Should mothers who use formula feel guilty?

Should mothers (and fathers) feel guilty for using formula rather than breastfeeding?

Plenty do - or feel they are expected to. Here's a comment someone has just posted anonymously on an earlier blog here:

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Since all of you are clearly obsessed with the idea that formula feeding is bad, bad, bad - perhaps I should mention that for some mothers, it's the only alternative. My wife tried to breastfeed and in the end had to resort to bottle feeding. We didn't want to, and we didn't like it. But it was the only option we had. So for all you mums who sneer at the poor ignorant women formula-feeding their babies - good for you. We had no choice - and guess what? Our baby is a year old, healthy and a joy. So stick that in your narrow-minded obsessive pipe and smoke it.

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I've also recently been contacted by a health worker who says she sees the ill health resulting from formula feeding - such as gastro-enteritis, ear infections - and raises the greater risk of diabetes and other long-term illnesses. She asks: " There seems to be an obsession about fear of "making Mums feel guilty" when it comes to breast feeding, but NOT with other health advice e.g. smoking and healthy eating and vacinnation advice etc. I don't know why this terror of Mums feeling guilty seems UNIQUE to breast feeding."

I stand by my often repeated - but as often ignored - comment that it is a mother's decision how she feeds her child and nobody should attempt to make her feel guilty about it.

I appreciate that some may disagree, but my view is that mothers have a right to accurate, independent information on infant feeding and the health implications of not breastfeeding. If a mother makes an informed decision not to breastfeed, then there are presumably reasons why other factors were judged to be of greater importance than breastfeeding. If she decided not to breastfeed because she was misinformed or misled by company propaganda which suggests formula and breastfeeding are equivalent, or did not have the support to overcome difficulties with breastfeeding, I'm not sure that it is either fair or productive to blame her for being failed by those responsible for regulating marketing practices and providing support.

Remember, in the UK, 90% of mothers who stopped breastfeeding before their child was 6 weeks old said they wanted to breastfeed for longer. The mother cited in the first quote, tried to breastfeed and wasn't able to make it work.

The ones who should feel guilty are those who have failed to implement and enforce the marketing standards that were adopted by the World Health Assembly in 1981 and Resolutions since which update and clarify them. In the UK, this means the drafters of the Infant Formula and Follow-on Formula Regulations which allow misleading advertising and labels to go onto the market. The ones who should feel guilty are the company executives who, as policy, seek to weaken legislation and systematically break the Code and Resolutions.

Those of us trying to promote and support breastfeeding need to do a better job of reaching mothers - it is not easy because the formula industry is far better resourced and uses dishonesty to undermine breastfeeding and suggest that formula feeding and breastfeeding are equivalent (or formula feeding is better - despite the legally required 'breast is best' message).

Rather than using guilt as a lever over mothers, I think a better approach is to understand the role of formula marketing and find better ways to communicate to mothers, particularly those who have had, or are having, a bad experience with breastfeeding. I do appreciate tireless efforts are being put into this already by many.

I do think all of us who are attempting to change formula-feeding cultures back into breastfeeding cultures - which exist or have been recovered in many countries - should redouble our efforts. Promoting the ONE MILLION CAMPAIGN is a good start:

http://www.onemillioncampaign.org/ - also shaming Nestlé, the worst of the baby food companies by promoting the Nestlé boycott: http://www.babymilkaction.org/

As a final thought, I think it is important that those who do use formula, for whatever reason, are also protected. Information should be accurate. Instructions should be correct. And formula should be cheaper - it has one of the highest mark-ups of any product. This is the aim of our safer formula campaign - see the site.

ONE MILLION CAMPAIGN - presentation at the World Health Assembly in May 2009

Please watch this film showing the presentation of 45,000 petition signatures gathered so far in the ONE MILLION CAMPAIGN to support mothers to breastfeed. Today there are over 59,000 signatures.

If you have not yet signed up, you can do so at:

http://www.onemillioncampaign.org/

If you have signed up, then spread the word using the resources you will find on the site.

