Asia this week. The report makes special mention of other practices in the UK. We are ashamed that the lack of action from the UK government to implement the World Health Assembly marketing requirements for baby foods makes the country a test bed for aggressive strategies.
The profile on NUMICO leads with tactics developed to target health workers and mothers, as first exposed in our pamphlet Hard Sell Formula.
Here is the feature in the Breaking the Rules report:
Click on the image for a larger version.
We have repeatedly drawn the attention of government Ministers and civil servants to these practices.
Earlier this year I spoke directly with the then Minister for Public Health, Caroline Flint MP, about the mail shot branded with the Cow & Gate formula logo which states: "I'm thinking of getting a t-shirt made - Danger! Sore boobs!"
See my blog:
So why is it that Ministers continue to refuse to implement the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions of the World Health Assembly in UK legislation. Why do they ignore the advice of their own Scientific Advisory Committee on Nutrition and the health professional bodies and mother support groups that make up the Baby Feeding Law Group, which submitted the report Protecting breastfeeding - Protecting babies fed on formula to the consultation on revising the law?
Is it because it is not only those who put infant health first who make recommendations to Ministers? The Infant and Dietetic Foods Association, the industry body, opposed any strengthening of regulations in its submission to the government.
At the Labour Party Conference, Nestlé, which wants to break into the UK formula market by offering financial support to health workers, funded a fringe meeting and shared a platform with Caroline Flint's successor, Dawn Primarolo MP. See:
And we have recently learned that the government will be appointing a new head to the Food Standards Agency responsible for drafting legislation and accompanying guidance notes in this area. It is Tim Smith, who comes from the dairy industry. As the FSA website informs us: "He has spent his entire career in the food business". See:
Can we expect a dairy man to take a robust line with the formula industry? He will certainly need to.
The government has refused to make it a statutory requirement that formula companies warn on labels that powdered formula is not sterile or to require clear instructions on how to reduce the risks of possible contamination with bacteria. We argue such regulations are essential because the companies are not warning parents and misadvise on their telephone 'carelines'. When I conducted spot monitoring, Hipp's advisor even argued against the Food Standards Agency guidance to parents.
The government proposes a voluntary agreement with the industry instead of legislation and is consulting on 'guidance notes'. Mr. Smith will be taking over in March as the consultation ends and it will fall to the former dairy man to pursue the agreement with the formula industry if the government approach goes unchallenged. You can challenge it by sending a message to the Minsters here:
Thursday, November 29, 2007
The good news is that some countries are taking action. The Philippines, thanks to an international campaign of support, is prohibiting health claims such as Nestlé's 'brain building blocks' boast about ingredients in its Nestogen infant formula.
Earlier this year the UK was applauded around the world for cracking down on health claims on labels of infant formula in the UK. There was international publicity for the move by the Food Standards Agency to finally enforce the Infant Formula and Follow-on Formula Regulations 1995 which only allow claims specified in the law to be used, if certain conditions are satisfied. We recognised the letters that the FSA sent to the companies reminding them of the law introduced 12 years before, as a significant advance. See:
But as I have tracked on this blog and we have reported in our newsletter, companies may have changed labels as a result, but they continue to use claims that are not on the permitted list and are getting away with it.
The Breaking the Rules, Stretching the Rules 2007 report acknowledges the action by the UK authorities, but notes that the new labels produced by the likes of Wyeth/SMA and NUMICO (owner of Milupa and Cow & Gate) are, in some ways, worse. Indeed, the profile on Wyeth highlights the new SMA labels in the UK as particularly scandalous. See:
Click on the image for a larger version if you cannot read its message: "From bad to worse".
Now it may well be that action will be taken over this label by the enforcement authorities. We have certainly complained vociferously about the way Wyeth and other companies have demonstrated their contempt for the regulations. But the wheels turn slowly and 9 months on from the launch of these labels onto the market, no visible action has been taken. My view is the companies should be prosecuted.
It does not bode well for the proposed new regulations which the government is suggesting will be made to work through 'robust guidelines' if companies can show contempt for the existing legislation and get away with it.
The Baby Feeding Law Group report Protecting breastfeeding - Protecting babies fed on formula, submitted to the government consultation stressed that clear implementation of the World Health Assembly marketing requirements in binding legislation is needed, not narrower measures in guidelines. See:
The UK was applauded at the beginning of the year for the crackdown on health claims. The lack of follow through has led to it being shamed in a global report that suggests companies have been permitted to go from bad to worse.
The world will continue to watch to see whether the government will rectify the situation by enforcing existing regulations and strenghtening them to close loopholes.
At the moment the signs do not look good. You can send a message to the Ministers responsible at:
Wednesday, November 28, 2007
IBFAN trains policy makers on implementing the International Code of Marketing of Breastmilk Substitutes and subsequent, releveant World Health Assembly Resolutions in legislation. Independently monitored and enforced regulations are necessary to ensure compliance as companies do not fulfill their obligation under Article 11.3 of the Code to abide by its provisions independently.
The new monitoring report, Breaking the Rules, Stretching the Rules 2007, shows the depths to which companies sink where there are no regulations. Nestlé is again leading the way in innovative strategies and, as market leader, sets trends others feel compelled to follow to compete. Here is an example highlighted in the Nestlé profile from China:
It says: "In some hospitals in China, babies are 'branded from birth' with identification tages bearing the Nestlé name and logo."
