We need to monitor the safety of new ingredients in formula - don't begrudge formula-fed infants this protection

I wrote yesterday of information obtained from the US Food and Drug Administration (FDA) about the adverse health impacts some parents have logged with this government body after feeding their children with formula containing LCPs (Long Chain Polyunsaturated Fatty Acids). The FDA had written to the manufacturer, Martek, suggesting that studies have shown an adverse reaction from some infants. These ingredients are, however, permitted in formulas in the US, the European Union and some other countries. See:
http://boycottnestle.blogspot.com/2008/01/lcps-questioned.html

Perhaps I should not be surprised that on one discussion board where the US evidence has come up it has been dismissed immediately as coming from a campaign organisation.

No, the information has come from the Food and Drug Administration.

This blog includes an appeal to focus on the real issue here: how best to monitor the adverse effects that new ingredients in formula may have on some infants, so as to reduce the risk of harm.

Our partners in the US in the International Baby Food Action Network (IBFAN) and their partners are calling for warnings on labels so that should there be an adverse reaction, parents using the formula are aware it may be due to the LCPs. An independent review of these ingredients has found no benefit from adding them to formulas for term infants, despite
claims from companies that they aid 'brain and eye development'. Accordingly companies are not required to add LCPs to formula. So if parents or carers using formula do suspect an adverse reaction they should consult their health worker about alternatives.

It is because of this need for independent advice that the World Health Assembly adopted marketing requirement for breastmilk substitutes, to protect those babies fed on formula as well as to protect breastfeeding.

The US has a pre-authorisation procedure for formula. In the UK the Baby Feeding Law Group, a coalition of health worker and mother support groups, is calling for the same. This was one of the recommendations in the report Protecting breastfeeding - Protecting babies fed on formula rejected by the government. Instead companies will only be required to submit a copy of the label to the Food Standards Agency and only then in the case of infant formula. This notification procedure isn't being applied to follow-on formulas. The BFLG also recommended a monitoring system for health workers and parents to report concerns they may have, particularly with novel ingredients being added to formula. More are coming soon, by the way.

This is not an unreasonable request. Nor should those who's automatic response is to dismiss anything coming from health advocates be so quick to turn away from the need to protect babies fed on formula.

The US Food and Drug Administration has such a monitoring system in place and also expects companies to monitor its customers for possible adverse effects. This is what it says in one of its responses to an application from a company (in this case Mead Johnson) to have its formula containing LCP formulations ARASCO and DHASCO declared Generally Recognised as Safe (GRAS) . See:
http://www.cfsan.fda.gov/~rdb/opa-g080.html

---

Based on the information provided by Mead Johnson, as well as other information available to FDA, the agency has no questions at this time regarding Mead Johnson's conclusion that ARASCO is GRAS under the intended conditions of use. The agency has not, however, made its own determination regarding the GRAS status of the subject use of ARASCO. As always, it is the continuing responsibility of Mead Johnson to ensure that food ingredients that the firm markets are safe, and are otherwise in compliance with all applicable legal and regulatory requirements.

As you know, under section 412 of the Federal Food, Drug, and Cosmetic Act (the FFDCA), a manufacturer of a new infant formula must make a submission to FDA, providing required assurances about the formula, at least 90 days before the formula is marketed. FDA's response to your GRAS notice does not alleviate your responsibility to make the submission required by section 412 for any new infant formula that you manufacture to contain ARASCO and DHASCO under the conditions of use described in your GRAS notice.

As you are aware, in our response to GRN 000041 FDA informed Martek that it is FDA's view that any evaluation that a use of a food ingredient is safe is a time-dependent judgment that is based on general scientific knowledge as well as specific data and information about the ingredient. For this reason, FDA would expect any infant formula manufacturer who lawfully markets infant formula containing ARASCO and DHASCO to monitor, through scientific studies and rigorous post-market surveillance, infants who consume such a formula.

Importantly, because the broader scientific community could contribute to this continuing evaluation, and because the use of ARASCO and DHASCO in infant formula would be based on the GRAS provision of the FFDCA, we also would expect that any reports to FDA about such studies would not be considered to be confidential.

---

Companies claim their studies show no adverse reactions.

The FDA claimed in its response of 17 May 2001 to Martek's application GRN 000041 mentioned above: "Some studies have reported unexpected deaths among infants who consumed formula supplemented with long-chain polyunsaturated fatty acids." It said it would convene an expert panel, despite Martek's suggestion this was unnecessary, and said it had no further questions at that time.

The Martek report on its investors website on the same date is headlined: "Martek's Oils for Use in Infant Formula Receive Favorable Review by FDA." See:
http://investors.martek.com/phoenix.zhtml?c=116214&p=irol-newsArticle&ID=176686&highlight=

It states: "The agency has issued a letter informing the company that the FDA has no questions regarding the company's conclusion that Martek's DHASCO(R) and ARASCO(R) oil blend is GRAS when used in specified ratios in infant formulas. Infant formulas containing Martek's oils will become available in the United States as soon as infant formula manufacturers satisfy FDA's pre-market notification procedures relating to infant formula."

