Friday, August 31, 2007

George Clooney questioned over role in advertising 'widely boycotted' Nestlé.

People have complained to us about George Clooney, actor and human rights campaigner, appearing in advertisements for Nestlé coffee. Gaining access to an A-list hollywood star has proved problematic, but Mr. Clooney was put on the spot about this at the Venice film festival today as he took part in a press conference about his latest role. Ironically he plays a lawyer caught in a moral dilemma - and mortal danger - when called on to defend a company against a lawsuit over its practices.

Asked about his real-life role in the Nestlé Nespresso advertisements, Mr. Clooney said he did not work for Nestlé, according to ABS-CBN which reports he said unsmilingly: "I'm not going to apologize to you for trying to make a living every once in a while. I find that an irritating question."


The report does refer to the controversy over Nestlé's marketing of baby foods, though it refers to the boycott in the 1970s, prompting me to send the following response to the news outlet and to issue a press release (see the Nestlé-Free Zone page if you are unfamiliar with the boycott):

Your article on George Clooney defending his involvement in Nestlé advertising states: "The company has been criticized in the past for its manner of marketing formula baby milk in developing countries. The controversy led to a boycott of its products in the late 1970s."

It is unfortunate your article did not report the current situation, which is that the boycott was re-launched in 1988 as Nestlé failed to abide by commitments made that led to the end of the first boycott in 1984. The second boycott has forced some changes in policy and does stop specific cases of malpractice, but monitoring shows Nestlé continues to violate the international standards for baby foods more than any other company as it promises to build significant year-on-year growth in sales. Nestlé has repeatedly rejected a four-point plan put to it by boycott coordinators to save infant lives and ultimately end the boycott.

Even Nestlé's Global Public Affairs Manager, Dr. Gayle Crozier Willi, acknowledged in April this year that Nestlé is 'widely boycotted' after an independent poll found it to be one of the four most boycotted brands on the planet.

Where our work with our partners for independently monitored and enforced legislation implementing the marketing requirements has succeeded, Nestlé´ánd other companies abide by the international standards, so it is not impossible to comply. The boycott helps to compel it to change its practices where effective legislation is not yet in place.

Let us hope Mr. Clooney will also update his knowledge and support the boycott in future to keep up the pressure on Nestlé to change.

Wouldn't it be great if Mr. Clooney made ammends by walking down the red carpet with one of our must-have, boycott Nestlé, reusable, Fairtrade-cotton bags! You can buy them here:

Let me know if you see any more reports of this story and why not leave your own comments or send a letter to the editor in response?

UPDATE 5 September: You can view the press conference and Nestlé coffee advertisement via:

Thursday, August 30, 2007

August promotion ending shortly

Tomorrow is the last day of our August promotion so take advantage of this great opportunity.

Order before the end of August and enter the promotional code 'blogaugust' when asked why you came to the shop today. View the great merchandise at:

You will then receive free gifts worth at least 10% of your order value.

So order our new IBFAN breastfeeding calendar for 2008 and you might receive a set of breastfeeding postcards.

Order our new t-shirts with our popular fridge magnets displayed upon them and you might receive a set of postcards, boycott badge and pack of 10 Nescafé - No Thanks cards.

Order two t-shirts any you might receive a fridge magnet (these are currently not on general sale).

Order 10 breastfeeding calendars, making a bulk order saving, and you might receive one of our books.

Only one day to go! So do take advantage of this offer before it ends!

Wednesday, August 29, 2007

Learning from the ice-cream wars

What can we learn from ice cream? I sometimes cite Nestlé's ice-cream war with Unilever when people question why Nestlé has not yet given in to the demands of boycott coordinators. Certainly we have won some grudging changes to policy and can stop specific cases of aggressive baby food marketing targeted by our Campaign for Ethical Marketing. But Nestlé still refuses to agree to our four-point plan aimed at saving infant lives and ultimately ending the boycott. It won't even agree to the first point, that it should accept the validity of the World Health Assembly marketing requirements.

Even Nestlé acknowledges that the company is 'widely boycotted'. Independent surveys have found it to be one of the four most boycotted companies on the planet.

So why hasn't it accepted the four-point plan? Well, we can learn from ice cream and I am prompted to write about this by an article in Business Week. See Ice Cream Wars: Nestlé v. Unilever.

Ice cream is a US$59 billion industry, now dominated by the two companies as they have gone on tit-for-tat acquisition sprees, buying up national ice cream companies. You may have seen this happening. A Nestlé oval appears around the old company name, such as Lyons Maid in the UK or Yopa in Brazil. After a few years for people to get used to that, the old company name is unceremoniously booted out and Nestlé replaces it in the centre of the oval.

It is a cut-throat business and Nestlé in particular demands strong growth. Though ice cream contributes billions to Nestlé turnover, it dumps any brand that is not reaching its growth targets of 5-6% per year. So Lyons Maid was divested a few years ago, with Nestlé continuing to profit from the licensing of brand names to the new owners.

Country by country Nestlé and Unilever go head to head, trying to out compete the other. Asia and Latin America are the current battle grounds and a fortune is being spent in trying to convince customers of the merits of their respective products.

This is the daily reality of Nestlé executives. With this aggressive culture permeating the company, the boycott is seen as another factor in their operating environment. Executives generally try to throw money at the problem, with their anti-boycott team, expensive publications and Corporate Social Responsibility strategy of improving the company image. When the pressure is too great, they are forced to give ground. Stopping a promotion. Changing an aspect of policy.

Our work for legislation is most effect because, when given no choice, the companies can comply. But it does require a strong stance as even then Nestlé is loathe to comply, for example, refusing to turn up to court in Costa Rica and India when prosecutions were brought. In India it took the government to court to try to have the law changed.

The Business Week article doesn't mention it, but the ice cream war is also a legal battle, with the companies suing and counter-suing over restrictive practices as they try to achieve exclusive deals for ice cream distribution. At least Baby Milk Action has never faced a legal challenge as Nestlé knows it would lose, so further fueling the campaign for it to change.

This is a campaign - and not just a request to Nestlé - for the simple reason that Nestlé is not willing to change. Whatever it may say as it tries to endear itself to the public and organisations it wants on its side, Nestlé is still contributing to the unnecessary death and suffering of infants around the world through its aggressive baby food marketing practices. It is still responsible for more violations of the marketing requirements than any other company.

The campaign has its successes and with greater support, through people spreading the word, writing to Nestlé and supporting us financially (perhaps by buying some of the boycott merchandise we sell) we can have a greater impact.

But don't be surprised that there is resistance from Nestlé. Infant nutrition has to deliver the same year-on-year growth as the rest of its sectors to comply with what the Chief Executive calls the Nestlé model. He has promised shareholders he will deliver and they shout down anyone who raises concerns about his methods. Nestlé won't stop its aggressive marketing readily.

Lives are at stake so we will not give up and we will continue making gains that help to save lives. But it is not easy taking on Nestlé.

Just take a look at the ice-cream war.

Tuesday, August 28, 2007

Wyeth SMA soya formula promotion shows need for independent information

We're starting to get reports of advertisements in Wyeth's £3 million promotion for its SMA brand of formulas in the UK. Look out for analysis here shortly. Today I am looking at how it fails to give parents the information they need about soya formula and invite you to sign up to receive information on our campaign to make formula feeding safer.

As I commented recently, calling for strengthened regulations on formula companies and for existing regulations to be enforced is not anti-formula or an attack on mothers who use formula. It is the opposite. It is protecting a mother's right to accurate information so she can make an informed decision on how to feed her child and, if using formula, knows how to reduce the risks. See:

In that blog I said I would return to the subject of soya and goats' milk formula.

