Rachel's Dairy added to Nestlé boycott list

Rachel's Dairy has been added to the Nestlé boycott list as it is now owned by Lactalais Nestlé Chilled Dairy (LNCD).

Lactalis purchased Rachel's Dairy in August 2010. In May 2012, the organic yoghurt and dairy product company, was moved into LNCD, which is a joint venture with Nestlé. Lactalis owns 60% of LNCD and Nestlé 40%.

Nestlé puts its own profits before health as it pushes its baby foods using strategies that violate internationally agreed marketing standards and is found to be the worst of the companies in terms of scale and scope of its violations. The boycott helps to force changes in Nestlé practices by raising awareness of Nestlé practices and giving it a financial reason to change.

Nestlé is one of the four most boycotted companies on the planet, according to GMI Poll. Wholefood shops and other retailers are now delisting Rachel's Dairy.

While this will impact on Nestlé profits, it is LNCD that is threatening jobs at Rachel's Dairy as Lactalis moves the business into the joint venture. Lactalis told the BBC in May 2012: "These changes will strengthen and help sustain Rachel's success for the future, and secure the long term business relationships with local farmers and the area." See: Jobs under threat at Aberystwyth dairy firm Rachel's

SMA formula pricing

Wyeth is embarking on yet another national advertising campaign for its SMA formula.

This must be costing millions of pounds - a bill ultimately paid by those who buy formula.

The subvert below made me think about how much mark up there is on formula.



Companies won't reveal the breakdown of their costs, so the calculation below is based on speculation.

A 250 ml bottle of Wyeth's new SMA ready-to-feed formula costs 89 pence.

The dairy farmer will have received less than 7 pence for the milk (according to Farmers for Action farmers currently receive 27 pence per litre for milk from processors - click here).

Changing the fat content, pasteurising, packaging and distributing whole milk costs about 3 pence for 250 ml (Farmers for Action figures suggest 27 pence processing costs for 2.3 litres). Let's speculate and say that changing the protein content, adding vitamins, extracts from algae (LCPs) and other additives triples the processing costs of formula milk compared with whole milk. That would be 9 pence for 250 ml. This would make the total cost of the milk and production 16 pence per 250 ml.

The remaining 73 pence of the 89 pence selling price will be split between company and retailer profit and the costs of marketing, including advertising campaigns, baby clubs, "carelines", events for health workers, and other promotion.

Although marketing figures are hard to come by, it is known that Wyeth awarded a contract for £2 million to a PR agency in 2008 for targeting pregnant women, new mothers and health workers. In 2012 it must surely have already spent far more than this, having run two national billboard advertising and mass media campaigns by the end of July and planned the SMA Baby Know How roadshow to launch its new formula packaging (which was cancelled following protests).

Wyeth already has a criminal conviction for breaking advertising regulations and complaints have been upheld by the Advertising Standards Authority. Its Self-serving Marketing Activities benefit no-one and inflate prices through the costs of these and by positioning the product with misleading, idealising claims.

All formulas on the UK market have to comply with composition regulations and optional ingredients (which have been added to most formulas) have no proven benefit, so there is no health advantage from buying more expensive formula.

Formula is said to have the highest profit margins of any product on the supermarket shelves. For example, New Zealand’s Economic Development Minister Gerry Brownlee stated in October 2010: "A kilo of infant formula is worth ten times the value of a kilo of milk powder, so it’s obvious which product New Zealand should be selling."

These are obviously rough calculations, but not for nothing are hundreds of people signing the 'No promotion - Cheaper formula' petition on Change.org at:
http://www.change.org/petitions/baby-milk-companies-no-promotion-cheaper-formula

If you can help improve this calculation, please contact Baby Milk Action.

Something nestling in the Baby Milk Action office

Many thanks to supporter Nigel Harrison for creating the MyMeter iPhone app for Baby Milk Action.
This is a fun detector simulator. Watch the film clip to see what it does and how it works.



You can download the app from the app store by clicking here.

You could use it as a fun way to raise the Nestlé boycott.

The beauty of the boycott is wherever you see Nestlé's products, that is an opportunity to talk about the way Nestlé pushes its baby milks in violation of international marketing standards. There is a potted explanation of the boycott below.

If you identify a product from the boycott list, you can use the MyMeter app to simulate detecting it. Then give your friend or colleague one of Baby Milk Action's leaflets or boycott cards. You could download the 'Fight the Nestlé monster' leaflet to use. Take a look at the leaflet for ten key facts that Nestlé executives do not want people to know. See:
http://info.babymilkaction.org/monster

For the 'Fight the Nestlé monster' t-shirts - click here.

The app has lots of other possible applications. You might like to use it with kids to identify the healthy or unhealthy option between different foods. Of course, you control the signal, so you need to know the facts.

Have fun and tell your friends!



Why boycott Nestlé


Nestlé pushes baby milk using strategies that are prohibited by international marketing standards, so undermining breastfeeding. For example, it claims on labels around the world that its formula 'protects' babies, but it knows that babies who are fed on formula are more likely to become sick than breastfed babies and, in conditions of poverty, more likely to die. According to UNICEF, "Improved breastfeeding practices and reduction of artificial feeding could save an estimated 1.5 million children a year."

Nestlé is the worst of the baby food companies and so is the target of a boycott. The latest global monitoring report from the International Baby Food Action Network (IBFAN) has page after page of examples of Nestlé materials that violate the marketing standards adopted by the World Health Assembly.

Some countries, such as India and Brazil, have introduced strong laws and have proved that companies can comply with the marketing requirements when they are forced to. In India companies have been unable to grow the market and in Brazil breastfeeding rates have increased significantly since violations have been stopped. Where companies think they can get away with it, they put their profits first. The boycott gives the global market leader a financial reason to think again.


Nestlé also endangers babies that are fed on formula by refusing to warn that powdered formula is not sterile and may contain harmful bacteria. It refuses to bring its instructions into line with World Health Organisation Guidelines for reducing risks.

Nestlé's 'protect' logos explained


Spoof marketing guru, Mr. Henry Nastie (really Baby Milk Action's Mike Brady) explains all about Nestlé's protect logos. Apart from the awful accent, everything is true.

Nestlé demonstration - Croydon

11:00 - 12:00 Saturday 19 May 2012
Download the flier with map, car park and travel details - click here
Join the virtual demonstration on Facebook - click here

Nestlé refuses to change its baby milk marketing practices - unless there are protests

Baby Milk Action and our partners around the world have been working for over thirty years to protect mothers, babies and their families from the aggressive marketing practices of the baby food companies.

Today over 60 countries had introduced laws to enforce the marketing standards we helped to bring at the World Health Assembly, the world's highest health policy setting body. However, according to industry analysts Euromonitor: "The industry is fighting a rearguard action against regulation on a country-by-country basis".

We monitor the companies and remind them they have a responsibility to respect the marketing standards even where governments have not yet introduced laws. On 19 April, I attended the Nestlé shareholder meeting in Lausanne, Switzerland, to ask the company's board and the shareholders to respect the marketing standards and to bring its policies and practices into line. One of the concerns is that Nestlé promotes its formula with the claim it "protects" babies. In truth, babies who are fed on formula are more likely to become sick than breastfed babies and, in conditions of poverty, more likely to die. The clip below from the 2010 demonstration includes and explanation of the logos:


Film clip - Nestle baby milk marketing strategy explained - click here if it is not displayed below.

Mr. Henry Nastie was played by me, Mike Brady of Baby Milk Action. Other people interviewed were campaign supporters who had come to demonstrate at Nestlé (UK) HQ

The response from the Nestlé Chairman, Peter Brabeck-Letmathé, at the shareholder meeting was that it is not for Baby Milk Action to tell him what to do. All we are asking is for Nestlé executives to follow the rules.

We need to keep up the pressure, because pressure works. Recently thousands of people emailed the company to complain about it promoting its formula with the claim it is "The new 'Gold Standard' in infant nutrition". As a result, Nestlé discontinued the leaflet with this claim. However, it is refusing to stop the majority (97%) of the violations in the last global monitoring report.


