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.

That's it for 2007

There will be a break with the blog until early in the new year.

There has been a lot going on during 2007. Two highlights for me are the contrasting fortunes of mothers and babies in the Philippines and in the UK.

In the Philippines campaigners supported the Department of Health in facing down the power of the baby food companies and the US Chamber of Commerce. In October we welcomed significant new controls on the marketing of baby foods following a ruling of the Supreme Court, which lifted a restraining order on Department of Health regulations.

There is a report rounding up some of the actions taking place around the world in our Update 40 newsletter. You can download this at:
http://www.babymilkaction.org/update/update40.html

Meanwhile in the UK the government received unanimous support from health professional bodies, mother support groups and other health advocates for stronger measures here. The Baby Feeding Law Group report Protecting breastfeeding - Protecting babies fed on formula called for implementation of the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions, which the government claims to support and which many other countries have already introduced in legislation.

In the UK, however, the government has followed the industry line of introducing only minimal changes to the legislation. It has not even introduced the measures called for by its own advisors, the Scientific Advisory Committee on Nutrition and LACORS (the umbrella body for Trading Standards officers who will have to try to enforce the regulations).

It was a disappointing end to the year, particularly as 2007 began with us welcoming a crackdown by UK authorities on illegal health claims on labels. After 12 years of campaigning, since the 1995 regulations were introduced, our monitoring evidence had finally been heeded and companies were called on to change their labels.

Unfortunately there has been no visible follow through on the crackdown as new labels have been introduced that continue to use health claims not on the list permitted by the law. As a result the latest IBFAN (International Baby Food Action Network) report, Breaking the Rules, Stretching the Rules 2007, shows the UK in a very poor light, as an apparent test bed for new idealizing marketing strategies.

In 2008 we will continue to campaign for stronger regulations in the UK and no doubt will have to work to defend and encourage enforcement of the regulations in the Philippines and other countries.

The Breaking the Rules report shows that while companies develop their tactics, the strategy remains the same: undermining breastfeeding to increase sales of formula and misadvising parents who do use formula as companies do not want to be honest about the risks and how to reduce them lest they put people off their products.

Nestlé is shown to continue widespread and systematic violations of the marketing requirements using strategies that it is defending publicly, demonstrating continued pressure from the boycott is essential as it can cause the market leader to back down.

In a significant development, Nestlé's Global Public Affairs Manager admitted that Nestlé is 'widely boycotted'. Beforehand Nestlé's Chief Executive Officer, Peter Brabeck-Letmathé, had dismissed the findings of independent surveys to claim the boycott had little support. See:
http://www.babymilkaction.org/press/press6july07.html

Nestlé sets trends others follow. NUMICO is trying to compete with Nestlé, particularly in Asian markets, and we have seen an increase in violations from it, to the point where it is rivalling Nestlé. With the takeove of NUMICO by Danone, IBFAN will put a similar plan to it as that already put to Nestlé: accept the validity of the marketing requirements and bring policies and practices into line or face consumer action.

So we can expect 2008 to be as busy as 2007. Some things will have got better in some parts of the world. In some places things are worse. One thing is certain, without this campaign and your support many more babies would suffer needless suffering and even death than is currently the case.

Have a good break if you are getting one and see you next year!

More on Nestle prizes bringing concerns to wider attention

Last week I wrote about children's author Sean Taylor refusing Nestlé prize money after winning a Gold Medal in the Nestlé Children's Book Prize, which is voted for by children. This has been greeted with messages of thanks for the support from campaigners around the world. At the prize ceremony, Mr. Taylor spoke of his concerns, saying:

"When a Monster is Born is a book that has something to do with choices. Some of these choices seem to be life-giving and some of them seem to take life away. I hope that I have made a life-giving choice. I have decided to refuse this cheque and ask that it goes back where it came from."

See the report on the Bookseller website at:
http://www.thebookseller.com/news/49893-author-refuses-nestl-prize-cheque.html

Then yesterday was the presentation of an award for Mr. Brabeck-Letmathé, Chief Executive Officer of Nestlé. It was the 'Black Planet' Award for harmful practices from Ethecon, which I wrote about recently. See:
http://boycottnestle.blogspot.com/2007/10/nestle-chief-award.html

You can find out more on the Ethecon site in German at:
http://www.ethecon.org/ethecon.php?id=269

Please contact your Member of Parliament over the UK formula regulations

We issued a press release today as it was confirmed that the UK Advertising Standards Authority sees nothing wrong with Wyeth promoting its SMA formulas in a television advertisement containing zero scientific and factual information. The advertisement is a declaration of love from a father to his partner, including promises of continued support, including with night feeds. You can find the press release at:
http://www.babymilkaction.org/press/press19dec07.html

As I say in my quote, the ASA has demonstrated once again that the regulatory system here is not fit for purpose. While the ASA interprets the UK law to declare the advertisement legal, it is also supposed to be 'decent, honest and truthful', which to my mind means it should comply with the World Health Assembly marketing requirements companies claim to support and are called on to abide by independently of government action. The ASA has told me they will only consider these measures if they are introduced in UK law. Despite a broad coalition of health advocates calling for that to be done, the government has refused.