I thought I would see what Wyeth has to say about its SMA Wysoy formula.

Companies should not be advertising infant formula under the provisions of the International Code of Marketing of Breastmilk Substitutes and the UK law. Under the Code, companies should not seek direct or indirect contact with mothers. They are limited to providing scientific and factual information to health workers who have responsibility for advising parents.

But Wyeth does promote formula on its website with impunity, at least so far. The Advertising Standards Authority refuses to even investigate claims on websites, even when companies direct parents to the site in their print and television advertisements. Trading Standards has not brought a single prosecution for illegal promotion on the internet.

So while companies are getting away with it, let's see what they are saying. This is what Wyeth says on its website about Wysoy. I'll quote it to analyse it:

---quote from Wyeth's SMA website
SMA Wysoy is a nutritionally-complete infant formula based on soya protein rather than cows’ milk protein, which makes it suitable for babies with cows' milk intolerance.

Cows’ milk intolerance is when the digestive system finds it difficult to cope with one or more of the ingredients in cows' milk and can result in a variety of symptoms, including eczema, vomiting, diarrhoea and stomach cramps. If you suspect your baby has cows’ milk intolerance, talk to your GP or other healthcare professional, who might be able to prescribe a cows’ milk free formula, such as SMA Wysoy.

Did you know?

SMA Wysoy is approved by the Vegetarian Society and is often used by parents who wish their baby to have soya-based infant formula for religious or cultural reasons.

“When should I use SMA Wysoy?”

SMA Wysoy can be used from birth onwards and can also be used as part of an older baby or toddler’s varied weaning diet. However, it should only be used if your baby has a cows’ milk intolerance or if you have other reasons for wanting your baby to have a soya-based infant milk.

Always consult your doctor or healthcare professional before making any changes to your choice of baby’s milk.

Dad bottle feeding baby

“What are the benefits of using SMA Wysoy?”

If your baby has cows' milk intolerance, you should completely remove cows' milk and any products containing cows' milk from her diet. SMA Wysoy, with its soya protein base, is a useful alternative to cows’ milk.
---quote ends

So there is the repeated advice to contact a health workers before changing the formula a baby is fed, which is good. But also the suggestion to use Wysoy "if you have other reasons for wanting your baby to have a soya-based infant milk".

Plus the image showing a man feeding the child is surely not there by accident, but is to highlight that formula feeding facilitates this.

There is small print on the Wyeth website page saying "Breast is best" and giving, in basic terms, some of the legally required information. But there is much information missing that we think parents should have brought to their attention.

The Food Standards Agency does provide independent information for parents on cows' milk intolerance. See:

Here is an extract:

---extract begins
You should only give your baby soya-based infant formula if your GP or health visitor advises you to. In almost all cases, breastfeeding or another type of formula will be a better choice.

Soya-based infant formula was originally developed for babies who can't have infant formula based on cows' milk, for example, because of a milk allergy. But there are now other types of formula that are more suitable for these babies and your GP or health visitor will be able to advise you about this.

Occasionally your GP or health visitor might recommend soya-based infant formula, for example, if your baby can't or won't drink other types of formula, or if you want your baby to eat a vegan diet and you're not breastfeeding.

If you're giving your baby soya-based infant formula at the moment, talk to your GP or health visitor about changing to a different formula.
---extract ends

Of course, we should not be surprised that the Wyeth website does not state that this product will rarely be recommended. It is a commercial enterprise, so why draw attention to the fact? Instead Wyeth's approach is to encourage people to speak to a health worker: "who might be able to prescribe... Wysoy."

This is exactly why companies should not be the source of information for parents.

As the Food Standards Agency article goes on to explain, there are some concerns about possible negative health impact of soya formulas. Soya contains phytoestrogens. These are compounds found naturally in some plants, which may mimic or block the action of the human hormone, oestrogen. Tests in animals have shown an impact on development, but the impact on humans is still unclear. Yet there is a need for caution when we are talking about the sole food for a baby in its most important months of development.

We should not underestimate the importance of regulations. Marketing in the United States is unregulated and a voluntary code that did exist collapsed when Nestlé entered the market. The American Academy of Pediatrics states: "Healthy full-term infants should be given soy formula only when medically necessary." Yet it is estimated that 20% of formula sold in the US is soya formula. See:

This article from the Food Standards Agency gives additional information about cows' milk allergy and milk intolerance. See:

Soya formula is not recommended for cows' milk allergy. It states: "Another type of infant formula is soya-based infant formula. But only use soya-based infant formula on the advice of your GP or health visitor. Babies who are allergic to cows' milk may also be allergic to soya. In almost all cases, breastfeeding or another type of formula will be a better choice."

Even when soya formula is recommended, there can be unexpected risks. Last year Farley's had to recall a batch of soya formula because it was contaminated with milk. See:

Wysoy has been recalled after being found to contain small pieces of stainless steel. See:

Goats' milk formula is not recommended either as it contains similar protein to that causing cows' milk allergy. In addition, goats' milk formula cannot legally be sold in the UK as insufficient testing has been done on it - find out more on the Department of Health website.

Babies with an allergy to cows' milk may sometimes have a reaction to the protein passing into a mother's breastmilk, but she can adjust her diet if this is an issue.

If you are concerned about any of these issues, speak to your health worker or contact one of the mother support groups listed on the Baby Milk Action website.

They are far better sources of information than companies with a vested interest in selling you their products. We want them to be better still, which is why we support the Breastfeeding Manifesto, which calls for better training for health workers.

Action is long overdue. Recall what Wyeth says on its website: "Cows’ milk intolerance is when the digestive system finds it difficult to cope with one or more of the ingredients in cows' milk and can result in a variety of symptoms, including eczema, vomiting, diarrhoea and stomach cramps. If you suspect your baby has cows’ milk intolerance, talk to your GP or other healthcare professional, who might be able to prescribe a cows’ milk free formula, such as SMA Wysoy."

Contrast that with this from the British Medical Journal over ten years ago: "Indiscriminate swapping between formulas, often on the advice of health professionals, should be avoided, as should spurious recommendations to use a soy based formula for vague symptoms and signs. These include normal crying-fussing behaviour of young infants, colic, and rashes, any of which may be ascribed to cow's milk protein intolerance. Casual treatment in this manner is undesirable because it leads to overdiagnosis of food allergy, with possible long term effects on children's dietary habits."

Hence our call for independent, accurate information.

You can sign up for information specifically on Baby milk Action's work to make formula feeding safer at:

Monday, August 27, 2007

News from our partners in Cameroon

A few years ago Baby Milk Action was contacted by health campaigners in Cameroon in an organisation called Cameroon Link. They became aware of our work after becoming concerned at Nestlé promoting its formula at health clinics. We ran a campaign on this and as a result of the communication campaigners in Cameroon decided to launch a national boycott of Nestlé. Nestlé since attempted to deny there is a boycott in Cameroon or any concern about violations, provoking a response from our partners and a further campaign. See:

The boycott remains active in Cameroon and our partners promoted International Nestlé-Free Week in July this year in the national media.

Health campaigners also contacted the African coordinating office for the International Baby Food Action Network (IBFAN) in Swaziland. A national IBFAN group - CIFAS - has since been set up by health campaigners in Cameroon to campaign for implementation of the World Health Assembly marketing requirements. Some of the provisions have now been introduced in legislation. The group is also promoting and supporting breastfeeding, providing a critically important counter-message to that of industry whose promotion suggest formula feeding is the modern way of infant feeding in developed countries.

The IBFAN group marked World Breastfeeding Week earlier this month with a series of events. This had the support of UNICEF, Yaounde University and the Minister of Public Health.