You may recall our campaign exposing a marketing strategy launched by Nestlé Chief Executive Officer and Chairman, Peter Brabeck-Letmathé, to target 'pregnant and lactating women' in China with 'nutrition corners' in supermarkets. Nestlé's anti-boycott team, led by Beverley Mirando in the UK, attempted to excuse the practice, arguing that only milks for older babies were on display. See:
These strategies for branding babies as Nestlé babies are to develop what Mr. Brabeck sees as a growth market. We will call on his designated successor, Mr. Paul Bulcke, to accept the four-point plan aimed at saving lives and ultimately ending the boycott, but the signs are not good as he drove growth of infant nutrition products in the Americas and has also cited China and India as the engines for growth in the company. See:
The good news is that where there are strong regulations, these can be effective at stopping violations. In Brazil median breastfeeding rates have increased from less than 3 months to ten months thanks, in part, to strong regulations. See:
Other good news is that the boycott can force some policy shifts, and was instrumental in persuading Nestlé to change its policy on promoting complementary foods from too early an age - though this does still happen. This was a point I made in the press release issued by our partners. See:
The bad news is, Nestlé continues to systematically violate the Code and Resolutions where it can get away with it, as the report demonstrates.
The other bad news is that NUMICO - parent company of Nutricia, Milupa and Cow & Gate and recently bought by Danone - is trying to capture what it calls 'stomach share' - that is, get its formula into infants instead of that of competitors and breastmilk. This has seen a rise in violations to the point where it is rivalling the market leader, Nestlé.
Nestlé may attempt to give the false impression it has changed itself. This is not the case - rather it has driven the industry to new depths, particularly in Asia. IBFAN will be contacting Danone, the new owners of NUMICO to call on it to change the practices of these companies. The International Nestlé Boycott Committee will consider how to bring consumer pressure to bear on Danone/NUMICO if it does not respond.
We will also continue with the strategies we know achieve change and are ultimately saving lives: keeping Nestlé, the market leader, under pressure from the boycott and working for legislation that compels compliance by all companies with the marketing requirements.
You can read profiles of all the major companies and obtain full monitoring results at:
Baby Milk Action is arranging to stock printed copies of the report when this is available.
Tuesday, November 27, 2007
Thank you to the reader who posted a link to:
You can read more at:
The Nespresso machine uses disposable pods containing the coffee, which are only available from Nestlé by joining a club, which results in direct mail promoting a lifestyle as well as the product.
This product is advertised by George Clooney, who was questioned at the Venice Film Festival recently about the conflict of him working for Nestlé and his humanitarian and campaigning work. See:
Curiously, like stars who advertise whisky in Japan, Mr. Clooney refuses to advertise Nestlé in his home country of the US. See Bloomberg:
Monday, November 26, 2007
Janipher is now living with her children in a one-bedroom flat, awaiting the outcome of her asylum application.
You can read her story, as told to The Guardian (24 November), at:
Many thanks to everyone who sent messages to politicians and officials.
We continue to support campaigns on similar cases where authorities do not recognise the right of mothers to breastfeed or provide expressed milk to their babies. A current case concerns a mother whose child was removed by Essex social services. See:
Friday, November 23, 2007
Here is one in today's Daily Express:
One of the great things with newspapers like the Express is you are able to leave comments. This is mine:
DON'T MOTHERS WHO USE FORMULA DESERVE PROTECTION?
It is very sad that there is not greater understanding over why the UK government is being called on to introduce the baby formula marketing standards adopted by the World Health Assembly and introduced by many other countries.
The aim of the International Code of Marketing of Breastmilk Substitutes - which companies are called on to abide by independently of government measures - clearly states it is to protect and promote breastfeeding AND to ensure breastmilk substitutes are used safely if necessary.
One of the great failures of the regulations that the government plans to introduce is they do not require companies to warn parents that powdered formula is not sterile and the simple steps to reduce risks of possible contamination with bacteria. The government has said that it will pursue a voluntary agreement with the industry. But this is an issue known about for years. The Food Standards Agency published its guidance to parents in 2005, but companies have not put this on their labels, despite launching new ones in 2007. A spot survey of company telephone carelines by Baby Milk Action found companies continue to misadvise parents.
It is also a mistake to believe advertising provides objective information - it does not. How could every company's claim that its formula is closer to breastmilk than its competitors to be true? Parents need objective, accurate, independent information and that is what the international standards aim for.
The Baby Feeding Law Group, a coalition of 22 health professional and mother support groups, submitted a report to the government consultation called 'Protecting breastfeeding - Protecting babies fed on formula' which contains plenty more evidence of how the industry and the government are failing parents.
Unfortunately some journalists find it is an easier narrative to pursue a bottle feeding v. breastfeeding angle, rather than examine why commercial pressure needs to be removed from the critically important area of infant feeding.
Thursday, November 22, 2007
You can find out more and follow links to some of the media coverage from our press release at:
As you will see Baby Milk Action or other members of the Baby Feeding Law Group are quoted in most of the reports.
I won't go through what's in the press release again here, but will write highlight two things with the media coverage today.
Firstly, my colleague Patti Rundall, came in with some of the papers and we were looking through them. There was a massive picture in one of the papers of some formula on a supermarket shelf. 'That's my picture!' I exclaimed. Patti didn't believe me, pointing out that formula is sold in a lot of supermarkets. But I was adamant I recognised the picture and quickly pulled it up on our flickr photo archive. We link to this from our website.
You can find the archive at:
A great innovation for hard-pressed picture editors, and one that clearly helped out the paper in question on this occassion. But if you are planning to use an image, please do check out the copyright restrictions. And a fee would be appreciated when possible. We would also like to be informed where images are used.
The second point is the industry position which appeared on the BBC website at:
Roger Clarke, head of the Infant and Dietetic Foods Association, said the new guidelines looked to be a "pretty sensible, measured approach from the government, although industry will still have to look in detail at what is planned".
He added: "All the data suggests that advertising is not a factor when it comes to women's decision to choose infant formula over breastfeeding. There are many other issues, from physical pain to achieving a balanced lifestyle."