We are holding a demonstration at Nestlé (UK) HQ in Croydon on Saturday 19 May from 11:00 to 12:00 to say this is just not good enough. Please do come along if you can. You can let us know you are coming by completing our online form - click here.


You might like to wear one of our new "Fight the Nestlé monster". The monster has just grown as it has swallowed Pfizer's infant nutrition business. That means it now owns the SMA brand, which brings it into the UK market. Click here for the t-shirt.

If you can't make it to the demonstration, you can support our other events and campaigns.
Donations are also very welcome and help to keep us operating to hold Nestlé and the rest of the baby food industry to account.

Download the attached leaflet for a map, NCP car parks and other information - click here.


You can scan the OCR code on the leaflet with a smartphone to access the data about the demonstration.

Latest news

While this blog has been a little quiet recently, a lot has been going on elsewhere.

You can catch up by reading Baby Milk Action's latest Update newsletter and Nestlé Boycott News available on the Baby Milk Action website at:
http://info.babymilkaction.org/update/update44contents

Another nail in the coffin of satire

I was going to include this expression in a press release sent out yesterday, but no-one in the office understood what it meant.

If you have to explain a joke then it isn't very funny. But here goes.

There is a famous (?) observation by the American musical satirist Tom Lehrer. When Henry Kissinger, President Nixon's Secretary of State during the Vietnam War, was awarded the Nobel Peace Prize in 1973, Lehrer said: "It was at that moment that satire died."

If satire is pushing the real towards the absurd to make a point, he felt "There was nothing more to say after that."

So what put another nail in the coffin of satire?

The Chairman of Nestlé, Peter Brabeck-Letmathé, is (possibly) to be awarded an honorary degree by the University of Alberta for "the preservation, distribution and management of one of humanity’s most vital resources: water."

Nestlé makes much of reducing its water usage in its Public Relations reports. What it is less forthcoming about - and what the award committee either disregarded or were ignorant of - is Nestlé and Mr. Brabeck are rather better known in human rights and environmental circles for their harmful impact on water.

See our press release for further information and an email campaign asking the University of Alberta not to make itself look foolish by giving a degree to Mr. Brabeck:

http://info.babymilkaction.org/pressrelease/pressrelease10feb12

You could tell them it puts another nail in the coffin of satire, but I guess they might not understand.

Governments should govern, and corporations should follow the rules

The latest edition of SCN News contains an article written by myself and Patti Rundall, our Policy Director, with this title. See page 51 of http://www.unscn.org/files/Publications/SCN_News/SCNNEWS39_10.01_high_def.pdf

SCN is the United Nations System Standing Committee on Nutrition. The theme of the journal is: Nutrition and Business - How to Engage?

There is a trend being followed by some policy makers at UN, government and civil society level to see working in partnership with corporations as the way to achieve goals relating to nutrition and tackling diet-related ill health, such as Non-Communicable Diseases or NCDs. NCDs include things like heart disease (responsible for 29% of global deaths) and diabetes, which are on the increase as more and more people become overweight and obese.

We see it with the baby milk issue and our latest newsletter, Update 44, examines some specific cases where a desire by policy makers to work with corporations (which sometimes includes accepting funding) has led to the rights of mothers and babies being neglected or even undermined. Baby Milk Action engages with companies such as Nestlé and Danone through ongoing correspondence regarding marketing practices that violate international standards. As we report in Update, Nestlé is not so keen to engage with our proposals for substantive meetings to discuss the need for it to make changes to its policies and practices, or even to resolve disagreements over interpretation of the marketing requirements.

The Editorial to SCN News is generally optimistic about working with corporations, stating, for example:

Nutrition and business interests are overlapping more and more. Businesses are increasingly including product and social innovation as well as sustainability into their core corporate strategies and supply chains. Business is also continuously reaching out to new consumers, including the urban and rural poor, exploring emerging markets and engaging with other nutrition stakeholders. While these overlaps create opportunities for cooperation and convergence of interests for achieving food and nutrition security, they also carry controversy, and sometimes cause heated debate, especially on transparency and accountability issues. There are cases of actual or perceived conflicts of interest that undermine such convergence and diminish trust, jeopardizing potentially fruitful initiatives.

The journal presents some cases of initiatives involving business that are deemed to be successful by the authors and also notes: "Millions of farmers and rural entrepreneurs form the bulk of agricultural production and investments. Private businesses, of all sizes, constitute the food supply chain as it evolves from the farm to the fork."

Like several other peer-reviewed articles in the journal, we warn that there is a failure in governance when it comes to nutrition and the industrialised food sector, which involves some of the world's largest transnational corporations.

Before even considering how to engage with business, we argue that policy makers need to understand that executives have a legal obligation to put their shareholders' interest before all others. If executives aren't looking for some advantage in engaging with policy makers, they are failing in this duty. That is not to question the ethics or morality of executives; it is to state what should be obvious. However, talk of win-win solutions sometimes seems to paint too rosy - or naive - a picture of the relationships.

So we set out and describe five key steps for policy makers to take when considering nutrition, health and other issues and the role of the private sector:

1. Understand the problem and the role played by the private sector

2. Determine the appropriate public-interest response

3. Decide the appropriate relationship with the private sector in this context

4. Identify the extent of conflicts of interest, minimise them and manage those that are consid- ered acceptable or unavoidable

5. If deciding to work with the private sector in some way, avoid the language of partnership, define the relationship clearly and ensure that your original objectives do not get subverted.

Read the full article for further details.

Product placement of baby milk in TV programmes is banned

Did you know that it is against the rules for television programmes to accept payment for showing baby milk in television programmes?

The ban is contained in the Ofcom Broadcasting Code.

Ofcom (the independent regulator and competition authority for the UK communication industries) introduced rules regarding product placement in television programmes in February 2011.

Products that cannot be placed in programmes include: "infant formula (baby milk), including follow-on formula". However, Ofcom does point out that some products may appear in programmes because they have been chosen by the producers as props. Companies can be fined for breaking the rules.

You can find the text of rules via the Law section of the Baby Feeding Law Group (BFLG) website and information on how to register a complaint in the Report violations section of the same site. Baby Milk Action coordinates the BFLG monitoring project.

Baby Milk Action submitted comments to the Ofcom and government consultations on the proposals, calling for all baby foods to be included in the ban. Our full submission can be downloaded by clicking here.

Was this useful? Please click here.

A question for members of the United Reformed Church

We have received shocking news from the United Reformed Church (URC) Secretary for Church and Society.

In July 2010 the URC Assembly renewed its long-running support for the Nestlé boycott until such time as Nestlé stops violating the international baby food marketing requirements.

The Resolution referenced inclusion in the FTSE4Good Index, an ethical investment listing from FTSE, as the criteria for ending support for the boycott.

Nestlé was included in the Index in March 2011 after the FTSE4Good criteria were changed in September 2010 - that is, after the URC Assembly Resolution - to allow companies that violate the marketing requirements into the Index. The stated aim was to weaken the criteria to bring half of the baby food sector into the Index on the grounds this would make it easier to engage with the companies.

Given this development, we expected the matter to go back to the URC Assembly so it could review the Resolution as the situation had changed. Nestlé would not have been included in the Index under the criteria in place at the time of the Resolution. It is not its marketing practices that have changed, but the FTSE4Good criteria.

Instead, URC Church and Society told us the Resolution was binding and had to be implemented as a matter of urgency.

Our press release regarding this shocking news can be found - along with a chronology of events - at:

http://info.babymilkaction.org/pressrelease/pressrelease26nov11

It is for URC members to decide whether to take any action over this matter - we have to concentrate on assisting our partners in developing countries, particularly as Nestlé will undoubtedly the exploit the URC announcement to undermine efforts to stop its ongoing marketing malpractice.

I would be interested in the views of URC members, however, particularly those who supported the July 2010 Resolution. Was it the intention of members to end support for the boycott if FTSE weakened the FTSE4Good criteria?