This has prompted the following Early Day Motion from Lynne Jones MP, a long-time campaigner for the rights of mothers to accurate and independent information on infant feeding:

---EDM 608
That this House notes the Government's responsibility to implement the International Code of Marketing of Breastmilk Substitutes and subsequent relevant Resolutions of the World Health Assembly (WHA) through national measures to protect breastfeeding and to ensure the safe use of breastmilk substitutes if these are necessary; regrets its failure to act on the advice of its own Scientific Committee on Nutrition, LACORS, the health professional bodies, and health advocates making up the Baby Feeding Law Group, through the proposed Infant Formula and Follow-on Formula Regulations, by failing to prohibit promotion of follow-on formula, health and nutrition claims and companies targeting parents or to require improved warnings and instructions to reduce risk of formula use; and urges the Government to bring the regulations into line with the International Code and WHA resolutions which call for such prohibition.
---text ends

Please do contact your MP asking him or her to sign the EDM or thanking them for doing so if they have already. You can check at:
http://edmi.parliament.uk/EDMi/EDMDetails.aspx?EDMID=34759&SESSION=891

A quick and easy way to contact your MP is through the website:
http://www.theyworkforyou.com/

I have sent a message saying: "I am contacting you to ask you to sign EDM 608. I am greatly concerned that the government is refusing to act on the recommendations of its own advisors, health worker professional bodies and other health advocates in revising the Infant Formula and Follow-on Formula Regulations. I believe that breastfeeding needs to be protected from aggressive marketing and that parents who use formula have a right to accurate and objective information on the differences between products and how to reduce risks of use. The government appears to disagree and, as requested by the baby food industry, is refusing to implement international marketing standards that have been introduced in many other countries."

Parliament is on holiday for Christmas, but MPs can sign as soon as they get back. Time is short as the Minister for Public Health has already signed the regulations and they will come into force at the end of January unless Parliament takes action.

You can send a message to the Ministers for Health via our page:
http://www.babymilkaction.org/CEM/cemnov07.html

Political leadership: where to find it

Here is a Christmas message from the nation's leader: "You - who are involved in infant and young child feeding are securing our country’s future, for tomorrow belongs to today's child. And you cannot give the nation a better christmas gift than what you are giving now."

This was not from Gordon Brown, the UK Prime Minister, thanking everyone who has sent messages of support for implementing the World Health Assembly baby food marketing requirements in the UK. Alas, we have yet to see such leadership in the UK.

The message came from President Gloria Macapagal Arroyo of the Philippines.

She was speaking at a meeting of almost 300 Chiefs and Hospital Directors who had gathered to express their support to the Infant and Young Child Feeding Program of the Government.

In the UK, by contrast, health advocates from the government's own Scientific Advisory Committee on Nutrition, LACORS (the umbrella body for Trading Standards officers), Royal Colleges and members of the Baby Feeding Law Group have called on the UK government to improve the weak Infant Formula and Follow-on Formula Regulations. Yesterday Lynne Jones MP tabled Early Day Motion 608 calling for the government to re-think its approach to the regulations (more on that tomorrow). Glenys Kinnock MEP wrote to Gordon Brown months ago calling for him to show leadership. See:
http://boycottnestle.blogspot.com/2007/12/try-again.html

While the UK government follows the industry line of minimal controls, the Department of Health in the Philippines fought the baby food industry in the Supreme Court, an action that gained world-wide support and galvanized backing from the highest levels of government.

Addressing the meeting on 17 December, President Arroyo said, in part:

---extract begins
The promotion of breastfeeding for children up to two years old, with emphasis on exclusive breastfeeding for the infant's first six months, is our fundamental approach to reduce if not eliminate hunger among infants and the very young children.

There is no substitute for mother’s milk, as most Filipinos know, but this knowledge has not been translated into practice. Our data indicate that more and more mothers are weaning their infants from breastmilk after only one month. A mere 16% of infants remain exclusively breastfed at 4-5 months, and very few are nourished by mothers’ milk up to 2 years old. We must act, and act fast to ensure that the nation builders of the future are provided proper nourishment.

One immediate concern which is why we’re having this is to involve all 1,426 accredited mother-baby friendly hospitals to fully implement the rooming in and breastfeeding act, the milk code and other laws on providing proper nourishment for infants. We need the strong will to make hospitals uphold our laws and work even harder to encourage other hospitals to join in our campaign.

The Supreme Court’s decision upholding all but three provisions of the milk code encourages us to be more creative in advocating breastfeeding as the best way to nourish our young.
---extract ends

The Philippines government is not only take action to protect breastfeeding. Important provisions upheld by the Supreme Court require companies to warn on labels that powdered formula is not sterile and the simple measures to reduce the risks of possible contamination with harmful bacteria. In the UK companies are failing to give this information despite the Food Standards Agency issuing its guidance to parents over 2 years ago. While companies have introduced new labels since then, they haven't brought their warnings and instructions into line and continue to misadvise parents on the telephone 'carelines'. Instead of including a requirements in the regulations to improve information for those who use formula, as health advocates were calling for, the UK government has instead advocated a voluntary agreement with the industry.

