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UK formula marketing practices
Quarterly round up from the
BFLG monitoring project                       May 2008




                                              BFLG
          Prepared by Baby Milk Action
          on behalf of BFLG, a coalition of
          22 health worker organisations
          and mother support groups           Baby Feeding Law Group
The BFLG monitoring project

      The Baby Feeding Law Group provides
      information and training to health workers and
      members of the public on how to monitor baby
      food marketing practices against international
      standards and UK legislation.

      Monitoring results appear in this and other
      BFLG reports such as Look What They’re Doing
      in the UK, Hard Sell Formula and Protecting
      breastfeeding - Protecting babies fed on formula.

      The project began with the help of a grant from
      the King’s Fund and is currently funded, at a low
      level, by donations from members of the public.


    Produced by Baby Milk Action for the Baby Feeding Law Group

    Written by:

    Mike Brady
    Campaigns and Networking Coordinator
    Baby Milk Action
    And Coordinator of the BFLG monitoring project

    Baby Milk Action is the secretariat for the BFLG
    and the UK member of the International Baby Food Action Network (IBFAN)

                             Baby Milk Action
                             34 Trumpington Street
                             Cambridge
                             CB2 1QY
                             Tel: 01223 464420


    www.babyfeedinglawgroup.org.uk
    BFLG Member organisations
    Association of Breastfeeding Mothers (ABM)                      La Leche League Great Britain (LLLGB)
    Association for Improvements in the Maternity Services (AIMS)   Little Angels
    Association of Radical Midwives (ARM)                           Midwives Information and Resource Service (MIDIRS)
    Baby Milk Action (BFLG secretariat)                             National Childbirth Trust (NCT)
    Best Beginnings                                                 Royal College of Nursing (RCN)
    Breastfeeding Community                                         Royal College of Midwives (RCM)
    Breastfeeding Network (BfN)                                     Royal College of Paediatrics and Child Health (RCPCH)
    Community Practitioners and Health Visitors Association         The Baby Café
    (CPHVA)                                                         UK Association for Milk Banking (U.K.A.M.B)
    Food Commission                                                 UNICEF UK Baby Friendly Initiative (BFI)
    Lactation Consultants Great Britain (LCGB)                      UNISON
                                                                    Women’s Environmental Network (WEN)


2   UK formula marketing practices - May 2008
    Quarterly report from the BFLG                                                                          BFLG
    monitoring project                                                                                Baby Feeding Law Group
Action needed to stop illegal practices
BFLG monitoring reports                                                  of the Regulations. Companies produced
                                                                         new labels in 2007 with non-compliant
The purpose of this monitoring report is to set out some current         claims such as ‘with prebiotics’ and
and recent baby milk marketing practices to assist Trading               ‘inspired by breastmilk’, with apparent
Standards Officers in taking action. Baby Milk Action has                 impunity - a year later these labels
produced monitoring reports on behalf of Baby Feeding Law                are still on the market and new non-
Group (BFLG) in the past focusing on violations of the Code              compliant ones are being produced. The
and Resolutions to justify strengthening regulations (see page           label shown here has just been launched
2). This report is different as it is restricted to practices believed   by Danone (Cow & Gate brand).
to break the much narrower UK regulations.                               Amongst the prohibited claims, text and
                                                                         images, is the lamb. Such images are not
The report is divided into sections on the major companies               required to identify the product or as part
operating in the UK. The first section includes key text from             of the instructions. As the images on the
the Infant Formula and Follow-on Formula Regulations and                 cover of this report show, cute animals
associated Guidance Notes.                                               are a common marketing strategy.

Updates are planned every three months to track new marketing            While the list has been updated in the
strategies and to demonstrate the success or otherwise of action         2007 Regulations, it remains true that
taken by the Trading Standards offices that are home authorities          only claims appearing on the list may be used. Action at the
for the companies concerned. The report is being sent directly           High Court has put back the date by which companies have to
to them as well as to LACORS, the umbrella body, which has               comply with the labelling provisions until 2010. But as current
convened a home authorities working group.                               labels comply with neither the 1995 nor the 2007 version of the
                                                                         Regulations there is no excuse for inaction.
The report will also be sent to a review panel convened by the
Food Standards Agency to evaluate the effectiveness of the               Good Night milks - a new marketing strategy
Regulations. These were revised in 2007, but did not respond to
the call by BFLG members and other health advocates to bring             A new marketing strategy from Danone and Hipp is the
these into line with the International Code of Marketing of              introduction of so-called Good Night milks. These are
Breastmilk Substitutes and subsequent, relevant Resolutions of           promoted as guaranteeing babies sleep through the night. The
the World Health Assembly. The United Nations Committee on               name itself is a health claim and the marketing undermines
the Rights of the Child and the UN Special Rapporteur on the             breastfeeding and misleads parents who use formula. See
Right to Food also called for the Code and Resolutions to be             the BFLG briefing paper examining the ingredients of these
implemented in the UK.                                                   formulas and the claims made for them.

For detailed analysis of the Regulations, what is required to            It is already the position of the Department of Health that
bring them into line and the possible health and economic                follow-on formula is an unnecessary product. The review panel
benefits of doing so, see the BFLG report Protecting                      should consider whether current regulations can deal with such
breastfeeding - Protecting babies fed on formula, which was              strategies and recall the recommendations of the Government’s
submitted to the FSA consultation on the Regulations.                    Scientific Advisory Committee on Nutrition (SACN):

Inaction has led to widespread abuses                                      SACN comments on the formula regulations
In the history of the Infant Formula and Follow-on Formula
Regulations, first introduced in 1995, there has only been                  “There is no case for allowing the ‘advertising’ of follow-
one prosecution of a baby food company, that of Wyeth/SMA                  on formula... there is no scientific evidence demonstrating
in 2003 by Birmingham Trading Standards for illegal infant                 nutritional advantage of this product over infant
formula advertising. Despite the company being convicted                   formula...[both these] are breast milk substitutes as defined
of a ‘cynical and deliberate’ breach of the regulations, no                by the Code (which sets no upper infant age limit on this
other company has been prosecuted, even though similar                     term)...We find the case for labelling infant formula or
advertisements being run by most of them. The Wyeth                        follow on formula with health or nutrition claims entirely
advertisement did not refer explicitly to the company’s infant             unsupportable. If an ingredient is unequivocally beneficial
formula, SMA Gold, but gave pointers to it. The same is true               as demonstrated by independent review of scientific
of many of the advertisements in this report, which are branded            data it would be unethical to withhold it for commercial
with the names and logos used for infant formula and direct                reasons. Rather it should be made a required ingredient of
the public to websites where the full range of products are                infant formula in order to reduce existing risks associated
promoted.                                                                  with artificial feeding. To do otherwise is not in the best
                                                                           interests of children, and fails to recognise the crucial
Action is also long overdue on labelling. In 2006 the                      distinction between these products and other foods.”
manufacturers were reminded by the FSA that claims are only
allowed on formula labels if explicitly listed in Appendix IV                www.sacn.gov.uk/pdfs/position_statement_2007_09_24.pdf

       BFLG                                                                                       UK formula marketing practices - May 2008
                                                                                                              Quarterly report from the BFLG
                                                                                                                                               3
Baby Feeding Law Group                                                                                                    monitoring project
Danone
    Brands: Aptamil, Cow & Gate, Milupa
                                                                  Magazine advertising - ignoring ASA rulings
      Snapshot
                                                                  A Cow & Gate follow-on formula advertisements in Mother
                                                                  and Baby and Practical Parenting in March 2008 states:
      Danone UK address:                                          “Immune system under construction. Cow & Gate follow-on
                                                                  milks support your baby’s natural immune system.”
        Danone UK,
        PO BOX 4261,
        Reading,
        RG8 9ZZ,
        UK.