Pressure and persuasion - small acts help to hold big corporations to account

I was pleased to provide information to the National Council for Voluntary Organisations (NCVO) for a briefing it produced on Campaigning and the private sector - click here.

This includes profiles of the campaigning strategies of a range of organisations, including Amnesty International, Greenpeace and Baby Milk Action.

Although it includes in the title the question Persuasion or pressure? these are not mutually exclusive. Indeed, with some corporations it takes pressure to persuade them to act.

However, it is not always necessary to launch a public campaign to force changes. I often take up cases when I receive reports of websites or shops that are violating the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions of the World Health Assembly. Sometimes simply informing the people responsible that their bright promotional idea is a violation of the Code and Resolutions - and perhaps even illegal -is often sufficient.

With Nestlé, which we target with the boycott as it is the worst of the baby food companies, we also try persuasion by reminding it of its obligations under the Code and Resolutions. It usually takes an exposure campaign to force changes as it is reluctant to admit to violations. For example, it initially ignored our report about point-of-sale promotion in Africa, but agreed to crack down on the practice after members of the public took up the case (see our Campaign for Ethical Marketing action sheet, July 2009).

Our partners in the International Code Documentation Centre (ICDC) recently reported that a Nestlé lunch for health workers in South Africa was cancelled after they raised concerns with Nestlé Head Office. Although such events are common - and usually defended by Nestlé executives - there were possibly greater sensitivities in this case as the South African authorities are currently considering what action to take to implement the Code and Resolutions. You can read a report from ICDC on the website of the International Baby Food Action Network (IBFAN) - click here.

As the NCVO briefing explains, we use a broad range of strategies to put pressure on companies, but we also work for strategic changes in the regulation of corporations that will provide a level playing field for all companies and back regulations with enforcement methods. This involves working for new Resolutions at the World Health Assembly, to address changes in marketing practices and scientific knowledge, and encouraging governments to implement the Code and Resolutions at the national level in independently monitored and enforced legislation. Achieving legislation is a major activity of ICDC, working with the IBFAN network as a whole. The strategy has been so successful that the industry itself is complaining of 'constraints' in countries such as India where the formula market has barely grown over the last decade, in contrast to China, where there is a weak code of conduct and sales have surged ahead. Industry analysts Euromonitor note (see Update 42): "The industry is fighting a rearguard action against regulation on a country-by-country basis."

That could explain why Nestlé wants to look responsive to complaints in South Africa at present. Its stated policy is to encourage governments to go for voluntary measures to implement the Code and Resolutions - rather than legislation with meaningful sanctions (which in the case of India's exemplary legislation include imprisonment of the Managing Director).

Introducing - and defending - legislation is no easy task. We have reported in the past how it took an international campaign to defend new baby food marketing regulations in the Philippines in 2007 (see Philippines Victory in Update 40). We have recently learned through the exposure of US diplomatic cables by Wikileaks that we not only faced the machinations of the baby food companies and the US Chamber of Commerce threatening to disinvest from the Philippines, the US Government was also putting pressure directly on the Philippines Government to weaken regulations drafted to protect infant health (see ABS-CBNNews report). That the regulations came in largely unscathed despite this pressure is a direct result of campaigning, nationally (including a petition shown left) and internationally (with petitions of support and other action). The main Philippines broadsheet put the campaign on its front page as a result of international concern, quoting a message from someone who had signed Baby Milk Action's petition in its report, showing how individual action can help to save lives on the other side of the world.

Where national measures are lacking or ineffective, we have argued that the global community has a responsibility to act. How this could operate in practice is something I explored in depth in a chapter I wrote for the book Global Obligations for the Right to Food as part of a Task Force of the UN System Standing Committee on Nutrition - click here to order.

At present, the best we have at the international level is the UN Global Compact and the OECD Guidelines for Multinational Enterprises. We have been pursuing complaints about Nestlé human rights abuses under both measures for the past two years and found them to be ineffective and in need of replacement or reform. In the case of the UN Global Compact, it is actually counterproductive as it provides public relations cover for companies by posting their social responsibility reports on the official website without any form of checking. In the case of Nestlé, the Global Compact Office even takes part in joint launch events and accepts Nestlé as a Patron Sponsor of prestige events, such as its 10th anniversary celebrations in New York last year. See our press release: UN Global Compact - 10 years of helping cover up corporate malpractice.

In recent weeks, Baby Milk Action has brought together over 140 citizens groups in the Conflicts of Interest Coalition to ensure that policy making on health issues, such as Non-Communicable Diseases, is pursued in the public interest. It is an uphill struggle as corporations not only have massive lobbying resources, but a revolving door operates between their staff and government and United Nations staff in many areas.

So campaigning continues to be essential: when policy makers fail to hold corporations to account, it falls to us - you and me, together with many other people around the world - to do so.

The Conflicts of Interest Coalition - protecting health right now in New York

Baby Milk Action recently formed the Conflict of Interest (COI) Coalition, bringing together - so far - over 140 international networks and civil society organisations calling for the United Nations to avoid conflicts of interest as it sets policies on obesity, diabetes and other Non-Communicable Diseases (NCDs).

The Coalition represents thousands of non-profit public health advocacy groups around the world.

It is necessary because food corporations such as Nestlé and alcohol companies companies are lobbying to set the rules on tackling the rise in NCDs for which they are partly responsible. Pharmaceutical companies that can also profit from policy decisions are also involved in lobbying. All want to be seen as 'partners' in tackling the problems.

The COI Coalition is calling for there to be a Code of Conduct on relationships so that policies are made in the public interest. While corporate interests can be consulted, they should not be involved in setting the policies or these will inevitably be weakened to protect corporate interests, instead of protecting health.

The corporations are out in force this week at the UN General Assembly where these issues are being discussed. Baby Milk Action's Policy Director, Patti Rundall, is also there, with colleagues in the COI Coalition.

You can follow developments on the new COI Coalition blog at:

http://coicoalition.blogspot.com/

and Patti's own Policy blog at:

http://info.babymilkaction.org/news/policyblog

Department of Health responds to Baby Milk Action email campaign

Over 1,000 people have sent emails to the Secretary of State for Health, Mr. Andrew Lansley, asking the Government to reconsider its decision to scrap its Infant Feeding Coordinator posts and its support for National Breastfeeding Awareness Week. The response from the Department of Health is given below.

It is welcome that the Department of Health recognises the health benefits of breastfeeding and the savings to the National Health Service. However, the Government has not only failed to meet its obligations under the Global Strategy for Infant and Young Child Feeding, which it supported at the World Health Assembly, it is backtracking on action that had been taken.

Please sign the ePetition on the Prime Minister's website calling on the Government to deliver on its infant feeding obligations - click here. Petitions receiving 100,000 signatures will be debated in Parliament.

If you have not signed up to receive email alerts from Baby Milk Action, please do so now to be kept informed of the next steps in this and other campaigns.

Thank you for your email of **** to Andrew Lansley about infant feeding which was forwarded to the Department of Health on ****. I have been asked to reply.

The Department of Health is committed to supporting healthier choices, including breastfeeding, through the ‘Healthy Child Programme’ as set out in the Public Health White Paper ‘Healthy Lives, Healthy People: our strategy for public health in England’.

The Department recognises the evidence-based health benefits of breastfeeding both for the mother and her baby and the savings to the NHS. The Department’s approach is to support all parents and parents-to-be with information to enable them to make an informed choice when deciding how to feed their baby.

Due to reduced budgets this year, the Department was unable to co-ordinate the National Breastfeeding Week and provide free resources for local events. However, support and information is currently available to health professionals and parents via NHS Choices, the National Breastfeeding Helpline, UNICEF UK Baby Friendly Initiative and localpeer support programmes.