Seeing the significant gains to protect breastfeeding and to protect babies fed on formula in the Philippines should encourage us all to continue campaigning in support of governments around the world as they seek to implement and defend the minimum standards first introduced by the World Health Assembly in 1981.

But how depressing it is that my government in the UK is so lacking in political leadership on this issue.

ASA ruling on Wyeth's SMA television advertisement

This week we are anticipating the ruling of the UK Advertising Standards Authority (ASA) on the Wyeth/SMA television advertisement promoting its formula brand name and website. If past experience is anything to go by, the advertising industry's self-regulatory body will take a pro-industry line in breach of its mandate, once again exposing the government’s failure to properly regulate the marketing of breastmilk substitutes.

I have a quote ready for when the ASA ruling comes out if action is not taken to censure Wyeth.

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

“If the ASA really believes that parents should be basing their decisions on how to feed a child during the most important phase of its development outside the womb on the heart-tugging, greeting-card sentiments of Wyeth's SMA advertisement then they have seriously failed in their responsibility to protect the public. We will consider taking the case to the ASA ombudsman or to judicial review. This is not an argument over soap powder or chocolate bars, it is about life-long issues of health. The ASA has already demonstrated the regulatory system for breastmilk substitutes in the UK is not fit for purpose and proposed changes to the law expected this week are unlikely to make much difference as the government has so far ignored the recommendations of its own advisors, health worker bodies and other health experts and is following the industry line.”

You can view the advertisement via my blog entry at:
http://boycottnestle.blogspot.com/2007/09/wyeth-sma-uk-tv.html

Our experience with the ASA is instead of examining such advertisements with the test of whether they are ‘legal, decent, honest and truthful’ it applies a narrow test of legality based on its own interpretation of the law.

If it did conduct a proper test it would evaluate advertisements against the International Code of Marketing of Breastmilk Substitutes, adopted by the World Health Assembly in 1981 and subsequent, relevant Resolutions. Companies are called on to abide by the provisions independently of government measures and all make public statements of support for the Code. So you would expect ‘decent, honest and truthful’ advertising to comply. Unfortunately the ASA does not see it that way and in protracted correspondence with me has basically told me to go away and change the UK law if I don’t like its position. Well, I have been with those trying.

The Code prohibits the advertising of breastmilk substitutes and bans companies from seeking direct or indirect contact with pregnant women and mothers of infants and young children. Companies are limited to providing scientific and factual information to health workers, who are given responsibility for providing information on infant feeding.

The advertisement is a clear violation. It promotes a breastmilk substitute (SMA Progress), it promotes a brand name used for the full range of products (including infant formula - and research commissioned by the National Childbirth Trust demonstrates that much of the general public associates the logo with infant formula or milks for young babies), it directs people to a website that promotes the full range of products and it encourages parents to trust the company for information on infant nutrition.

The ASA should have slapped a ban on it as soon as it appeared and invoked its powers to require Wyeth/SMA to submit advertising for pre-authorisation as similar breaches by the company are common place.

On past experience, however, the ASA takes the view that as in the UK only infant formula advertising is illegal, that is all it will consider. Follow-on formula advertising is permitted by the current UK law - and will be permitted by a proposed revised version of the law we are expecting to be presented to Parliament any day. The ASA dismisses the argument that such advertisements are de facto infant formula advertisements, and so illegal, if at some point there is a reference, however fleeting, to follow-on formula. I fear it will take the same line with this advertisement.

But the advertisement is even worse in some respects than others we have seen. It contains no information about the product, idealising or otherwise. It is an emotional declaration of love from a man for his partner, promising to love her through all she has to experience with bringing up their child, including the smell of baby sick, and undertaking to help with night feeds. It is solely aimed to invoke an emotional response to the SMA brand, a poor basis for making a decision on infant nutrition. You can read an interesting analysis of the psychology of the approach at:
http://morgangallagher.livejournal.com/124770.html

However, other information from the company is no better for making an informed decision on infant feeding. If you go to the SMA website as the advertisment encourages you to do there are offers of a free DVD and entreaties to call the telephone 'careline' and join the SMA baby club. There is advertising for infant formula – illegal under the UK law, though this has yet to be enforced. And the advice on the site is misleading. For example, I have analysed previously how the SMA information on soya formula contradicts that of the Food Standards Agency and Chief Medical Officer. Wyeth is abusing the right of parents who use formula to accurate and objective information.
http://boycottnestle.blogspot.com/2007/08/wyeth-sma-soya.html

If you call the telephone careline, you find that the company does not admit that powdered formula is not sterile and may contain intrinsic contamination with harmful bacteria. When I conducted a spot check, the information was there was only a risk of contamination after the formula is opened. Parents have a right to know the true situation to better understand why the steps needed to reduce risks are important.