      Trading Standards Home Authority

        Wiltshire County Council was responsible for
        Milupa and Cow&Gate. Now Danone has
        bought NUMICO, this may change.

      Recent UK action

        The Advertising Standards Authority1 ruled
        against a Cow&Gate follow-on formula
        advertisement containing the claim : “Our
        range of follow-on milks all contain a bunch
        of goodies called prebiotics to help build
        natural defences.”

      Other developments

        Danone purchased NUMICO, the owner of
        Nutricia, Milupa and Cow&Gate brands,
        in 2007. It has promised the International                Yet, the Advertising Standards Authority (ASA) warned
        Baby Food Action Network (IBFAN) a ‘root                  Nutricia/Cow & Gate in November 2006 about claims in its
                                                                  follow-on formula advertising, stating: “We noted much of
        and branch review’ of NUMICO practices,                   the evidence sent by Cow & Gate was associative, rather than
        but has so far refused to give an undertaking             showing causality. ... Because they had not sent evidence to
        that it will bring them into line with the World          show a direct link between an infant taking their formula and
        Health Assembly’s minimum standards.                      it helping to build defences against a number of everyday
                                                                  illnesses or conditions to which they were susceptible, we
                                                                  considered that Cow & Gate had not substantiated the claim....
      The next report will give feedback on any                   We told Cow & Gate to amend the ad to make clear that
      action taken on the cases highlighted.                      the product could help build “some” and not “all” natural
                                                                  defences.”

                                                                  Similar claims are made for Aptamil follow-on formula
                                                                  in the same magazines: “After 50 years of research into
                                                                  breastmilk, our Aptamil research experts have developed
                                                                  IMMUNOFORTIS, a patented mix of special prebiotics. This
                                                                  unique formulation helps to support your baby’s natural
                                                                  immune system, making it the best follow on milk.”

    1. http://www.asa.org.uk/asa/adjudications/non_broadcast/Adjudication+Details.htm?Adjudication_id=41915

4   UK formula marketing practices - May 2008
    Quarterly report from the BFLG                                                                            BFLG
    monitoring project                                                                                 Baby Feeding Law Group
At the end of
                                                                                                         April a 30 second




                                                                                                                                 Danone
                                                                                                         advertisement for
                                                                                                         Aptamil began to be
                                                                                                         shown on television
                                                                                                         and the internet.


                                                              The film speaks
                                                              of the importance
                                                              of breastfeeding
                                                              which ‘strengthens
                                                              your baby’s natural
                                                              defences’ then
                                                              promotes Aptamil ‘if
                                                              you decide to move on
                                                              from breastfeeding’ with a similar expression - ‘to help support
                                                              some of you bay’s natural defences’ - implying equivalence.

                                                              Mother and Baby and Pregnancy and Birth magazines in
                                                              March 2008 include promotional fliers for the Aptamil brand
                                                              name, encouraging mothers to visit the site where the full
                                                              range of products is promoted, and to sign up to mailing lists
                                                              to receive a free gift. The promotion targets pregnant women:
                                                              “Just as you are unique, how your body and mind respond
                                                              to pregnancy is also unique. That’s why our Careline team of
The above advertisement for Aptamil follow-on formula         midwives, healthcare professionals, nutritionists, and feeding
appeared in Mother and Baby and Practical Parenting March     advisors is here to offer expert advice tailored to you and your
2008 editions.                                                baby as you both grow and develop.”

                                                              The Aptamil name appearing
  Infant formula and follow-on formula regulations            on the flier is exactly the same
                                                              as used on infant formula
  Follow-on formula advertising shall : “(a) be designed to   labels. In addition, the attempt
  provide the necessary information about the appropriate     to present the company as
  use of the product so as not to discourage breast           an alternative source of
  feeding; and (b) not contain the terms “humanised”,         information and educational
  “maternalised”, “adapted” or any similar term.              materials to the health care
              2007 and (almost identical) 1995 regulations.   system is a breach of section
                                                              24 of the Infant Formula
Advertising for Aptamil and Cow & Gate follow-on formula      and Follow-on Formula
breaks the provisions of the 1995 and 2007 Regulations as     Regulations, which state such
it idealizes infant feeding and undermines breastfeeding by   materials must not refer to
drawing equivalence between the product and breastfeeding.    infant formula brand names
For example, the Aptamil advertisement above states: “You     and (continued overleaf...)
protect him from the outside; now you can help support him
from the inside with Aptamil Follow on milk. After 50 years     Guidance Notes
of research into breastmilk, our Aptamil research experts
have developed IMMUNOFORTIS, a patented mix of special          67. Any general advertisement placed by a manufacturer
prebiotics. This unique formulation helps to support your       must not feature a brand name, trade mark, business
baby’s natural immune system, making it the best follow on      name or logo uniquely [?] associated with an infant
milk.” [emphasis added]                                         formula or mention breastfeeding. If this advertisement
                                                                includes a response mechanism this must be of an ‘opt-
  Guidance Notes                                                in’ type, so that only parents or carers actively requesting
                                                                information on infant formula milks can be sent this
  70. To minimise the risk of consumers making a                information and nothing else. Attempting to solicit
  connection between follow-on formula and the act of           requests for information, providing information on
  feeding infants from birth, information in advertisements     products outside the scope of the initial enquiry or
  for follow-on formula should not include pictures or          making undue references to proprietary infant formula
  text which relate or compare follow-on formula to             brand names in a response to a request for product
  breastmilk. [emphasis added].                                 information is considered advertising and is
                                                                not permitted under regulation 21. [emphasis added]



      BFLG                                                                             UK formula marketing practices - May 2008
                                                                                                   Quarterly report from the BFLG
                                                                                                                                    5
Baby Feeding Law Group                                                                                         monitoring project
may only be distributed through the health care system, with       In the example below from Mother and Baby magazine March
    prior permission. Aptamil is an infant formula brand name, as      2008, pregnant women are offered a cow soft toy for signing
    the pack shot in this report shows.                                up to receive company materials. The branding used for infant
                                                                       formula is promoted.
      Infant formula and follow-on formula regulations

      24 (4) No manufacturer or distributor of an infant formula
      shall make a donation of any informational or educational
      equipment or materials except in accordance with the
      following conditions—

      (a) the donation shall be made following a request by the
      intended recipient;
      (b) the donation shall be made with the written authority
      of the Secretary of State or in accordance with guidelines
      drawn up by the Secretary of State;
      (c) the equipment and materials shall not be marked or
      labelled with the name of a proprietary brand of infant
      formula; and
      (d) the equipment or materials shall be distributed only
      through the health care system.
                                       2007 and 1995 regulations.