This is the same IDFA which opposed any strengthening of the regulations in the consultation just finished. Our press release quotes their response.
So if IDFA is happy with the guidelines that is a bad sign.
In the separate consultation on those we will be calling on your assistance in strengthening them. As I wrote yesterday, the government has said that in the guidelines it will interpret the legislation in light of the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions of the World Health Assembly.
The press release links to the draft guidelines. They make interesting reading, well, at least they are if you are like me and see the significance of individual words being included or not.
Whether IDFA will be so supportive when it comes to its submission on the guidelines remains to be seen. For example, what does it really make of the proposal that follow-on formula must be sold in a separate part of the supermarket to the infant formula? The government shied away from banning the promotion of follow-on milk and this is a proposal for stopping follow-on formula promotion functioning to also promote infant formula.
At present the follow-on formula promotions are used to promote the full range. They dominate the infant feeding sections, and most people wouldn't register they escape through loopholes in the law because they don't specifically mention infant formula.
If you want to see some pictures, visit our photo archive.
Wednesday, November 21, 2007
Here is what happened.
At 10:30 I was part of a delegation meeting the UK Minister for Public Health to discuss the forthcoming Infant Formula and Follow-on Formula Regulations, put out for consultation earlier this year. Last week we asked supporters to send a final message to the Minister to support the call for the regulations to be brought into line with the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant World Health Assembly Resolutions. This is the position of the health worker bodies, mother support groups and other organisations belonging to the Baby Feeding Law Group and Breastfeeding Manifesto Coalition.
The Government's own Scientific Advisory Committee on Nutrition and LACORS (the coordinating body for Trading Standards officers, responsible for enforcing the regulations) were calling for many of the same specific things, such as an outright ban on the advertising of follow-on formula.
The invitation to brief the Minister directly today was a great opportunity and suggested seriousness on the part of government to engage.
Yet at 9:30 the Minister was at a press conference telling the media the regulations had been finalised. A press release was issued at 10:00 hailing them as "stricter controls on the promotion, labelling and composition of infant and follow-on formula". See:
So as journalists were filing their stories we were out of contact in the meeting with the Minister learning for the first time that there was no opportunity to influence the regulations further (well, we can take action such as a judicial review, but that is a consideration for another day). It emerged we were there simply to be briefed on a new consultation on the guidelines to accompany the regulations.
And it seems that we were only supposed to learn of the press conference by reading of the launch in the media after the meeting.
Coupled with the public announcement, the Food Standards Agency (FSA) has today published its response to the consultation submissions. If you are one of the organisations or thousand plus people who responded to the consultation you will find the response here:
The finalised regulations themselves do not appear, but it is clear from the responses that little if anything has been changed as a result of the consultation. Our press release concerning this disappointing news can be found at:
The government press release does promise: "Robust guidance for industry and enforcement authorities to correctly apply the new law".
We are now asked to believe that we have an opportunity to influence the guidance in the consultation opened today. See:
Indeed, it has been suggested the guidance goes some way to bring the UK closer to the International Code of Marketing of Breastmilk Substitutes. The FSA consultation response states: "The Agency considers that the Directive [from which the regulations derive] should be interpreted in the light of the Code. The guidance seeks to do this."
In the Baby Feeding Law Group submission report Protecting breastfeeding - Protecting babies fed on formula we argued guidance notes are not the best approach as they do not have the same status as regulations and from our experience of the current situation, Trading Standards officers look to the regulations and interpret them while sometimes being unaware of the guidance notes.
Allowing follow-on formula advertising to continue, along with company carelines and websites (which are not permitted by the World Health Assembly marketing requirements), means parents will continue to be bombarded with misleading, inaccurate and sometimes dangerous messages. I wrote here yesterday how company carelines directly contradict government advice on reducing the risk of possible contamination of powdered formula. Surely it is better to direct parents to accurate, independent sources of information than expect companies to change voluntarily (when they have failed to do so already) or expecting poorly resourced organisations such as ours and Trading Standards to police these well-resourced company marketing channels. See:
All the same, we will prepare a full analysis and response on the draft guidance notes in due course to try to make these as strong as possible. If the government has taken on board some of our concerns in the guidance notes we will give acknowledge this.
That is for the future. Today I am disappointed that the previous consultation did not result in changes to the regulations.
More than this I am shocked and disappointed at the attempt to put the government line into the media without forewarning us this would be done today, leaving us to learn of it through the media. I can't speak for others at the meeting, but this does not seem to be the way to build trust with stakeholders.
The only reason I am not more annoyed is because we did manage to get the Baby Feeding Law Group position into the media reports despite the government's best efforts to have a clear run at spinning the regulations. For example, this is in the Daily Mail piece: Baby follow-on milk adverts tightened but not banned
Baby Milk Action, which represents the Baby Feeding Law Group coalition of 22 organisations, had called for a total ban on all baby milk formula advertising and online promotions.
It also called for infant formula company representatives to be banned from having contact with mothers via their telephone carelines or other channels.
The campaign group wanted a ban on promotional claims and images on infant milk formula product labelling and improved warnings and instructions.
Tuesday, November 20, 2007
So I thought I would find out what happens if a confused parent calls to try to get their head around the differences between formula. How can you understand which is the best for your child when they all have impressive-sounding claims on them? Such as:
- Prebiotic care
- New improved protein balance
- With omega-3 LCPs
It turns out they all are. That is what I was told. Each formula has something added which is, so they told me, also in breastmilk, making that particular formula closer than others.