The company has issued labels with health claims that are not on the permitted list of claims, suggesting it has 'new improved protein balance' and is 'easily digested'. For more on the label see:
http://boycottnestle.blogspot.com/2007/04/lesson-from-wyeth-two-steps-forward-one.html

Wyeth/SMA is not a trustworthy source of information on infant nutrition. Indeed, it already has a criminal conviction for a ‘cynical and delibrate breach of the regulations’. See:
http://www.babymilkaction.org/press/press31july03.html

As I mentioned, the ASA has said if we want it to judge advertisement against the World Health Assembly marketing code, which companies are called on to abide by independently of any other measures under Article 11.3 of the Code, then we have to change the UK law. Well, the government has just consulted on the law. UK health worker organisations and mother support groups in the Baby Feeding Law Group made a submission called: “Protecting breastfeeding – Protecting babies fed on formula” calling for the Code and Resolutions to be implemented in the UK. This was endorsed by the broader Breastfeeding Manifesto Coalition. The government’s own Scientific Advisory Committee on Nutrition and LACORS (the umbrella body for Trading Standards officers, responsible for enforcing the law) called for stronger measures too, including a ban on advertising of follow-on milks.

The government has rejected these recommendations and is shortly to put its proposed regulations before Parliament. The Royal Colleges have written to the Minister for Public Health calling for a re-think and recommending that companies should not be allowed to target parents. They argue that the independent and accurate information that is available and their members are responsible for providing to parents should not be contradicted and undermined by the companies.

Unfortunately executives at Wyeth/SMA may well end up rubbing their hands with glee. They will most likely be able to carry on churning out this guff if the ASA betrays parents and babies as it has done in the past.

Proposed UK law: please try again

If you sent a message to the UK Secretary of State for Health and Minister for Public Health recently calling for it to strengthen formula marketing regulations in line with international standards, then you may have received a reply. Though not from the Ministers, but civil servants at the Food Standards Agency. Getting a response from Ministers is a little more difficult. Even if you have sent a message already, please send another now as the response from the Food Standards Agency is just not good enough. You can do so easily at:
http://www.babymilkaction.org/CEM/cemnov07.html#letter

We need to re-enforce the message we are sending to the decision makers to persuade them to look more closely at this issue and take action. When Alan Johnson MP, the Secretary of State for Health, was asked in a live webchat last week why the regulations resulting from the consultation do not implement the World Health Assembly market requirements and specifically why the government is not proposing to take action protect parents who use formula, he did not answer the question. See:
http://boycottnestle.blogspot.com/2007/12/minister-wrong-answer.html

I wrote yesterday that it seems an unwarranted fear of the government that the European Commission is an obstacle to action. Yet other countries both within and outside Europe are prepared to face a legal challenge should it be necessary to protect their citizens' rights - and have won. See:
http://boycottnestle.blogspot.com/2007/12/fear-of-commission.html

Glenys Kinnock MEP, a veteran campaigner for mothers and babies, wrote to Gordon Brown encouraging him to give a lead and sharing her detailed understanding of the European Union. She said:

---extract begins
The implementation of this legislation into UK law marks an excellent opportunity to go further than the minimum standards set out in the Directive 2006/141/EC, which, despite UK efforts to strengthen it, is still widely regarded as not going far enough. There is huge potential to use this opportunity to strengthen UK policy on this issue and to bring it in line with the International Code of Marketing of Breastmilk Substitutes. However, any decision to go further than the directive would require your intervention and support.

As you know, EU Directives are binding as to the result to be achieved by the Member States to which they are directed, however it remains up to the national authorities to decide upon the means and form of implementation used in order to realise the Community objective set out in the directive. Inherently, therefore, there is scope for discretion left to Member States and there exist a range of options for implementation of Directives. I hope that you will agree therefore that the implementation of the legislation is not required to mirror exactly the original wording of the directive.
---extract ends

However, following the 12-week consultation which saw unaminous support amongst health advocates for stronger measures, including from the government's own advisors, the response to the consultation suggest no change from the original weak proposals. There is a promise to issue 'guidance notes' to address some of the concerns, but without force of law these may be shown the same contempt as the International Code, which companies are also called on to abide by independently of legislation.

The letter you may have received from the Food Standards Agency tries to put a brave face on the weak proposals, talking up the changes since the 1995 version of the regulations. Specifically the FSA states :

---extract begins
These new provisions will offer increased consumer protection compared to the previous Regulations as they:

• update compositional requirements, in line with the most recent advice from pan-European independent scientific experts;

• update labelling rules clarifying that follow-on formula should only be used by infants from six months of age (the current Regulations specify that follow-on formula can be used from four months);
  

• clarify that only a small number of specific health and nutrition claims can be used on infant formulae;
  

• lay down a new national notification requirement for infant formulae which will allow EC countries to monitor the marketing of new infant formulae more effectively (no such provision exists in the current legislation);

• prohibit the advertising of infant formula directly to the public;

---extract ends

It was because of the pressing need to introduce the improved compositional requirements, which we worked for, that the Directive was signed off by Member States without a further battle by concerned Member States for improving other aspects of it. But the Directive does not prevent governments from taking further action to protect health, in line with the International Code, specifically referenced by the Directive.

The recommendations of the Baby Feeding Law Group, the coalition of UK health worker and mother support groups, are contained in the report 'Protecting breastfeeding - Protecting babies fed on formula' available at:
http://www.babymilkaction.org/shop/publications01.html#bflgsubmission

Significant differences between the minimal action proposed by the government and the recommendations of the BFLG, endorsed by the Breastfeeding Manifesto Coalition, a broader grouping still include the following.