                                                                       The same strategy of promoting the infant formula brand name
    There may be some ambiguity over whether the materials             and encouraging mothers to visit the company website to sign
    referred to in Aptamil and Cow&Gate advertising should             up to receive information is used with advertisements placed on
    be viewed as advertising or information materials. In both         third-party websites as with this example on a parenting site.
    cases they should not refer to infant formula. If information
    materials, they should be authorised by the Secretary of State
    for Health. It would be useful to know if such authorisation has
    been obtained.


      Guidance Notes

      77. The following is a list of some of the types of materials
      which, if they provide information or are educational,
      would be controlled by regulation 24(4) and require
      approval from the Secretary of State7 before formula
      manufacturers donate them to third parties:
      • CDs and DVDs
      • Wallcharts, posters
      • Booklets or leaflets which are designed for reference
      purposes
      • Electronic files that can be downloaded directly from a         Mothers have also been targeted in supermarkets, where Cow
      website                                                          & Gate branded gifts such as dummies and growth charts have
                                                                       been distributed. The example below is from Sainsbury’s in
                                                                       September 2007.

    Gifts and baby clubs

    The Danone companies use gifts such as this Aptamil polar
                                            bear to promote their
                                            formula brand names
                                            and to encourage
                                            mothers to visit
                                            websites and sign
                                            up for information
                                            promoting infant
                                            formula. Promotional
                                            gifts are prohibited
                                            by the Regulations.


6   UK formula marketing practices - May 2008
    Quarterly report from the BFLG                                                                                BFLG
    monitoring project                                                                                      Baby Feeding Law Group
Cow & Gate Good Night milk launch




                                                                                                                                       Danone
                                  A major promotion has been launched for the new product Cow
                                  & Gate Good Night milk (see BFLG briefing on these products).

                                  The advertisement shown left appeared in the celebrity magazine
                                  Reveal in March 2008. It is dominated by the idealizing text
                                  and image implying that infants fed on the formula will sleep,
                                  playing on a parents insecurities and concerns about night
                                  feeding. The name itself is an idealising claim about the product.

                                  The ad states : “New Cow & Gate good night milk has been
                                  specially developed to help settle your baby at bedtime. Thicker
                                  than regular follow-on milk, but gentle on your baby’s tummy, it
                                  provides a warm, contented and satisfying end to the day.”

                                This undermines the Department of Health recommendation to
                                continue breastfeeding beyond 6 months. As the briefing explains,
                                there is also concern over the composition of these products.

                                The launch has been backed by special displays and discounts,
                                such as that shown in Boots, above right, in April 2008. The
                                flier shown right is promoting the formula in Morrisons in March
                                2008.

                                The product is also being used to encourage mothers to visit the
                                Cow & Gate website where the full range of products is promoted.
                                The 12-page leaflet left, distributed in Boots, promotes Cow &
                                Gate as a source of information on infant care.

Labelling                                                            “‘Why should I choose Cow & Gate
                                                                     Comfort 1? Some babies have sensitive
UK regulations permit health and nutrition claims only if they       tummies and need a formula to gently
are specifically referenced in Annex IV of the Infant Formula         aid comfortable digestion. Cow & Gate
and Follow-on Formula Regulations 1995 or in the similar             comfort 1 has been specially formulated to
annex to the more recent Directive 2006/141/EC. Cow & Gate           be more easily digested. It is a thicker feed
and Aptamil infant formula labels use claims that are listed in      which will help your baby swallow less air
neither, including:                                                  whilst feeding, thereby aiding comfortable
                                                                     digestion.”
•   IMMUNOFORTIS/prebiotics (Aptamil)
•   With prebiotic care (all brands)                                 The label draws equivalence with breastmilk: “Not all milks
•   For comfortable digestion (Cow & Gate comfort)                   are the same. Cow & Gate milks contain prebiotics, special
•   Good Night (formula name implying sleep benefits)                 nutrients that are similar to the ones found in breastmilk and
                                                                     some fruit and vegetables. Breastmilk is special because it
Labels use idealizing images, such as the shield and polar bear      strengthens a baby’s natural immune system, helping them to
on Aptamil formula (see overleaf and front cover). No labels         fight off bugs and infections. A strong immune system is one of
currently on the UK market provide warnings and instructions         the key ingredients for a happy and healthy baby.”
to reduce risks of possible intrinsic contamination of powdered
infant formula with harmful bacteria.

New formula labels, still with prohibited claims, have been
introduced for Comfort and Cow & Gate branded formulas this
year, despite the industry’s claim in the High Court that it could
not comply with the 2007 Regulations for 2 years because of
the time it would take to change labels. As all labels on the
market are non-compliant Trading Standards should advise the
company to recall and replace the products immediately.

Labels contain idealizing text which undermines breastfeeding.
For example, Cow and Gate comfort states:


      BFLG                                                                                    UK formula marketing practices - May 2008
                                                                                                          Quarterly report from the BFLG
                                                                                                                                           7
Baby Feeding Law Group                                                                                                monitoring project
Opinion from the European Commission

                                                                          “The use of the claim ‘contains prebiotics’ is a claim
                                                                          describing a function and therefore has to be considered as
                                                                          a health claim which is currently not foreseen in Directive
                                                                          2006/141/EC and consequently is not permitted for use for
                                                                          infant formulae.”
                                                                                                 Letter to FSA, 4 October 2007, from
                                                                                                   European Commission Health and
                                                                                      Consumer Protection Directorate (DG SANCO)


    Promotion to health workers

    In addition to the fact that the prebiotics claim is not permitted
    on infant formula, independent analysis of research by the
    Cochrane Library finds the claims are not substantiated.
    While the regulations on labelling follow-on formula are not
    so strict, the ASA has ruled against prebiotic claims used in
    follow-on formula advertising. Despite this the claimed benefits
    of prebiotics in formula are promoted to health workers in
    advertising, as in these examples targeting midwives in April
    2008.




                                                                             Independent review of Prebiotics research

                                                                             “There is insufficient evidence to recommend the
                                                                             addition of prebiotics to infant feeds for prevention of
                                                                             allergic disease or food reactions.”