I've written here before about other materials in which each company claims its formula is the best. See:
On the 'carelines' I also asked about the instructions for mixing up formula. Hipp says on its labels that powdered infant formula is not sterile. None of the others do. Hipp says use water at 50-60 deg. C to mix up formula, but the advice from the Food Standards Agency and the World Health Organisation is to use water above 70 deg. C to kill any bacteria in the formula. See:
So what hapened when I asked the advisors on the company 'carelines' about their instructions? Well, in summary. Hipp argued that the FSA guidance was wrong. Some of the other companies said use water at room temperature. Only one said use water at 70 deg. C.
You will find fuller details in our forthcoming Update newsletter, being sent to members next week. Join now if you want a copy (though I must confess, it will be available on our website later). There are edited highlights in a press release we have issued today. See:
If you are interested in being a mystery caller to monitor the 'carelines' then contact me and I'll send you information.
The Baby Feeding Law Group is calling for the World Health Assembly marketing requirements for baby foods to be implemented in the UK, which prohibit companies seeking contact with mothers. We will find out very, very soon if the Government is listening. If it does ban company carelines it will be no great loss. They do not provide useful information, in fact they provide dangerous information. Better to look to independent sources. You can't trust the companies, they are not honest about the risks and how to reduce them.
You can send a message to the Minister responsible at:
Monday, November 19, 2007
As you will notice, it carries no advertising, other than for Baby Milk Action products and an appeal for an occassional donation of, say, £3.00.
No google ads, for example. Google ads are something I have experimented with using myself to promote Baby Milk Action. You submit a short text ad to their system. You can assign keywords to it. It then runs an algorithm on it to ascertain how relevant your ad is when people search on specific keywords, or include ads in their own page - so called context advertising. You provide a bid value for each click. The more popular the keyword, the more you need to bid to be in the top 10 appearing on a seach page. The poorer the match of your ad to the keyword, and, I think, the rarer the clicks when people see it, the more you have to bid.
Some keywords are more expensive than other. I ran a test to promote our breastfeeding calendar using breastfeeding' as one of the key words. Try it on google and you'll see that ads from some big companies come up, such as Mothercare and Aptamil formula, all purporting to offer breastfeeding advice. They pay for each time someone clicks on their link - and the amount can be typically 50 pence.
So if you are bored you could click on their link for a while to eat into their budget. They do have a massive budget, however, and obviously see it is worth spending just to have people visit their website looking for breastfeeding information because they anticipate future sales of formula as a result. The site you are led to by Aptamil, encourages you to sign up for information, another key internet marketing strategy.
I too like it if you sign up for my briefings, not just in the hope that you will buy something or become a member, but also in the hope you will become that most valuable resource for the campaign: an informed person.
If you see google ads that you think are inappropriate you can report them. Look at the bottom of the search page for a link saying 'disastified'. Context ads on the pages of others have a link to Google ads where you can give feedback on them.
This blog also appears on the social networking sites:
Myspace, which does carry advertising (revenue goes to Myspace), at:
and Yusie, which carries advertising and splits revenue with users (though some people thinks this will make them rich, you will only likely only qualify for a few cents a month and only see any money when it reaches $25), at:
I'm on Facebook to - which again takes advertising (revenue goes to Facebook) - and flag up particular blogs there. See:
So if you go to any of the sites that take advertising and see anything you think is inappropriate, please do complain to Google ads. You can also report to us via our monitoring
If you want the ad-free blog, see the blogger version - well, on that one you are only subjected to Baby Milk Action advertising.
Clicking on our own ads is the best way to support us, if you think this blog is useful.
Friday, November 16, 2007
If you have not done so yet, please do. It just takes a second. See:
You will likely receive a reply saying Ministers are busy people and the messages are being forwarded to the Food Standards Agency (FSA), which takes the lead on this subject.
However, we do want the level of public support to register with the Ministers, to back up our contact with them. As I wrote on Tuesday, Nestlé, which is trying to break into the UK market by offering to sponsor health workers, has access simply by opening its cheque book to sponsor events at the Labour Party Conference. See:
Even though your messages are being passed on to the civil servants at the FSA, I have been assured by the office of the Minister of Public Health that she is aware of the support for implementing the minimum standards adopted by the World Health Assembly. Ministers are specifically informed about correspondence if there is a large volume on one topic, for instance if there is a particular campaign. I know that there have been hundreds of messages already through the campaign we launched on Tuesday. Let us keep working for hundreds more over the coming days.
These will add to the submissions we, our partners and members of the public have made to the consultation on the proposed regulations. There were 1,341 submissions to that and I am sure the vast majority are supporting our position set out in the report:
Protecting breastfeeding - Protecting babies fed on formula.
At the end of the day it will come down to whether the politicians are prepared to put infant health first in the face of industry pressure.
We saw in the Philippines that the industry is prepared to take legal action against governments and make economic threats. Here they may try to use a fallacious argument that the government can do no more than the minimum set out in the EU Directive on Infant Formula and Follow-on Formula. We have included in our submission the legal reasons why the Directive not only permits implementation of the International Code, but, as it references it, can be argued to require implementation.
Behind the scenes there are efforts by a Commission official to knock governments off track. We have registered an official complaint to the EU Ombudsman about this behaviour, which will be explained in our imminent newsletter sent to members (click here to become a member) and posted on our website.
If we do not gain the protection babies and their families need in the next week or so, there may not be another chance for over a decade.
It can't be easy for the Ministers who have to grasp the details of the case, alongside every other area they are responsible for, and find the courage to stand up to powerful vested interests. Every message from a member of the public or an organisation helps to demonstrate the support Ministers can rely on. If they do put infant health and mothers' rights first, there will be applause across the land and around the globe. So please do take action.
