Why would the charity Tommy's think it's a good idea to "team up" with Aptamil?!

[tabouleh]

Tommy's and Aptamil's midwifery training grants.

Unbelievable.

It gets the Aptamil logo onto Tommy's website.

Tommy's should be encouraging BFing not giving space to a formula company on its website and sposoring midwives!

Aptamil must be so pleased with themselves.

and that is true. it is surely the refusal of those agencies to accept support from formula companies that enables their 'ethical stance' as you put it...

Ruby - a few reasons really. Often (as you've already identified) a lack of milk banks. Fulltime expressing can be incredibly hard for some mothers and, despite drugs / kangeroo care / expressing next to baby / photos / smells etc it just doesn't work.

The fortifiers are often needed as the calorific demands of an extremely preterm baby are greater (and slightly different) from a term baby. Alot of this extra need is possibly due to medicalisation eg underdeveloped lungs being compromised further by ventilation needing 'catch up' growth. My depth of knowledge in this particular field isn't brilliant (intrest now piqued, so off to do some reading) so hope that helps!

Outing myself here, but in the latest issue of Paediatric Nursing, there are 3 adverts for infant formula. 2 high calorie, and one for (hands up who can guess) Aptamil. HCPs are not some higher beings that are immune to
pernicious and persistent advertising, and it's incredibly naive to think so.
There's a reason why 'more midwives recommend Aptamil', and it ain't got nothing to do with product quality!

The training courses being funded aren't being run by Aptimil- the grants can be used for any training course you like, providing that you answer yes to the following question (per the application form)

"Does your training course promote breast feeding or the care of women who are at risk of, or have experienced a miscarriage, premature birth or stillbirth?"

I think people are getting a bit over stressed about this.

i actually know a quite revered HV who is incredibly pro breastfeeding who still says aptimil is 'closest to breastmilk' and if formula must be used, it should be aptimil

thanks boobbuffet . and are these fortifiers subject to rigid testing? (will also do own research...)

Happy to help Ruby. Interestingly, the Royal College of Midwives finally stopped allowing formula companies to advertise in their professional journal, so this may well be an example of them looking for other ways to promote their brand to HCPs.

that is a good thing then... well done the RCM

Ok, point taken - wasn't trying to compare formula itself to cigarettes. Just trying to question where do people draw a line regarding ethics / charitable donations / conflicts of interest. No offence intended, just genuinely interested.

But that's not the only question, is it, BaggedandTagged? The other questions about the course are:

12 * Name of your training course

13 * Address of your training course provider

14 * Email address of your training course provider

15 * Telephone number of your training course provider

16 * Who should the cheque be made payable to? (Tommy's will only make cheques payable to training providers)

17 * Date of your course

From	
To	

18 * Does your training course promote breast feeding or the care of women who are at risk of, or have experienced a miscarriage, premature birth oo stillbirth?

Yes No

19 * The grant amount you are applying for (please include VAT)

£0-£500
£500-£1000
£1000 plus

20 * Please enter the exact cost of your course including VAT

21 * When is payment required by?

Please select date	

22 * Course title

23 * Please outline the course contents

24 * Is there is a website address where we can view the course details?

25 * What skills will you acquire or improve as a result of attending this course and how will this benefit patient care?

---

...Neatly allowing them to sidestep any course they don't like the sound of. Nope, I don't trust them one little bit.

It is definitely a coflict of interests though. I suppose it is more like an arms dealer donating money to the Rwandan Red Cross when they are supplying arms to the Hutus or the Tutsies, rather than an arms dealer donating money to Tommy's.

Ruby - I'm not sure of the research base, but the one we use is Cow and Gate and has bloody big colourful logos all over the packets. There really is NO escape.

< puts heads in hands and wonders if it's too early for a drink? >

Its weird though because formula has saved lives whereas guns haven't, or have they? confusing myself now sorry. not trying to piss anyone off - just exploring the issue...

PS, thanks Ruby. That's what I was failing to get across!

HEAD. Just one. Honest.

and cow and gate are also owned by danone. so they have more than one baby milk, but one of them is closest to breastmilk, but the other isn't?!

what gets me is that they are all basically owned by two massive minted companies and they are offering £1000 as grants which will transfer into millions of pounds profit...

BertieBotts- agree but if they wanted to not support the breastfeeding courses they could easily have excluded that category and said it's just for premature baby and miscarriage courses.

If I was them, that's what I would have done because those are, after all, the main objects of the charity.

Exactly. Charitable donations from multi-nationals never come without strings.

I only went out for the morning.

Just picking up on some of the points aspecially on preterm babies (I@ve made my views known on Aptamil and Tommy's before)

Ruby and others, preterm babies need a lot of calories, often for a very long time if they end up with chronic lung disease. I have EBF my DS from the beginning (29+3)> At that beginnign he weighed 1360grams. He then went down to 1060 grams in the first week. It then took him a while to regain that weight. We were lucky, he did so with my BM. Many many mums are less lucky. fast forward 6 weeks, he was 1900grams. When taking him off the hot cot he lost weight as he couldn't maintain his temperature and grow on the amount of milk he could consume without other problems, breathing difficulities apnea etc from reflux due to his underformed oesaphagus. The consultants were disucssing supplementing with formulas we needed to get more calories in when he couldn't physically fit any more food in his tiny stomach. Again he turned the corner the mronign before we did so so we stayed EBF. Again i was really really lucky in this regard. That's why some preterm babies need supplementing.