                                                                                          Cochrane Database of Systematic Reviews



    Osborn DA, Sinn JK. Prebiotics in infants for prevention of allergic disease and food hypersensitivity.
    Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD006474. DOI: 10.1002/14651858.CD006474.pub2.
    See:http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD006474/frame.html

8   UK formula marketing practices - May 2008
    Quarterly report from the BFLG                                                                                    BFLG
    monitoring project                                                                                        Baby Feeding Law Group
Heinz
Brand: Farley’s
                                                                Despite taking advantage of this change in the Regulations it
  Snapshot                                                      still does not comply with the other requirements, nor does it




                                                                                                                                  Heinz
                                                                comply with the 1995 regulations whose labelling provisions
  Heinz/Farley’s UK address:                                    remain in force following the industry challenge at the High
                                                                Court.

     HJ Heinz Company Ltd                                       Labels contain idealizing text (such as ‘our most advanced
     South Building                                             formula ever’) and images, such as the teddy bear used in the
     Hayes Park                                                 free booklet shown below and other promotional materials to
     Hayes                                                      promote the full range of products (see past BFLG monitoring
                                                                and consultation reports such as Hard Sell Formula and
     Middlesex                                                  Protecting breastfeeding - Protecting babies fed on formula).
     UB4 8AL                                                    Labels do not provide warnings and instructions to reduce the
                                                                risks of possible intrinsic contamination of powdered infant
  Trading Standards Home Authority                              formula with bacteria.


     London Borough of Hillingdon, Environmental
     Health Department.

  The next report will give feedback on any
  action taken on the cases highlighted.


Labels non-compliant with regulations

Heinz/Farley’s pre-empted the introduction of the Infant
Formula and Formula Regulations 2007 by introducing a ‘with
                                                                Advertising of complementary foods
omega-3 LCPs’ claim in a prominent banner on the front of the
pack, as shown here.
                                                                Heinz/Farley’s has advertised its formula brand on television
                                                                and in print in the past. Its current advertising is focused on
                                                                complementary foods.

                                                                Government policy is that complementary foods are not
                                                                needed until 6 months of age, but Heinz promoted foods for
                                                                use from 4- 6 months of age in Practical Parenting in April
                                                                2008 as shown below.




     BFLG                                                                               UK formula marketing practices - May 2008
                                                                                                    Quarterly report from the BFLG
                                                                                                                                     9
Baby Feeding Law Group                                                                                          monitoring project
Hipp
                                                                       be produced. However, the agreed labels have reached
      Snapshot                                                         the final stage, they will be printed very soon and then the
                                                                       new labels will be used in production.”
      Hipp’s UK address:
                                                                    Hipp is unwilling to share the labels before they appear on the
                                                                    shelves. A future report will contain analysis.
         HiPP UK Ltd
         165 Main Street                                            Hipp labels are curious when it comes to warnings regarding
         New Greenham Park                                          powdered formula not being sterile. Its infant formula labels
         Newbury                                                    are the only ones to give a warning, but it states: “Powdered
                                                                    baby milk formulas are not sterile and reconstituted feeds
         Berks                                                      are at risk of infection.” As the risk comes from possible
         RG19 6HN                                                   intrinsic contamination, it makes more sense to say: “a risk of
                                                                    infection.”
      Trading Standards Home Authority
                                                                    The instructions state: “Boil water and leave to stand until
                                                                    temperature reaches 50 - 60 Deg. C (30 - 40 minutes).”
         West Berkshire Council.
                                                                    Since November 2005 the Food Standards Agency has been
      The next report will give feedback on any                     advising: “the risks associated with using powdered infant
      action taken on the cases highlighted.                        formula milk are reduced if [inter alia]: feeds are made up
                                                                    using boiled water that is greater than 70°C; in practice, this
                                                                    means using water that has been left to cool for no more than
                                                                    half an hour.”

                                                                    The Guidance Notes accompanying the Regulations state in
                                                                    section 24:

                                                                       The Agency recommends that these instructions should
                                                                       include information noting that:

                                                                       • Powdered infant formulae and follow-on formulae are
                                                                       not sterile, and as such can contain harmful bacteria. It
                                                                       is therefore important to be very careful when preparing
                                                                       formula to reduce the risks. Boiled tap water (not bottled
                                                                       water) cooled for no more than 30 minutes should be used
                                                                       to prepare infant feeds.

                                                                                                              • All equipment
                                                                                                              used for feeding
                                                                                                              and preparing feed
                                                                                                              must be thoroughly
                                                                                                              cleaned and
                                                                                                              sterilised before use,
     Labels non-compliant with regulations
                                                                                                              and bottles should
                                                                                                              be made up fresh for
     Hipp labels contain idealizing images and make much of its
                                                                                                              each feed, as storing
     ‘organic’ claim. Hipp has responded to a Baby Milk Action
                                                                                                              made-up formula
     campaign calling on companies to bring labels into line with
                                                                                                              milk may increase
     regulation by stating:
                                                                                                              the chance of a baby
                                                                                                              becoming ill.
        “Hipp has been working very closely with the FSA and
        our local Trading Standards Officer to ensure our milks
                                                                                                              The FSA advice
        packs conform with the new Infant and Follow-on formula
                                                                                                              to parents was
        Regulations (2007), which has not been easy in the
                                                                                                              introduced nearly 3
        absence of any finalised guidance notes from the FSA.
                                                                                                              years ago, but still
                                                                                                              companies have
        “Obviously, changes take a while to implement as we need
                                                                                                              not brought their
        to ensure that all the changes are correct and then the
                                                                                                              instructions into line.
        labels/packs have to be printed before the products can

10   UK formula marketing practices - May 2008
     Quarterly report from the BFLG                                                                              BFLG
     monitoring project                                                                                   Baby Feeding Law Group
Good night milks

Hipp, like Danone/Cow & Gate, has launched a Goodnight
milk (see BFLG briefing on these new products). This is
promoted in a way that undermines breastfeeding with the
advertisement shown right from Mother and Baby magazine,
March 2008, suggesting that thanks to the milk “Now everyone
can get a good night’s sleep.” It also describes it as: “the ideal
end to a busy adventure filled day.”

Targeting mothers

Hipp makes much of its company ‘careline’ and website. Baby
Milk Action monitoring of the HIPP company careline found
that the information given directly contradicted that from FSA
and WHO.




                                                                                                                                     Hipp
The website promotes the full range of Hipp formulas,
including infant formula.

In a bid to encourage mothers to visit and to look to Hipp for
information, Hipp is offering mothers web space for a blog
on their babies and a free gift if they sign up to the Hipp baby
club. The advertisement shown below appeared in Mother and
Baby magazine in March 2008.




                                                                     For example, the advertisement shown below from Pregnancy
                                                                     and Birth March 2008 includes a pack shot for apple and pear
                                                                     baby food labelled for use from 4 months of age.




Undermining advice on complementary feeding

The free gift offered to mothers signing up to the Hipp
baby club is a ‘weaning pack’. Experience shows that Hipp
encourages weaning before the age of 6 months, despite it
being the position of the Department of Health and World
Health Organisation that, as a general health recommendation,
babies need only breastmilk or formula before 6 months.