Official ceremony: Urbain OLANGUENA AWONO (Minister of Public Health) making a speech, with to his right Prof. Maurice NKAM (Director of the Yaounde University Teaching Hospital), Jacques Boyer (UNICEF).

CIFAS members marched to various events to draw the attention of the surrounding population.

Information was given to mothers and their families on the importance of exclusive breastfeeding and early initation (the theme of World Breastfeeding Week 2007).

Breastfeeding is the best for babies in all societies.

I send my congratulations to our partners in Cameroon for their dedicated and imaginative work. They are helping to save infant lives and improve the well-being of families.

Friday, August 24, 2007

Yes to information - no to propaganda

I wrote earlier this week about criticism of the baby food industry in the Philippines by the Department of Health, UNICEF and the World Health Organisation for its misrepresentation of data on breastfeeding rates in the country and failure to provide essential information on infant formula labels to reduce risks of its use. See:

Today I have learned of a campaign in the Philippines that goes under the name 'Mothers Knows Best'. This campaign ignores the fact that marketing requirements for baby foods are intended to protect all mothers and babies, whether breastfeeding or using formula, and is trying to recruit mothers to petition for the proposed restrictions on advertising and misleading claims to be blocked. There is no disclosure of who is behind this campaign.

I have commented before about the way the call for international marketing standards to be implemented in the UK is sometimes misrepresented as an attack on mothers who use formula. The fact that formula companies here break our existing weak law by making misleading and idealizing claims while failing to give clear warnings on risks of formula and how to reduce them receives scant coverage in the media.

All we ask is that people look at the evidence that shows so clearly that company promotion is not providing information, but is aimed to increase sales. For a recent blog on this see:

It would not surprise me if we saw something like 'Mothers Know Best' appearing in the UK. In fact, we already have it. It is called Inform and is a front organisation for the baby food industry. We have exposed in the past how it has failed sometimes to reveal its connection to the companies, and how mothers who contacted it then received mailshots from formula companies. See:

Inform is, in truth, an initiative from Cow & Gate, Heinz Farley's, Milupa and SMA/Wyeth. The same Wyeth that is part of the legal attack on the regulations in the Philippines. This is what Inform says:

"INFORM fully supports breastfeeding as the best way to feed a baby but is concerned that mothers should receive good advice and education on formula feeding. Current legislation, adopted in 1995, has created an information gap in that women seeking information or advice on infant formula feeding or products have restricted access to that information. As a result they are often left feeling ill-informed and ill-equipped to bottle feed their baby safely and successfully."

Yeah, right. These are the same companies that have so far refused to put warnings on labels that powdered infant formula is not sterile and to give clear instructions on how to reduce the risks. It falls to organisations like Baby Milk Action and UNICEF to draw attention to how to make formula feeding safer. See:

In the Philippines 'Mothers Know Best' also says mothers should have better access to information. We certainly agree there needs to be better information for parents. But it is serving the industry not mothers and babies to suggest that is achieved through striking down the regulations introduced by the Ministry of Health last year.

This is how 'Mothers Know Best' presents the issue:

---Quote begins
In recent weeks we have seen demands from WHO, UNICEF and other activist groups for a complete ban on advertising of products for children under 2 as well as "an absolute ban on false health and nutritional claims." This outcry comes as these groups are finding it difficult to succeed with their programs to increase the popularity and rate of breastfeeding throughout the Philippines. Unfortunately, it also appears to be a campaign dangerously driven by politics. The campaign to blame companies that produce safe, healthy infant formula for child nutrition problems is bad for Filipino mothers and their infants for three reasons:

1. It amounts to government censorship on information for mothers. We need more education on nutrition for infants, not less.

2. It creates a stigma around formula and will encourage the use of more dangerous supplements.

3. It diverts resources away from the true problem -- the barriers to breastfeeding for many women, such as the lack of accommodations in the workplace.

WHO and UNICEF are leading a charge to convince the world that people somehow believe that Breast milk is not the best nutrition for babies. We are not aware of anyone who believes that. What is wrong with this campaign is that they use patently false claims concerning formula that will have little real effect while they attack multinational corporations for political gains. They fail to face the reality that the government has failed to monitor advertising and enforce existing laws. It is easy to attack companies. Making real change that will have real impact is much harder. The end result is that instead of positive change, they demonize mothers who find that breastfeeding -- for one reason or another - -is not an option.
The real solution is:

1. Enforce Executive Order No 51. to bring manufacturers AND health workers and centres in line with the law.

2. New laws (and enforcement) to enable mothers to breastfeed in any location without fear of intimidation, retribution or criticism.

3. New laws to provide workplace accommodations for mothers to breastfeed with out danger of loosing their jobs and without fear of intimidation, retribution or criticism.

4. Education programs to demonstrate that Breast milk is indeed the best nutrition for babies along with information that properly utilized and prepared formula is the only second best choice.

The issue is not anti-advertising legislation. The issue is enforcement of existing legislation and new legislation to support the rights of mothers who choose to breastfeed while not stigmatizing mothers who chose formula.
---Quote ends

I certainly agree with their calls for enforcement of the existing law. As we have exposed on our Campaign for Ethical Marketing action sheet, Wyeth, Nestlé and the other companies systematically break the marketing requirements in the Philippines.

But calling for companies to abide by the marketing requirements adopted by the World Health Assembly over 25 years ago - as they are forced to in many countries that have implemented them in legislation - is not an attack on mothers who use formula. It is the opposite. It is respecting their right to accurate and independent information on infant feeding.

It is a right enshrined in the Convention on the Rights of the Child. And it is a right that is abused by companies when they promote their own misleading claims, in the Philippines and the UK.

The International Code of Marketing of Breastmilk Substitutes explicitly aims to ensure the safe use of breastmilk substitutes when these are necessary. It does not prevent their sale and it certainly does not encourage mothers to use unsafe alternatives. Nor does it compel mothers to breastfeed. The Code and subsequent, relevant Resolutions of the World Health Assembly are addressed to governments, companies, health workers and Non-Governmental Organisations.

Go back and watch the film produced by UNICEF Philippines. It shows the importance of giving parents accurate information and support as well as the need for stopping aggressive marketing.

If the industry uses front organisations and bogus arguments to try to get mothers to fight for its right to mislead them, then we should not really be surprised. It is very much in keeping with the way they put their own profits before the well being of babies and their families.

They conflate different issues to try to avoid necessary controls on their practices.

The same is happening in Australia, where a Senate Committee is calling for the International Code and Resolutions to be implemented.

This is from the Sidney Morning Herald.

---Extract begins

The most worrying promotion of formula is the constant exploitation of the normal anxieties that beset parents, particularly first-time parents, who may not have access to good information about what is and isn't normal in regards to baby health and behaviour. Specialised formulas cater to the 50 per cent of healthy babies who regurgitate, and there is a range of products designed for "crying" babies, "constipated" babies, "colicky" babies and babies who "won't sleep".

One company has even named its formulas after these conditions: Sweet Dreams, Anti-Constipation, Anti-Diarrhoea, and Anti-Colic. Labels such as these are not based on peer-reviewed scientific studies but marketing research. These tins of formula are often located in pharmacies in stands right near cash registers, positioned to catch the eyes of worried mothers.

Unrestricted advertising for products designed for babies over six months is still permitted in Australia. "Follow-on" formula and "toddler" formula are unnecessary products packaged in identical ways to infant formula.

At a recent Senate inquiry into breastfeeding, spokespeople for the Infant Formula Manufacturers Association of Australia expressed concern that the restrictions on advertising meant that families were not getting clear, objective information about infant formula.