The government limits the regulations on marketing and health claims to infant formula, instead of applying them to all breastmilk substitutes, which includes follow-on formula.

The proposals do not require companies to warn parents that powdered formula is not sterile and the simple steps to reduce the risks from possible contamination with harmful bacteria.

There is no prohibition on companies targeting parents directly or promoting websites and company telephone 'carelines', used to promote products which cannot be advertised more conventionally. We have conducted spot monitoring which shows these idealize products and misadvise parents on preparation.

There is no requirement for new ingredients to be approved before being added to formula - companies only have to submit a label in the case of infant formula and there are no controls on follow-on formula.

See the full list of BFLG recommendations in the submission or on the Baby Feeding Law Group website.

The draft regulations are to go to Parliament, apparently unchanged following the consultation, very soon. You can send a last message to the Ministers asking them to reconsider before doing so. Please do send this message even if you sent a message before. Indeed, if you did send a message before you can add a note saying you find the response disappointing or unacceptable. See:
http://www.babymilkaction.org/CEM/cemnov07.html#letter

Do not fear the European Commission

Bear with me, this blog is on an issue of critical importance, though for some very tedious. This information could determine whether the UK continues to be highlighted as particularly lax in regulating the baby food industry, or takes the action its own advisers and a broad coalition of health worker and mother support groups are calling for.

Only the baby food industry is opposing stronger Infant Formula and Follow-on Formula Regulations. But it is getting its way? It is not for economic reasons. The UK economy stands to save far more money by protecting babies and parents from aggressive marketing than it gains in tax on sales of formula.

It is not because of 'freedom of choice', because the regulations health advocates want do not ban the sale of formula. On the contrary they aim to ensure that parents who use formula receive accurate independent information about the different types on the market and clear instructions on how to prepare it. The promotional materials from the companies do not provide this.

What it seems to come down to is the government is scared of the European Commission. While the Department of Health in the Philippines battled for a year in the Supreme Court to successfully defend its regulations from industry attack, I have the impression the UK government is worried it may have its knuckles rapped for going further than the Commission wants it to go. And remember the European Union is a trading block so has an in-built bias to increase sales of products such as formula.

UK health worker bodies and mother support groups, along with development agencies such as Save the Children and UNICEF and trade unions such as UNISON and UNITE are together in saying the government will have their support if it implements the World Health Assembly marketing requirements, as many other countries have done. Countries such as Italy have drafted proposals bringing in some of the measures the UK fears will put it in the Commission's bad books.

But, at present, there is a lack of political leadership in the UK. So let us take a closer look to see if the apparent fear is justified.

It comes down to whether the EU Directive that Members States have to implement is a minimum standard or a maximum standard. Do Member States have to do everything in the Directive and no more - a process called total harmonisation - or do they have flexibility to do what they feel is best as long as it fulfils the aim of the Directive and puts in place a common framework, where relevant - so-called partial harmonisation.

The official line from the Commission is that some things are set. For example, there are minimum composition standards for formula. This is a good thing - we campaigned to make them as good as possible. At the same time the Commission wanted to allow optional ingredients to be added such as probiotics, which companies are clamouring to be able to make health claims about as a marketing tool, while many Member States were more cautious and want to see a scientific case made first and any beneficial and safe ingredients to be included in all formulas. As the UK Government's Scientific Advisory Committee (SACN) on Nutrition said in its submission to the consultation:

---extract begins
We find the case for labelling infant formula or follow on formula with health or nutrition claims entirely unsupportable. If an ingredient is unequivocally beneficial as demonstrated by independent review of scientific data it would be unethical to withhold it for commercial reasons. Rather it should be made a required ingredient of infant formula in order to reduce existing risks associated with artificial feeding. To do otherwise is not in the best interests of children, and fails to recognise the crucial distinction between these products and other foods.
---extract ends

While the government has rejected the advice of SACN, the fact that Member States can choose whether to allow optional ingredients shows it is partial harmonisation.

The Commission says at the end of the day it would come down to a ruling by the European Court of Justice, should there be a challenge to a government line. Is a challenge likely? I don't think so, and if it arose then I would like to see our government stand up for the rights of its citizens as the government of the Philippines did this year.

Other countries within Europe are also standing up to the Commission in other areas. For example, the German Government recently achieved a significant victory at the European Court of Justice over regulations for foreign agencies posting workers to work in Germany. The German authorities wanted contracts and certain other documents regarding the pay and conditions of the workers to be available in the German language in Germany. The Commission challenged this as an infringement of Directive 96/71/EC, arguing that co-operation between Member States meant such measures were superfluous. The Court dismissed most of the Commission's challenge in July, in what John Monks, General Secretary of the European Trade Union Confederation, heralded as a common-sense ruling for effective monitoring and worker protection. See:
http://www.europeanvoice.com/archive/article.asp?id=29443

Another case cited by John Monks as a common-sense ruling by the Court relates to compulsory retirement agreements in Spain. A challenge came to the court suggesting this was age discrimination. The Court ruled that though age was undoubtedly an issue, workplace agreements for compulsory retirement at the age set by national legislation when retirement benefits became available were permissible. It concluded that Directives on age discrimination were not being infringed stating:

---extract begins
It is, therefore, for the competent authorities of the Member States to find the right balance between the different interests involved. However, it is important to ensure that the national measures laid down in that context do not go beyond what is appropriate and necessary to achieve the aim pursued by the Member State concerned.
---extract ends

This is a key judgement and should reassure UK politicians if they feel held back by the risk of an appearance at the European Court of Justice. Implementing internationally-agreed measures for the marketing of breastmilk substitutes, as has been done in many other countries, cannot be portrayed as 'unbalanced'. It is proportionate to the need to protect infant health and mothers' rights. Everyone from the World Health Assembly and the UN Committee on the Rights of the Child to the government's own advisers, enforcement authorities and health advocates are calling for such action.

The aim of implementing the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions of the World Health Assembly is entirely consistent with the of the Directive itself and so cannot be deemed to go beyond it. The Directive states:

---Directive 2006/141/EC extract
(27) In an effort to provide better protection for the health of infants, the rules of composition, labelling and advertising laid down in this Directive should be in conformity with the principles and the aims of the International Code of Marketing of Breast-milk Substitutes adopted by the 34th World Health Assembly, bearing in mind the particular legal and factual situations existing in the Community.

(28) Given the important role which information on infant feeding plays in choosing, by pregnant women and mothers of infants, the type of nourishment provided to their children, it is necessary for Member States to take appropriate measures in order that this information ensures an adequate use of the products in question and is not counter to the promotion of breast feeding.

---extract ends

So in the unlikely event of a challenge, the government has a very strong case for defending implementing the Code and Resolutions. It has the support of all relevant organisations in the UK, except the baby food industry. And the European Court of Justice has shown it does not bow to demands from the Commission, but can take a common-sense approach.

Why then does the government not act? Exactly. There is no good reason, so let us see if can persuade them before it is too late.

There is still time. You can send a message to the Ministers responsible using the simple form you will find at:
http://www.babymilkaction.org/CEM/cemnov07.html

The message has been updated to reflect the lack of response of the government to the consultation, so please do send this message, even if you have sent one before.

Sean Taylor, award winning author, refuses Nestle money

Nestlé Children's Book Prize winner refuses Nestlé money - Sean Taylor rejects cheque.

That's the headline of a press release we have issued today. Sean Taylor received a Gold Medal for his book 'When a Monster is Born' illustrated by Nick Sharratt (Orchard Books). Concerned about Nestlé marketing of baby foods, Mr. Taylor refused the prize money from the award sponsor. See:
http://www.babymilkaction.org/press/press12dec07.html

Mr. Taylor's public letter is given below in its entirety:

---Quote begins
Being on the short list for the 2007 Nestlé Children’s book Prize is a significant honour for me, especially since so many children around the country have been involved in choosing the winning books. And I am delighted to accept the award offered to me.

However, because of questions surrounding Nestlé’s marketing of breast-milk substitutes, I do not feel able to accept the prize money.

This has not been a decision I have taken lightly. It has involved conversations with Baby Milk Action (a campaign group against Nestlé), Nestlé themselves, and an authoritative third party with experience in the field (who wishes to remain nameless).

In the light of these conversations, it is apparent to me that many of Nestlé’s controversial activities took place in the past and that the company has taken steps to improve its practice.

Nevertheless, it is my view that their interpretation of the International Code of Marketing of Breast-milk Substitutes sets up the risk that profit is put before infant health. And, in addition, it seems that the actions of some of their employees on the ground are inconsistent with company policy as set out in the Head Office.

For these reasons I do not feel that Nestlé are the most appropriate sponsors for this major children’s book prize.
---quote ends

When I spoke with Mr. Taylor, the most recent global monitoring report was Breaking the Rules, Stretching the Rules 2004.

Since then the latest report was launched earlier this month. This shows continued systematic and widespread violations by Nestlé. While tactics have changed - thanks to the boycott closing down practices such as promoting complementary foods from too early an age in many countries - the strategy of undermining breastfeeding to increase formula sales continues. See:
Breaking the Rules, Stretching the Rules 2007.

Not only do violations continue, these are defended at the highest level of the company. Just yesterday Nestlé defended branding babies from birth in China. See:
http://boycottnestle.blogspot.com/2007/12/nestle-defends-branding-babies.html

Earlier in the year I wrote about Nestlé's attempt to justify targeting mothers in Bangladesh with promotional fliers. See:
http://boycottnestle.blogspot.com/2007/05/nestl-responds-to-investigation-in.html

As I say in our press release, Nestlé will once again appreciate that opening its cheque book will not buy it a good image. It has to stop breaking the rules.

Nestle defends branding babies

I wrote last week of the new global baby food marketing monitoring report from the International Baby Food Action Network (IBFAN). The UK looks particularly bad in it, thanks to the failure of our government to introduce the World Health Assembly marketing requirements introduced by many other countries.

Nestlé also comes out very badly as its claim to abide by the requirements is shown to be false.