      BFLG                                                                                  UK formula marketing practices - May 2008
                                                                                                        Quarterly report from the BFLG
                                                                                                                                         11
Baby Feeding Law Group                                                                                              monitoring project
Nestlé
                                                                        about breastfeeding, it has been criticised as presenting a very
      Snapshot                                                          negative view of it. Under the Infant Formula and Follow-
                                                                        on Formula Regulations 1995, in force when the video was
      Nestlé’s UK address:                                              produced, educational materials should only be produced
                                                                        in accordance with government guidelines or on the written
                                                                        authority of the Secretary of State for Health. As there were no
         Nestlé UK                                                      relevant guidelines produced, questions were raised regarding
         St. George’s House                                             whether the video had approval. It is understood that Nestlé
         Park Lane                                                      attempted to gain approval retrospectively, but this does not
         Croydon                                                        appear to have been given.
         CR9 1NR                                                        In more recent developments, the same midwife, Chris
                                                                        Sidgwick, contacted health journalists with an invitation from
      Trading Standards Home Authority                                  Dr. Miriam Stoppard, a well known author and broadcaster
                                                                        on child care. The invitation was for journalists to join an all-
         London Borough of Croydon.                                     expenses-paid trip to Nestlé’s Swiss headquarters in February
                                                                        2008. Perhaps similar articles to that run in the British Journal
                                                                        of Midwifery will result. Dr. Stoppard’s message said:
      The next report will give feedback on any
      action taken on the cases highlighted.                               I’m helping the educational division of the Nestle
                                                                           Nutrition Institute to organise a trip that would encompass
                                                                           fact finding, an introduction to Nestlé research and
                                                                           presentations on topics such as obesity, infant nutrition
     Nestlé’s dubious strategy for entering the UK                         and pre and probiotics where Nestlé scientists are
     mass market                                                           engaged in cutting edge research. There will be trips to
                                                                           the laboratories and the opportunity to chat to researchers
     Nestlé currently sells only specialised formulas in the UK, such      first hand. There will also be seminars where you can
     as Nan HA or hypoallergenic formula. The hypoallergenic term          question the decision makers in Nestlé about any topic you
     is misleading as the formula should not be used with allergic         wish.
     infants. In the US and Canada, following legal action, Nestlé
     is not permitted to use the term. After discussions with the UK       We will be housed in the Nestlé Research Centre, nestled
     Department of Health, Nan HA packs should carry a warning             in the hills just outside Lausanne. It will be a very pleasant
     that the formula should not be used with allergic infants.            social occasion as well as giving you the opportunity to get
                                                                           to know Nestlé, its work and its programme of corporate
     The launch of the Nan HA formula in the UK in 2004 was seen           social responsibility in some detail.
     as the start of a strategy for entering the mass market. Given
     widespread concern about its aggressive marketing practices           I do hope you’ll be able to join us, if so please let me know
     in other countries, Nestlé is first attempting to improve its          as soon as possible and I will organise your flights and
     relationship with health workers by a media campaign and              accommodation.
     offering sponsorship.
                                                                        Training days for midwives are also being organised by the
     In 2006 Nestlé paid for a group of health workers to visit         same midwife and due to commence in October 2008 with:
     its head quarters in Vevey, Switzerland, which resulted in
     an article regarding its baby food marketing practices in the         Zelda Wilson a State Registered Dietician specialising in
     British Journal of Midwifery, a magazine sold in WH Smiths.           human interaction and behaviour.
     The article was much criticised by Baby Milk Action, which
     was attacked in the article. Baby Milk Action was given a          Zelda Wilson is the Nestlé Nutritionist who organised the
     substantial right to reply in a subsequent issue.                  trip resulting in the British Journal of Midwifery article. Her
                                                                        connection with Nestlé is not mentioned, though small print
     The conclusion of the article stated:                              does indicate the event is sponsored by Nestlé.

        “Nestlé have financial and education resources available         In an attempt to gain influence with the Department of Health,
        which would improve services to women and, as a result          Nestlé has awarded a ‘fellowship’ to the Parliamentary Private
        of fact finding, we see no reason not to tap into those          Secretary of a government minister and taken her and other
        resources at a time when most Trusts and educational            MPs on an expenses-paid trip to South Africa to show off
        establishments have very limited funds available.”              humanitarian projects. Ironically, Nestlé is in the spotlight in
                                                                        South Africa for advertising infant formula in supermarkets
     One of the authors of the article, Chris Sidgwick, had already     and using labelling claims that breach national regulations.
     worked with Nestlé to produce a video for midwives. Although


12   UK formula marketing practices - May 2008
     Quarterly report from the BFLG                                                                                   BFLG
     monitoring project                                                                                        Baby Feeding Law Group
Advertising targeting pregnant women and new mothers

At present Nestlé’s marketing strategies are directed at health workers.

However, in May 2008 it was advertising in Mother and Baby magazine.

Curiously the product being advertised was Nestlé milkybars, so outside the scope of
the Infant Formula and Follow-on Formula Regulations.

However, as chocolate is inappropriate for babies, the choice of magazine is curious.
Is Nestlé wishing to raise the profile of its name in the context of pregnancy and
motherhood?

Interestingly, Nestlé is also making claims about milk: “Only the best is good enough
for Milkybar kids. And that means only natural ingredients like fresh milk.”

While this is not a breach of the Regulations, it may well be part of the long-term
strategy of its formula launch.

In other countries Nestlé is particularly aggressive with its formula advertising. When
it entered the US market in the 1980s it broke a voluntary ban on advertising and took
the companies party to it to court for restrictive practices.




                                                                                                                                     Nestlé
Trading Standards need to be alert to Nestlé driving practices to a new low as its launch strategy progresses.




      BFLG                                                                                  UK formula marketing practices - May 2008
                                                                                                        Quarterly report from the BFLG
                                                                                                                                         13
Baby Feeding Law Group                                                                                              monitoring project
Wyeth
     Brand: SMA
                                                                       While the small print states that the product is not intended to
      Snapshot                                                         replace breastfeeding it also states: “When used in conjunction
                                                                       with solid feeding, it provides the nourishment essential to a
      Wyeth’s UK address:                                              baby’s healthy and sustained growth.” [emphasis added].

                                                                       This undermines the recommendation from the World
         Wyeth                                                         Health Organisation and Department of Health for continued
         Huntercombe Lane                                              breastfeeding after 6 months with the introduction of
         South Taplow                                                  complementary foods and the position that follow-on formulas
         Maidenhead                                                    are ‘not necessary’.
         Berkshire                                                     The advertisement states: “See our Progress range at
         SL6 0PH                                                       www.smanutrition.co.uk”

      Trading Standards Home Authority                                 In fact the website promotes the full SMA range, including the
                                                                       similarly packaged infant formula.
         Buckinghamshire County Council.                               Progress was again promoted in OK celebrity magazine in
                                                                       April 2008 as shown below, again directing people to the
      The next report will give feedback on any                        website where infant formula is promoted.
      action taken on the cases highlighted.