---extract ends

It is the same strategy.

What is really needed is clear.

Yes to accurate, independent information. Yes, to support for mothers with breastfeeding. Yes, to accurate information on formula and how to reduce the risks for those who use it.

No to company propaganda.

The primary interest of companies - actually and legally - is their shareholders. Let us see them for what they are: commercial organisations aiming to grow their market.

Nestlé, for one, has promised significant year-on-year growth in the infant nutrition and every other sector. If they don't grow quickly enough they sell the business. And the shareholders, who are supposed to hold publicly hold companies to account, shout down anyone who questions their tactics. See:

Thursday, August 23, 2007

Breastfeeding calendar 2008 - order now to receive a free gift

This is to inform you about some developments with Baby Milk Action's on-line Virtual Shop and website.

First up, the IBFAN Breastfeeding Calendar 2008 is on its way from the printers and can now be ordered. It is just £7 including UK postage and packing (£2 extra for overseas orders). Order 10 or more and the price drops to £6.

You can view the 12 great full-colour pictures on line and order at:

If you order before the end of August, you will be able to take part in our promotion. Simply enter the code 'augustpromo' when you are asked why you visited the shop and we will send you free gifts worth at least 10% of the value of your order.

If you have ever bought anything from our Virtual Shop then we would like to invite you to leave feedback using our new comment feature. Simply visit the shop and click the 'comment' button next to the items you purchased to tell people your views. To browse all comments go to:

Finally, if you haven't made use of our podcast, now might be a good time to do so. There has been a lot happening with both UK and overseas campaigns. The latest podcast rounds up the following blogs:

* Which infant formula is the best? (An examination of company claims)
* Where is the proof? (Can you believe Baby Milk Action?)
* ASA will not investigate SMA promotion in OK! Magazine
* Now Aptamil promotes in a celebrity magazine
* Emergencies in Iraq and Peru

Access the podcast at:

Wednesday, August 22, 2007

False claims on infant formula bared

The media in the Philippines has picked up on the joint press release from health agencies there, which I wrote about yesterday. See:

Here is one of the articles, in the Manila Standard. See:

It is headlined: "False claims on infant formula bared". It leads on the news that powdered infant formula is not sterile and that this fact is not disclosed to the public by the baby food industry.

The same is true in the UK. Only one company includes this fact on its labels, but then it contradicts the expert advice on how to reduce the risks.

We have been calling for Trading Standards and the Food Standards Agency to take urgent action to ensure that parents who use formula have the information they need. We have also told parents where they can find independent information. I've written about this topic several times on this blog and we have tried to alert the UK media to the scandal with a press release of our own. See:

While the UK media has given publicity recently to concerns over breastfeeding being undermined by aggressive company marketing, it has missed the point about the need for parents who use formula to be protected and to be provided with accurate and independent information. This is as much an aim of the call for international marketing standards to be implemented in the UK.

While babies in the UK who are formula-fed are unlikely to die as happens too frequently in the Philippines, there are still short and long-term health implications.

While it may be attractive for journalists to stir up controversy - and attract readers - by portraying our work and that of our partners as anti-formula, I do hope they will sooner or later give coverage to the work we do on behalf to those who use formula. This is, after all, an important public health issue.

Tuesday, August 21, 2007

Industry offensive criticised in the Philippines

It was not only in the UK that Wyeth (makers of SMA formula) was on the offensive during World Breastfeeding Week.

The company, which is about to launch a £3 million baby formula promotion campaign in the UK, is a member of the Pharmaceutical and Health Care Association of the Philippines (PHAP) which has taken the Ministry of Health to court for the regulations it has introduced to implement World Health Assembly baby food marketing requirements. PHAP ran advertisements during World Breastfeeding Week to support their call for the marketing regulations to be struck down. A past campaign was criticsed by the UN Special Rapporteur on the Right to Food for being 'misleading, deceptive and malicious in intent'. See:

In the Philippines the World Health Organisation (WHO) estimates that 16,000 babies die every year as a result of inappropriate feeding. WHO suggests in an advisory issued to correct the latest PHAP advertising campaign that formula-fed infants should be attended as a 'risk group' and that formula should be seen as the fourth option after a mother's milk or donated breastmilk.

WHO also comments on the lack of awareness that powdered infant formula is not sterile. We face the same problem of most companies not disclosing this information in the UK. See:

Last year Wyeth joined Nestlé in calling for the UNICEF and WHO representatives to be sacked after they spoke in favour of strong regulations, alleging they were 'not competent' to look after the welfare of Filipino children. See:

The access to health care we have in the UK means that infants who are formula-fed are unlikely to die, but they are more likely to suffer short and long-term sickness. Treating the higher incidence of gastro-entiritis in formula-fed infants alone was estimated in 1995 to cost £35 million per year.

All parents have a right to independent and accurate information on infant feeding including how to overcome breastfeeding difficulties and, if they are using formula, clear information on the risks and how to reduce them.

Whether it is in the UK or the Philippines, companies do not provide this: they idealise their products to undermine breastfeeding and don't give parents who use formula the information they need. They should be limited to providing scientific and factual information to health workers and ensuring there are better warnings and instructions on labels. See:

We will continue to work to hold the companies to account in the UK and the Philippines and hope for your support.

---Press release from Philippines health organisations


The Department of Health, World Health Organization and United Nations for Children’s Fund released a joint advisory the public on the true state of breastfeeding practices in the country today.

“We are appalled by the persistent distortion of data by PHAP,” DOH undersecretary Alex Padilla said. “They propagate misleading information that seriously undermines breastfeeding in the country.”

The group cited in particular the press releases and paid advertisements that appeared in newspapers during the commemoration of World Breastfeeding Week. The worldwide event is the widest and largest annual celebration of breastfeeding by advocates held every first week of August.

“The timing and nature of the materials are clearly unethical and is the very reason why the new implementing rules and regulations of Executive Order 51, or the Milk Code, is all the more imperative,” added Usec. Padilla.

The revised guidelines of the Milk Code impose an absolute ban on advertising, promotions, or sponsorships of breastmilk substitutes up to 24 months of age. The Supreme Court is currently studying the documents submitted by the DOH and PHAP following a much publicized oral argument last month.

The materials of PHAP cited studies and data by the National Demographic and Health Survey (NDHS), DOH, WHO, and UNICEF that painted encouraging breastfeeding rates in the country.

According to Usec. Padilla, the contentions derived from those materials are deceptive. He cited the 2003 NDHS conclusions used by PHAP that “54% of Filipino mothers initiate breastfeeding in the first hour of life” and “Filipino infants are being breastfed more frequently”.

“A little more than half is not an encouraging statistic,” he asserted. “This ranks the Philippines as one of the countries with the lowest breastfeeding initiation rates in the world.

The same NDHS study he said showed dismal numbers where only 16.1% are exclusively breastfed for 4 to 5 months of age and 13% of Filipino babies were never breastfed.

The WHO also clarified data used by PHAP, particularly its recognition of using infant formula as “appropriate”.

“The WHO strongly recommends breastfeeding for its undeniable superior benefits,” said WHO country representative Dr. Jean-Marc Olivé.

Dr. Olivé discussed that breastfeeding can prevent diseases and promote better health to both mother and child.

He also said that breastfeeding can be done by a vast majority of women and only under exceptional circumstances does WHO recognize alternative feeding practices.

The first option is expressed breastmilk from the infant’s own mother. The second is breastmilk from a healthy wet nurse. The third choice is breastmilk from a human-milk bank.