So what happened next? The FDA response to GRN 000041 is referenced in other responses as recently as last week (example here) so I am still seeking information about whether the expert panel Martek was opposing did indeed meet.

Companies wishing to use LCP's in their formulas made their applications for pre-market approval and this was granted. In the example of Mead Johnson's application for Generally Recognised as Safe status for its formula quoted above, the company was told it has to monitor any adverse effects of the formula.

Now it seems to me perfectly reasonable that this sort of monitoring should take place and should be backed by an independent system as they have in the US. The FDA has registered 98 cases of adverse effects reported by parents, details of which were released under the Freedom of Information Act. This information is important for evaluating safety. It will also help to determine whether information for parents who use formula should alert them to the possibility of an adverse reaction to LCPs. The more data there is, the better.

If you are one of that select group that will read this blog and launch into a 'stop making mothers who use formula feel guilty' attack, then please don't. Whether you believe it or not I happen to think that babies fed on formula have a right to be protected and that if there is a problem for a small group of infants from these ingredients then monitoring systems are essential. If you use the formula and your baby is fine, then please don't begrudge those who have concerns the opportunity to report them.

And if you are breastfeeding and are feeling pleased that your breastmilk is tailored to your baby so this discussion is not relevant to you, then that is wonderful, but also please let the discussion take place without it immediately turning into a breastfeeding/bottle feeding debate.

Sometimes discussion of infant feeding becomes so heated and emotional the real issues can be lost. This is about how best to monitor the adverse effects that new ingredients in formula may have on some infants, so as to reduce the risk of harm.

Baby Milk Action has a group on facebook specifically for discussions around our safer formula campaign, so please do drop by there if you are using formula. Click here. You won't find medical advice, but it is a forum to discuss these regulatory issues.

LCPs blamed for causing illness in some formula-fed babies

A Freedom of Information action in the United States has revealed that regulatory authorities permitted LCPs (Long-Chain Polyunsaturated Fatty Acids) to be added to infant formula despite evidence that these cause illness in some babies.

If you are using formula and you have noticed problems with diarrhoea, fusiness or breathing problems when using formula with LCPs please contact us and the other organisations mentioned at the end of this blog.

The findings come in a report from the Cornucopia Institute, which presents itself as "Promoting Economic Justice for Family-Scale Farming", and has worked to defend the organic classification for food from being weakened. It presented its report in partnership with the National Alliance for Breastfeeding Advocacy (NABA), which, like Baby Milk Action, is a member of the International Baby Food Action Network (IBFAN).

Most of the LCPs added to formula are produced by the company Martek. Specific types produced have the names DHA (docosahexaenoic acid) and ARA (arachidonic acid).

These are the products which formula companies promote as 'for brain and eye development' or as 'brain-building blocks' despite the fact that independent reviews of research by the Cochrane Library has found the claims are not supported by the evidence. See:
http://boycottnestle.blogspot.com/2006/10/health-claims-goldmine.html

Now the Cornucopia Institute has uncovered scores of cases of illness attributed to the additives registered by the US Food and Drug Administration.

Its press release and report is available at:
http://cornucopia.org/index.php/infant-formula-manufacturers-again-under-ethical-cloud/

It states in part:

---press release extracts

Martek’s products are extracted from fermented algae and fungus, with the use of the synthetic solvent hexane, a neurotoxic chemical. They contain only 40 to 50% DHA and ARA, with the balance being sunflower oil, diglycerides, and nonsaponifiable materials. Some of these components are not found in human breast milk, and the triglycerides carrying DHA and ARA are not identical to those found in human breast milk—and have never been part of the diet for human infants.

[...]

“This report presents a disturbing look at the addition of novel ingredients into infant formula,” says Marsha Walker, Executive Director of the National Alliance for Breastfeeding Advocacy. “The FDA has received scores of reports on the adverse effects of these ingredients, but, to date, the public’s only access to these is through Cornucopia’s Freedom of Information Act request. This report will help alert the health care community and federal agencies to some of the adverse effects of added DHA and ARA in infant formulas.”

[...]

While FDA officials had previously noted studies that reported diarrhea, flatulence, jaundice, and apnea in infants fed DHA/ARA-supplemented formula, they nevertheless did not block the use of the oils. That action gave the green light for infant formula manufacturers to add the oils to formula. Today, Martek boasts that 90% of formula in the U.S. contains its patented DHA- and ARA-containing oils.

---extract ends

NHS Direct describes apnea as follows : "Apnoea is when the airway collapses and is blocked completely, cutting off the flow of air."