     Magazine advertising

     Last year Wyeth advertised its SMA Progress formula in OK
     Magazine alongside an article with model Jordan/Katie Price,
     who was pictured using ready-to-feed formula. The ASA was
     asked to investigate the advertising strategy, but did not rule
     against it.

     Promotion of Progress continues in parenting magazines, with
     idealizing claims. The example shown here is from Practical
     Parenting March 2008.




                                                                       Last year Wyeth ran a television advertisement containing
                                                                       only emotional content and the SMA name, which generated
                                                                       many complaints but was cleared by the Advertising Standards
                                                                       Authority (ASA).

                                                                       As in the television advertisement, in these print
                                                                       advertisements Wyeth promotes itself as a source of expertise
                                                                       of infant feeding. The advertisements carry the slogan
                                                                       “Understanding parents. Understanding babies”, attempting
                                                                       to replace the health service and mother support groups as
                                                                       sources of information.


14   UK formula marketing practices - May 2008
     Quarterly report from the BFLG                                                                                BFLG
     monitoring project                                                                                      Baby Feeding Law Group
Use of health claims on labels and promotion to health
workers

Wyeth introduced new labels in 2007 after being reminded
by the Food Standards Agency that claims such as ‘now even
closer to breastmilk’ are not on the permitted list.

The new labels contained other claims and idealizing text that
are permitted by neither the 1995 nor 2007 versions of the
Infant Formula and Follow-on Formula Regulations.

Examples include:

       “New improved protein balance.”

       “Easily digested.”

       “Love the milk you give.”
                                                                  Point of sale promotion
       “Gold.”
                                                                  Generally discounts on SMA formula in retail outlets are
The label also has idealizing images:                             limited to the follow-on milk as in the example shown here in
                                                                  Morrison’s.
A new logo incorporating a breastfeeding mother now that the
‘closer to breastmilk’ slogan has been removed.

A mother’s face.

                                    The idealizing health




                                                                                                                                    Wyeth
                                    claims made on the
                                    labels are combined with
                                    targeting health workers
                                    to encourage them to
                                    communicate the claims
                                    to mothers. The examples
                                    shown here are directed at
                                    midwives.
                                                                  Such promotions do appear
                                       Significantly when Wyeth/   alongside the infant formula,
                                       SMA has been invited       something the Guidance Notes that
                                       to provide scientific       accompany the 2007 Regulations are
                                       substantiation for its     seeking to stop.
                                       claims for review by a
                                       committee of one health    Other promotional strategies are
trust it has apparently been reluctant to do so.                  used to draw attention directly to
                                                                  the infant formula, as shown in
                                                                  Morrison’s and Babies’R’Us.




      BFLG                                                                                 UK formula marketing practices - May 2008
                                                                                                       Quarterly report from the BFLG
                                                                                                                                        15
Baby Feeding Law Group                                                                                             monitoring project
It is time to enforce the law!
     This report shows some of the methods the main baby milk companies in the UK are using to
     promote their products. They boost sales by undermining breastfeeding and idealising their
     products. Parents that use formula are misled.

           Companies are advertising on televison and in magazines.

           They encourage parents to visit websites which suggest their products protect against
           infection, help in the development of intelligence and ensure babies sleep through the
           night.

           They provide free gifts if mothers join baby clubs to receive company promotional
           materials.

           They use telephone ‘carelines’ to idealize their products and undermine independent
           advice from health workers.

           They compete to have the most appealing cuddly animal images on their labels and the
           most impressive sounding ingredients. But they do not warn that powdered formula is
           not sterile or the simple steps required to reduce health risks.

     The examples selected for this report are not necessarily the worst cases of companies
     undermining breastfeeding and misleading parents who use formula. They have been
     selected because they are believed to break the UK Infant Formula and Follow-on Formula
     Regulations. These are weak measures that allow many other aggressive practices to take
     place.

     To date, the Regulations have not been enforced - since being introduced in 1995 there
     has only been one prosecution, for illegal advertising. Though successful, similar practices
     continue unpunished.

     Hopefully the situation is about the change. The Regulations have been updated. New
     Guidance Notes have been introduced to assist Trading Standards officers in taking
     action.

     Further monitoring reports will be produced as resources allow to show if the enforcement
     system is now working. Ideally these reports will appear every three months.

     Find out more about the monitoring project coordinated by Baby Milk Action on behalf of
     the Baby Feeding Law Group at www.babyfeedinglawgroup.org.uk

     You can denounce aggressive marketing practices via the website. You just might find your
     information used in a future report!

16   UK formula marketing practices - May 2008
     Quarterly report from the BFLG                                                   BFLG
     monitoring project                                                          Baby Feeding Law Group

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Uk Formula Marketing Practices