“The use of breastmilk substitute is the last resort,” Dr. Olivé said. “In fact, infants who are not breastfed, for whatever reason, should receive special attention from the health and social welfare system since they constitute a risk group.”

Health studies in the past ten years show that not breastfeeding increases the likelihood of children suffering from diarrhea, pneumonia, asthma, allergies, chronic diseases, and even lower intelligence.

“Most people are also unaware that infant formula is not a sterile product,” Dr. Olivé stated.

The Food and Agriculture Organization (FAO) and WHO in February 2004 convened a panel of experts who concluded that intrinsic contamination of powdered infant formula with Enterobacter Sakazakii and Salmonella has caused serious illness leading to developmental sequelae and even death.

He said that it is important for consumers to know, especially those directly involved in caring for babies, that the infant formula they are using may contain pathogenic microorganisms and that their handling, storage, and preparation practices can increase health risks.

Colin Davis, the UNICEF Philippines Officer-in-Charge said: “Recent statements from the infant formula industry distort clear evidence and can confuse the public regarding two important facts: once, exclusive breastfeeding in the Philippines is declining; and two, the use of formula exposes infants to serious health risks. These ads are further proof that the National Milk Code needs to be rigorously implemented.”

“We want to set the record straight and call on the wisdom of the public,” Sec. Duque said. “It is the duty and responsibility of the DOH to inform the public about the risks and dangers to their health, especially those that concern our children.”

Earlier this year, Jean Ziegler, the Special Rapporteur on the right to food appointed by the United Nations Human Rights Council has already described the PHAP’s media campaign as “misleading, deceptive, and malicious in intent”.

Mr. Ziegler cited that the content of the communication materials by PHAP “manipulate data emanating from UN specialized agencies such as WHO and UNICEF, as well as the Department of Health” and “contribute to misleading the public by claiming that breastfeeding can not be done by a majority of women and that their products raise healthy, smart, and happy babies”.

Ms. Ma. Alexis Rodrigo
Senior Communication Assistant
Telephone: (632) 901-0173
Fax: (632) 901-0195
Cellphone: +63917-8589447

For Every Child
Health, Education, Equality, Protection

Monday, August 20, 2007

Wyeth/SMA prepares for £3 million UK campaign

Wyeth/SMA is following the news that the Advertising Standards Authority is not even going to investigate its recent promotion in OK! celebrity magazine, by preparing a £3 million promotion for its baby formula, according to Marketing Week magazine.

This dwarves the government's expenditure on promoting breastfeeding, which is £729,011 for 2006/07, a decrease on the previous year.

It is a mistake to think about attempting to outspend the formula industry, however. The industry needs to be regulated in accordance with the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions of the World Health Assembly.

As the preamble to the Code states: "in view of the vulnerability of infants in the early months of life and the risks involved in inappropriate feeding practices, including the unnecessary and improper use of breastmilk substitutes, the marketing of breastmilk substitutes requires special treatment, which makes usual marketing practices unsuitable for these products."

Wyeth/SMA is not seeking to provide information to parents, it will be using its massive resources to issue misleading propaganda which undermines breastfeeding and does not provide the information parents who will use formula are needing.

Our UK law campaign is calling for the Code and Resolutions to be implemented in full, for better support for mothers who are breastfeeding and correct, independent information on formula feeding for those that use it and clearer warnings and instructions. See:

Last year the Food Standards Agency wrote to the companies reminding them of the provisions of the Infant Formula and Follow-on Formula Regulations 1995, our weak implementation of the Code and Resolutions in the UK. The regulations allow only 6 claims on formula labels. The guidance issued to Trading Standards officers (download it here) is explicit about some of the claims that are not allowed, such as 'closer than ever to breastmilk'. Wyeth has launched new SMA labels since then claiming it is 'as close as possible to breastmilk' (just as Aptamil has launched labels claiming 'inspired by breastmilk').

The labels also include non-compliant claims such as 'improved protein balance' and 'easily digested'. Wyeth is already targeting health workers to promote its formula to parents. See:

These claims are not useful information for parents as they are simply promotional. Parents who decide to use formula require independent analysis of the different formulas on the market to understand the differences and how to reduce risks. SMA is suggesting its 'new protein balance' makes it as close as possible to breastmilk, yet all companies claim their formula is the closest to breastmilk for one reason or other. They are clearly not providing objective information. This is why the Code limits companies to providing scientific and factual information to health workers, who are responsible for advising parents. See:

The ban on promotion contained in the Code needs to be implemented and enforced. As do the bans on companies seeking contact with parents and offering inducements to health workers. We have exposed in the past how Wyeth, which already has a criminal conviction for illegal advertising, offers gifts and VIP trips to health workers to gain their support. See:

In the OK! Magazine promotion, Wyeth was ostensibly promoting its SMA follow-on milk. The weak UK law only prohibits infant formula advertising. Yet the advertisement displays the logo used for infant formula and directs people to a website promoting the full range of products. It is a de facto infant formula advertisement.

To date we have been disappointed by the action, or lack of it, by UK authorities to enforce the regulations. So as well as campaigning for companies to bring their practices into line, we also have to hold the authorities who should protect to public interest to account. I will say more about this in due course.

At the same time we ask you to support our campaign for full implementation of the Code and Resolutions to close the loopholes the companies exploit.

Friday, August 17, 2007

Emergencies in Iraq and Peru

We have received reports of free formula being distributed in Iraq and have raised this with the UK authorities and partners. News just in is that UNICEF is calling for the Government of Iraq to take action by enforcing the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant World Health Assembly Resolutions. The experiences in Iraq and during the Asian tsunami of 2004 show why donating formula to Peru, hit by an earthquake this week, is the wrong way of trying to help.

The Code and Resolutions aim to protect and promote breastfeeding and to ensure the safe use of breastmilk substitutes if these are necessary.

In a UNICEF press release Roger Wright, UNICEF’s Representative for Iraq, called on Iraq’s government to reinforce national compliance with the International Code on Marketing of Breastmilk Substitutes. He also urged Iraq’s communities to give new mothers special care and support to help them breastfeed successfully. “Exclusive breastfeeding is the single most powerful means of protecting the health of Iraqi babies during this time of crisis,” he said.


According to UNICEF, free formula is being distributed to all infants as food rations as part of Iraq's Public Distribution System (PDS).

---UNICEF press release extract

Dr. Nidhal, Manager of the Breastfeeding Programme for Iraq’s Ministry of Health, noted that Iraq’s rate of exclusive breastfeeding was worryingly low, at just 25 per cent for infants under six months. The free distribution of infant formula through the PDS is a negative factor in contributing to these low rates, discouraging the traditional and much better exclusive breastfeeding.

“Breast milk is the best possible nourishment for children and contains everything they need to be healthy for the first six months,” she said. “It protects against diarrhoea from contaminated water, and also provides vital antibodies against pneumonia and other illnesses that could affect many Iraqi children during infancy. Mothers must not risk any other food or additional water for their young babies.”

---extract ends

The situation for mothers and babies in particular is very difficult in Iraq.
According to UNICEF about one in 10 children under five in Iraq are underweight and one in five are short for their age, this report states:
Baby Milk Action and our partners in the International Baby Food Action Network (IBFAN) have long worked as part of the Emergency Nutrition Network on raising awareness of appropriate infant feeding support in emergency situations.

During the response to the asian tsunami at the end of 2004 we had to resort to warning the public in the UK that they were breaking the law if they sent free formula to the region as labels would not be in the appropriate language. It is far better for any required formula to be sourced locally so the instructions are in the correct language and distribution can be appropriate and accompanied by training. See:

However, in an Indian survey in Pondicherry it was found that infant formula was distributed by Non-Governmental Organisations (NGOs) indiscriminantly and: "The occurrence of diarrhea was three times higher among children who were fed with free breast milk substitutes (BMS) than in those who were not fed with the same."