The European Union has also cleared the way for LCPs to be added to formula. Its Scientific Committee found no benefit from doing so and did not make it a requirement, stating: "Having reviewed the available literature the Committee sees the evidence insufficient to set an obligatory minimum level of LCPUFA." It did suggest that there is no risk from the additives.

Evidence obtained from the US Food and Drug Administration and cited in the Cornucopia Institute report suggests, however, that there may be risks of illness and even death. It quotes an Food and Drug Administration response to a Martek application for its additives to be declared GRAS (Generally Recognised as Safe) available at:
http://www.fda.gov/Food/FoodIngredientsPackaging/GenerallyRecognizedasSafeGRAS/GRASListings/ucm154126.htm

---FDA response to Martek - extract

Some studies have reported unexpected deaths among infants who consumed formula supplemented with long-chain polyunsaturated fatty acids. These unexpected
deaths were attributed to Sudden Infant Death Syndrome (SIDS), sepsis or necrotizing enterocolitis. Also, some studies have reported adverse events and other morbidities including diarrhea, flatulence, jaundice, and apnea in infants fed long-chain polyunsaturated fatty acids.

---extract ends

The FDA also stated:

"In addition, CFSAN [Center for Food Safety and Applied Nutrition] noted that your notice had not accounted for the fact that the bioactive fatty acids ARA and DHA when consumed in mature human milk are part of a complex matrix that includes, for example, linoleic acid, alpha-linolenic acid, and other polyunsaturated fatty acids and that important physiologic considerations relative to the matrix are not accounted for by the simple addition of LCPUFAs to infant formula."

The documents obtained using the Freedom of Information Act application found 98 cases had been registered with the FDA by concerned parents. Some are quoted in the report. Here is an example:

---report extract

“My son cannot tolerate the infant formulae with the DHA/ARA additives. Similac Advance, Enfamil Lipil, Good Start with DHA/ARA—every time he has tried a DHA/ARA formula he gets extremely gassy, fussy and has terrible gas pains. He does do better on the Similac Advance, which has less DHA/ARA than the other products. I can’t find plain Similac in my local grocery store, as they only carry the DHA/ARA formulae.

Why did the FDA allow the formula companies to produce these formulae without long-term testing???”

---extract ends

LCPs are already in formula in many countries and provide Martek with exclusive contracts and growing revenues. See:
http://boycottnestle.blogspot.com/2007/09/misleading-mothers-profits.html

The Cornucopia Institute also questions the use of Martek's additives in organic formulas. While conceivably it may be possible to argue that algae and soil fungus from which the LCPs are now obtained are organic, the cocktail of other chemicals from the extraction process are another matter.

In the US: "The Cornucopia Institute is urging parents of infants who have reacted negatively to formula with DHA and ARA to report these adverse reactions to the FDA’s Safety Information and Adverse Event Reporting Program."

And it is calling for warnings to parents. From its press release:

---extract begins
Cornucopia and the National Alliance for Breastfeeding Advocacy also announced that they are calling for a warning label on all formula containing DHA/ARA. The groups are petitioning the FDA for a label alerting parents of the range of possible complications from DHA/ARA-supplemented formula.
“Although many infants seem to be able to tolerate these materials, regardless of their efficacy, we know that some children face serious and even life-threatening impacts,” said Vallaeys [the report author]. “At a minimum parents need to be informed of the risks so they can immediately pull children off these designer formulas if health complications occur.”
---extract ends

As part of Baby Milk Action's safer formula campaign we would like to receive reports from parents in the UK who may have concerns that their child has experienced diarrhoea, fussiness or breathing difficulties specifically when fed with a formula containing LCPs. Click here to contact us. This is to help track the problem. We cannot provide medical advice in these cases and health workers should be consulted.

Concerns can also be reported to the Food Standards Agency office for your country (England, Ireland, Scotland or Wales). Find contact details for the officer working on baby foods at:
http://www.food.gov.uk/aboutus/contactus/

Ireland's new guidance on reducing formula risks

Health authorities in Ireland yesterday issued guidance for parents on how to prepare powdered formula. The press release is available at:
http://www.vhi.ie/news/n280108a.jsp

An extract: "Dr Cliodhna Foley-Nolan, Director, Human Health and Nutrition at Safefood warned that powdered infant formula is not a sterile product and has the potential to cause illness if not prepared properly. In rare circumstances, powdered infant formula can contain the bacterium Enterobacter sakazakii (E.sakazakii) and other harmful bacteria. These bacteria can cause illness in infants. Babies under 2 months are most at risk. However, making up the formula using water that is above 70°C will kill E.sakazakii and any other bacteria like salmonella that may be present, said Dr Foley-Nolan."