  • 1. UK formula marketing practices Quarterly round up from the BFLG monitoring project May 2008 BFLG Prepared by Baby Milk Action on behalf of BFLG, a coalition of 22 health worker organisations and mother support groups Baby Feeding Law Group
  • 2. The BFLG monitoring project The Baby Feeding Law Group provides information and training to health workers and members of the public on how to monitor baby food marketing practices against international standards and UK legislation. Monitoring results appear in this and other BFLG reports such as Look What They’re Doing in the UK, Hard Sell Formula and Protecting breastfeeding - Protecting babies fed on formula. The project began with the help of a grant from the King’s Fund and is currently funded, at a low level, by donations from members of the public. Produced by Baby Milk Action for the Baby Feeding Law Group Written by: Mike Brady Campaigns and Networking Coordinator Baby Milk Action And Coordinator of the BFLG monitoring project Baby Milk Action is the secretariat for the BFLG and the UK member of the International Baby Food Action Network (IBFAN) Baby Milk Action 34 Trumpington Street Cambridge CB2 1QY Tel: 01223 464420 www.babyfeedinglawgroup.org.uk BFLG Member organisations Association of Breastfeeding Mothers (ABM) La Leche League Great Britain (LLLGB) Association for Improvements in the Maternity Services (AIMS) Little Angels Association of Radical Midwives (ARM) Midwives Information and Resource Service (MIDIRS) Baby Milk Action (BFLG secretariat) National Childbirth Trust (NCT) Best Beginnings Royal College of Nursing (RCN) Breastfeeding Community Royal College of Midwives (RCM) Breastfeeding Network (BfN) Royal College of Paediatrics and Child Health (RCPCH) Community Practitioners and Health Visitors Association The Baby Café (CPHVA) UK Association for Milk Banking (U.K.A.M.B) Food Commission UNICEF UK Baby Friendly Initiative (BFI) Lactation Consultants Great Britain (LCGB) UNISON Women’s Environmental Network (WEN) 2 UK formula marketing practices - May 2008 Quarterly report from the BFLG BFLG monitoring project Baby Feeding Law Group
  • 3. Action needed to stop illegal practices BFLG monitoring reports of the Regulations. Companies produced new labels in 2007 with non-compliant The purpose of this monitoring report is to set out some current claims such as ‘with prebiotics’ and and recent baby milk marketing practices to assist Trading ‘inspired by breastmilk’, with apparent Standards Officers in taking action. Baby Milk Action has impunity - a year later these labels produced monitoring reports on behalf of Baby Feeding Law are still on the market and new non- Group (BFLG) in the past focusing on violations of the Code compliant ones are being produced. The and Resolutions to justify strengthening regulations (see page label shown here has just been launched 2). This report is different as it is restricted to practices believed by Danone (Cow & Gate brand). to break the much narrower UK regulations. Amongst the prohibited claims, text and images, is the lamb. Such images are not The report is divided into sections on the major companies required to identify the product or as part operating in the UK. The first section includes key text from of the instructions. As the images on the the Infant Formula and Follow-on Formula Regulations and cover of this report show, cute animals associated Guidance Notes. are a common marketing strategy. Updates are planned every three months to track new marketing While the list has been updated in the strategies and to demonstrate the success or otherwise of action 2007 Regulations, it remains true that taken by the Trading Standards offices that are home authorities only claims appearing on the list may be used. Action at the for the companies concerned. The report is being sent directly High Court has put back the date by which companies have to to them as well as to LACORS, the umbrella body, which has comply with the labelling provisions until 2010. But as current convened a home authorities working group. labels comply with neither the 1995 nor the 2007 version of the Regulations there is no excuse for inaction. The report will also be sent to a review panel convened by the Food Standards Agency to evaluate the effectiveness of the Good Night milks - a new marketing strategy Regulations. These were revised in 2007, but did not respond to the call by BFLG members and other health advocates to bring A new marketing strategy from Danone and Hipp is the these into line with the International Code of Marketing of introduction of so-called Good Night milks. These are Breastmilk Substitutes and subsequent, relevant Resolutions of promoted as guaranteeing babies sleep through the night. The the World Health Assembly. The United Nations Committee on name itself is a health claim and the marketing undermines the Rights of the Child and the UN Special Rapporteur on the breastfeeding and misleads parents who use formula. See Right to Food also called for the Code and Resolutions to be the BFLG briefing paper examining the ingredients of these implemented in the UK. formulas and the claims made for them. For detailed analysis of the Regulations, what is required to It is already the position of the Department of Health that bring them into line and the possible health and economic follow-on formula is an unnecessary product. The review panel benefits of doing so, see the BFLG report Protecting should consider whether current regulations can deal with such breastfeeding - Protecting babies fed on formula, which was strategies and recall the recommendations of the Government’s submitted to the FSA consultation on the Regulations. Scientific Advisory Committee on Nutrition (SACN): Inaction has led to widespread abuses SACN comments on the formula regulations In the history of the Infant Formula and Follow-on Formula Regulations, first introduced in 1995, there has only been “There is no case for allowing the ‘advertising’ of follow- one prosecution of a baby food company, that of Wyeth/SMA on formula... there is no scientific evidence demonstrating in 2003 by Birmingham Trading Standards for illegal infant nutritional advantage of this product over infant formula advertising. Despite the company being convicted formula...[both these] are breast milk substitutes as defined of a ‘cynical and deliberate’ breach of the regulations, no by the Code (which sets no upper infant age limit on this other company has been prosecuted, even though similar term)...We find the case for labelling infant formula or advertisements being run by most of them. The Wyeth follow on formula with health or nutrition claims entirely advertisement did not refer explicitly to the company’s infant unsupportable. If an ingredient is unequivocally beneficial formula, SMA Gold, but gave pointers to it. The same is true as demonstrated by independent review of scientific of many of the advertisements in this report, which are branded data it would be unethical to withhold it for commercial with the names and logos used for infant formula and direct reasons. Rather it should be made a required ingredient of the public to websites where the full range of products are infant formula in order to reduce existing risks associated promoted. with artificial feeding. To do otherwise is not in the best interests of children, and fails to recognise the crucial Action is also long overdue on labelling. In 2006 the distinction between these products and other foods.” manufacturers were reminded by the FSA that claims are only allowed on formula labels if explicitly listed in Appendix IV www.sacn.gov.uk/pdfs/position_statement_2007_09_24.pdf BFLG UK formula marketing practices - May 2008 Quarterly report from the BFLG 3 Baby Feeding Law Group monitoring project
  • 4. Danone Brands: Aptamil, Cow & Gate, Milupa Magazine advertising - ignoring ASA rulings Snapshot A Cow & Gate follow-on formula advertisements in Mother and Baby and Practical Parenting in March 2008 states: Danone UK address: “Immune system under construction. Cow & Gate follow-on milks support your baby’s natural immune system.” Danone UK, PO BOX 4261, Reading, RG8 9ZZ, UK. Trading Standards Home Authority Wiltshire County Council was responsible for Milupa and Cow&Gate. Now Danone has bought NUMICO, this may change. Recent UK action The Advertising Standards Authority1 ruled against a Cow&Gate follow-on formula advertisement containing the claim : “Our range of follow-on milks all contain a bunch of goodies called prebiotics to help build natural defences.” Other developments Danone purchased NUMICO, the owner of Nutricia, Milupa and Cow&Gate brands, in 2007. It has promised the International Yet, the Advertising Standards Authority (ASA) warned Baby Food Action Network (IBFAN) a ‘root Nutricia/Cow & Gate in November 2006 about claims in its follow-on formula advertising, stating: “We noted much of and branch review’ of NUMICO practices, the evidence sent by Cow & Gate was associative, rather than but has so far refused to give an undertaking showing causality. ... Because they had not sent evidence to that it will bring them into line with the World show a direct link between an infant taking their formula and Health Assembly’s minimum standards. it helping to build defences against a number of everyday illnesses or conditions to which they were susceptible, we considered that Cow & Gate had not substantiated the claim.... The next report will give feedback on any We told Cow & Gate to amend the ad to make clear that action taken on the cases highlighted. the product could help build “some” and not “all” natural defences.” Similar claims are made for Aptamil follow-on formula in the same magazines: “After 50 years of research into breastmilk, our Aptamil research experts have developed IMMUNOFORTIS, a patented mix of special prebiotics. This unique formulation helps to support your baby’s natural immune system, making it the best follow on milk.” 1. http://www.asa.org.uk/asa/adjudications/non_broadcast/Adjudication+Details.htm?Adjudication_id=41915 4 UK formula marketing practices - May 2008 Quarterly report from the BFLG BFLG monitoring project Baby Feeding Law Group