Our IBFAN partners, the Breastfeeding Protection Network of India (BPNI) reviewed this and other studies at its national convention in December 2005. The proceedings can be downloaded by clicking here:

A survey on the response to the tsunami in Tamil Nedu, where Nestlé formula was routinely distributed by NGOs, found that "64% NGOs, 76% social workers, 32% paramedical staff and 87% victims" were unaware of the importance of breastfeeding in emergency situations.

The importance of promoting the benefits of breastfeeding before an emergency and enforcing the International Code and Resolutions (implemented comprehensively in India as the Infant Milk Substitutes Act) was stressed.

Also important is training of field workers on supporting mothers who may experience difficulties with breastfeeding due to stress and, in extreme cases, their own poor diet (though undernourished mothers are able to breastfeed). The Emergency Nutrition Network produces training modules for field workers.

IBFAN has a guide for the public, warning not to send donations of formula. With the tragic situation in Peru, which has just been hit by an earthquake, we are making our banner advertisement to this live to help to stop a bad situation being made worse by well-meaning people sending formula. See:

Feel free to copy the banner to your site, with the above link:

We have worked closely with organisations such as Save the Children and Oxfam in the past. Both are responding to the Peruvian earthquake and have good operational guidance to make sure interventions are appropriate. Oxfam reports that 150,000 people are affected and so the effort to provide assistance will be considerable. You can donate following the links to the organisations.

Thursday, August 16, 2007

Now Aptamil promotes in a celebrity magazine

News of more formula promotion in a celebrity magazine in the UK. The Baby Feeding Law Group monitoring project we coordinate began to record advertisements in fashion magazines as well as parenting magazines a few years ago.

Now people are reporting advertisements in celebrity magazines. Companies are becoming more aggressive in their marketing strategies.

You can help our UK monitoring and campaign work to continue by taking advantage of our August promotion. You can also report violations yourself (many thanks to everyone that does) at:

The latest advertisement appears in Reveal magazine (18 - 24 August 2007). It is ostensibly for Aptamil follow-on milk, headlined: "Your baby's natural immune system. We've done the research, he's doing the development".

It claims:

"You protect him from the outside; now you can help support him from the inside with Aptamil Follow on milk. After 50 years of research into breastmilk, our Aptamil research experts have developed IMMUNOFORTIS, a patented mix of special prebiotics. This unique formulation helps to support your baby's natural immune system, making it the best follow on milk."

We already know Trading Standards are unlikely to act because the UK law allows follow-on milk advertising. We argue such advertisements are de facto infant formula advertising and so illegal because the infant formula has the same branding and is promoted on the website this advertisement directs people to. Companies are simply exploiting a loophole in the law. But there is little chance of action until the loopholes are closed, which you can help to achieve by supporting our campaign with our partners in the Baby Feeding Law Group and Breastfeeding Manifesto coalition. See:

The absurdity of the current situation is that Aptamil is linked in the advertisement to breastmilk, with its claim 'inspired by breastmilk', but it is not covered by the UK regulations for breastmilk substitutes. The UK law only prohibits advertising of infant formula.

The situation is even worse, though. The UK law prohibits claims on infant formula, such as 'inspired by breastmilk', 'prebiotics' and 'immunofortis' as it only allows 6 specified claims to be used. These Aptamil claims are not on the list. The list, in the official guidance to Trading Standards officers, can be downloaded here. For analysis of Aptamil's new infant formula label see:

Action by Trading Standards on these claims in a follow-on milk advertisement is unlikely, regardless of how misleading they are, because of the loopholes in the law. Their hands are tied.

But what of the advertising industry's self-regulatory body, the Advertising Standards Authority? Well, I wrote yesterday of how it fails in its responsibility to ensure advertising is 'legal, decent, honest and truthful' by refusing to investigate the majority of such claims, including the recent Wyeth/SMA promotion in OK! Magazine. See:

We have exhausted ourselves and the ASA arguing that 'decent, honest and truthful' advertising should be in line with the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions of the World Health Assembly. These are regulations companies should abide by independently of government measures. The ASA disagrees.

I have reported this advertising to the ASA anyway, but using a different approach, noting:

The advertisement states: "This unique formulation helps to support your baby's natural immune system, making it the best follow on milk."

I question the claim that it supports baby's natural immune system given the ASA has ruled against a similar claim by Cow & Gate, which is owned by the same company as Aptamil.

I question the claim that Aptamil is the best follow on milk as all companies are claiming their milk is the best. They cannot all be the best. You can find my blog on how companies all claim to be the best at:

Let us see if the ASA will take any action. We are talking about the health and well-being of babies after all, not which shampoo or chocolate bar is claimed to be the best.

What we really need, of course, is an end to company propaganda and more objective and accurate information from health workers. That's why we are calling for the government to implement the International Code and Resolutions and the other measures in the Breastfeeding Manifesto. So please do help the campaign by taking advantage of our August promotion and visiting the action page:

Wednesday, August 15, 2007

ASA will not investigate SMA promotion in OK! Magazine

The Advertising Standards Authority (ASA) has replied to Baby Milk Action regarding our complaint over the Wyeth/SMA formula promotion in OK! Magazine with a feature on Katie Price/Jordan. For a reminder of what the fuss was about see:

The ASA, an industry self-regulatory body, states:

---Extract begins
Unfortunately the ASA is unable to take action because we cannot investigate issues relating to editorial material. Nor de we regulate the placement of advertisements in magazines; that is the editor's decision. The ASA can only consider the content of advertisements.

However, because the issue relates to 'product placement' and the legality of promoting formula milk, as suitable for children less than 6 months old, we have passed the complaints, including yours, to Buckinghamshire County Council Trading Standards. You should hear from them in due course.
---extract ends

I had already written to Buckinghamshire Trading Standards and hope they will investigate the background to the product-placement picture and the SMA follow-on formula advertisment being placed on the next page.

The ASA suggests contacting the Press Complaints Commission as well, so I have forwarded the letter I sent to the ASa, which you can download by clicking here. The website is:

According to a report in Brand Republic the ASA received 101 complaints. See:

The ASA says of the follow-on milk advertisement:

---Extract begins

We have considered the SMA follow-on milk advertisement on page 54 but there are no grounds for us to investigate. It states "IMPORTANT NOTICE SMA PROGRESS is a follow-on milk for babies over 6 months and is not intended to replace breast feeding".

---extract ends

The ASA is failing in its duty we believe. There is a requirement under the industry voluntary code that advertisements be 'legal, decent, honest and truthful'.

The advertisement is of dubious legality as infant formula advertising is illegal and this advertisement promotes the brand name and logo used for infant formula and directs people to a website where infant formula is advertised. The website is, therefore, an extension of the advertisement, but the ASA refuses to consider the content of websites, arguing again that their content is 'editorial'. The advertisement 'carrot in your hair' line also links to the SMA infant formula shot where Jordan talks of her daughter having ginger hair. We view it as a de facto infant formula advertisement. As 60% of mothers in an NCT/UNICEF survey said they had seen infant formula advertisements when these are illegal, they are clearly functioning in that way.

That only deals with the 'legal' part of the advertising code. We believe that in following a narrow interpretation of legality only, the ASA is failing to apply the other tests.