One practice highlighted in the report, which I included on this blog, was its branding of babies in China. Here's a pic:

This has been picked up and reported on a trade website, where the practice has been defended by Nestlé. See:
http://www.nutraingredients.com/news/ng.asp?n=81843-nestle-heinz-who-bma-infant-nutrition

Here is an extract:

---Quote begins
But Nestle this morning hit back at those claims and said that under the WHO code they were allowed to donate equipment and materials to healthcare systems "with a company's name and logo - but not with a formula product name or brand."

A spokesperson told NutraIngredients.com that the: "are provided as a service to the hospitals with their approval, and is completely permitted."

He added that Nestle "firmly believes that breast-feeding is the best way to feed a baby and we are strongly committed to the protection and promotion of breast-feeding."
---quote ends

Before getting into the provisions of the marketing requirements, let's just take the above at face value.

Nestle is suggesting that putting its name and logo onto newborn babies has nothing to do with it wanting to promote its products - and the only product relevant to a new-born child being infant formula.

Really? Then why on earth does it want them there? Why, now that it has been criticised, is its response to defend the practice, rather than to remove it?

For the simple reason it is part of a marketing strategy and one which it want to carry on investing in.

There are various provisions of the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions of the World Health Assembly that are relevant.

Article 6.8 states: "Equipment and materials... donated to a health care system may bear a companys name or logo, but should not refer to any proprietary product within the scope of this Code."

This is the article to which Nestle is referring.

However, try this experiment. Take a look at Nestlé products on the shelves. You will not see the Nestlé logo and name which appears on the wrist bands in China on the front of the products - with one exception. It is on the infant formula. Other products sometimes have the Nestlé name on them, but the logo is hidden away, so much so that most people don't notice it. That is even the case with the milks for older children. It is only on the formula that it features prominently, as on the wrist band. Take a look and let me know if I am wrong.

Nestlé is developing the logo even further to associate it even more closely with infant formula. Here is an example of a Nestlé poster, shown in the IBFAN report, ostensibly for breastfeeding:

As with the wrist band, this features the Nestlé name and logo prominently.

Now look to the formula. The Nestlé name and logo have grown substantially in recent years.

Indeed the more realistic rending of the bird and nest logo used on the poster is specific to formula packaging - so clearly within the scope of Article 6.8. Here is an example from the Breaking the Rules report showing a label:

The formula bird and nest logo is as on the poster in China, and dominates the label as much as the formula brand. Above it is the conventional logo, as on no other product.

Here they both are again on formula in the Philippines, exposed in our campaign here and in the Breaking the Rules report:

The logo - and the Nestlé name - will be associated with the formula.

As the report notes, some countries, such as Tanzania have prohibited the large bird and nest logo, seeing it as an attempt to get around restrictions on idealizing images - the reason why Nestlé introduced it.

There is also the issue of conflicts of interest. Nestlé claims that in China the donation had approval. Yet, Article 11.3 of the Code says companies are responsible for complying independently of government measures.

Resolutions 58.32 calls for care : "to ensure that financial support and other incentives for programmes and health professionals working in infant and young-child health do not create conflicts of interest."

Nestlé claims to back breastfeeding. Indeed in the advertisement pictured above, the small print also says : “At Nestlé, we believe breastfeeding is the best for babies”.

The large print is a little different. The advertisement is from a Spanish magazine in the United States. It states: "“Entrust the nutrition of your baby to Nan. For over 40 years Nan infant formula has been the number 1 brand for Latin American families”. A slogan beneath a packshot of Nan says “Helping them to grow from generation to generation”.

Article 5.1 states: "There should be no advertising or other form of promotion to the general public of products within the scope of this Code."

So such advertising is a clear breach of the the marketing requirements. Though Nestlé may choose to disagree.

Find many more examples in the Breaking the Rules report at:
http://www.ibfan.org/site2005/Pages/article.php?art_id=510&iui=1

Breastfeeding Manifesto tops

Baby Milk Action took pre-orders for these tops on behalf of the Breastfeeding Manifesto Coalition - we are a member.

These have now all been despatched by the Breastfeeding Manifesto Coalition. If you ordered through Baby Milk Action and haven't received yours, then contact the Coalition direct on: 0208 8305576.

You can now order through a dedicated B*Glam website: click here.

Politicians listening in Gambia

While health workers and campaigners in the UK are trying to get the Secretary for State for Health to take notice of recommendations for protecting breastfeeding and protecting babies on formula, news from The Gambia suggests our colleagues are treated very differently.

Yesterday I reported how the Minister responsible for the Infant Formula and Follow-on Formula Regulations in the UK, Alan Johnson MP, had totally missed the point in a webchat when he was questioned on why the proposed revision to the regulations do not bring them into line with international standards adopted by the World Health Assmbly and introduced in many other countries. Mr Johnson said there had been a consultation on strengthening the regulations and these would be presented to Parliament shortly. It is these very bad proposals he was being asked about. Even his own advisors have recommended stronger action.

So to the Gambia where I have just seen a news report about the National Nutrition Agency working with our partners in the International Baby Food Action Network (IBFAN) to brief parliamentarians on the importance of the marketing requirements and programmes to support parents. In The Gambia exclusive breastfeeding rates have increased markedly between 1990 and 2007 according to the permanent secretary of the Vice-President's office. See:
http://www.thepoint.gm/National%20Stories1492.htm

Let us hope the UK will learn from the practices and experiences of The Gambia in this area.