Global Compact Critics on our Nestle complaint

Our complaint to the UN Global Compact office regarding Nestlé bringing the voluntary initiative into disrepute by using it to cover up its malpractice, is being downloaded and reported elsewhere.

The Global Compact Critics website tracks the shortcomings of the UN initiative. Its report on our complaint can be found at:

http://globalcompactcritics.blogspot.com/2009/06/international-campaign-calls-on-global.html

The World Alliance for Breastfeeding Action has highlighted the complaint on its front page at the moment. There is also news there of the rd WABA Global Forum, 14 -17 June 2010, Quebec City, Canada. See:

http://www.waba.org.my/

Interview on Nestlé's UN Global Compact cover up

I recently gave an interview to a Sheffield Live! radio station as part of an international student initiative in the build up to the next G8 summit. This has appeared on various websites, where you can listen to in online, including:

http://www.canstream.co.uk/sheffieldlive/index.php?id=16726

This included an exclusive on the launch of our report: Nestlé's UN Global Compact cover up. This report exposes how Nestlé breaches human rights and environmental standards and the strategies it uses to divert criticism. Amongst these is using the UN voluntary Corporate Social Responsibility initiative, the Global Compact, to portray its impact as wholly beneficial. We and colleagues who contribute to the Nestlé Critics site have lodged a formal complaint calling for Nestlé to be expelled from the initiative. See our press release for information at:

http://www.babymilkaction.org/press/press17june09.html

It is possible to download the report from the above link.

Fundraising to hold UK formula companies to account

We are waiting for the UK government's review panel to give its recommendations on what to do in response to continued aggressive marketing of formula following the introduction of the new Infant Formula and Follow-on Formula Regulations 2007 and the associated guidance notes.

As the monitoring reports we produce for the Baby Feeding Law Group (BFLG) show, violations remain 'commonplace' - to use the word of the UN Committee on the Rights of the Child in its assessment of the government's performance in protecting child rights. The Committee, like all health worker bodies, mother support groups and the government's own Scientific Advisory Committee on Nutrition have called for stronger regulations.

We continue to monitor the companies and will be producing a further report in the coming months. The next report will respond to the action - or lack of it - taken by the review panel. It will also go to the home authorities responsible for enforcing the regulations, to the Advertising Standards Authority and the Food Standards Agency. As the latest report shows, this has stopped some questionable marketing practices, but has mainly demonstrated the failings of the current regulatory and enforcement system.

To do this work, we rely on the support of volunteer monitors (some of whom we have trained), donations and sales of reports.

We are grateful to LatchOn.org for listing our project on its site at:

http://www.latchon.org/projects.htm?region=17

You can make a donation via that site or the BFLG site:

http://www.babyfeedinglawgroup.org.uk/

You can download the latest report and purchase a printed copy at:

http://www.babymilkaction.org/shop/publications01.html#bflgreports

Call for Nestlé to be expelled from UN initiative

As you may recall, Nestlé attempted to hi-jack the Nestlé Critics site shortly before its launch. The site serves as a portal for information on various aspects of Nestlé malpractice. See:
http://www.nestlecritics.org/

Nestlé not only tries to silence critics and to spy on them (see the report on the site), it uses a UN initiative called the UN Global Compact as cover so its abuses of human rights and the environment can continue. Nestlé produces glossy reports which are published on the UN Global Compact and have even been launched at joint events.

Unfortunately the UN Global Compact has no procedure for confirming if the reports are accurate and complete. Indeed, it stresses it is not intended to be an enforcement or verification agency. Its aim is to encourage corporate responsibility through voluntary means and by holding up good examples of 'Communications on Progress' - Nestlé has been honoured in this way.

So the initiative is fundamentally flawed and much criticised. I wrote a chapter in the book 'Global Obligations for the Right to Food' analysing these issues and calling for a regulatory system that could stop malpractice.

The Global Compact does have integrity measures, under which complaints can be filed if it is thought that a company is bringing the initiative into disrepute by systematic abuses of the principles it claims to support. Nestlé does this and more: it uses the initiative as cover so abuses can continue.