Thursday, November 15, 2007
I wanted to flag up that it has an in-built podcast player. So you don't have to visit my podcast page or subscribe to iTunes to listen to the latest or one from the archive.
Here is the widget again. It has several feeds, which you can scroll through using the arrows at the top. When you get to the podcast one, you'll see how you can play them.
I hope it is useful!
Wednesday, November 14, 2007
A version of the obituary also appears in today's Guardian newspaper. See:
The following appears in our forthcoming Update newsletter, which will be sent to all Baby Milk Action members shortly. Click here to join Baby Milk Action.
Dr Clavano - tiny woman who moved mountains
“We allowed the companies to touch the lives of our babies, not because we did not care, but because we did not realise the consequences of granting such a privilege. How to change all that? How to break the ‘friendly’ stranglehold that we had allowed the milk companies to have on our hospital? We closed the door of the nursery to the milk companies. We stopped giving our babies the starter dose of infant formula. Down came the colourful posters and calendars; in their place we hung the “baby killer’ posters which show an emaciated baby inside a dirty feeding bottle.”
IBFANers marked the death on October 4th of Dr. Natividad Relucio Clavano, Chief of Paediatrics, Baguio General Hospital, the Philippines. Natividad’s 10,000 baby study (which Nestlé tried to suppress) demonstrated the damaging impact that western medical practices can have on breastfeeding and child survival and gave foundation to the global movement that followed.
Her life took a dramatic turn in 1974 when she came to the UK to take Post-Graduate Studies in Pediatrics at the Institute of Child Health, London University. Initially keen to learn about asthma, she studied under Baby Milk Action Advisor, Prof David Morley. She returned home armed with practical information about how to change hospital practices and prejudices about infant feeding. Her changes resulted in an increase of breastfeeding rates from 40% to 87%, a 94% reduction in the rates of diarrhoea and a 95% reduction in the rates of infant death.
She spoke in Washington at the 1978 US Senate Inquiry under Senator Ted Kennedy which led to the Code and in 2005 at the Philippine Senate in support of the Department of Health. We send our love to her husband and sons.
You can find a transcript of Dr Clavano's testimony to the Senate Hearing on our website, in our analysis of an article Nestlé is using to misrepresent the history of the campaign and its current practices. See:
It is important that we do not forget what really happened, or those who have taken principled stands against corporate malpractice. They give us strength to continue.
See the link to my blog entries on the Philippines for the unfolding story of the recent battle just won to protect infants and mothers from the latest challenge by the industry.
Tuesday, November 13, 2007
All bodies and organisations whose primary concern is health and mothers' rights, including the Government's own advisors, are calling for World Health Assembly standards to be implemented in full in the regulations. This will help to protect breastfeeding and to protect babies fed on formula. Many thanks if you have already sent a message to the Government. Now please send one more.
The Government is reportedly under intense pressure from the baby food industry to stick with existing weak measures. The industry body has said: "We believe the existing regulations are sufficient." Existing regulations allow widespread idealizing promotion, which undermines breastfeeding and does not provide those who use formula with the information they need.
Please send a message of solidarity to the Secretary of State for Health, Alan Johnson MP, and the Minister for Public Health, Dawn Primarolo MP.
You can find further information and a form for submitted a suggested message at:
Messages of support from anywhere in the world are extremely welcome and valuable. Our campaign of support for the Philippines helped to raise awareness of the industry attack on the regulations there, generate publicity, boost our partners campaigning nationally and ultimately helped achieve the significant protection won as the Supreme Court lifted the restraining order on the regulations. See the Philippines link for blogs as the campaign unfolded.
If you happen to have Alan Johnson or Dawn Primarolo as your Member of Parliament, why not contact them locally as their constituent?
Yet another violation report today demonstrates why UK regulations need strengthening. I've written in the past about the Wyeth/SMA television advertising campaign. Now it seems that the company is contacting mothers to ask them to complete an on-line 'survey', which as one mother reports: "was basically about SMA nutrition, its advertising, and some really pathetic questions such as How does it make you feel (and one answer was, I quote, "warm and happy")."
As I wrote when analyzing the advertising campaign, warm and fuzzy feelings are not a good basis for making decisions on what will be the sole food for a child during its most important phase of development outside the womb. See:
So please do send a message to the UK Government. Simply go to this page, enter your email and name and submit the message:
Monday, November 12, 2007
According to a presentation earlier this month at the American Society of Plastic Surgeons a study: "showed no difference in the degree of breast ptosis (or sagging) between women who breastfed and those who didn't".
In the study, led by surgeon Brian Rinker: "Rinker and his colleagues interviewed 132 women who came in for breast lifts or augmentation between 1998 and 2006. On average, the women were 39 years old, and 93 percent had experienced at least one pregnancy. Among the mothers, 58 percent had breastfed at least one of their children. The average duration of breastfeeding was nine months."
See the LiveScience website report at:
According to the report: " The main factors that did affect sagging were age, smoking status and the number of pregnancies a woman has had."
Rinker says this finding should alleviate the fears of new mothers over what nursing their child might do to their breasts in the long run and will encourage them to breastfeed because of the health benefits to their infant.
"Women may be reluctant to breastfeed because of this unfounded myth that doing so means the end of youthful breasts," Rinker said. "Now, expectant mothers can relax knowing breastfeeding does not sacrifice the appearance of their breasts."
Phew. That's a relief.
Friday, November 09, 2007
UK parents have the right to demand support for breastfeeding and accurate information on reducing risks of formula feeding
NICE produces advice (guidance) for the NHS about preventing, diagnosing and treating different medical conditions. The guidance is written by independent experts including healthcare professionals and people representing patients and carers. They consider the best available evidence on the condition and treatments, the views of patients and carers and the experiences of doctors, nurses and other healthcare professionals working in the field. Staff working in the NHS are expected to follow this guidance.