An advertisement that was 'decent, honest and truthful' would surely comply with the provisions of the International Code of Marketing of Breastmilk Substitutes adopted by the World Health Assembly, the world's highest health policy setting body made up of the health ministries of member states. Article 11.3 is clear:

---quote begins
11.3 Independently of any other measures taken for implementation of this Code, manufacturers and distributors of products within the scope of this Code should regard themselves as responsible for monitoring their marketing practices according to the principles and aim of this Code, and for taking steps to ensure that their conduct at every level conforms to them.
---quote ends

The Code prohibits the advertising of all breastmilk substitutes, which includes follow-on milks. Wouldn't 'decent, honest and truthful' advertising have to comply? Meaning no advertising of follow-on milks. Not according to the ASA.

We have argued these points with the ASA until we are both exasperated, to no avail.

The ASA's final word is basically that we have to get the law changed. You can help us to do so by visiting this page:

With the Code and subsequent, relevant Resolutions not yet implemented in UK legislation and the lack of rigour of the ASA companies get away with systematic violations of the provisions.

Remember, this is not about denying mothers information, quite the opposite. It is about stopping misleading propaganda, ensuring labels provide the information mothers need and providing independent, accurate information through health workers. As my recent analysis of company promotion shows, they cannot be trusted. See:

The role of regulations in protecting all mothers is often lost by the media, sometimes deliberately, it seems.

Although we are talking about regulating companies, the publication Nursing in Practice, opens its story about the promotion in OK! Magazine by stating: "A row has broken out over mothers using formula milk instead of naturally breast feeding their babies."

That just seems designed to stir up a breastfeeding v. bottle feeding argument, inevitably diverting attention from the real issues.

Why do some journalists take that line when they could be supporting our work to protect all mothers and babies, for example, by exposing how companies such as Hipp are endangering infant health by contradicting expert advice on how to mix up formula? See:

Tuesday, August 14, 2007

Where is the proof?

Can you trust Baby Milk Action to tell the truth? There are two answers to this question.

The first is : YES!

The second is : Look to the evidence and challenge us if you want more.

Sometimes it is necessary to spend the time to dig into the substance of the campaign, because Nestlé uses a strategy I call mid-point bias. Basically it says whatever sounds reasonable, regardless of the truth, in the hope confused on-lookers will conclude the truth must lie somewhere between what Baby Milk Action says and what it says. In reality, we stand on the spot marked truth. Regardless of anything else, Nestlé would sue us to oblivion if we stepped off it! See:

Someone did challenge us a few weeks ago to substantiate two of the claims on our Give Nescafé the boot flier.

Rather than photocopy of load of stuff from the files and stick it in the post, I have written a new entry for our Your Questions Answered section of the website, with substantiation for every point on the flier, with links to as many of the documents I could find on-line or scan myself.

You can see it here:

I'll give you a flavour with an examination of this claim on our flier:

"According to UNICEF: 'Improved breastfeeding practices and reduction of artificial feeding could save an estimated 1.5 million children a year'."

This quote is from the State of the World’s Children 2001. Available at:

It has been given in various other forms by UNICEF and WHO. The UNICEF website states (on 14 August 2007):

"It has been estimated that improved breastfeeding practices could save some 1.5 million children a year. Yet few of the 129 million babies born each year receive optimal breastfeeding and some are not breastfed at all. Early cessation of breastfeeding in favour of commercial breastmilk substitutes, needless supplementation, and poorly timed complementary practices are still too common. Professional and commercial influences combine to discourage breastfeeding, as do continued gaps in maternity legislation."

In a 1997 press release responding to the independent Cracking the Code report UNICEF stated:

"Marketing practices that undermine breastfeeding are potentially hazardous wherever they are pursued: in the developing world, WHO estimates that some 1.5 million children die each year because they are not adequately breastfed. These facts are not in dispute."

However, the figures are disputed by Nestlé. How it does so, I've analysed in detail at:

In 1995 Baby Milk Action was required to defend the statistic before the Advertising Standards Authority after stating in a Nestlé boycott advertisement:

"Every day, more than 4,000 babies die because they're not breastfed. That's not conjecture, it's UNICEF fact."

We did so successfully and, as the ASA report notes, this was with the support of the World Health Organisation (WHO).

A 2003 study in the Lancet examined the question “How many child deaths can we prevent this year?” and concluded that promotion, protection and support of breastfeeding is potentially a more effective health intervention than provision of save water, sanitation and vaccination. Improved breastfeeding rates could prevent 13% of under-5 deaths in the 42 countries where most occur, amounting to 1.3 million. Appropriate introduction of complementary foods could prevent 6% of deaths.

You can find plenty more information responding to questions people have raised at:

For an in-depth look at the history of the campaign look at the response to an awful article published by the British Journal of Midwifery a while ago which we see as part of Nestlé's strategy to sponsor health workers in the UK to break into the market here.

There are two ways to approach information on this issue. If Nestlé says something that contradicts Baby Milk Action you can safely assume they are using deceit to try to divert attention. Or you can investigate in depth and see for yourself the documentary evidence backs Baby Milk Action's position.

Really you should do the latter, because why are we any more deserving of your trust than anyone else? But if time is short, please remember Nestlé's track record and it's mid-point bias strategy, and do the former.

Monday, August 13, 2007

Which infant formula is the best?

UPDATE 3 February 2010: In response to some of the comments on this post, I have produced a short online film with information which I hope is useful for understanding the differences between brands and I will be maintaining a page on the formulas on the UK market. See:

Now back to the original post....

There has been a lot of discussion about the advertising of infant formula following the Wyeth/SMA promotion with an article on Katie Price (Jordan) and Peter Andre in OK! Magazine. See:

I've seen a couple of comments suggesting that the ban on formula advertising and other measures called for by the Baby Feeding Law Group and Breastfeeding Manifesto coalition in the UK is wrong. Similar bans on company promotion have been called for in recent days in China and Australia.

The comments suggest that advertising is necessary for mothers to gain information on infant formula so they understand which is the best for their baby. Campaigners argue that this information should not come from companies, which profit from a mother's decision, but through independent information from health workers.

Mothers who choose to use formula, for whatever reason, want to know which formula is best, which is closest to breastmilk. The government line is all formulas have to comply with composition standards and so any cow's-milk-based formula that is on the market is suitable for use as a breastmilk substitute (soy formulas and goat's milk formulas are another matter, but more on those another time).

This perhaps does not meet the demand of mothers for information. I read someone describing having to select a brand of formula from a cupboard in the hospital, with nothing to go on from the health workers as to which was the best.

So I am going to attempt to answer the question by looking at the information available from companies, information that would be advertised freely if the present weak marketing restrictions were not in place.

At first sight it seems easy to say which infant formula is the closest to breastmilk. Just read the labels.

Click on the image for a larger version.

Here is the red rectangle at the top right a little larger:

So if you can believe what is on the label, Milupa Aptamil claims it is 'The closest to breastmilk', presumably because 'prebiotics support natural defences'. As this has been sold in the UK for years with this claim, you could be forgiven for assuming that Milupa's claim to be the closest must be true. If it wasn't then surely the authorities would have done something about it.

Well, belatedly they have told Milupa to remove both these claims. Last year the Food Standards Agency wrote to the companies saying that claims such as this are 'non-compliant' with the UK law. See:

If you look around you will see this label is disappearing from the shelves. The new label says: "Inspired by breastmilk" - which again is non-compliant with the regulations. The law is clear. Guidance notes issued to Trading Standards officers set it out. There are only 6 claims which are permitted on labels. Don't take my word. You can download the guidance notes to read for yourself - click here.

Okay, you may say. That is the problem with regulations. If Milupa Aptamil really is the 'closest to breastmilk' then why can't the company say it?