Neither this warning nor the advice on how to reduce the risks of possible contamination is provided by baby food companies, though they have known of the problem since the 1960s. It came to widespread public attention following the death of a 5-day-old child in Belgium in 2002 linked to contaminated Nestlé formula.

The UK authorities updated their guidance to parents in 2005, put despite all formula companies issuing new labels since then, they have not included the warning or brought instructions into line. This can be found at:
http://www.food.gov.uk/news/newsarchive/2005/nov/infantformulastatementnov05

Calls by the Baby Feeding Law Group, consisting of UK health worker and mother support groups, to make it a legal requirement to bring labels into line were rejected in a consultation last year as the industry called for action to be kept to a minimum. Instead Guidance Notes 'recommend' that companies change their labels. Even this recommendation though has not come into force as the industry has succeeded in having the regulations suspended through an action at the High Court.

For those using formula, or planning to do so, the Irish guidance is as follows:

---
The 10-steps on making baby’s bottles safely are:

1. Boil water
2. Leave to cool for 30 minutes * but no longer* [emphasis added - water should be above 70 Deg. C - companies do not tell parents this].
3. Clean surfaces, wash hands
4. Read the instructions on the formula’s label carefully
5. Pour the boiled water into sterile bottle
6. Add formula using scoop provided
7. Shake well
8. Cool quickly
9. Check temperature is cool enough for baby
10. Throw away any unused feed after 2 hours.

---

You can support Baby Milk Action's campaign to make formula feeding safer at:
http://www.babymilkaction.org/action/saferformula.html

The need for a legal requirement that companies bring their labels into line was demonstrated by the Belgium case. The parents took Nestlé to court for negligence in not providing correct warnings and instructions. The Judge found for Nestlé on the basis it had done what was required by the law.

Brendan O'Neill attacks those calling for a regulated formula market

Brendan O'Neill, who describes himself as a journalist, has once again misrepresented what I have written and, once again, I have asked him to make a correction. Let us hope that, once again, he will do so.

This time his misrepresntation comes in a rant against 'militant lactavism' in an article published on The Guardian website.

You can find his article, "The Tyranny of Militant Lactavism", at:
http://commentisfree.guardian.co.uk/brendan_oneill/2008/01/the_tyranny_of_militant_lactiv.html

He criticises the call for controls on the marketing of the baby food industry, stating: "The implicit political message of the restrictions on infant formula is that Bottlefeeding is Bad, and the mums who do it ought to be ashamed of themselves."

As I posted in my first comment to the article:

---extract
You write: "The implicit political message of the restrictions on infant formula is that Bottlefeeding is Bad, and the mums who do it ought to be ashamed of themselves."

This is rubbish and you know it.

The Baby Feeding Law Group, a coalition of UK health worker professional bodies and mother support groups, submitted a report to the government consultation on the regulations.

It was called: "Protecting breastfeeding - Protecting babies fed on formula".

The campaign to bring UK regulations into line with international standards, as many other countries have done, is to protect all mothers and babies. The implicit political message is: "Companies should meet their obligations to comply by international standards and all parents have the right to make an informed choice, free from commercial pressure."

No-one should try to make a mother feel guilty over the way she feeds her child. Your attempt to present the issue in such a polarised way helps to incite the breastfeeding/bottle-feeding argument you criticise.

In you apoplexy over 'lactavists' and your apparent desire to present the companies as on the side of the angels, you neglect to mention the willful neglet the formula industry show to their customers - and here I am talking about those who choose to use formula, for whavever reason.

This has been brought to your attention before, but let me remind your readers. [Continues on the Guardian website].

----extract ends

But later I noticed that his article linked to this blog. That prompted me to post another comment:

---extract begins

Brendan, I have just noticed that you link to my blog as the reference for the word 'thoughtless' in your sentence:

"Today a moral divide is made between responsible and thoughtful women who breastfeed, and "unaware" or "thoughtless" women who bottlefeed."

The blog was about promotion for Wyeth/SMA formula in OK! magazine linked to the model Jordan/Katie Price. See:
http://boycottnestle.blogspot.com/2007/08/jordans-comments.html

You have been a little bit naughty citing that blog as evidence of your alleged 'moral divide' haven't you?

Let me put the comment on 'thoughtlessness' into context by quoting more from the blog than your half word:

"Some of the comments on the discussion boards are strongly critical of Katie, not for formula feeding or for holding these views, but for putting them forward in the article. For some she is a villain.

"It brings to mind a piece of wisdom that has served me well: don't automatically attribute to ill will what can also be explained by thoughtlessness."

So the suggestion of possible 'thoughtlessness' was explicitely not about formula feeding or favouring formula, but about how she spoke about this in a mass-circulation magazine.

This is what I wrote in that same blog:

"While it is Katie's decision how she feeds her child and no-one should set out to make a mother feel guilty, the comments will have an impact in idealizing and glamourising formula feeding. Materials dealing with infant feeding are required to include certain information by article 21 of the UK law. It is for the authorities to decide how culpable OK! is for not including this information.