At present, the Department is reshaping the whole health and social care system, and looking at how this can work to deliver the best possible health and social care outcomes. Public health will remain a key component in all of this. It is important that organisations working to promote better health engage with all parts of the new health system as it develops to ensure that we make the most of the available evidence on infant feeding to drive the greatest health gains. The Department is also already actively encouraging local groups to nominate representatives from their networks to attend national meetings to continue to share positive practice and information on infant feeding. This will help the Department to ensure continued communication and support to the current infrastructure until the new system is operating.

The Department received a large number of responses to its recent consultation on the White Paper and the associated proposals for a new public health outcomes framework, and for funding and commissioning of public health services in the newly defined system. Responses to the consultation were used to inform ‘Healthy Lives, Healthy People: Next Steps and Way Forward’, which sets out the key elements of the new public health system. This can be accessed at the link below:

http://www.dh.gov.uk/en/Publichealth/Healthyliveshealthypeople/index.htm

Following this publication, the Department of Health will issue a series of policy statements including the final outcomes framework in the autumn.

I hope this information is helpful.

Yours sincerely,

Customer Service Centre

Department of Health

Reuniting mothers and babies - we are all Habiba

Baby Milk Action has repeatedly raised concerns when mothers have been separated from their babies in immigration or detention centres or denied access to feed them. This action has led to questions being raised in Parliament and changes to government procedures.

We have been asked to support mothers' rights in a similar case in Spain, that of Habiba and her daughter.

You can find information in English and a petition to send on the Habiba campaign page. There is also a Facebook group and blog, with various events planned in Spain, the UK and other countries, such as a gathering in Trafalgar Square on 21 June.

Baby Milk Action has sent the following letter to the authorities who have separated Habiba from her daughter claiming that breastfeeding is "chaotic" and "damaging".

I apologise for writing in English, but the case of the mother Habiba who has been forcibly separated from her daughter has been brought to our attention and we wish to bring the following information to your attnetion and call for a review of the case as a matter of urgency.

Baby Milk Action is the UK member the International Baby Food Action Network (IBFAN) a network of over 200 citizens groups in over 100 countries and together the world’s health community we work to ensure that the critical value of breastfeeding and the importance of keeping mothers and babies together is recognised. We are contacting you to clarify your policies regarding breastfeeding mothers.

Apart from its psychological importance, breastfeeding reduces the incidence of infectious diseases, chronic diseases and auto-immune diseases, offers optimal development and growth, cognitive and visual development and evidence suggests that it decreases the risk of obesity. The benefits of breastfeeding extend throughout the whole life cycle. In the global context, breastfeeding and appropriate complementary feeding help fulfil the Millennium Development Goals and have the potential to reduce under-5 mortality by 19%. (ref 1).

The decision to separate breastfeeding mothers from their babies flies in the face of a number of UN Resolutions and conventions, including the International Code of Marketing of Breastmilk Substitutes and the relevant, subsequent WHA resolutions, the Global Strategy on Infant and Young Child Feeding, UNICEF’s Baby-friendly Hospital Initiative and the Innocenti Declaration on the Protection, Promotion and Support of Breastfeeding, which all stress the critical importance of exclusive breastfeeding for the first six months of life with nutritionally adequate and safe complementary feeding alongside continued breastfeeding up to the age of two years and beyond. Article 24 of the Convention on the Rights of the Child also recognizes the contribution breastfeeding makes to the fulfilment of the right of the child to the highest attainable standard of health.

We would be grateful if you could review your policies in this area as a matter of urgency to ensure they are in line with these measures and provide mothers with the necessary support to continue breastfeeding.

Ref. 1 Jones G et al. (2003) How many child deaths can we prevent this year? The Lancet, no 362, 65-71.

Nestle's brave new world. Good Grief!

It has been a busy month for Nestlé as it tries to remake the world in its own image. It culminated in Nestlé announcing "The first comprehensive nutrition system for babies", a machine that squirts out milk into feeding bottles for new borns. How on earth has the human race survived without there being a way to provide nutrition to its young? In Nestlé's world, the past is prelude and the fact that babies were once nurtured by milk produced by their mothers' bodies is to be consigned to our primitive past it seems. Nestlé, Good Grief! (Click here for the ringtone).

In the old days, people sometimes talked of the mother-baby pair. Once breastfeeding was established - which sometimes required a little guidance as breastfeeding became an increasingly lost art - the mother would produce milk in response to cues from her child and it would change during the day and over time, tailored to the needs of the child. Milk was available on demand, at the right temperature. In Nestlé’s brave new world, it says of its BabyNes machine:

"The composition of the six consecutive formulas meets the evolving nutritional needs in the first three years of life: four formulas in the first year, and one formula for each of the following two years. The customised composition of these products is tailored to suit the growth pattern in early life and the baby’s changing nutritional needs, while taking into account the steady introduction of solid food into the infant’s diet."

The language has been appropriated. The machine produces milk 'tailored' to the baby we are to believe. Human milk is a living substance and not only adapts in its nutritional content, it is truly tailored to the needs of the baby as the mother’s body produces protective factors in response to infections in the environment, a medicine that is essential for reducing risk of infections. Without breastmilk babies are more likely to become sick and, in conditions of poverty, more likely to die.

Nestlé further extols the virtues of its magical machine thus:

"The single-serve portions are sealed in capsules, used in the proprietary BabyNes machine, which recognises each capsule and prepares the bottle with precisely the right dosage and temperature, at the push of a button, in less than one minute. The BabyNes machine combines state-of-the-art technology with the utmost safety and convenience, and ensures a hygienic, quick and easy bottle preparation."

So we are to believe BabyNes knows how to produce precisely the right dosage. Yet it is a false picture. A breastfed baby takes as much as it needs, not so easy to do when a plastic nipple is held in its mouth, no matter how precisely the volume in it has been decreed by the Nestlé machine.

Most misleading of all is to describe the machine's output as hygienic. The water used to make the formula is not boiled, just filtered. The World Health Organisation recommends all water be boiled, even bottled water. The capsules contain powder, and as they are sealed might appear to offer sterile certainty, but powdered formula is itself not sterile and may contain harmful pathogens such as Salmonella and Enterobacter Sakazakii. Nestlé knows this well as it has had to recall thousands of tins of formula in the past after such contamination has been found in its powder. The US Food and Drug Adminstration has cited a study of tins on the market that found 14% contained Enterobacter Sakazakii, which in rare cases can lead to fatal illness, though there are simple steps to reduce the risks - steps Nestlé’s machine seems not to take.

It was the death of a child in Belgium fed on contaminated Nestlé formula in 2002 that was a catalyst for a World Health Organisation investigation leading to its recommendations on reconstituting powdered formula. This includes reconstituting formula with water above 70 degrees Celsius to kill any harmful bacteria, then cooling the formula. Nestlé says its machine mixes feed in one minute without boiling the water.

Baby Milk Action recently produced on behalf of the Baby Feeding Law Group called Infant Formula Explained to show how to prepare a bottle in line with this guidance - necessary because companies are reluctant to tell parents that powdered formula is not sterile and how to reduce the risks. We have asked Nestlé many times to bring its warnings and instructions into line, and it has refused. Now we know part of the reason why: its machine has been under development for six years and if it acknowledged that formula should be prepared with water above 70 degrees, it would have had to go back to the drawing board.

Instead a potentially dangerous method of preparing formula is being touted as offering the "utmost safety".

In the world of marketing, of course, everything is always new and improved.

Last year we exposed Nestlé claiming the formula in its tins was 'The new "Gold Standard" in infant nutrition', another attempt to appropriate the language of breastfeeding, long described as the "Gold Standard". After thousands of emails from boycott supporters, Nestlé said it had discontinued the leaflet - after attempting to argue that the 'Gold' referred to the colour of the formula labels.

The withdrawal of the leaflets was one of four actions highlighted by Nestlé in its response to the Breaking the Rules, Stretching the Rules 2010 monitoring report which profiles the practices of 22 formula and feeding bottle companies with examples of violations from 46 countries.

