Wednesday, February 20, 2008

House of Lords debate - trying to make formula feeding safer

There was a debate in the UK House of Lords on Monday about the Infant Formula and Follow-on Formula Regulations 2007. You can read the full text in Hansard here:
http://www.publications.parliament.uk/pa/ld200708/ldhansrd/text/80218-0012.htm

The debate was called by Baroness Finlay of Llandaff who challenged the Regulations for not going far enough and so not providing adequate protection for breastfeeding or for parents who use formula. On this latter point she said:

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Sadly, some mothers cannot breastfeed, but infant formula should be a fallback choice if breastfeeding is not right for them. Of course, such mothers must not feel stigmatised and safe formula products have been important for many women.

Those mothers need clear information on what is contained in formula products and how to prepare the formula safely. For example, current World Health Organisation guidelines recommend that the water used to mix the formula powder should be 70 degrees centigrade or higher to kill any bacteria and that the formula should then be allowed to cool. However, that information is not on labels, even though the WHO says that it is the single most effective step to reduce the risk of bacterial contamination and that contamination with Enterobacter sakazakii is found in some tins of formula, even before they are opened.

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Lord Avebury spoke in favour of implementing the International Code of Marketing of Breastmilk Substitutes and referred to information we had submitted to the Lord's' Merit Committee which scrutinises such legislation:

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The Merits Committee has drawn to our attention the evidence that it received from a powerful consortium of professional and lay organisations; that is, that these regulations should have banned the advertising of infant milk formula and follow-on formula and that the labelling should include, as the noble Baroness said, a minimum temperature for the water used for mixing. By failing to do so, according to the Baby Feeding Law Group, the regulations undermine the efforts being made by health professionals to see that mothers are provided with scientifically correct advice on the best feeding regime for infants. That point of view is supported by the Scientific Advisory Committee on Nutrition and the Local Authority Coordinators of Regulatory Services.

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Speaking for the Conservative Party, Baroness Hanham also referred to the need to provide better information to parents and carers who use formula, but advocated two years delay until 2010 before asking companies to bring their instructions into line with that introduced by the Food Standards Agency in 2005. She said in part:

---extract begins

The Merits of Statutory Instruments Committee draws attention to Baby Milk Action’s concerns that the question of labelling giving details of the minimum temperature of water used for mixing the formula does not seem to have been resolved either. It would seem logical that the manufacturers should be involved in discussions as to whether and why this is necessary now, before they have to introduce new labelling, rather than in 12 months’ time, or 12 months after the FSA’s independent review. That is another good reason for giving a proper transition time.

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This is the same old industry tactic of delay, delay, delay.

The problem of intrinsic contamination has been known about by the industry for decades. It came to public prominence with the death of a child in Belgium in 2001. The issue has been addressed several times at the World Health Assembly, where the industry lobbies against controls. Both the World Health Organisation and the Food Standards Agency have introduced guidance for parents after a great deal of investigation and thought.

But still Baroness Hanham questions whether it is necessary to inform parents that powdered formula is not sterile and how to reduce the risks, which, remember, can, and have, led to brain damage and death.

Don't forget the government has already bowed to industry pressure and instead off making it a legal requirement to provide this information is only 'recommending' that companies do so.

Cases of infants dying in the industrialised world due to this contamination are rare, though no-one yet knows how much of the greater sickness is due to the all-too-common contamination of infant formula with harmful bacteria. The steps to reduce the risks are simple, they just detract from the message of technological perfection the industry tries to impart with its messages claiming formula is the 'most advanced ever'.

When the parents in Belgium sued Nestlé for failing to warn them of a known risk, they lost on the basis that Nestlé's labels had complied with the law.

Is there a need to re-do the work of the World Health Organisation and Food Standards Agency? I think not. Let us hope that misinformed parents will not have cause to lament this strategy of delay.

The debate ended with Baroness Finlay accepting assurances from the government that the Regulations will be strengthened if they do not work. More on that tomorrow.

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