The Royal College and the marketing of breastmilk substitutes
On 27th April, 2016 a motion was passed at the Annual General Meeting of Royal College of Paediatrics and Child Health (RCPCH), stating that “the College should decline any commercial transactions or any other kind of funding or support from all companies that market products within the scope of the WHO Code on the marketing of breast milk substitutes”.1
La Leche League GB welcomed this announcement. We are therefore disappointed to learn that, in October 2016, the Council of the RCPCH decided to continue to accept funding from manufacturers of breast milk substitutes. 2
The importance of accurate and unbiased information
The original motion stated that it was important for the RCPCH to avoid conflicts of interest to “maintain its reputation as an unbiased, independent educator and advocate for child health.” This would have been a very positive move in helping to limit the marketing of breastmilk substitutes.
In the face of overwhelming evidence that breastmilk contributes to both the short- and long-term health of children,3 their intellectual and emotional development, as well as the health and well-being of mothers, it is important that the RCPCH consider this their over-riding priority.
Accepting funding to advertise products which undermine breastfeeding is contrary to the expectation that the College will protect children’s health and well-being.
Abiding by the International Code of Marketing of Breast-Milk Substitutes
Breastfeeding and children’s organisations with the UK abide by the International Code of Marketing of Breast-Milk Substitutes.4 One of the resolutions of the Code is to prevent health workers from receiving financial or other incentives from companies that market foods for infants and young children. It also states that these companies should not sponsor meetings of health professionals.
The RCPCH’s decision to continue to accept money from the advertising and promotion of breastmilk substitutes violates this Guidance and gives cause for concern that the College will be unable to maintain its integrity and impartiality as an independent advisor to parents.
While the RCPCH says it will exercise diligence with regard to advertising, it would be a huge task to examine a company’s compliance with the International Code.
Protection from “aggressive marketing”
After the publication of The Lancet Breastfeeding Studies in 2016, 5 many lay organisations, including La Leche League GB, and health professionals joined together to write an open letter calling for the government to commit to increased support for breastfeeding.6 Amongst other things, the open letter stated that there should be protection from “aggressive marketing” by formula manufacturers, by fully enacting the International Code of Marketing of Breast-Milk Substitutes within UK law. The WHO has specifically advised that health practitioners should not meet with representatives of formula companies. The RCPCH was a signatory to this letter.
In order to give women and children impartial and accurate information it is important that the RCPCH is not associated with any form of promotion of breast-milk substitutes. . The College has an opportunity to contribute to better breastfeeding practices which will lead to improved health worldwide, and to stop manufacturers of breastmilk substitutes from using reputable organisations to market their products.
The promotion of breastmilk substitutes
The majority of mothers in the UK (88%) feed their babies with formula at some point before they are one year old. 7 Follow-on formulas, “growing-up” and toddler milks are promoted to mothers for use after first formula. However, infant formula is suitable up to 12 months and after that babies can drink pasteurised whole cow’s milk, sheep’s milk or goat’s milk.8
In fact, follow-on formula was invented to bypass the current regulations on promoting infant formula. It is deemed unnecessary and the World Health Organisation has even said it may not be a healthy choice. 9
There is also little proven benefit to “special formulas” for “hungrier” babies or those which claim to help with colic or constipation.
Finding new ways to promote breastmilk substitutes
The manufacturers of breastmilk substitutes want to promote their products and look for new ways to do so. For instance, Aptamil, Cow & Gate and SMA Nutrition are among the companies who sponsor the 2015/16 edition of the Pharmacy Guide to Infant Feeding10. The guide gives pharmacists and the pharmacy support team information on all aspects of infant feeding, an area which should ideally be free from the sponsorship of formula manufacturers to maintain impartiality.
Giving mothers the best support and information
Mothers will only receive the best accurate and impartial information when manufacturers of breastmilk substitutes are prevented from giving them confusing or misleading facts about their products, or influencing those who promote infant feeding. LLLGB hopes that the RCPCH will reconsider its decision and support the WHO Code.
This update replaces the original published in April 2016.
2 Costello A. et al: “Health professional associations and industry funding”, The Lancet, Volume 389, No. 10069, p597–598, 11 February 2017 (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30277-5/fulltext?elsca1=etoc)
4 World Health Organization, “International Code of Marketing of Breast-Milk Substitutes”, 1981 (http://www.who.int/nutrition/publications/infantfeeding/9241541601/en/)
5 The Lancet, “Breastfeeding Series”, 2016 (http://www.thelancet.com/series/breastfeeding)
See also https://www.laleche.org.uk/the-lancet-series-on-breastfeeding-lllgb-comments/
6 “Open letter on the current crisis in breastfeeding in the UK – UK mothers are being let down” (https://ukbreastfeedingtrends.files.wordpress.com/2016/02/open-letter-uk-response-to-lancet-updated7.pdf)
See also https://www.laleche.org.uk/open-letter/