The report contains page after page of examples of Nestlé materials showing how the company systematically violates the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions of the World Health Assembly. Earlier this month I joined Annelies Allain from the International Code Documentation Centre to present the report in Geneva prior to the World Health Assembly (you can watch the film below).

While promising action on just four of these examples - including the ‘Gold Standard’ leaflet - Nestlé defended the rest of the 130 violations it counted in the report.

So Nestlé intends to continue with 97% of the violations exposed.

In Nestlé's brave new world this open contempt for the marketing requirements adopted by the world's highest health policy setting body - which repeated its call last year for companies to meet their responsibilities - is turned on its head. Nestlé cites the fact that it decided only four violations were valid as proof it is doing little wrong - whereas in reality this shows it is doing virtually nothing to put things right (Danone, by contrast, said action it has taken would stop 50% of the violations in its profile and it promised to make other changes such as removing the Immunofortis claims from its formula labels).

Nestlé continues with marketing strategies such as claiming its formula 'protects' babies, with colourful logos on labels and promotion to health workers and mothers. This is despite acknowledging to Baby Milk Action in our ongoing correspondence that actually there is 'no proven benefit' from adding highlighted ingredients such as DHA to formula. Nestlé's argument is that it refers to the benefits of DHA in breastmilk, not in its formula - though whether parents who are drawn in by the logos appreciate this sophistry is debatable.

Where Nestlé does make changes it is either because legislation gives it no choice, or because of campaign pressure. Although Nestlé prefers to invest in diverting criticism, when executives judge bad publicity is fuelling the boycott to too great a degree, or it is bombarded with messages, then it changes policies and practices. Even though Nestlé is one of the four most boycotted companies on the planet, further pressure is needed.

To this end some of us gathered at Nestlé (UK) HQ last Saturday to record some campaign clips that will be available soon. You can already download a Nestlé, Good Grief! jingle as a ringtone - click here.

The boycott means that even in some of the reporting about BabyNes, journalists are questioning Nestlé on violations of the Code.

How Nestlé responds is illuminating. Nestlé told Nutraingredients:

"We have the industry’s toughest system in place to enforce WHO Code compliance. Indeed, we are the only infant formula manufacturer listed by FTSE4Good, the London Stock Exchange’s Ethical Index.”

The first statement is demonstrably false given the systematic way Nestlé violates the Code. The second statement ignores the fact that in order for Nestlé to be listed by FTSE4Good, FTSE changed the criteria. Systematically violating the Code on the ground is not an obstacle to being listed and FTSE has not yet conducted any evaluation of Nestlé marketing practices. In Nestlé's brave new world something becomes true just because Nestlé says it is true and FTSE decided to believe Nestlé rather than monitoring evidence when Nestlé said it had put policies and systems in place to stop violations.

Nestlé is promoting its new BabyNes product with a press release, news conference and postings on its website and in social media. However, all forms of promotion of breastmilk substitutes are prohibited by the Code and Resolutions.

If Nestlé tried these tactics in a country that has implemented the Code and Resolutions in legislation it could find itself in court, as Johnson and Johnson did in India in the 1990s for press releasing information about a new feeding bottle. India has exemplary legislation with a sanction of imprisonment for the Managing Director under what is criminal law. Johnson and Johnson apologised and later said it realised it was inappropriate to be marketing feeding bottles in India and discontinued its feeding bottle business. Nestlé has also been taken to court in India, for failing to translate warnings on formula labels. It continues to fight the case and unsuccessfully took the government to court to have the law struck down on the grounds it was infringing its rights.

All this is as nothing to Nestlé's master stroke last week in tyring to usher in its brave new world. Thirty years after the adoption of the International Code, "top government officials" met to discuss "Future Directions in Nutrition, Water, Rural Development". I'm not talking about the World Health Assembly gathering in Geneva, where the world's health ministries discussed these and other issues such as the growing problem of non-communicable diseases caused by the diets promoted by junk food companies such as Nestlé (for that is what much of its food is, despite its attempt to rebrand itself as a Nutrition, Health and Wellness company).

No, the "top government officials" were in Washington at Nestlé's Creating Shared Value Forum. This was not only an attempt by Nestlé to appropriate the language of development, portray itself and its model as beneficial, and set the policy agenda. It was surely also a shot across the bows of the World Health Assembly meeting at the exact same time across the Atlantic, a warning that in Nestlé’s brave new world the world’s highest health policy setting body was close to being irrelevant.

In Geneva the Director General of the World Health Organisation, Margaret Chan, was presenting a report to Member States on funding as WHO's budget is being squeezed. The solution the DG proposed is to bring in business by setting up the World Health Forum. Perhaps with an eye on Nestlé's event in Washington she said this would be a "multi-stakeholder forum" which will "identify future priorities in global health".

Baby Milk Action and its partners in the International Baby Food Action Network (IBFAN) and other organisations raised concerns over conflicts of interest. Corporate Accountability International joined us in delivering a letter to Dr. Chan signed by over 100 organizations and individuals from more than 24 countries.

The same week as Nestlé Creating Shared Value Forum, Save the Children Australia, Oxfam, Care and 13 other Aid agencies working in Laos wrote a letter to Nestlé stating that they will not be applying Nestle's Creating Shared Value Prize because the company's continued marketing of formula "still jeopardizes the health of infants and children in Laos." - Click here.

However, we can expect some organisation to accept Nestlé’s money and Nestlé will publicise this as if it is some kind of development agency.

The campaign against Dr. Chan’s proposed partnership with corporations in a World Health Forum continues. The stated aim of the Forum is to “Improve health outcomes, with WHO meeting the expectations of its Member States and partners”.

Well, we already know what Nestlé expects.

Nestlé wants people to believe that its refusal to act on 97% of the violations of the WHO Code is a good thing and that those experts on the ground who state the company "jeopardizes the health of infants and children" are to be ignored because a FTSE committee sitting in London examining Nestlé’s policy statements and other presentations.

While Nestlé continues to undermine breastfeeding and refuses to warn parents who use formula of the risks, in its brave new world it wants people to believe that thanks to Nestlé the human race has finally been delivered "The first comprehensive nutrition system for babies".

Nestlé, Good Grief!

Hype about 'human breastmilk' from GM cows tells us much about existing formula

Headlines claiming that scientists have produced 'breastmilk' from Genetically Modified (GM) cows should sound alarm bells for policy makers as they vote this week in the European Parliament on whether to improve measures for approving health claims on formula. Firstly, this story demonstrates once again that existing formulas lack many of the components found in breatmilk, three of which the researchers claim now to be able to produce from different GM cows. Given the existing misleading claims that formula companies put on labels, about how their formula boosts the immune system and supports brain and eye development for example, over a third of parents already believe formula is "very similar or the same" as breastmilk according to a survey by the UK Department of Health. Secondly, the GM cow's are not producing 'human breast milk' (hence the quotes in the reports), but are potentially a source of some of the missing components. Other components, some of which may still need to be discovered, and living substances, are not being produced by the cows and the milk will still require subsequent processing even if it was found to be beneficial and safe (aside from animal welfare and environmental considerations).

Members of the European Parliament will be voting on a Resolution on Wednesday 6 April about the approval process for health claims and deciding whether to block a claim for an ingredient, DHA, generally produced by microalgae fermentation. Companies claim this is important for eye and brain development, but independent research has found "no proven benefit" from adding it to formula - if there was, it would have been made a required ingredient in the European Union's composition regulations. The industry is lobbying hard to stop the Resolution from the Environment, Public Health and Food Safety Committee from being approved by the full Parliament. Click here to send a message to your representatives in the European Parliament.