"It may be a naive hope, but I do hope that Katie Price, Jordan, will react to the concern over the product promotion by supporting the campaign to hold baby food companies to account. As I state and re-state many times, our work aims to benefit mothers and babies who formula feed as well as those who breastfeed. Here is one thing we are looking for help with - providing accurate information on how to mix up formula safely. Katie is using ready-to-feed formula which is sterile, but very expensive. The majority of mothers will use powdered infant formula, which is not sterile...

"Hopefully we can persuade celebrities that there is no contradiction between a decision to formula feed and taking care over public comments and encouraging government action over aggressive marketing and support for breastfeeding."

So much for your 'moral divide', Brendan.

Clearly it supports your agenda - and that of the formula companies for whom you sometimes work (as referenced in other comments) - to misrepresent the position of others, just as you did with your spiked on-line article on the Joradn piece in OK! magazine. You kindly added a correction to your spiked article. I hope you will do so here and try to be a little more honest and accurate in future.

---

His earlier article on the OK! Magazine promotion was called: "Hands off Jordan's Breasts!". You can find it here:
http://www.spiked-online.com/index.php?/site/article/3705/

He attacks Baby Milk Action as 'militant lactavists' having a go at Jordan for bottle feeding. I contacted Mr. O'Neill to point out that my quote about the OK! Magazine article said:

"How Jordan feeds her child is her decision. No-one should try to make a mother feel guilty about how she feeds her child, our responsibility is to ensure all mothers receive accurate information on infant feeding and support if they have problems breastfeeding. My anger is directed at Wyeth which knows its campaign in OK! magazine promoting SMA formula breaches marketing requirements adopted by the World Health Assembly."

I asked for a correction and he posted a grudging addition to his footnote, not mentioning Baby Milk Action: "Some have criticised the formula milk companies rather than Katie Price herself; for example, see the Boycott Nestle blog."

Now I won't automatically attribute to malice what can be explained by lax fact checking, but I do note that Mr. O'Neill has a financial connection with the baby food industry. As someone posted on the latest article on The Guardian website:

---comment from BVGeesten

Q: "What do infant formula milk, cigarettes and alcohol have in common?"

A: The fact that all of the industries that make these products have historically poured money into phoney thinktanks and front groups to try to deflect criticism, and push the idea that any attempt to regulate their activities is "irrational" and "hysterical".

Brendan, why don't you tell us a bit more about the relationship between your online magazine, Spiked Online, and the "Infant and Dietetic Foods Association"?

On page 10 of your "Brand Manager's Pack" (http://www.spiked-online.com/pdf/BrandManagersPack.pdf) it says that you've "worked with" the INFORM campaign, which is apparently "an Infant and Dietetic Foods Association (IDFA) initiative on behalf of the UK infant formula manufacturers SMA Nutrition, Nutricia (Cow & Gate, Milupa) and Farley/Heinz." (http://www.idfa.org.uk/resources/public/InformManifesto.pdf)

Also quite striking is the fact that all 8 articles on breastfeeding on the Spiked website (http://www.spiked-online.com/index.php?/site/issues/C112/) seems to take exactly follow the industry line in attacking what you call "militant lactivism".

Sorry to bang on, but in your "Brand Manager's Pack" it also says that one of the services you offer to businesses is that you can help them with "brand alignment", or they can "commission a Spiked series". I'm curious - how much does it cost to "commission a Spiked series", and what would I get for my money?

In the name of robust, open debate, free speech etc., do you not agree that journalists with financial links to a particular industry ought to declare any such affiliations up front?

---comment ends

A good point.

IDFA, of course, is the industry body that has taken the UK government to the High Court and succeeded in having new formula marketing regulations suspended, so Mr. O'Neill's article comes at an opportune time for the industry.

Whether his financial connection with INFORM/IDFA continues or not, taking half a word from a blog to build a false argument is not good journalism.

Bans and banners

Well, this blog may provide a look behind the scenes of my work as Campaigns and Networking Coordinator at Baby Milk Action, but I'm afraid I will have to be a little quiet about the Judicial Review ordered by the High Court following the industry challenge on the UK Infant Formula and Follow-on Formula Regulations 2007. This is because the case is sub judice, meaning not yet decided by the court, and the court is to be respected. So the news will come at the time deemed by the court.

So instead here is news of an advertising banner:



Monitoring of the baby food companies continues so if you see any activities that you think could be a violations of the rules, then report it to the Baby Feeding Law Group monitoring project which we coordinate.