UPDATE 22 July 2009: Since this post, the Aptamil brand has been relaunched with a new ingredient, branded as IMMUNOFORTIS. The Aptamil brand has also been taken over by Danone. An advertisement for Aptamil follow-on formula claimed: "This unique formulation helps to support your baby's natural immune system, making it the best follow on milk." I asked the UK Advertising Standards Authority to investigate whether these claims were true. Although the ASA refuses to even investigate most cases, this time it do and found the claims are not true. The ASA found the company had broken the advertising code clauses on substantiation, truthfulness and comparisons. See:
Even without this ruling there was an immediate problems about the claim that Aptamil is the best formula (as the original posting continues....)

This is a recent image from the Cow & Gate website:

It is also about prebiotics, like the Milupa Aptamil 'closest to breastmilk' claim and shows Cow & Gate is ahead of 'normal infant formula' in the race to be closest to breastmilk.

Again, you may say, well if it is not true that Cow & Gate is closest to breastmilk, they wouldn't be able to say it. Here there is a problem. Baby Milk Action has reported promotions on websites to the authorities many times without any action being taken. This is because the internet falls into a regulatory black hole. The Infant Formula and Follow-on Formula Regulations were introduced in 1995 and the internet wasn't a big route of information then, so doesn't figure. The advertising industry's self-regulatory body, the Advertising Standards Authority (ASA), refuses to examine content on websites. The ASA says it is not advertising. People choose to visit a website, they argue, so it is editorial content and there is no requirement for it to be "legal, decent, honest and truthful" as with other forms of advertising. Most print and television advertisements direct people to a website for information, but still you get nowhere with the ASA.

So there are no grounds for trusting what is on a company website. You might think you will believe the company is being honest.

Well, Cow & Gate has made its claim about prebiotics in a printed advertisement. It claimed: "Our range of follow-on milks all contain a bunch of goodies called prebiotics to help build natural defences."

This was for a follow-on milk, for the simple reason that it is illegal for companies to advertise infant formula. If some of the critics of our campaign have their way, companies would be free to advertise infant formula with claims such as this.

As I said above, there is a requirement that print advertisements must be "legal, decent, honest and truthful" so the Advertising Standards Authority (ASA) did investigate this claim about the formula that 'prebiotics help build natural defences' after a request from a mother. They asked Cow & Gate to provide the scientific proof and they found that the claim was not substantiated. The ASA upheld the complaint and told Cow & Gate it could not repeat this claim in an advertisement and stated: "Because they had not sent evidence to show a direct link between an infant taking their formula and it helping to build defences against a number of everyday illnesses or conditions to which they were susceptible, we considered that Cow & Gate had not substantiated the claim."

This ruling does not prevent Cow & Gate making exactly the same claim on its website or in other materials. Only a revised law would do that.

Okay, so the claims about prebiotics don't stand up. The most the ASA will let them say is prebiotics support 'some' natural defences, though this is not a permitted claim for infant formula.

Could it still be possible that Cow & Gate formula really is the closest to breastmilk?

There is another problem.

Heinz/Farley's have distributed a flier to clinics with this graph:

It says on the top: "No. of Nutrients Closest to Breast Milk". Breastmilk is in the red. Farley's is next to it in brown and is clearly better on this graph than the SMA, Milupa and Cow & Gate. So, on the basis of its graph, Farley's claims its formula is the 'Best Formula'.

This was on a flier for health workers, because companies can promote infant formula to health workers. Again you might think they wouldn't be able to say this if it was not true. Strictly speaking that is correct, because information for health workers has to be scientific and factual. However the basis of the claims in such materials does not stand up to much scrutiny and because of the weak state of the current law it is difficult to persuade the authorities to take any action.

If, as some suggest, companies are allowed to advertise infant formula, we would probably see graphs like this appearing in advertisements in parenting magazine and, who knows, OK! Magazine.

Would it mean mothers are better informed? On the basis of the information so far, we have learned that Milupa claims to be the closest to breastmilk, so does Cow & Gate and so does Farley's.

Wyeth/SMA claimed it was 'closer to breastmilk' until the crackdown on illegal claims. Its new slogan is 'love the milk you give' and it claims its formula has a 'new improved protein balance'. So perhaps SMA is the closest to breastmilk?

Looking at what companies say about themselves we are none the wiser.

What about some of the other claims they make? Can that help us decide?

I've already discussed the 'prebiotics help support your baby's natural defences' claim, which the ASA ruled against. Most companies make similar claims.

They are all promoting added LCPs in their formulas. These are Long Chain Polyunsaturated Fatty Acids. For example, Wyeth/SMA formula stated before the crackdown: "Helps brain & eye development." That was 'non-compliant', as the official guidance note to Trading Standards officers states.

You may say that taking this information from labels is denying mothers valuable information. But how reliable is the information Wyeth/SMA put on its labels in breach of the law?

An independent review of the science found: "At present there is little evidence from randomised trials of LCPUFA supplementation to support the hypothesis that LCPUFA supplementation confers a benefit for visual or general development of term infants".

This is from a review by a respected academic institute called The Cochrane Library. Don't take my word for it. You can read it yourself. Find the links here:

Companies love using these claims to promote their products. They know it makes them more attractive to consumers. Even if an ingredient has no proven benefit they will add it to use it in their marketing campaigns, exploiting whatever loopholes in the law they can to put across their message.

This is what market analysts Hambrecht & Quist said about the company Martek, which supplies the LCPs for most of the formula in the world, with its product launched as Formulaid:

"The history of infant formula has shown that virtually all similar examples have led to wide-scale introduction of such additives into infant formula, even if there was no evidence that the additives were important. Infant formula is currently a commodity market with all products being almost identical and marketers competing intensely to differentiate their product. Even if Formulaid had no benefit we think that it would be widely incorporated into most formulas as a marketing tool and to allow companies to promote their formula as 'closest to human milk.'"

So which is the best infant formula? If you try to decide on the basis of what companies tell you, then you get nowhere. They are commercial organisations and aim to convince that their formula is the best.

The official line that there is nothing to choose between the brands comes from the requirement that they comply with compositional standards. See article 8 of:

The logic is that infants should have the best formula possible. So the regulations require all formulas to contain the ingredients that are proven to be necessary and to have a beneficial effect.

A few points to close. I haven't mentioned Hipp formulas above. I am really concerned about their labels. As I wrote recently, powdered infant formula is not a sterile product and so may contain bacteria, which may lead to infection. The good news is there are simple steps to deal with this. The World Health Organisation states: "preparation of Powdered Infant Formula with water at a temperature of no less than 70 °C dramatically reduces the risk." The bad news is that Hipp says on its labels: "Boil water and leave to stand until temperature reaches 50 - 60 Deg. C".

Companies are lax in providing information on the importance of breastfeeding and the difficulty of reversing a decision not to breastfeed and the financial and other costs of using formula. But this is not just about protecting breastfeeding, it is about making formula feeding safer. Companies are required by law to include information on the health hazards of inappropriate foods or feeding methods, and, in particular, the health hazards of improper use of an infant formula.

Other companies do not give the important information on temperature of the water for mixing up powdered infant formula or warn parents that powdered infant formula is not sterile. See:

Another point is there is increasing medicalisation of infant feeding. Companies roll out specialised formulas. The claims for these need close scrutiny. I will go into these another time. It seems to me these confuse health workers as much as they confuse parents. The information companies distribute is not limited to scientific and factual information. Worse than that, companies offer gifts to health workers to try to get them to promote their particular brand.

It seems to me the present situation is highly unsatisfactory. But I don't see that scrapping regulations on formula companies, as some are suggesting, will make it better .

What do you think? Contact me or leave comments here. If you are a mother or carer using formula I particularly want to hear from you.