Here is a quote from Mike Brady, Campaigns and Networking Coordinator, Baby Milk Action for any journalists that need one:

"Every time we see these types of headlines it reinforces the fact that formula currently on the market is not the same as breastmilk and scientists are still seeking ways to reduce its shortcomings - yet misleading claims made on labels and in advertising have convinced a third of parents in the UK that existing formula is the 'very similar or the same' as breastmilk. The Advertising Standards Authority has already ruled against claims that formula boosts the immune system and the suggestion these cows are producing 'human breastmilk' is just as misleading - scientists are actually claiming they have found a way to produce three components missing from current formulas and change fat and protein levels. This is not going to be a living substance tailored to the baby like breastmilk. Baby Milk Action is working for the composition of formula to be improved for those babies who are not breastfed and it will be interesting to see if the missing components that these scientists claim to be able to produce can be proven to be beneficial and safe if included in a formula. The European Parliament has the chance to vote on Wednesday 6 April in support of a Resolution from the Environment, Public Health and Food Safety Committee that will improve the process for approving health claims and block misleading claims. I urge all MEPs to vote in favour of the Resolution."

To protect babies fed on formula we need to look behind the hype and put in place a system that requires benefits and safety to be proven. If ingredients are beneficial and safe, they should not be promoted with marketing claims, but required as an ingredient in all formulas, so inferior formulas are not being fed to babies. This chance of a mass market attracts investors backing new wonder ingredients to add to formula, but policy makers need to keep clear heads and do what is right for infant health - and in this case, also consider the animal welfare and environmental issues.

The current regulatory system means that companies can add ingredients to formula and make health claims about them, at least on follow-on formula, without evidence of benefit. In the case of DHA, in 1996 investment advisors Hambrecht & Quist suggested investing in Martek Bio-sciences Corporation, that had developed Formulaide, an additive produced by microalgae fermentation, saying:

"Even if Formulaide (DHA/AHA) had no benefit we think that it would be widely incorporated into most formulas as a marketing tool and to allow companies to promote their formula as ‘closest to human milk’."

Beware of the hype. Left: Mead Johnson suggests its formula improves babies eye sight, although there is 'no proven benefit' from adding DHA to formula.

Baby Milk Action takes the view that if there truly is evidence for a health claim that should trigger a review of the list of ingredients required in formula by law and the evidence - including a substantial amount of independent research, not just company-funded research - should be examined. This happened when the EU Infant Formula and Follow-on Formula Directive was updated in 2006 and it was decided not to add DHA to the required list of ingredients because there was 'no proven benefit'. There is also evidence of possible adverse reactions amongst some infants, which suggests a warning is more appropriate than a health claim. In the United States, manufacturers are required to record and report cases of adverse reactions - and the US Food and Drug Administration had recorded 98 cases itself by 2007. Those backing the baby food industry's DHA claim are lobbying hard to stop the European Parliament voting to improve the health claim approval system - click here.

Research in the public interest should take place to try to reduce the poorer health outcomes amongst babies fed on formula. With regard commercial research there are two different approaches as to how to motivate it.

The health claims approach: Advocates of allowing companies to make health claims have suggested: "In the future, manufacturers might not be willing to invest major financial resources into the development, clinical evaluation and implementation of further improvements, if there is no chance to communicate such improvements." This encourages companies to seek ingredients about which they can make a claim, regardless of the benefits (as with DHA). If improvements have a genuine benefit, then making them optional in this way will mean some babies receive inferior formula.

The evidence-based approach: Baby Milk Action's view is that breastmilk substitutes (the only food for a child for about the first 6 months of life) is too important a product and that adding new ingredients should be based on scientific evidence. Adding ingredients without approval effectively means a mass uncontrolled trial is being conducted on the population at large. Requiring companies to prove ingredients are beneficial and safe will not stop ingredients from being added and will not stop companies from profiting from their investment - advances are generally driven by biotech companies who will find a greater market if their products are added to the list of required ingredients.

Following the evidence-based approach means companies and investors profit from producing something that will benefit health, rather than producing something to be used in a marketing campaign.

If policy makers are serious about infant health, then supporting an evidence-based approach is the way to go.

Press reports with 'human breast milk' from cows headlines cite publications in the Public Library of Science One by Professor Ning Li and name three ingredients. From searching the Public Library of Science One website, these appear to be the papers (to be confirmed):

Lysozyme (results from four GM cows): Characterization of Bioactive Recombinant Human Lysozyme Expressed in Milk of Cloned Transgenic Cattle

Lactoferrin (results from two GM cows): Cattle Mammary Bioreactor Generated by a Novel Procedure of Transgenic Cloning for Large-Scale Production of Functional Human Lactoferrin

Alpha-lactalbumin: paper not yet found.

Please contact us if you have further information on the actual research. We would also like to track how this story is reported around the world, so please post links to articles as comments to this blog.

Offensive from those defending industry DHA health claim

Thank you so much to everyone who has contacted their representatives in the European Parliament asking them to vote in favour of a Resolution to protect the rights of parents and carers to accurate information on infant formula. We know it is having an impact because those defending the rights of the baby food industry to put misleading claims onto formula are becoming more active and Mead Johnson has apparently hired a Public Relations firm to lobby politicians. We need the voices of the public to counter this offensive. Click here if you have not yet sent a message to your representatives in the European Parliament yet or to spread the word if you have. If you want to know the detail of what is taking place, read on.

The European Commission has just written to all Members of the European Parliament (MEPs) supporting authorisation of a claim about DHA and eye development and attacking the Resolution adopted by the European Parliament Environment, Public Health and Food Safety (ENVI) Committee that would prevent this and lead to improvements in the authorisation process. The arguments the Commission presents show even more clearly that the evidence has not been adequately scrutinised, as will be explained. We have also seen a Professor wading into the debate and calling Baby Milk Action a 'loud-mouthed lobbying organisation' - while failing to reveal his relationship with the company that produces the DHA additives added to formula and the company that has applied for the right to use the health claim. More than ever, we need voters to send messages to their representatives asking them to put the scientific evidence and the well-being of infants before the vested interests of the formula industry and unelected European Commission officials who seem intent on providing a boost to the formula industry regardless of the evidence - click here.

UNICEF gives its strong support to the Resolution

On the side of mothers and babies, we see that UNICEF has responded to a request from MEPs for an opinion indicating its strong support for the Resolution opposing the claim. And from the responses sent to our supporters its clear that many MEPs are determined to back the Resolution. But when the vote goes to the full Parliament on the 5th or 6th of April we will need 369 of the 736 MEPs on side - even if only 400 are in the room at the time. We are trying to directly contact those who say they are intending to vote against the resolution (and FOR the claim) to find out their reasons for doing so. There seems to be some confusion that prohibiting the claim will stop DHA being added to formula, which is incorrect. DHA is a permitted ingredient, though it is not a required ingredient, because it has no proven benefit.

MEPs opposing the Resolution use an argument that makes support more sensible

The argument put by some MEPs explaining their opposition to the Resolution actually makes more sense as a reason for voting in favour. We have seen several state: "If an ingredient is proven to be safe and important for baby health, then it should be included." That is the position of those supporting the Resolution: if an ingredient is proven safe and beneficial it should be a requirement in all formulas and added to the list of essential ingredients in the EU Infant Formula and Follow-on Formula Directive. Nobody who really cares about infant health would want an inferior formula on the market, it is too important a product.

DHA is not a required ingredient because it has no proven benefit

When the composition requirements were updated in 2006, DHA was not included on the list of required ingredient because of the lack of evidence of benefit. Those opposing the Resolution are opposing the principle that safe and important ingredients should be included and if successful will allow an unproven ingredient to be added and promoted to mothers with an unsubstantiated claim. The image on the left shows how Mead Johnson promotes its formula as if it will transform a child's eyesight.

The Commission has written to MEPs attempting to defend the scientific basis of the claim, including a letter from the European Food Safety Authority (EFSA). However, the arguments prove the point that consideration of the evidence of benefits and risks is incomplete.

Cochrane Library review attacked

EFSA's letter suggests that the independent, systematic Cochrane Library review, which found 'no proven benefit' from adding DHA to formula, did not separately consider DHA supplementation at the levels specified by Mead Johnson, which filed the original claim of benefit for the ingredient. Yet Cochrane explicitely refers to the Birch study used as justification and would surely have mentioned the evidence of benefit at higher levels had the evidence been convincing. It states: "Only one group of researchers have shown some beneficial effects on VEP [visually evoked potential] acuity.... Further research is needed to see if the beneficial effects demonstrated by Dallas 2005 trial of Birch et al can be replicated in different settings."

