Government admits proposed new baby milk law will make no difference to breastfeeding rates
Press release 3 July 2007
Coverage: UK FSA consult on infant nutrition. Baby milk lobby criticises 'ineffective' new ad rules.
The Food Standards Agency (FSA) has issued redrafted regulations for the marketing of baby milks, in an effort to meet a commitment made by the government in its 2004 public health white paper. The draft, which has been put out for consultation, has been condemned by health advocates as being little better than existing regulations, which are narrower than international standards and poorly enforced.
In its Regulatory Impact Assessment accompanying the draft legislation, the FSA evaluates some of the costs to industry, but makes no mention of reduced sales through an increase in breastfeeding rates, nor benefit to mothers, infants and the health service through increased breastfeeding and reduced sickness. Effectively the Government is already admitting the new law will do nothing to help meet its targets for improving breastfeeding rates, which are amongst the lowest in the world (breastfeeding at 6 months is the second lowest rate in Europe).
Mike Brady, Campaigns and Networking Coordinator at Baby Milk Action, said:
"It is significant that the Government's own Regulatory Impact Assessment includes no gains from increased breastfeeding rates, because if this law is passed they are unlikely to improve. If aggressive marketing of formula, which undermines breastfeeding, had been prohibited we would expect to see improvements to infant health, family incomes, carbon emissions and significant savings of health service costs.
"Unless changes are made, the law will become an embarrassment to Gordon Brown's new administration, showing industry profits continue to be put before infant health and mothers' rights. Five years ago the UN Committee on the Rights of the Child called on the Government to implement the International Code of Marketing of Breastmilk Substitutes in the UK. This draft revised law does not do so and the Government is due to report to the Committee shortly. It has let down mothers and infants by apparently bowing to industry pressure and not prohibiting the promotion of all breastmilk substitutes as the International Code requires. Mothers have a right to independent information on infant feeding and protection from the misleading and aggressive propaganda of the baby food companies and we will continue campaigning for the law to be brought into line with international standards. The present law is poorly enforced and the loopholes in the draft revision will not help the situation."
The Baby Feeding Law Group, a coalition of leading UK health worker and mother support groups has called for the Government to take full account of the heath, social and environmental costs of not implementing the Code and Resolutions. In countries that have implemented the Code and Resolutions and made efforts to promote and support breastfeeding, such as Brazil, breastfeeding rates have increased markedly. Increased breastfeeding reduces short and long-term illness and costs to the health service. The Government's own Infant Feeding Survey published in May 2007 found significant reduction in illness when infants were breastfed (for example, 41% of formula-fed infants had incidents of diarrhoea compared to 26% of infants breastfed until 6 months of age). If changes called for in labelling by the World Health Assembly were also introduced this would also reduce the risk to formula-fed infants.
While the FSA has suggested its hands have been tied by the European Commission, an expert analysis of EU law has shown that the Government is not only legally empowered but could also be obligated to implement the Code as this is specifically referenced in EU Directives.
The Infant Feeding Survey found that few of the mothers who stopped breastfeeding in the first months wished to do so. According to the Infant Feeding Survey (page 207): "Nine in ten mothers who gave up breastfeeding within six months would have preferred to breastfeed for longer, this level declining as breastfeeding duration increased. Although even among those who breastfed for at least six months, 40% would have liked to continue longer."
Baby food companies are particularly agressive in exploiting difficulties mothers may experience with breastfeeding to push their products. The example of direct mail sent to a mother with a four-week-old baby shown below was exposed in the Baby Feeding Law Group's Hard Sell Formula pamphlet (available here).
This and other examples were brought directly to the attention of the Minister for Public Health. Unless the law is significantly strengthened as a result of the consultation ambiguity over whether such promotion is permitted will continue to be exploited by the companies.
Follow-on milks are aggressively marketed as helping develop the immune system and develop intelligence and the proposed law does not implement the Code's ban on the promotion of these products, which are also breastmilk substitutes. A survey by the National Childbirth Trust and UNICEF found that such promotion is misleading and some mothers are using follow-on milks incorrectly.
Over 250 Members of Parliament have signed up in support of the Breastfeeding Manifesto campaign, which calls for the International Code and Resolutions to be implemented in the UK alongside other measures to protect, promote and support breastfeeding.
The Baby Feeding Law Group will provide a detailed response to the consultation in due course.
Loopholes need to be closed as Trading Standards officers appear reluctant to enforce the current legislation. Since the Infant Formula and Follow-on Formula Regulations were introduced in 1995, companies could only use a list of permitted health claims. It took 12 years of campaigning to prompt the authorities to tell companies to stop using illegal claims, but the baby food companies have ignored this as they issue new labels with claims not included on the permitted list. Last month the Minister for Public Health said Trading Standards Officers have been encouraged to enforce the existing law. The Baby Feeding law Group are calling on the government to require any permitted claims to be positioned at the back of the package next to the nutrition panel to avoid the risk of idealisation and ensure that the claim is read in the context of the whole product (click here for further changes the Baby Feeding Law Group would like to see made).
In May the Government released breastfeeding statistics for the UK. While these showed a small increase in breastfeeding initiation, mothers are no more likely to continue breastfeeding in the months after they leave hospital than in the past. While the government has cut expenditure on breastfeeding promotion, formula company expenditure on advertising is ten times greater and has been increasing (£7,626,847 spent on baby food advertising in 2006/07 according to Nielsen Media - an increase of 36.6% on the previous year - compared to £729,011 on breastfeeding promotion. The UK baby food market was
worth £329 million in 2004/05 and is set to grow by 20% by 2010. See Save the Children briefing paper).