So the Nestlé Critics have filed a complaint and Nestlé has 3 months to respond. We and our partners have raised our various concerns with Nestlé repeatedly without success, so if they are dismissed again, will the Global Compact act to remove Nestlé's reports and strike it from the list of partners? We shall see.

There is a rather nice report of our own to go with our complaint, which I have put together. You can download this from our website, via the press release issued today at:
http://www.babymilkaction.org/press/press17june09.html

Martek profits boosted by formula company bogus claims

Martek, the company that produces Long Chain Polyunsaturated Fatty Acids, from algae for adding to formula is doing well for itself.

The BioHealth Investor site reports "its fiscal 2009 second-quarter profit rose by 20 percent"

Why such demand for LCPUFAs? The report notes: "Omega-3 fatty acids are believed to play an important role in brain and eye development."

True, as far as it goes. Adding processed LCPUFAs to formula, a different environment to breastmilk, where human LCPUFAs naturally occur, is not found to provide any benefit.

The independent and respected Cochrane Library reviewed the evidence and concluded:

http://www.cochrane.org/reviews/en/ab000376.html

"It has been suggested that low levels of long chain polyunsaturated fatty acids (LCPUFA) found in formula milk may contribute to lower IQ levels and vision skills in term infants. Some milk formulas with added LCPUFA are commercially available. This review found that feeding term infants with milk formula enriched with LCPUFA had no proven benefit regarding vision, cognition or physical growth."

Of course, the facts do not prevent Nestlé claiming its formula with LCPUFAs contains 'brain building blocks' or UK formula companies claiming they benefit brain and eye development. The companies do not follow the marketing requirements adopted by the World Health Assembly unless forced to do so.

This need not worry investors however. As Hambrecht & Quist said when it strongly recommended investors to buy shares in Martek Biosciences in the 1990s when it launched its Formulaid LCPUFA additive:

"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.'"

The question that parents need answered is whether it is worth spending more on formula that contains LCPUFAs. We have to direct parents to their health worker for information. However, as the World Health Assembly marketing requirements are not enforced in many countries, we know that health workers are not only misled by companies, but bombarded with gifts and hospitality to influence their views of the companies and their claims.

The official UK Department of Health line is that all formulas have to comply with composition standards so all formulas are equally suitable. There is no requirement to add LCPUFAs as there is not proven benefit from adding them. They are, however, believed to be safe.

The formula marketing regulations in the UK allow companies to add new ingredients to formula without proving their benefit or even safety: all they have to do is submit a copy of the label they plan to use to the Food Standards Agency.

This means that we are seeing what some have described as mass uncontrolled trials on populations of babies. While some parents may be persuaded to use formulas with LCPUFAs just in case, there is also the possibility that there may be unknown risks. In the US, a freedom of information request found that the Food and Drug Administration had registered reports from parents who believed their babies had had an adverse reaction to these ingredients. See:

http://boycottnestle.blogspot.com/2008/01/lcps-questioned.html

Formula is a nutritional medicine and, like any medicine, is intended for specific cases where it is needed. If it can be avoided, then the known health risks and possible unknown ones can also be avoided. This common sense approach is lost in the hype around formula - hype which is intended to make formula use seem to be a simple question of lifestyle so as to boost sales and profits for companies such as Martek.

It is a mother's right to decide how to feed her child and no-one should try to make her feel guilty for her decision: there are many factors involved.

It is not my purpose in pointing out what companies hide to make mothers feel guilty, but to shame our politicians for allowing companies to make bogus claims. My purpose is to defend a mother's right to make an informed decision. If she decides to use formula afterwards in any case, a decision based on facts rather than misinformation should be empowering.

While we have to be aware that some mothers feel pressured to breastfeed and demonised if they decide not to (or have no choice), I think it is also wrong and patronising to believe or argue that information should be kept hidden.

Those that use formula require better information: independent, objective information from health workers that have not been targeted by companies seeking to increase sales.