So what can parents expect and can demand if they are disappointed? You can download the brochure by clicking here:
This covers the first 6-8 weeks after the birth and covers much more than infant feeding. But here are some key passages on infant feeding:
---page 6 extract
Within the first hour of giving birth you should not be separated from your baby. You should be encouraged to have skin-to-skin contact with your baby and offered support to help you and your baby start breastfeeding.
The benefits of breastfeeding and colostrum should be explained to you. Colostrum is the first milk and gradually changes over time. It is rich in fats and protein, and helps protect babies against infection.
You should be offered advice on how to best position your baby and yourself for breastfeeding. This will help to ensure your baby attaches correctly and that you are both comfortable. You should be reassured that you may experience brief discomfort when you start a breastfeed, but this should not persist.
If you have had a caesarean section, pain-killing injections or anaesthetic, or a delay before being with your baby, you should be offered extra support to help you start breastfeeding. If you give birth in hospital and go home soon after, you should be reassured that you will still be able to breastfeed successfully.
You should be shown how to express breast milk by hand, and if you have been separated from your baby you should be shown how to use a breast pump to help encourage your milk supply. Your healthcare professional should also give you information on how to store and freeze breast milk.
If you are going to feed your baby with formula milk, you should be advised on how to prepare and store formula and how to clean and sterilise bottles and teats.
Milk for your baby (breast milk and formula milk) should not be warmed in the microwave as it can become dangerously hot.
If a mother is breastfeeding then:
---page 8 extact
Your healthcare professional should ask you about breastfeeding at every contact. You should be offered advice and support if you have any concerns (see page 15). For example, if you find breastfeeding painful your healthcare professional should work with you to find the right position for you and your baby and ensure your baby is attaching properly.
You should be encouraged to breastfeed your baby as often and for as long as he or she wants. This will help your body produce enough milk.
Your baby will stop feeding when he or she is satisfied; this may be after feeding on both breasts or just one breast. You should not be advised to give your baby a top-up of formula milk if you are breastfeeding.
Questions you might like to ask your healthcare team
• How can I get some help with breastfeeding?
• Is there a breastfeeding support group in my area?
• How can I make sure my baby is getting enough milk?
• How can I increase my milk supply?
---Page 9 extract
Your healthcare professional should review your breastfeeding experience each time they talk with you. If you or your healthcare professional has any concerns – for example, that your baby is not getting enough milk, or you are experiencing pain – these should be discussed. If you think your baby is not getting enough milk you may be advised to increase your milk supply by feeding more regularly or to use expressed breast milk in a cup (or bottle).
You should be encouraged to discuss any concerns you may have about breastfeeding with your healthcare professional or support worker (some common concerns are listed on page 15). Your healthcare professional should work with you to help you breastfeed successfully.
If using formula, health workers should help with information on mixing up formula to reduce the risks of possible intrinsic contamination with harmful bacteria. As I have written previously, most baby food companies are failing to warn on labels that powdered infant formula is not sterile and the necessary steps to reduce the risks. See:
You can find the brochure for parents and other relevant NICE guidance documents for health professionals and policy makers at:
While only 52 out of 317 maternity hospitals in the UK are accredited as Baby Friendly by UNICEF, parents still have the right to demand the support set out above and to complain if they do not receive it.
Thursday, November 08, 2007
Yesterday I learned of a study that shows the cost benefits. I was speaking at the Annual General Meeting of the Breastfeeding Network, an inspiring UK mother support group, whose trained counsellors provide support to mothers and operate a 24 hours helpline. They were celebrating 10 years of abiding by the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions of the World Health Assembly. I'll explain what that means at the end of this blog.
My presentation was about the Code and Resolutions and the current UK law campaign. I ran through some of the economic benefits of protecting, promoting and supporting breastfeeding. In the course of the discussion, I learned of an important cost analysis conduced by the National Institute for Clinical Excellence (NICE) on "Postnatal care: Routine postnatal care of women and their babies". You can find a comprehensive set of documents setting out best practice guidance for health workers, information on what to expect for parents and cost analysis for those holding the purse strings. See:
I'll say a bit more about the best practice guidance tomorrow, but a key recommendation is to implement the practices in UNICEF's Baby Friendly Hospital Initiative as a minimum standard. This involves 9 steps in hospital and a further step of community support from peer support groups, such as the Breastfeeding Network.
There are just 52 out of 317 maternity hospitals in the UK which are accredited as Baby Friendly. The scheme began in 1992 and the UK Government has voiced its support for initiatives such as the Innocenti Declaration which call for the scheme to be promoted.
The NICE analysis considers national savings and the local savings for an "’average‘ maternity unit with 220 staff members and an average number of births per year of 2,534." See page 31 of the document available by clicking here:
Nationally the Government - and tax payers - could save over a million pounds per year after initial investment in training and resources to make all hospitals Baby Friendly.
If such a hospital is already accredited, it will be saving £23,436 per year in expected increases in breastfeeding rates. Increased rates mean fewer sick infants and so less expenditure on treatment as well as saving on the cost of providing formula and equipment. Even after extra spending to support breastfeeding, there would be a net saving of around £9,000 per year. Extra expenditure covers:
- UNICEF BFI fees for work planning and assessment
- training costs, and
- employment costs for a breastfeeding coordinator.
So it takes a longer-term view from the accountants to support the up-front expenditure. But after three years the budget will benefit as well as mothers and babies.