And you can add this banner to your website. Use the code we provide so it automatically links to the right page. You will find this at:
http://www.babyfeedinglawgroup.org.uk/monitoring/monitoringpromote.html

You'll see some changes with the BFLG website in the coming weeks and months as we seek to make it easier to report violations. For behind-the-scenes news of those, keep an eye on this blog.

Demise of the Nestlé Children's Book Prize - Guardian article

There is an opinion piece on The Guardian website by Julia Eccleshare about the demise of the Nestlé Children's Book Prize.

Here is an extract:

---extract begins
Arguments about the rights and wrongs of the decision taken some 23 years ago by Booktrust to accept from Nestlé will continue even though the prize itself will not. The long relationship, which has been both amicable and mutually beneficial, has finally ended. The move is apparently for good policy reasons, as well as from a sensible recognition that Nestlé's powdered baby milk programme in developing countries has always made it a questionable partner for anything to do with children.

And, it's not just baby milk. Food or drink companies and children do not sit well together, and sponsorships of all kinds have been dropped as a result. But while there's no doubt that this is, ethically, the right decision, it shouldn't be forgotten that the Nestlé Children's Book Prize has done much good over the past two decades - by celebrating the pleasure of reading and encouraging children to get involved in it.

---

You can read the full article at:
http://blogs.guardian.co.uk/books/2008/01/the_demise_of_the_nestle_prize.html

Here is the comment I have left:

---
Thank you for this article.

It is worth remembering that authors informed the Booktrust in 2003 that they did not want Nestle to sponsor a teenage book prize, as was being proposed at that time, because of its irresponsible baby food marketing activities.

The result? Booktrust found another sponsor.

In 2006, Nestlé pulled out of the Perrier Comedy Award at the Edinburgh Fringe Festival following protests and boycotts by artists and the establishment of an alternative, corporate-free prize (The Tapwater Awards).

The result? The organisers found another sponsor.

And in both cases Nestlé's baby food marketing practices were highlighted. More people came to the Baby Milk Action website to view the documentary evidence for themselves. There is a new global monitoring report available via the site now, which shows Nestlé continues systematic violations of the international standards adopted by the World Health Assembly, in those countries that don't have independent and enforced legislation in place. Find out more at:
http://www.babymilkaction.org/

The boycott helps to draw attention to this malpractice and force changes in Nestlé practices, though at present it is defending one of the practices that has caught media attention - that of branding babies in hospitals in China from birth with the Nestlé logo as used on infant formula packs on the wrist bands with the baby's details. See for yourself at:
http://boycottnestle.blogspot.com/2007/12/nestle-defends-branding-babies.html

So great that Nestlé malpractice is being raised as a result of authors speaking out and the end of its involvement in the prize.

Great too if the Booktrust does as it did in 2003 and finds a more appropriate sponsor.
---

Nestle children's book prize ends following protests by authors

The Nestlé Children's Book Prize in the UK has come to an end by mutual agreement between Nestlé and the Booktrust.

As you may recall, last month Gold Medal winner, Sean Taylor, publicly refused the Nestlé prize cheque, citing concerns over Nestlé's baby food marketing practices. Other authors have spoken out against Nestlé's involvement in past years.

See our press release at:
http://www.babymilkaction.org/press/press12dec07.html

Now the business website, Bookseller.com, is reporting that the Nestlé Children's Book Prize has come to an end after 23 years.

The report says Booktrust was reviewing its priorities.

The report also says: "Nestlé explained that it was increasingly moving its community support towards nutrition, health and wellness issues."

That would be schemes promoting unhealthy cereals in schools ('box tops for education') and trying to divert attention from its role in promoting junk food to children by sponsoring projects on obesity.

In 2006 Nestlé ended its sponsorship of the Perrier Award at the Edinburgh Fringe, also after more than 20 years and bad publicity from an artists boycott. Then too it neglected to mention this. An alternative sponsor was quickly found. See:
http://www.babymilkaction.org/press/press14june06.html

A few years ago the Booktrust bowed to protests from authors over proposed Nestlé sponsorship for a teenage book prize and found a different sponsor.

I have left the following comment at:
http://www.thebookseller.com/news/51924-nestl-childrens-prize-to-end.html

---
Curious that neither Nestle nor the Book Trust refer to the bad publicity having a sponsor which is one of the most boycotted companies on the planet for practices that endanger children. Nestlé's own Global Public Affairs Manager admits Nestlé is 'widely boycotted', targeted over its aggressive marketing of baby foods in breach of international standards.

Gold Medal Winner, Sean Taylor, refused the Nestlé cheque at the last award ceremony and made his concerns public. So well done to him and everyone else who has helped to raise awareness of Nestlé malpractice and show that the company is not an appropriate sponsor until it changes its baby food marketing practices and addresses other concerns.