Kathy Kennedy, Professor Alan Lucas and Mary Fewtrell, authors of a study (see below) that has found possible negative health impacts of DHA-supplemented formula, pointed out in defending their study from industry attack in the Archive of Diseases in Childhood: "Birch's study, which may have been one of the most influential trials driving the addition of LCPUFA to US formulas, was based on an incomplete follow up where only 19 subjects remained in the relevant intervention group, providing inadequate power to provide any realistic estimation of the treatment effect." [emphasis added]

Evidence of risks ignored in EFSA letter

The EFSA letter dismisses the need for further research on possible risks from DHA supplementation, rejecting a study by Kennedy et al published in the Archive of Disease on Childhood as having 'considerable weaknesses (e.g. a very low number of subjects)' - in fact a study group of 105. The Kennedy paper itself states that further research is needed to see if the evidence of high blood pressure etc. found in the 10-year follow-up is replicated. Significantly EFSA seems to ignore the evidence we raised in our submission about the evidence held by the US Food and Drug Administration (FDA) of parents and carers reporting adverse reactions to formulas supplemented with Long Chain Polyunsaturated Fatty Acids (such as DHA). The FDA noted in its response to a filing from Martek Biosciences, manufacturer of the DHA additive, for Generally Recognised As Safe approval (click here):

"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."

The FDA requires formula companies to do post market surveillance - yet in the 9 years since this stipulation no industry reports appear to have been made, while the FDA had recorded 98 cases of parents and carers reporting adverse reactions by 2007.

EFSA 'unaware' of other factors in breastmilk relevant to DHA effect

EFSA also dismisses the point that DHA is in a different environment in formula than in breastmilk, yet the FDA stated in its response to Martek:

"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."

EFSA states:

"We are unaware of any factor in breast milk which is needed for DHA to exert its 'optimal' effect."

This raises questions about gaps in the scientific basis for EFSA's position.

EFSA dismisses the call for further research by pointing out:

"DHA levels in formula as proposed for the claim are in the normal range of DHA content naturally present in mother's milk."

It is over-simplistic simply to look at breastmilk as a template in setting levels; health outcomes need to be properly considered. Even when there is benefit from adding an ingredient to formula, it may be required at different levels to those in breastmilk. It should be remembered, for example, that the iron levels in formula are around 5 times that in breastmilk because a child absorbs it differently from the different environment - if formula simply followed the levels in breastmilk, children fed on formula would not absorb enough iron.

Professor with links to Martek and Mead Johnson attacks Baby Milk Action

Wading into the issue in extended comments in Nutraingredients is Professor Berthold Koletzko, calling the EFSA investigation a "profound scientific evaluation", ignoring the shortcomings mentioned above and the findings of independent scientists.

Professor Koletzko attacks Baby Milk Action for 'pseudo-scientific' arguments and is entitled to his opinion, but it is relevant to examine his conflicts of interest, which were not declared in the article. Professor Koletzko was lead author of a 2008 paper recommending DHA be added to formula. The declaration included in that paper states:

"The scientific workshop held at Barcelona was financially supported by Martek Biosciences Corporation. BK is the recipient of a Freedom to Discover Award of the Bristol Myers Squibb Foundation, New York, NY, USA."

Martek Biosciences manufactures the DHA additives used by the majority of formula companies.

Until recently (December 2009), Bristol Myers Squibb owned Mead Johnson, the company that filed the application to use the DHA claim which Prof. Koletzko is seeking to defend by labelling Baby Milk Action as a 'load-mouthed lobbying group'.

The need for objectivity

We believe that policy should be based on objective evidence. This is even more important for foods for infants and young children, which is a multi-billion pound industry. There is a need to ensure that research free from commercial influence forms the main basis for policy setting and that the totality of the evidence is independently reviewed. It is impossible to know with industry funded research how much inconvenient data has been hidden.

We agree that if an ingredient is of proven benefit and safe then it should be included in formula. No claims should be made about these ingredients; claims only have the purpose of boosting sales. Inferior formula should not be on the market and parents and carers have a right to accurate information.

The wider harm that will be caused by opposing the Resolution

As UNICEF points out: "There can be little doubt that the use of such health claims can mislead parents into thinking that the formulas are as good as, if not better than breastmilk."

We saw in the Philippines how claims about DHA led some parents and carers to believe it was better to use formula rather than breastfeed. You can watch a UNICEF film about this online by clicking here.

Even in the UK, where companies get away with many health claims, access to midwives, health visitors and others is not enough to correct the misleading impression given by baby food industry promotion. According to a Department of Health survey a third of mothers incorrectly believe that infant formula is the same or almost the same as breastfeeding. See Myths stop mothers giving their babies the best start in life.

Protecting babies fed on formula

There is an argument that allowing companies to make health claims encourages investment on new ingredients that may be of health benefit. Professor Berthold Koletzko sent a statement dated 28 February to all MEPs attacking the Resolution as the German Society for Paediatrics and Adolescent Medicine. There is no declaration of Prof. Koletzko's links with the baby food industry, as described above. Prof. Koletzko states:

Preventing the communication of scientifically assured benefits of optimised products bears the risk that it may slow or stop the significant quality improvements of foods for infants has occurred over the last years and decades in numerous single steps, and which has led to large benefits for child health. In the future, manufacturers might not be willing to invest major financial resources into the development, clinical evaluation and implementation of further improvements, if there is no chance to communicate such improvements.

There are several issues with this argument.

Firstly, while it is true that the possibility of making claims about some new ingredient encourages investment, this is not necessarily going to lead to benefits for infant health. In the case of DHA, investment advisors Hambrecht & Quist suggested investing in Martek Bio-sciences Corporation in 1996, saying:

"Even if Formulaide (DHA/AHA) had no benefit we think that it would be widely incorporated into most formulas as a marketing tool and to allow companies to promote their formula as ‘closest to human milk’."

They understood the value comes from health claims as a marketing tool, not from any health benefit from the ingredient. This approach advocated by Prof. Koletzko also drives a search for something to make a claim about - and we have seen this result in unnecessary and even potentially harmful products such as so-called Goodnight milks (click here for analysis by the UK Scientific Advisory Committee on Nutrition of Goodnight milks and associated claims).

Secondly, the US Food and Drug Administration requires companies there to record evidence on ill effects and keeps its own record (see above). Effectively, an uncontrolled mass trial is taking place amongst those who use formula, based on parents self-selecting whether to buy formula with DHA or not. If this was a scientific study, participants would have the right to free and informed consent. Health claims not only negate that principle, they turn it on its head.

Thirdly, science IS conducted in the public interest on new ingredients.

Fourthly, if an ingredient is of benefit, should it be denied to babies by allowing inferior formula to be marketed? Note that in this case, Martek does not produce formula itself. If DHA had been accepted as beneficial and added to the list of required ingredients when this was discussed when the EU Directive was updated in 2006, it would have found an even larger market. Pre-approval would not prevent development, it would simply require the benefit and safety of new ingredients to be proven through experiments with proper informed consent, preferably with a significant level of independent studies.

To ensure that formula is as safe and as beneficial as it can be and that information about it is accurate, we need the Resolution to be supported by the European Parliament at the beginning of April.

So please do keep sending messages. Our multilingual campaign page tells you how to do so quickly and easily - click here. If you have already sent your own messages, use the tools on that page to ask friends and colleagues to do the same.

Is breast best? book launch - a bit less polarisation please for the sake of the children

Get ready for another round of 'Breast not best' headlines in the UK that will echo around the world as a book by Joan Wolf, a political scientist, is launched here. It has the title: "Is Breast Best?: Taking on the Breastfeeding Experts and the New High Stakes of Motherhood" and Joan Wolf is speaking on it at a conference on 21 March.