Minister doesn't listen to the question and gives wrong answers

As I wrote earlier in the week the UK Secretary of State for Health invited people to put questions to him in a live webchat, which took place today.

Great in theory, but a disappointment in practice. There were two really good questions about the government's proposed revision to the Infant Formula and Follow-on Formula Regulations. The government has not followed the recommendations of health experts, including its own advisors. The proposed revisions are little better than the existing law, which is failing to protect mothers and their babies. This is not just about protecting breastfeeding, but also protecting babies fed on formula.

So two people wanted to know why the government wasn't providing this protection and wasn't implementing the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant World Health Assembly Resolutions - the WHO International Code as some put it.

As you see from the exchange I have copied from the webchat and posted below, the Minister didn't answer the question. Instead of explaining why the expert recommendations to the government's consultation have been rejected, Mr Johnson simply explained about the flawed consultation!

---Webchat extract
Anita Cartlidge: Breastfeeding rates in England are amongst the lowest across the world. As a result children’s and women’s short term and long term health is suffering. Supporting Breastfeeding is mentioned in many health documents some several years old yet there has been no significant long term investment in supporting initiatives to increase breastfeeding rates. Why is the Government not following a similar model to Norway who had similar breastfeeding rates to us in the 1960's but due to a concerted whole systems approach to change now has breastfeeding initiation rates above 95% and high continuation rates? And why is the Government not implementing the full WHO Code on breastmilk substitutes. Thanks

Alan replies: Breastfeeding initiation rates have been rising across all socio-economic groups in the UK and currently stands at 78% in England. We have a commitment arising from our NHS Plan in 2000 to increase support for breastfeeding . Through schemes such as the National Breastfeeding Awareness Week, Healthy Start and working with UNICEF to encourage hospitals to implement Baby Friendly Initiative policies, we are looking both to incentivise and encourage women to breastfeed.

It's also important to mention the huge increase in statutory paid maternity leave from 14 weeks to 9 months under this government, recognising that if women have to return to work in the first six months, they cannot commit to breastfeeding.

Finally on the issue of milk substitutes, my Department and the Food Standards Agency have set out stricter controls on the promotion, labelling and composition of infant and follow-on formula milk.

barbara: If the government proposes to protect infants fed on formula milk, why then is it proposing only a voluntary agreement to improve the information on the labels with the formula companies rather than a mandatory requirement, since it is clear that the companies will not comply with such a request?

Alan replies: After consideration of all the comments received during a 12-week public consultation on infant formula regulations, we are proposing new measures which include updating the rules on the composition of all types of formula, tighter rules on labelling, tougher restrictions on advertising and robust guidance for industry and enforcement authorities to use to correctly apply this new law. The regulations will be laid before Parliament shortly with a view to being on the statute books by January 2008.
---webchat extract ends

What a disappointment! The question is why are the regulations to be laid before Parliament so bad! You can read more about response to the proposals and send a message to Mr. Johnson asking him to revise the regulations before they go to Parliament via our website at:
http://www.babymilkaction.org/press/press21nov07.html

But great that the issue did make it into the discussion alongside the other health topics covered. Thank you to everyone who posted questions and made this an issue that the moderator allowed through.

Without regulations the efforts the government is putting into protecting and promoting breastfeeding will continue to have little impact. While Mr. Johnson is correct to state that initiation rates have increased, breastfeeding duration has barely changed, and in some regions is actually decreasing. Initation can be influenced by hospital practices, such as UNICEF Baby Friendly, but once outside hospital the marketing efforts of the baby food industry have greater impact.

And the fact is, that expenditure on promotion by the baby food industry is increasing, while government expenditure on breastfeeding promotion is decreasing. Here is an extract from my talk during National Breastfeeding Awareness Week:

---
The advertising spend for baby foods: £7,626,847 in 2006/07 according to Nielsen Research Multimedia. That’s an increase of 36.6% on the previous year.

Breastfeeding has a promotional budget of £729,011 in 2006/07. That’s a decrease on the 2004/05 figure of £747,000.
---

Thanks to Save the Children for researching these figures. You can find my full talk and listen to it on line at:
http://www.babymilkaction.org/resources/nbaw07.html

Increases in maternity benefits have been welcomed by us, though returning to work does not have to be a barrier to breastfeeding.

There are, however, concerns arising about the impact of the government's Healthy Start scheme, referred to by Mr. Johnson. This is from an industry marketing report:

---Extract begins
Milks receive boost from Healthy Start

In 2007 sales received a boost due to the introduction of the Healthy Start welfare scheme in late 2006, which gives less well-off mothers vouchers to spend on infant formula purchased from retail outlets, rather than being given free milks via clinics.
---extract ends

Journalists wanting the full report can contact me. I'll write more about it in due course.

So while it is great that Mr. Johnson has participated in this webchat, his answer show the government does not understand the impact of its policies and is not answering the questions it is being asked.

Please do keep on supporting our work and the wider Baby Feeding Law Group and Breastfeeding Manifesto campaigns.