Mike Brady,
Baby Milk Action
http://www.babymilkaction.org/

The UK government defends its 'proportionate' approach to avoid delays

Something that happenend last week while my blog was on a break, was a debate in Westminster Hall in the UK Parliament over the Infant Formula and Follow-on Formula Regulations 2007. These Regulations have been blocked by the baby food industry taking action at the High Court, as I wrote yesterday.

As the industry tries to weaken and delay measures that are already weak and long overdue, everyone else from the government's own expert advisors to the Baby Feeding Law Group and the Breastfeeding Manifesto Coalition are calling for stronger measures.

A founder member of the BMC, David Kidney MP, called a Parliamentary debate on 16 January. You can find the full text in Hansard here (scroll down the page or search for 'infant formula'):
http://www.publications.parliament.uk/pa/cm200708/cmhansrd/cm080116/halltext/80116h0004.htm

Here is an extract from Mr. Kidney's opening statement.

---Extract begins

There are good public health reasons why the activities of companies marketing breast-milk substitutes should be controlled, including the safety and health of new-born babies. Powdered formula is not sterile, so care needs to be taken over preparation in order to avoid contamination. Furthermore, the activities of companies should be controlled so as not to undermine efforts to promote breastfeeding.

The international standard for such control is the World Health Organisation’s international code on the marketing of breast-milk substitutes. The WHO is an organisation of member states, 118 of which, including the United Kingdom, voted to adopt the code as long ago as 1981; the United States of America was the only nation to vote against it. Ever since, we have been signed up to the WHO code and I dare say that Ministers have visited other countries and recommended it to them. However, our domestic law has not yet implemented the code and even though an opportunity to implement it has now arisen, the Minister has not proposed that we should do so.

I shall use the debate, therefore, to make representations to the Minister. It is not too late for us to be bolder and to implement fully the WHO code. We have a law to control the marketing activities of companies that make and sell infant formula, but it is widely recognised that it is not sufficiently effective. The debate comes at a time when the Minister is seeking to tighten that law to make it more effective. At present, I do not think that her proposal for changing the law takes us as far as it should, particularly towards full implementation of the WHO code. My purpose in this short debate is to urge her to go further.

---extract ends

After setting out the need for stronger Regulations, with a supportive intervention from long-time campaign supporter Annette Brooke MP, Mr. Kidney praised some of the government's efforts to promote breastfeeding and asked the Minister for Public Health, Dawn Primarolo MP, to respond. She said in part:

---Extract begins

My hon. Friend acknowledged that not all mothers choose to, or are able to, breastfeed, and that it is vital both that bottle-fed babies are protected and that mothers are in the best possible position to make informed decisions about feeding choices for their babies. The Government are developing an agenda on two fronts. Our central policy is to encourage, promote, protect and support breastfeeding mothers. We want to ensure that mothers who choose not to breastfeed or who cannot do so, receive the best advice so they can choose what is best for their babies without other people interfering in those decisions or causing confusion. For those reasons, we have placed stricter controls on the promotion, labelling and composition of infant and follow-on formula.

The main points made by my hon. Friend and the coalition concerned follow-on formula, and I concur entirely, because parents tell us that the available information is confusing. We recognise that advertisements for follow-on and infant formula may provide confusing advice about what is appropriate for infants and can be misinterpreted by parents. The hon. Member for Mid-Dorset and North Poole (Annette Brooke), who has been very active in this campaign, touched on that point. Let me make the position absolutely clear: the Government are determined to take tough action to stamp out those practices and to prevent marketing activity that directly or indirectly undermines breastfeeding. We are acting on evidence suggesting that consumers in the UK cannot clearly differentiate between infant and follow-on formula when purchasing those products.

As my hon. Friend pointed out, maternal and infant support groups have brought the issue to our attention. I have had many meetings with different organisations about press and TV adverts on follow-on formula which, they believe, undermine breastfeeding. In the guidance issued alongside the regulations, we have explicitly taken up every example that was put to us and said, “This is not acceptable, and action will be taken.” There have been complaints about the industry seeking to bypass restrictions on the direct advertising of infant formula by the way in which it labels infant and follow-on formula, and advertising follow-on formula in such a way that it is difficult to distinguish between the two. I absolutely agree. On that basis, following extensive consultation with stakeholders, I have agreed a package of measures that will strengthen controls in this area. The package is made up of effective, proportionate and evidence-based controls, and I am confident it will improve consumer protection and give us a robust system can withstand challenges, should they be made.

I gave a further commitment, after looking at everything that I received in representations about advertising, to provide guidance. That guidance is now operational, and it shows how the regulations should be interpreted. I have made a commitment, too, to provide an independently chaired review of the new controls after their first year of operation. As I made absolutely clear to the relevant organisations in our private meetings, the review will play an important role in policy making and in assessing whether the new controls worked as expected. It will assess whether people have found new ways of getting around the rules or whether they are simply not complying with the rules. If the new arrangements are found not to be working, because they have been circumvented or because new methods emerge, the Government will respond proportionately and take the next step of considering further legislative action. We have therefore put robust measures in place.