You can find out the status of your local hospital and more about Baby Friendly at:
Making a hospital Baby Friendly also benefits mothers and babies who use formula. UNICEF produces materials on how to reduce risks from formula providing information that companies fail to give on their labels. For further details see my blog:
Now, what does it mean to say the Breastfeeding Network is complying with the International Code and Resolutions? It means ensuring that information provided to parents is accurate and independent and avoiding conflicts of interest with regard to sponsorship. The Breastfeeding Network, like Baby Milk Action and our partners in the International Baby Food Action Network (IBFAN), refuses funding from companies with an interest in infant feeding, including breastpump companies. This is not an issue of whether such products are needed, but about the importance of giving and being seen to give impartial advice.
We have a great resource for health workers on how to comply with the Code and Resolutions. Find it here:
Wednesday, November 07, 2007
However, I did come across the response to the consultation from the enforcement body.
The Local Authority Coordinators of Regulatory Services (LACORS) is the umbrella body for Trading Standards Officers. It issued new guidance earlier this year regarding claims on formula labels, which have gone some way to seeing idealizing claims removed from labels using existing powers.
However, Trading Standards Officers, often find loopholes and ambiguity in the law makes enforcement problematic. This is reflected in the response to the consultation which is available at:
As with the submission we prepared on the behalf of the Baby Feeding Law Group, LACORS raises concerns over the failure to implement the World Health Assembly marketing requirements in the proposed legislation and, in particular, the difficulty in enforcing regulations that treat infant formula and follow-on formula differently. The following is an extract from the LACORS submission:
The FSA covering letter indicates that part of the intention of Directive 2006/141 is to ensure that “ the rules on the composition, labelling and advertising are in line with the principles and aims of the International Code of Marketing of Breast-Milk Substitutes “.
LACORS is aware that significant enforcement problems are experienced because the proposed FSA implementation of Directive 2006/141 may unintentionally perpetuate enforcement uncertainty in relation to controls over the advertising and marketing of follow-on formulae and related marketing practices.
LACORS view is that alignment of brand names and company names and logos blurs the distinction between infant formula and follow-on formula to the extent that consumers are unable to adequately distinguish between them. Consumers “ read across “ and whilst the manufacturers indicate that there are advertising/promoting follow-on formulae the consumer sees this as applying to infant formula as well LACORS believes that there is sufficient legal authority contained within EC Directive 2006/141 to enable greater implementation within the UK legislation of the controls set out in the International Code.
LACORS is aware that the National Childbirth Trust have sought legal advice on this aspect ( copy attached as Appendix A ).
LACORS supports the view that the same advertising and marketing and promotional controls which currently apply to infant formula should also apply to follow-on formulae.
These extended controls should be framed in such a way so as to cover generic manufacturers names, logos and other pictorial devices in the same manner as those which currently apply to specific individual product names or logos where the likelihood of consumer “ read across “ mentioned above will occur.
---extract ends.Amongst responses on specific issues, LACORS shares our concern that formula manufacturers are not providing parents with the information they need to reduce the risk of possible intrinsic contamination of powdered formula with bacteria.
With regard to Regulation 17(1)(d) LACORS is aware that current FSA/Department of Health guidance is that minimum water temperature required to safely prepare infant formula is 70deg C. LACORS suggest that this figure is specifically included in the Regulations. LACORS is aware that one UK producer currently indicates that the temperature should be in the range 50 – 60 deg C. This is suggested to be a precursor for the possible future inclusion of probiotics. This is totally unacceptable on protection of infant health grounds
See our press release on this topic, which includes a scan of the Hipp label which gives this erroneous temperature information, at:
If you are a regular reader of this blog, you will know I am concerned about idealizing claims on labels and the fact companies continue to use them, despite a crackdown earlier this year. LACORS stresses the need for clarity in the legislation: "With regard to Regulation 17(4) the wording used should be amended to indicate that any claim relating to nutrition, health and composition are prohibited unless specifically included in Annex IV."
And you will know I have complained about the regulatory black hole that the internet and product placement fall into. We have tried to argue that these come within the scope of the law. LACORS wants clarity in the legislation: "LACORS recommends that the Regulations are extended to address the issues of website advertising; product placement in publications and advertorials."
So it is not only health advocates calling for the proposed regulations to be improved, it is also those who will have responsibility for improving them.
The report we prepared on the Baby Feeding Law Group is called: Protecting breastfeeding - Protecting babies fed on Formula. Available at:
Let us hope the policy makers are listening.
Tuesday, November 06, 2007
Click here for a report in the Daily Mail.
This article states:
The findings appear in the journal Proceedings of the National Academy of Sciences. Professor Terrie Moffitt, based at the Institute of Psychiatry in London, said: "The argument about intelligence has been about nature versus nurture for at least a century. We're finding that nature and nurture work together.
"Our findings support the idea that the nutritional content of breast milk accounts for the differences seen in human IQ. But it's not a simple allornone connection: it depends to some extent on the genetic makeup of each infant."
---It then considers additives made to formula:
In the last decade, many infant formula makers have started adding two Pufas [or LCPUFAs] - docosahexaenoic acid (DHA) and arachidonic acid (AA) to their products.
But the children taking part in the gene study were born in 1972-73 in New Zealand and 1994-95 in England, before fatty acid supplementation of infant formula began.
The jury is still out on whether Pufa supplementation has made a difference. However, in laboratory tests, animals given fatty acid supplements have performed better at learning, memory and problem-solving tests.
At present there is little evidence from randomised trials of LCPUFA supplementation to support the hypothesis that LCPUFA supplementation confers a benefit for visual or general development of term infants.