We saw similar headlines last month with the publication of an article in the British Medical Journal questioning the World Health Organisation's recommendation that babies be exclusively breastfed for 6 months, with continued breastfeeding beyond this alongside the introduction of complementary foods. Interestingly one of the co-authors of that paper pops up on the panel at the book launch. In fairness to Mary Fewtrell, she did not question the benefits of breastfeeding in her article, even if that's what some newspaper headlines said. She was questioning the duration of exclusive breastfeeding, when no other liquids or foods are introduced.

Also on the panel is Guardian journalist, Zoe Williams, who also has a book to sell on her take on childcare. Personally, I have always liked Zoe's writing in The Guardian and I note she always prefaces her pieces relating to breastfeeding with comments like: "So before I start, can I just reiterate how good it is for baby; and I think I've mentioned already a million times, it's an incredibly beautiful thing, when it works."

But I do wonder about Zoe's understanding of how science works when I read her criticism that in research on health outcomes: "these haven't been adjusted for social class and environment. It boils down to: 'Middle-class babies do better; middle-class babies tend to be breastfed.'"

Now, I'm not a scientist, political or medical, but I've read plenty of research papers and know that adjusting for confounding variables is one of the most basic aspects of research. It's not always easy to do, but the class factor is not something that slipped the minds of scientists in analysing their data. I don't see them reading Zoe Williams and rushing back to their ivory towers, hitting their foreheads and exclaiming, 'How could we have been so stupid!'

I haven't read Joan Wolf's book yet, so I'm not going to critique the argument she has with 'breastfeeding experts' at this stage.

There are two points that I would like to make, however.

Firstly, 'breastfeeding experts', sometimes labelled more emotionally as the 'breastfeeding mafia' and worse, are often really objective 'health experts' basing their comments on evidence. And the evidence is that babies who are not breastfed, as a population, have poorer health outcomes in the short and longer term than babies who are breastfed. It is an uncomfortable fact when in the UK a quarter of babies receive no breastmilk at all, but fact it is.

Saying so does not make someone anti-baby milk. Baby Milk Action is sometimes attacked as anti-baby milk, even though our work is, as our slogan says, about 'Protecting breastfeeding - Protecting babies fed on formula'.

I have been working with experts in a range of disciplines (pharmacy, midwifery, paedology etc) over the past 18 months to produce a DVD called Infant Formula Explained. Yes, you've got me - we too have something to sell, well license for use in health facilities. The DVD has been produced by the Baby Feeding Law Group (BFLG), which consists of 23 health professional, mother support and consumer protection organisations, and Mark-it Television. This is my quote from our DVD press release - Mike Brady, who appears in the film speaking about the BFLG monitoring project which examines company marketing materials, said:

"The media and people with books to sell sometimes like to sensationalise health advocates as breastfeeding zealots, but the fact is we want the best for babies. In the UK nearly a quarter of babies are never breastfed and many mothers who start breastfeeding will use formula at some point. We believe they all have a right to accurate information. As the BFLG monitoring projects shows, company information for both health workers and parents and carers is designed to push the brand and so the Baby Feeding Law Group decided to produce an independent, objective film."

After trying to persuade others to produce such a film, we took it on as the BFLG because of the lack of objective information for mothers and carers who use formula. All baby food companies claim that their particular brand is better than their competitors, leaving people confused.

I asked the Advertising Standards Authority to investigate the claims of one company that its formula, the most expensive on the market, is the 'best'. The ASA ruled two years ago, after a long investigation, that the company could not substantiate its claim.

Paying more for expensive brands does not give a health benefit, it provides the company's marketing department with more money for television advertisements, free cuddly toy gifts, jollies for health workers and whizzy websites (examples here).

However, price can be used as a basis for choosing formula, in terms of not wasting your money: all formula on the market has, by law, to contain what is know to be necessary and beneficial to health. Optional ingredients are allowed, but the reason they are not on the required list of ingredients is exactly because there is no proven benefit from them. If there was a benefit, we would be campaigning for the ingredients to be a legal requirement so that inferior formula is not on the market. All the same, companies base their multi-million pound marketing campaigns on them. In the Infant Formula Explained films, the health experts dig into the research to give health workers the information and confidence they need to answer questions from parents and carers about formula and these optional ingredients.

It also includes films for use with parents showing how to mix up formula in line with World Health Organisation and Department of Health guidance.

You see, what we and our partners in the BFLG want is the best for babies.

Which brings me to my second point: this constant fuelling of the so-called 'breastfeeding versus bottle feeding debate' may help to sell books and bring traffic to websites, but it is unhelpful for mothers and babies. For many mothers in the UK, it is pitching them against themselves.

According to the Infant Feeding Survey from the Office of National Statistics, only 63% of mothers who started breastfeeding were still breastfeeding at 6 weeks and only a third were still breastfeeding at 6 months (pg. 35). Many mothers in the UK both breastfeed and use formula.

Another statistic tells us that 90% of mothers who stopped breastfeeding by 6 weeks would have preferred to breastfeed for longer. Of those who stopped by 6 months, 40% wanted to breastfeed for longer.

We can decide how we want to respond to these figures - and the feelings of distress that may lie behind the statement that mothers wanted to breastfeed for longer.

The response of the formula companies and people who try to negate the evidence regarding infant feeding and health outcomes is to suggest it doesn't matter, formula is almost as good as breastfeeding - or maybe even better if you take the formula companies' claims about benefits to eyesight, brain development and building the immune system at face value. The more 'breast not really best' headlines they can generate, the better they seem to think it is.

Alternatively, we can acknowledge that there are differences in health outcomes. We can use the fact that the National Health Service spends millions of pounds every year treating some of the extra illness amongst formula fed babies (according to NICE, the National Institute of Clinical Excellence) to make the case for better support for mothers.

I think we should be shocked that 90% of mothers who stopped breastfeeding at 6 weeks wanted to breastfeed for longer and be calling for better support. We should also be shocked that formula companies target mothers so aggressively in breach of international marketing standards, profiteer by playing on mothers fears over which is the 'best' formula and market unnecessary, expensive, heavily-advertised products. Aside from exceptional cases of medical need, the only formula that a baby needs when not breastfed is whey-based formula used from birth. Follow-on milks and growing up milks are unnecessary products - any extra nutrients a baby requires can be supplied by solid foods introduced alongside breastfeeding or the whey-based first milk.

So-called 'hungry baby' and 'good-night' milks do not have any evidence to support the claims they are more satisfying - and as you have to clean a baby's teeth after feeding with 'good-night' milk because of the risk of tooth decay from its sugar content (check the instructions), it is counterproductive even if it did do what it says on the tin.

We should also be concerned that some of the unnecessary illness comes from formula not being reconstituted properly.

I would like to ask everybody to write to the Secretary of State for Health, Andrew Lansley, complaining that the Department of Health is planning to scrap its Infant Feeding Coordinator posts and its support for National Breastfeeding Awareness Week. These were manifestations of government commitment to the Global Strategy for Infant and Young Child Feeding and the Innocenti Declaration. It seems that commitment is being forgotten under the cuts agenda. This is one of the worst examples of short-term penny pinching that will lead to medium and long-term costs to the health service and growth in health inequalities.

The Department of Health was not only promoting and supporting breastfeeding, it was working to help mothers who bottle feed. The Infant Feeding Coordinators have just updated the guide to bottle feeding that we used the basis for the guidance in the Infant Formula Explained DVD (alongside that from the World Health Organisation). The DVD is in line with the new guide and is also appropriate for use in UNICEF Baby Friendly accredited facilities.

No doubt we will have a spate of 'breast not best' headlines in response to Joan Wolf's book launch and these will echo around the world, undermining breastfeeding cultures in other countries.

What we really need are headlines saying, 'Department of Health plans to abandon mothers and babies'. Those might help reverse the decision to scrap efforts to improve breastfeeding rates and reduce unnecessary illness amongst formula-fed babies.

That would benefit ALL mothers and babies.