In respect of donated BM. First thank you very very much to anyone who has ever done this. I am much more evangelical about this than almost anything else. Many mums do not produce breast milk in the first days of their prems lives. Their bodies are often in shock. A lot of prems are born by C Section. The body can take time to catch up. If prem is born and the mother has no milk they need feeding and donated bm is the next best thing (to start with) as the risk of NEC is very high. But again Prem mothers milk is different to ordinary mothers milk in composition, and higher calory. Many many prem mothers donate any excess they have as we are all graetful for those who did it for us. I donated litres of the stuff. But there is not always enough, and even if there is some babies will still need fortification and higher calorie formulas.

As I have stated before I believe Tommy's does very useful and necessary research, and that if this is a source of funding for them I have no difficulty with them taking it. I do however think that this debate makes it very clear they must consider how it is viewed by other potential donors.

Ruby well said.

Ruby, fairly sure that guns have saved lives although perhaps not when they are fired obviously...

It is unhelpful to equate formula with cigarettes, arms dealers or the like. It's really not the same at all, I was just being mischievous.

Aptamil has a special place in my heart because I have met so many women who believed it was synthesised breastmilk with added vitamins .

ok, Ruby....(deep breath)

Yes, formula milk has saved the lives of babies who in an earlier age would have died unless a wetnurse could be found but.....

• it took the best part of a hundred years to develop enough understanding of the balance of nutrients needed by human babies and of hygiene standards to develop artificial milk that was broadly safe. How many babies died during that time of malnutrition and diarrhoea.

• in developed countries, today, babies who are not breastfeed are more likely to suffer from gastric, respiratory, urine and ear infections than babies who are. They rarely die as a result, but we see accept this increased incidence as normal.

• premature babies are particularly at risk due to gut infections (the NEC hilda referred to above). Mortality is about 30% and survivors often have a stoma and then a bowel resection.

(None of this is a comment on any poster's individual situtation, just what applies right accross the population. Just saying)

But that's why it's so insidious - of course they could have excluded breastfeeding, but by including it they make it look like they are being really helpful and supportive of breastfeeding whereas in fact it's pretty unlikely that they are.

porcamiseria - it's not about women saying "ooh, I'll stop breastfeeding and use Aptamil", it's about women NOT BEING SUPPORTED who may end up feeding formula who will then CHOOSE Aptamil because of the brand awareness/promotion.

As I believe I already mentioned - it's a proven fact that formula companies make MORE money out of those who tried to breastfeed and couldn't (for whatever reason) than those who choose to formula feed from the off. The reason being (if I recall correctly) is because FFers generally feed their babies what their friends and family fed their babies. Breastfeeders - in the midst of grieving a 'failed' BFing relationship - are more likely to be swayed by samples and advertising.

It is a plain indisputable fact that in countries where formula advertising of all sorts has been banned, breastfeeding rates have gone up massively.

It is frankly naive to believe that Aptamil are doing this from the good of their heart, or that advertising doesn't work.

This may be a bit tangential at first but bear with me. Formula companies have erm formulated specialist high energy formula to help very prem babies gain weight and in theory and in practice this is combined with mother's milk where possible, one should hope (though the reality is that the logistics of it all in the hospital settings as we know them now set up a lot of breastfeeding mothers whose babies are in NICU for failure.)

It has been shown in Africa where these same very prem babies actually thrive on breastmilk. They have to thrown out the western medicine guidelines for calculating milk per hour and what not and just feed the babies and wait and see if they thrive or fail. And they positively thrive. Some babies are latching on and drinking from the breast from as early as 30 weeks iirc.

Now I am not trying to say one size fits all, of course as these babies have a range of problems many of which may not be directly connected to feeding.

So where is the problem in the first world NICUs? The problem is the lack of Kangaroo Mother Care, I suspect. These babies go into a shutdown mode. They go into suspended animation almost, because for a tiny baby, to be separated from its mother means death, so they go into survival mode, trying not to consume too much energy, waiting for her return. So they don't eat well either, they lower their body temps, etc. So we put them in incubators and tube feed them to counter what their bodies want to naturally do.

the evidence is already there that it works. So why aren't we in the first world not trying out something from the developing world which has been proven to work? I don't know but I have a feeling that our medico-cultural arrogance, with its deeply held ff culture plays a big role in it.

And I can tell you that there is no money in it for Aptamil.

this blog kinda says it in a different way.

2 of the presentations on the bottom of this page illustrate what I am getting at.

I agree Bertie, they want to be associated with promoting breastfeeding because their usp is the "midwives recommend aptamil as it is closest to bm" guff. They get to look like unbiased infant feeding experts (because they help train midwives) when they are far from it. It is just a cynical marketing technique which works, and has done for years or they wouldn't do it.

Hilda, I am only just now reading your last post and I really don't want you to feel like any of the things it says are a reflection of what I think was your individual situation. You had a very difficult time and you don't need me to tell you that it taught you things about yourself that you never know you had to capacity of bearing.