Childhood Obesity Inquiry highlights baby food industry marketing and sponsorship

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Parliamentary Select Committee Childhood Obesity Inquiry.   House of Commons,  20th October, 2015
 
The Select Committee inquiry on Childhood Obesity ended last week, with much of the attention focusing on the  proposed tax on sugary drinks an intervention with the strong support of health professionals and campaigners and championed by TV Chef Jamie Oliver.  The high sugar content of baby foods and excess nutrients in formulas is also something that health advocates are concerned about. 
 
In the final session on Tuesday 20th October, the Committee’s attention turned to early years nutrition and the marketing of foods for infants and young children in particular.   Professor Susan Jebb, Dr Alison Tedstone,  Public Health England, Prof Simon Capewell and Dr Colin Michie of the Royal College of Paediatrics and Child Health and a member of the Baby Feeding law Group  affirmed the importance of breastfeeding and the need to control marketing and the risks of corporate sponsorship:  

Dr Michie explained: “…paediatricians have many years of experience in dealing with the milk formula companies, and trying to agree with them on any voluntary arrangement is a very frustrating business. There is a great history to this, the consequence of which is that this country now has the lowest exclusive breastfeeding rate in Europe. We have shelves full of unnecessary products in every supermarket and there is a continual business in trying to fight the advertising from these companies to promote their products very surreptitiously or very obviously in every possible part of the media. Paediatricians would never buy a voluntary arrangement with a large company for precisely the reasons that Simon has just outlined. They are in this as a business, they are extremely good at doing what they are doing and the voluntary arrangement is only ever a very temporary one. The consequence of this infant feeding has been a disaster and history will write it down as such because of this problem that we have with trying to defend breastfeeding in the face of this barrage from companies, from industry.

Dr Sarah Woollaston, Chair: “Are you concerned about things such as, for example, proxy advertising of infant formula with follow-on formulas and things like that?”

Dr Michie: “Precisely. Follow-on formulas are not necessary for human beings, but it would not seem so if you watch television. They problem is we are all very convinced by the stories. There are other issues that have parallels for what was said earlier in that the milk companies sponsor education, training, events and an awful lot of professional activities, which again does exactly, to our minds, what we heard it does to infants’ minds: when we see brand names, we equate certain things with them. It is an insidious business that we know enough of to be very wary of. For this reason, we would be extremely worried about any voluntary arrangements with big companies…..I have a brief comment on the business of advergaming. There is a great— although not as vast as we have been hearing this morning—research interest in gaming to treat children with neurological problems and we have discovered that gaming has profound effects on the human brain, especially when you are three, four and five. Certainly very large groups like Wellcome and the MRC are recruiting gamers to try and get gaming introduced for little three, four and five-year-olds to help them when they have a neurological problem. The only difficulty is that the foods industry—and the baby milk industry—are ahead of us in this; they have already developed these gaming techniques. They are very important. We can use them as treatments and these folks are using them for advertising purposes. Just to add one specific observation about that, it is a sinister thing for our children and we need to try and control this.”

Baby Milk Action, the UK member of the International Baby Food Action Network (IBFAN), and secretariat of the Baby Feeding Law Group (BFLG) – a coalition of 20 leading health groups (Dr Michie is the BFLG representative for the RCPCH) is calling for reduced levels of sugar in baby foods (current legislation allows products to provide 30% of their energy from sugar) and strict controls on the promotion of follow-on formula and so called “growing up milks.’    New regulations are being proposed by the European Commission. 
 
All these products are aggressively promoted with health and nutrition claims and advertised on TV and media.(1,2).  The ‘ look alike’ formulas for older babies were designed to get round the advertising restrictions on formulas for newborn babies.  They are universally acknowledged to be unnecessary (3,4) expensive and often risky (5) Their advertising misleads parents encourages over-consumption of nutrients  (5,6,7), flies in the face of all health recommendations and wastes public health resources. (8,9,10)

The impact of early life feeding and behaviour is often overlooked.  Yet breastfeeding is an ideal window of opportunity for the prevention of obesity and a host of other health problems. Breastfeeding mothers are more likely to return to pre-pregnancy bodyweight  and exclusive breastfeeding for 6 months and the introduction of complementary foods at about 6 months is associated with lower rates of obesity. Breastfeeding helps in the development of taste receptors and appetite control.   The EU Childhood Obesity Action Plan 2014-2020 (11) and most recently the Second International Conference on Nutrition  in Rome (12) all called for implementation of the marketing controls that have been endorsed by all EU Member States  at the World Health Assembly. (13)The UK has the lowest breastfeeding rates in Europe. (14) New marketing regulations are being proposed by the European Commission. (15)

Breastfeeding can help reduce health inequalities. 120 million Europeans at risk of poverty or social exclusion. 100 million Europeans lack access to piped water in their homes and 66 million lack access to adequate sanitation. (16,17) Artificial feeding adds to environmental burden: 800 litres of water are needed to make a 1 litre of milk and 4700 litres for 1 kilo of milk powder. (18)

for more information contact:  Patti Rundall, 07786 523493   prundall@babymilkaction.org

footnotes:

  1. Breaking the Rules, Stretching the Rules 2014   http://www.babymilkaction.org/archives/358 
  2. Look What They’re Doing in the UK – 2013  http://www.babyfeedinglawgroup.org.uk/reports/bflgreports
  3. WHA Resolution (WHA 39.28 ) adopted in 1986  3. REQUESTS the Director-General 3(2) to specifically direct the attention of Member States and other interested parties to the following:…(b) the practice being introduced in some countries of providing infants with specially formulated milks (so-called “follow-up milks”) is not necessary.’Growing-up’ formula:   Creating new markets: ‘Growing up’ and ‘Toddler’ milks  http://info.babymilkaction.org/update/update44page14
  4. No additional value to a balanced diet, says EFSA, 25th October 2013 http://www.efsa.europa.eu/en/press/news/131025
  5. First Steps Nutrition Trust: http://www.firststepsnutrition.org/pdfs/Statement%20on%20Growing-up%20milks_July_2014.pdf  “…. recommended daily serving of powdered toddler milk can cost up to £235 per year, using ready-to-feed toddler milk increases this cost to up to £593, the annual cost of 300ml of cow’s milk is £62….. Cow’s milk contains 4.7g sugar per 100ml, compar A ed to 7.9g of sugar per 100ml of Hipp Organic Combiotic Growing up milk. And some daily servings contain twice as much sugar – three teaspoons a day for cow’s milk compared to seven teaspoons a day for SMA Toddler milk.”  
  6. WHICH? SMA Toddler milk also contains vanilla flavouring, which encourages children to prefer sweetened products. http://www.which.co.uk/news/2013/08/should-parents-buy-toddler-milks-330947/
  7.  Advertisements of follow-on formula and their perception by pregnant women and mothers in Italy, Cattaneo A, et al. Arch Dis Child 2014;0:1–6. doi:10.1136/archdischild-2014-306996
  8. WHO Healthy diet  Fact sheet N°394   Updated September 2015http://www.who.int/mediacentre/factsheets/fs394/en/
  9. www.unicef.org.uk/BabyFriendly/News-and-Research/Research/Obesity/  UNICEF Baby Friendly: Breastfeeding has been found to generally reduce the risk of obesity. A number of studies have been published. Three good and moderate meta-analyses of methodological quality which infer that the risk of obesity is reduced in later life by breastfeeding have been published. Harder (2005) reviewed 17 studies including over 120,000 babies. They concluded that every month of breastfeeding was found to be associated with a 4% decrease in risk. Arenz (2004) reviewed 9 studies, 69,000 babies and concluded that breastfeeding appears to have a small (odds ratio 0.78, 95% CI (0.71, 0.85) but consistent protective effective against obesity. Owen (2005) reviewed 61 studies, 29,800 babies again found a reduced risk of obesity in later life even when confounding variables such as parental obesity, maternal smoking and social class were taken into account. www.unicef.org.uk/BabyFriendly/News-and-Research/Research/Obesity/Timing-of-solid-food-introduction-and-the-risk-of-obesity/    
  10. Potential economic impacts from improving breastfeeding rates in the UK. Pokhrel S, et al. Arch Dis Child 2014;0:1–7.doi:10.1136/archdischild-2014-306701  “Treating the four acute diseases in children costs the UK at least £89 million annually. The 2009–2010 value of lifetime costs of treating maternal Breast cancer (BC) is estimated at £959 million. Supporting mothers who are exclusively breast feeding at 1 week to continue breast feeding until 4 months can be expected to reduce the incidence of three childhood infectious diseases and save at least £11 million annually. Doubling the proportion of mothers currently breast feeding for 7–18 months in their lifetime is likely to reduce the incidence of maternal BC and save at least £31 million at 2009–2010 value.” http://adc.bmj.com/content/early/2014/11/12/archdischild-2014-306701.full.pdf+htm
  11. http://ec.europa.eu/health/nutrition_physical_activity/docs/childhoodobesity_actionplan_2014_2020_en.pdf
  12. ICN2 Political Declaration:  http://www.fao.org/3/a-ml542e.pdf   ICN2 Framework for Action: http://www.fao.org/3/a-mm215e.pdfPress
  13. Since 1981 when the International Code of Marketing of Breast-milk Substitutes (IC) was adopted at the World Health Assembly, the European Parliament has called for its adoption as an EU Directive. All EU Member States (MS) have endorsed the International Code of Marketing of Breastmilk Substitutes (IC) and the 15 subsequent relevant WHA Resolutions.
  14. WHO European Region has lowest global breastfeeding rates  http://www.euro.who.int/en/health-topics/Life-stages/maternal-and-newborn-health/news/news/2015/08/who-european-region-has-lowest-global-breastfeeding-rates
  15. The Commission’s weak proposals on baby food and formula acts are out  http://www.babymilkaction.org/archives/7151  http://www.babymilkaction.org/archives/3666  New EU rules will trick parents into buying expensive and unnecessary products that will fuel the obesity crisis http://www.babymilkaction.org/archives/3200  
  16. Breastfeeding Initiation at Birth can help reduce health inequalities.  http://www.euro.who.int/__data/assets/pdf_file/0005/277736/Breastfeeding-initiation-at-birth-can-help-reduce-health-inequalities.pdf?ua
  17. http://www.euro.who.int/en/health-topics/environment-and-health/water-and-sanitation   Economic Commission for Europe & World Health Organization Regional Office for Europe Meeting of the Parties to the Protocol on Water and Health to the Convention on the Protection and Use of Transboundary Watercourses and International Lakes Working Group on Water and Health Seventh meeting Geneva, 26 and 27 November 2014   www.unece.org/fileadmin/DAM/env/documents/2014/WAT/11Nov_26-27_WGWH/item_5_informaldoc_WRD_meeting.pdf   Formula for Disaster, Weighing he impact of Formula
  18. Feeding Vs Breastfeeding on Environment. http://bpni.org/ibfan-newswire-2014/9
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