---extract ends

Actually the Guidance Notes are still out for consultation. We will be making our submission public in the next few days and tell you how you can support stronger measures.

In taking legal action against the Regulations at the High Court, I suspect that the industry's concern is not so much the weak Regulations, but that they may be strengthened through this year-long review process.

The longer it can put off that and any strengthening of the law to bring it into line with international standards, the longer it can fill its coffers. It is noteworthy that spending on promotion has increased markedly in the current period as companies try to get away with as much as they can before action is taken.

The Minister's strategy is to take a whole longer demonstrating the effectiveness or otherwise of the revised Regulations to justify any strengthening as 'proportionate' through the review.

Mr. Kidney asked the Minister about the remit for the review and whether it will be broad enough. The Minister began her reply:

---Extract begins
I can assure my hon. Friend that the review will be every bit as broad as I have suggested. I am sure that he will recognise, both from his parliamentary experience in Parliament and from the work that he did before he was elected, that Governments must always proceed in a proportionate way. Stepping outside that process can bring other complications that slow down progress.
---extract ends

Well, we certainly don't want progress in introducing the International Code, adopted 27 years ago in 1981, to slow down any further!

You can help by asking your Member of Parliament to sign Early Day Motion 608 calling for stronger measures. The government is under legal pressure from the industry. Let it know that it has support for taking required action to protect breastfeeding and to protect babies fed on formula.

You can send a message to your MP at:
http://www.theyworkforyou.com/

If you are inside or outside the UK you can send a message of support direct to the Minister using our form:
http://www.babymilkaction.org/CEM/cemnov07.html#letter

The blog is back and we're in court

This blog has a longer holiday than I do over the Christmas and New Year period. There has been a lot going on in the past few weeks and the updates will start coming here.

If you are glad to see this blog back in business, how about making a small donation by clicking the button on the right? Baby Milk Action relies on your support to keep going and staff are currently on reduced hours due to lack of income, so it would really help.

We are also involved in a legal battle with the baby food industry so need all the help we can get.

As you are probably only too well aware, we have been campaigning for the UK government to introduce marketing requirements for infant formula and follow-on formula in line with international standards, as many other countries have done. It has refused to do so, rejecting not only our recommendations (submitted as the Baby Feeding Law Group, a coalition of UK health professional bodies and mother support groups), but of its own advisors. The government basically followed the industry line of doing the minimum possible to strengthen a law that was already failing to protect mothers and babies.

Many marketing practices are illegal under the existing legislation, but this is virtually never enforced. The government is currently consulting on new Guidance Notes which are intended to resolve arguments over interpretation which tie the hands of Trading Standards officers and mean that the Advertising Standards Authority dismisses most complaints without even an investigation.

The good news was the government promised to keep the situation under review and introduce new regulations in a year's time if the industry did not clean up its act.

The reaction of the industry to this?

It has taken the government to the High Court and has succeeded in having the new regulations suspended. It argues that they came as a surprise and it was not consulted. For the government, the Food Standards Agency says it consulted over the course of three years. The legal challenge by the industry aims to stop the regulations from coming into force before 2010 and is perhaps intended to delay the review that could see the regulations strengthened further.

In the meantime the industry has stepped up its aggressive marketing practices, churning out as much idealizing gumph as it can before it is stopped from doing so.

The cynicism of the industry is demonstrated by this comment from Roger Clarke, director general of the IDFA (the Industry and Dietetic Food Association): "The industry carries out a very important role in terms of being able to give people advice on safe preparation or choice of product once they have made their decision."

This appeared in The Sunday Herald yesterday. See:

http://www.sundayherald.com/news/heraldnews/display.var.1979147.0.0.php

I left the following comment:

---
How cynical of Roger Clarke, representing the formula industry, to state: "The industry carries out a very important role in terms of being able to give people advice on safe preparation or choice of product once they have made their decision."

One of the labelling issues health campaigners want companies to address is their failure to provide warnings that powdered formula is not sterile and simple instructions on how to reduce the risks in line with government and international guidance to parents. The industry lobbied against this being a requirement in the law and succeeded in having it appear only as a recommendation in guidance notes.

A spot survey of company telephone 'carelines' found that advisors give incorrect information about reconstituting formula. Analysis of company websites has found information contradicting the advice of the Food Standards Agency and Chief Medical Officer on when to use soya formulas. Analysis of promotion shows all companies claim their formula is better than competitors, perhaps acceptable if we are talking about washing powder, but does nothing to help parents decide which formula to use if they are formula feeding for whatever reason, and undermines the independent advice available from health workers.
---

Baby Milk Action, on behalf of the Baby Feeding Law Group, is submitting evidence to the High Court.