Why a group of British pediatricians cut financial ties with infant formula – Quartz


On Wednesday, 13 February, the Royal College of Pediatrics and Child Health of the United Kingdom (RCPCH) announced that it would no longer accept financial contributions from the infant formula sector. This decision will cost the group around £ 40,000 a year. RCPCH was vague about the reasons for its decision, focusing instead on its support for breastfeeding. But health advocates celebrated this decision amid a growing reaction against what is known as the "big formula", a $ 70 billion industry that produces and markets breast-milk substitutes. .

The debate over when it is appropriate for doctors to advise women to use formula instead of breast milk is hot and related to a broader discussion of the relative benefits of breastfeeding and the gaps that separate medical care in poor and rich countries. A related question is whether the medical industry can trust infant formula manufacturers who have used deceptive marketing practices in the past to encourage mothers to reduce or discontinue breastfeeding.

To understand the importance of RCPCH's recent decision, it is therefore necessary to understand its context in a much broader discussion of the health of children and mothers, as well as the powerful institutions that influence this space.

The debate on breast milk and formula

Leading medical organizations around the world recommend that mothers breastfeed exclusively for the first six months of life. But in some cases, mothers are unable to produce enough breast milk for long, if at all, while others face barriers because of work or school.

This is where high quality infant formula can be useful. But it's not a perfect choice. And in some countries, where the quality of water is poor, formula is expensive and refrigeration is often unavailable, breast-milk substitutes can be very dangerous. As Annalisa Merelli wrote for Quartz:

"The main concern is not whether breastfeeding needs to be supplemented with formula, but what happens when formula milk replaces breast milk entirely. When breastfeeding mothers feed their babies exclusively with formula, they stop producing breast milk quickly, making it impossible to go back. This makes preparation particularly problematic for poor mothers, who may not be able to buy sufficient quantities of the product and eventually dilute it. [with contaminated water] or feed the child in small amounts, which leads to malnutrition. "

This is where the debate differs in rich and poor countries. Some scientists in developed countries have questioned whether exclusive breastfeeding provides children and mothers with health benefits over the formula. But in developing countries, breast milk has been shown to save lives. For example, the World Health Organization estimates that "nearly half of all diarrheal diseases and one third of all respiratory infections in children in low- and middle-income countries could be prevented by increasing breastfeeding rate ".

A story of misleading business practices

The history of infant formula manufacturers in poor countries is tainted with scandal. According to Save the Children (pdf), a non-profit children's rights organization, six companies (Nestle, Danone, RB, Abbott, FrieslandCampina and Kraft Heinz) have succeeded in establishing "equivalence" in the field of children's rights. many people's minds between formula milk and formula milk. , creating the perception that the latter is simply an artificial replica of the first. "

But formula does not replace breast milk. Many studies have shown that breast milk has unique health, nutritional, immunological, developmental, psychological, social, economic, and environmental health benefits, and that breastfeeding has been associated with improved outcomes. positive for the health of mothers. According to the New York Times (Paywall), "no formula can completely mimic the immunological composition or benefits of breastfeeding." There is even a global legal text prohibiting companies from promoting breast-milk substitutes as superior or interchangeable with breast milk: the WHO International Code of Marketing of Breastmilk Substitutes (1981) (pdf).

But over the years, non-profit organizations (pdf) and the media have accused "Big Formula" of circumventing this code, as well as other local codes setting out the rules of the industry, in order to promote its products in hospitals and replace mothers Milk. In 2013, a unit of Danone was accused of bribing doctors in Tianjin, China, to promote its product. In the same year, a Reuters investigation revealed that Nestle and Mead Johnson had distributed advertising material for their products in hospitals, donated free samples to new mothers and offered doctors "small gifts" to promote their products. A Guardian investigation revealed similar practices in Bangladesh and the Philippines.

The RCPCH recently found itself at the center of a controversy related to this story. In January, the group was criticized for organizing its first international conference in Egypt with financial support from Nestlé, Nutricia and Danone. Dozens of health professionals and non-profit groups have sent RCPCH an open letter urging them to remove sponsors from all its material. "We strongly condemn the manufacturers of BMS who sponsor any child health conference," they wrote, "but especially in a low- and middle-income country, the market most vulnerable to predatory advertising and where most violations of the WHO Code are reported. "

The RCPCH responded 10 days later by stating in a statement that it had temporarily suspended all funding agreements with these companies because of "concerns raised by the members". A spokesperson for the group then explained by e-mail that "members expressed concerns about accepting funds from dairy companies was inconsistent with the promotion of breastfeeding," and that " RCPCH is a strong advocate of breastfeeding and advocates it as the best method of infant feeding. "The result of this review was this week's decision to cut all ties with these companies, although the group stated that it "would continue to engage and work in partnership with powdered milk companies with regard to specialty milks".

Patti Rundall, Policy Director of Baby Milk Action, the UK's arm of the international Baby Food Action Network, told Quartz that her organization is celebrating RCPCH's decision. As she explained, if a doctor takes "money from a business [group] who has a direct interest in what you say, you are threatening the trust the public places in you to speak independently. "And that matters," she said, because in some cases, "breastfeeding is a matter of life and death. "

Learn more about our series on the rewiring of childhood. This report is part of a series funded by a grant from the Bernard van Leer Foundation. The opinions of the author are not necessarily those of the Bernard van Leer Foundation.

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