The Infant Feeding Survey can be downloaded at:
For further information contact Mike Brady on 07986 736179 or mikebrady(at)babymilkaction.org or Patti Rundall 07786 523493 prundall(at)babymilkaction.org
Notes for editors
The UK Infant Formula and Follow-on Formula Regulations 1995 are a partial implementation of the World Health Assembly International Code of Marketing of Breastmilk Substitutes, adopted in 1981 with the support of the UK. The Assembly regularly calls for governments to take action to implement the Code and subsequent Resolutions. In 2005, after evidence was presented by Baby Milk Action and partners, the Assembly said in Resolution 58.32 that it was: “Concerned that nutrition and health claims may be used to promote breast-milk substitutes as superior to breastfeeding”.
The UK has breastfeeding rates amongst the lowest in the industrialised world. Despite government commitments to improve breastfeeding rates there has been little change, with initiation rates of just 76%, meaning nearly a quarter of infants receive no breastmilk at all. Breastfeeding rates then decline rapidly as the promotion exposed in Baby Milk Action’s recently launched Hard Sell Formula pamphlet undermines breastfeeding and encourages mothers to use formula (available at www.babymilkaction.org). In the UK few infants are breastfed at 6 months. Government figures show just 48% are breastfed at 6 WEEKS.
In its Public Health White Paper, Choosing Health, the Government stated: “Further action will include the review of the Infant Formula and Follow-on Formula Regulations (1995) with a view to further restrict the advertising of infant formula. We will continue to press for amendments to the EU Directive on infant formula and follow-on formula.” While the Government did push for changes to the EU Directive, its efforts largely failed. However, legal experts agree that the Directive does not prevent the Government taking action to protect health by introducing World Health Assembly marketing requirements in UK law. The Labour Party opposed the 1995 regulations as too weak, Tony Blair stating: “That this House is alarmed at the decision taken recently by Health Ministers to put commercial interests before infant health when it refused to ban the advertising of infant formula in the United Kingdom; is aware that such a decision is contrary to all its statements in support of an advertisement ban over the last 13 years, and contradicts also the advice given to it from major health bodies including the British Medical Association, the British Paediatric Association, and the Royal College of Midwives; and calls upon Her Majesty’s Government to rethink its approach instead of simply responding to UK baby milk companies’ promotions.” It was hoped a change in Prime Minister would see action to strengthen the law. See: Will Gordon Brown protect infants and mothers?
A Department of Health survey in 2004 found that 34% of mothers incorrectly believed that modern infant formula milks are very similar or the same as breast milk (see ‘Myths stop women giving babies the best start in life’)
A survey of 1,000 women conducted by MORI for the National Childbirth Trust and UNICEF in 2005 found the impact of allowing follow-on formula advertising :
The majority of women (60%) believed they had seen infant formula advertising even though it's been banned for ten years
Around a third said the advertising gave the impression that infant formula milk was ‘as good as' or ‘better than' breastmilk
Nearly one in five mothers (17%) who used follow-on milk said they started before their baby was three months old – even though it's unsuitable for children of this age
The Progress of Nations 1999, published by UNICEF, highlighted countries where breastfeeding rates are increasing and stated: "Breastfeeding gains stem from initiatives to publicize the benefits to both mother and child and to prohibit the advertising and promotion of breastmilk substitutes, feeding bottles and teats."
The UK Baby Feeding Law Group is an adhoc group of health professional and lay organizations working to bring UK and EU legislation into line with the International Code of Marketing of Breastmilk Substitutes and subsequent relevant WHA resolutions. Its members are: The Association of Breastfeeding Mothers, the Association for Improvements in the Maternity Services, the Association of Radical Midwives, Baby Milk Action, the Breastfeeding Network, the Food Commission, the Community Practitioners and Health Visitors’ Association, Lactation Consultants of Great Britain, La Leche League (GB), Little Angels, Midwives Information and Resource Service, the National Childbirth Trust, the Royal College of Midwives, the Royal College of Nursing, the Royal College of Paediatrics and Child Health and the Unicef UK Baby Friendly Initiative.
The Infant Feeding Survey states (page 213): " Babies who were breastfed for a minimum of six months were significantly less likely than other babies to experience colic, constipation, sickness/vomiting, diarrhoea, chest infections and thrush. This difference was most apparent for gastro-intestinal conditions. For example, 33% of babies who were breastfed for at least six months suffered constipation compared with 45% of all babies; for sickness/vomiting the equivalent proportions were 35% and 43%; and for diarrhoea 26% and 41%.
"Babies who were breastfed for at least six months had the lowest likelihood of developing symptoms related to the conditions highlighted above. However, for each of these conditions, there was also a gradually reduced likelihood of developing symptoms as breastfeeding duration increased. Babies who were breastfed for up to two weeks had the highest propensity to develop colic, constipation, sickness/vomiting, and diarrhoea. Thereafter, the rate of each of these conditions falls as breastfeeding duration increases, with a significant drop in prevalence between babies breastfed for 4-6 months and those breastfed for at least six months. Therefore, the survey results support the contention that that it is not breastfeeding per se which offers the greatest protection against these conditions, but breastfeeding over the longer-term.
"Interestingly, babies who were not breastfed at all had a slightly lower likelihood of developing the above-mentioned conditions when compared with babies who were breastfed for a short period (up to two weeks). However, babies formula-fed from birth had the highest rate of chest infections and symptoms relating to thrush."