Companies have been claiming benefits from adding LCPUFAs to their products. At the turn of the year the UK Food Standards Agency told companies to stop doing so on labels of infant formula as they were in breach of the law. See:
In the Philippines, Nestlé has been promoting its Nestogen infant formula as containing 'Brain Building Blocks', something that is now illegal there following the Supreme Court rejection of an industry attempt to strike down Department of Health regulations. See:
At the time when LCPUFAs were first being synthesized on industrial scale for adding to formula, in the additive Formulaid, market analysts Hambrecht & Quist strongly recommended investors buy shares in the producers, Martek Biosciences. They saw a goldmine.
This is what they said back in the 1990s about the additives Martek had come up with:
"The history of infant formula has shown that virtually all similar examples have led to wide-scale introduction of such additives into infant formula, even if there was no evidence that the additives were important. Infant formula is currently a commodity market with all products being almost identical and marketers competing intensely to differentiate their product. Even if Formulaid had no benefit we think that it would be widely incorporated into most formulas as a marketing tool and to allow companies to promote their formula as 'closest to human milk.'"
No doubt the industry will attempt to exploit the new findings on the benefit of breastfeeding to continue to suggest that their formula with LCPUFAs will confer similar benefits, though the indepedent review of the science finds no evidence to suggest ingredients in the different environment of formula have the same beneficial effect.
The Food Standards Agency is expected to reveal this week whether it will allow companies to continue to make idealizing claims about formula and to arget parents to promote their products. See:
On additives, the Baby Feeding Law Group takes the view that if an ingredient is necessary to reduce the health disadvantages of formula feeding, then it should be a requirement in all formulas, but the assessment must be based on an independent review of the science and much of this must be free from commercial influence. See the report: Protecting breastfeeding - Protecting babies fed on formula, available at:
Monday, November 05, 2007
And as the Sunday Express reports, the Public Health Minister "Dawn Primarolo has been under intense pressure from milk manufacturers not to legislate." And: "A spokesman for the Infant and Dietetic Food Association said last night: “We believe the existing regulations are sufficient."
As I reported here in September, Dawn Primarolo, shared a platform with Nestlé at an event sponsored by the worst of the baby food companies (on a global scale) hosted at the Labour Party Conference. See:
Nestlé has twice tried and failed to launch itself into the UK mainstream formula market in recent years. The UK is about the only country where it doesn't market its mainstream formula - here it has only specialised formulas at present. It is currently trying to enter the market by attempting to persuade midwives to accept sponsorship for materials ostensibly about breastfeeding. See:
So it is not yet clear whether the pressure from the established UK companies and the cheque book of Nestlé will sway Ministers over the advice of health experts, including the Government's own Scientific Advisory Committee on Nutrition.
We should know at the end of the week when we expect the Food Standards Agency to publish its response to a consultation on its draft revision of the law. The draft was widely condemned by health experts as insufficient. For further details see the report we produced on behalf of the Baby Feeding Law Group: Protecting breastfeeding - Protecting babies fed on formula. Available at:
Friday, November 02, 2007
In an area where breastfeeding at 6 weeks was just 20% Little Angels are having a significant impact. Breastfeeding at 6 weeks has already climbed to 40%.
Here is one of a great range of posters which are part of their campaign.
You can order the posters at:
Recall that according to the government's national survey 9 out of 10 mothers who stopped breastfeeding by 6 weeks said they wanted to breastfeed for longer (as did 40% who breastfed for at least 6 months). More support is needed as well as cultural change. That is the aim of the Breastfeeding Manifesto, working for action in 7 areas. See:
I was there to talk about the need to protect a mother's right to independent information on infant feeding. Those using formula require objective information on the differences between those on the market and how to reduce the risks of formula feeding. This information is not coming from the companies.
Breastfeeding also needs protecting from aggressive marketing. Groups such as Little Angels provide support with one arm tied behind their backs because companies are able to target mothers with materials such as this mailshot from Cow & Gate.
This was sent to a mother when her child was 4 weeks old. She didn't recall what she had signed to get on the company's mailing list.
Targeting mothers with formula brand names and negative messages about breastfeeding at a time when they are likely to be experiencing difficulties with breastfeeding is a deeply cynical strategy. Unfortunately it is one that the authorities allow to continue and the law currently under review is unlikely to make any differences unless the advice of the government's own Scientific Advisory Committee on Nutrition to strengthen the law is heeded.
For further details of the demands of health advocates see the report we have submitted to the government on behalf of the Baby Feeding Law Group and Breastfeeding Manifesto Coaltion. It is called 'Protecting breastfeeding - Protecting babies fed on formula' and can be found at:
Thursday, November 01, 2007
NUMICO, a Dutch company, owns formula brands Nutricia, Milupa and Cow & Gate. Hence the name.
It is being taken over by Danone, a French company. Known in the UK for its yoghurts. Known to infant health campaigners for violating the baby food marketing requirements in Europe and Francophone Africa in particular.
The deal is worth 12.3 billion euros according to Reuters. See:
According to a report on Forbes, the deal has been cleared by European Competition authorities subject to some divestment. See:
"The commission said its decision is conditional upon the divestment of Numico's baby milk and baby drink business in France, Danone's baby meals, baby milk, baby snacks, and baby drink activities in Belgium, and Danone's baby meal and baby snacks activities in The Netherlands."
You can find profiles of the companies in the Breaking the Rules reports produced by the International Baby Food Action Network (IBFAN) at:
A survey in West Africa published in the British Medical Journal found Danone to be responsible for more labelling violations (21) than Nestlé (11) and concluded: "In west Africa manufacturers are violating the code of marketing of breast milk substitutes". See Monitoring compliance with the International Code of Marketing of Breastmilk Substitutes in west Africa: multisite cross sectional survey in Togo and Burkina Faso, BMJ 2003;326:127 at:
For past campaigns we have run targeting malpractice by all these companies see the 'codewatch' section of:
Globally Nestlé is responsible for more violations than any other company.