For 13 years, Britain, along with 118 other countries and the baby food industry, has supported a World Health Organisation international code of marketing which states: ?In view of the vulnerability of infants in the early months of life and the risks involved in inappropriate feeding practices... the marketing of breast-milk substitutes requires special treatment.? The main tenet of this code is that baby milks, as the sole food of new-borns, have a unique, semi-medicinal role to play, and should not be promoted.
The new law, arising from two EU directives will implement some of the code?s provisions concerning baby milks sold in and exported from the UK. It has been welcomed by health professional bodies, including the BMA and the British Paediatric Association. They are urging the government to extend its proposed advertising ban to follow-on milks, which the new law will permit to be marketed from four months, against UK health advice.
The proposals are causing alarm in the UK baby food industry which, desperate to increase and maintain its £108m market, is claiming that advertising to mothers is an essential avenue of information. Since 1983 there has been only a weak voluntary code in the UK. Unlike the WHO code or the new proposals, it has allowed companies to push £12m of advertising through the health service, targeting mothers when they are most vulnerable. The code has been monitored by an industry-financed committee with no powers of sanction and which in nine years upheld little more than a handful of the hundreds of complaints. In the last few years companies have ignored it completely, advertising direct to mothers in supermarkets and sponsoring TV shows.1
For our beleaguered NHS the controls are long overdue. Bottle-fed babies are twice as likely as breastfed babies to suffer from respiratory infections and five to ten times more likely to suffer from gastroenteritis.2
Problems with bottle feeding are never mentioned in advertising material or labels, neither are the raw ingredients manufacturers use. Few parents are aware that baby milk is cow?s milk and may contain beef fat, maize oil, chicken egg or large amounts of glucose syrup. Yet according to a so-called independent survey, 88 per cent of mothers think that without advertising they will be unable to choose a milk, as if a lack of advertising will prevent products being sold and as if the adverts contain more information than already appears on the tins.
The ?independent? survey was commissioned by Bounty Services, a company that hands out bags of baby goods samples and baby milk adverts to new mothers in hospital. Bounty is funded by advertising revenue and two health authorities have already banned it because the bags? contents counter their health messages.
The Bounty survey implied that since breastfeeding rates have not risen despite ?strict advertising controls?, advertising cannot be the problem. Yet UK breastfeeding rates have fallen as advertising budgets have increased: only 63 per cent of British babies are breastfed at birth and only 53 per cent at one week. The 25 per cent of mothers who breastfeed for four months are the only ones who say that they have ?breastfed for as long as intended?.
One area of promotion that often goes unnoticed is sponsorship and training of health workers. Spending on sponsorship can, according to the Inland Revenue, be offset against a company?s tax liability since the money is spent ?wholly and exclusively for the purpose of trade?. It can be very cost effective. A £2,000 Farley?s sponsorship scheme in one UK hospital, for example, was recouped after only ten mothers chose the Farley?s brand. The hospital lost out after four babies returned with gastroenteritis.
Since the most common reasons for giving up breastfeeding are the easily remedied problems of a perceived lack of milk and sore breasts, it is vital that mothers get the right type of help. Yet 45 per cent of breastfed new-borns in the UK were still being given bottles in hospital in 1990, despite the fact that this practice decreasesmilk production.3
Unsubstantiated claims such as ?closest to breast milk? and ?suitable for the hungry baby?, are all part of the marketing plan. So is the use of the ?breast is best? statement, since breastfeeding mothers who ?fail? after a few weeks spend more money on expensive baby milk than mothers who choose to bottlefeed from day one.
The UK government has set itself a Health of the Nation target to increase breastfeeding rates. Now is the time to show how serious it really is.
References
1 Baby Milk Action reports to the Code Monitoring Committee. 1983-1994.
2 Howie et al. Protective effect of breastfeeding against infection. Br Med J 1990; 300:11-16.
3 Infant Feeding 1990, OPCS.
Baby Milk Action is part of a network of 150 groups in 70 countries working to protect infants from the commercial promotion of bottle feeding. Baby Milk Action, 23 St Andrew?s Street, Cambridge CB2 3AX.
Patti Rundall is co-ordinator of Baby Milk Action