  • 5. At the end of April a 30 second Danone advertisement for Aptamil began to be shown on television and the internet. The film speaks of the importance of breastfeeding which ‘strengthens your baby’s natural defences’ then promotes Aptamil ‘if you decide to move on from breastfeeding’ with a similar expression - ‘to help support some of you bay’s natural defences’ - implying equivalence. Mother and Baby and Pregnancy and Birth magazines in March 2008 include promotional fliers for the Aptamil brand name, encouraging mothers to visit the site where the full range of products is promoted, and to sign up to mailing lists to receive a free gift. The promotion targets pregnant women: “Just as you are unique, how your body and mind respond to pregnancy is also unique. That’s why our Careline team of The above advertisement for Aptamil follow-on formula midwives, healthcare professionals, nutritionists, and feeding appeared in Mother and Baby and Practical Parenting March advisors is here to offer expert advice tailored to you and your 2008 editions. baby as you both grow and develop.” The Aptamil name appearing Infant formula and follow-on formula regulations on the flier is exactly the same as used on infant formula Follow-on formula advertising shall : “(a) be designed to labels. In addition, the attempt provide the necessary information about the appropriate to present the company as use of the product so as not to discourage breast an alternative source of feeding; and (b) not contain the terms “humanised”, information and educational “maternalised”, “adapted” or any similar term. materials to the health care 2007 and (almost identical) 1995 regulations. system is a breach of section 24 of the Infant Formula Advertising for Aptamil and Cow & Gate follow-on formula and Follow-on Formula breaks the provisions of the 1995 and 2007 Regulations as Regulations, which state such it idealizes infant feeding and undermines breastfeeding by materials must not refer to drawing equivalence between the product and breastfeeding. infant formula brand names For example, the Aptamil advertisement above states: “You and (continued overleaf...) protect him from the outside; now you can help support him from the inside with Aptamil Follow on milk. After 50 years Guidance Notes of research into breastmilk, our Aptamil research experts have developed IMMUNOFORTIS, a patented mix of special 67. Any general advertisement placed by a manufacturer prebiotics. This unique formulation helps to support your must not feature a brand name, trade mark, business baby’s natural immune system, making it the best follow on name or logo uniquely [?] associated with an infant milk.” [emphasis added] formula or mention breastfeeding. If this advertisement includes a response mechanism this must be of an ‘opt- Guidance Notes in’ type, so that only parents or carers actively requesting information on infant formula milks can be sent this 70. To minimise the risk of consumers making a information and nothing else. Attempting to solicit connection between follow-on formula and the act of requests for information, providing information on feeding infants from birth, information in advertisements products outside the scope of the initial enquiry or for follow-on formula should not include pictures or making undue references to proprietary infant formula text which relate or compare follow-on formula to brand names in a response to a request for product breastmilk. [emphasis added]. information is considered advertising and is not permitted under regulation 21. [emphasis added] BFLG UK formula marketing practices - May 2008 Quarterly report from the BFLG 5 Baby Feeding Law Group monitoring project
  • 6. may only be distributed through the health care system, with In the example below from Mother and Baby magazine March prior permission. Aptamil is an infant formula brand name, as 2008, pregnant women are offered a cow soft toy for signing the pack shot in this report shows. up to receive company materials. The branding used for infant formula is promoted. Infant formula and follow-on formula regulations 24 (4) No manufacturer or distributor of an infant formula shall make a donation of any informational or educational equipment or materials except in accordance with the following conditions— (a) the donation shall be made following a request by the intended recipient; (b) the donation shall be made with the written authority of the Secretary of State or in accordance with guidelines drawn up by the Secretary of State; (c) the equipment and materials shall not be marked or labelled with the name of a proprietary brand of infant formula; and (d) the equipment or materials shall be distributed only through the health care system. 2007 and 1995 regulations. The same strategy of promoting the infant formula brand name There may be some ambiguity over whether the materials and encouraging mothers to visit the company website to sign referred to in Aptamil and Cow&Gate advertising should up to receive information is used with advertisements placed on be viewed as advertising or information materials. In both third-party websites as with this example on a parenting site. cases they should not refer to infant formula. If information materials, they should be authorised by the Secretary of State for Health. It would be useful to know if such authorisation has been obtained. Guidance Notes 77. The following is a list of some of the types of materials which, if they provide information or are educational, would be controlled by regulation 24(4) and require approval from the Secretary of State7 before formula manufacturers donate them to third parties: • CDs and DVDs • Wallcharts, posters • Booklets or leaflets which are designed for reference purposes • Electronic files that can be downloaded directly from a Mothers have also been targeted in supermarkets, where Cow website & Gate branded gifts such as dummies and growth charts have been distributed. The example below is from Sainsbury’s in September 2007. Gifts and baby clubs The Danone companies use gifts such as this Aptamil polar bear to promote their formula brand names and to encourage mothers to visit websites and sign up for information promoting infant formula. Promotional gifts are prohibited by the Regulations. 6 UK formula marketing practices - May 2008 Quarterly report from the BFLG BFLG monitoring project Baby Feeding Law Group
  • 7. Cow & Gate Good Night milk launch Danone A major promotion has been launched for the new product Cow & Gate Good Night milk (see BFLG briefing on these products). The advertisement shown left appeared in the celebrity magazine Reveal in March 2008. It is dominated by the idealizing text and image implying that infants fed on the formula will sleep, playing on a parents insecurities and concerns about night feeding. The name itself is an idealising claim about the product. The ad states : “New Cow & Gate good night milk has been specially developed to help settle your baby at bedtime. Thicker than regular follow-on milk, but gentle on your baby’s tummy, it provides a warm, contented and satisfying end to the day.” This undermines the Department of Health recommendation to continue breastfeeding beyond 6 months. As the briefing explains, there is also concern over the composition of these products. The launch has been backed by special displays and discounts, such as that shown in Boots, above right, in April 2008. The flier shown right is promoting the formula in Morrisons in March 2008. The product is also being used to encourage mothers to visit the Cow & Gate website where the full range of products is promoted. The 12-page leaflet left, distributed in Boots, promotes Cow & Gate as a source of information on infant care. Labelling “‘Why should I choose Cow & Gate Comfort 1? Some babies have sensitive UK regulations permit health and nutrition claims only if they tummies and need a formula to gently are specifically referenced in Annex IV of the Infant Formula aid comfortable digestion. Cow & Gate and Follow-on Formula Regulations 1995 or in the similar comfort 1 has been specially formulated to annex to the more recent Directive 2006/141/EC. Cow & Gate be more easily digested. It is a thicker feed and Aptamil infant formula labels use claims that are listed in which will help your baby swallow less air neither, including: whilst feeding, thereby aiding comfortable digestion.” • IMMUNOFORTIS/prebiotics (Aptamil) • With prebiotic care (all brands) The label draws equivalence with breastmilk: “Not all milks • For comfortable digestion (Cow & Gate comfort) are the same. Cow & Gate milks contain prebiotics, special • Good Night (formula name implying sleep benefits) nutrients that are similar to the ones found in breastmilk and some fruit and vegetables. Breastmilk is special because it Labels use idealizing images, such as the shield and polar bear strengthens a baby’s natural immune system, helping them to on Aptamil formula (see overleaf and front cover). No labels fight off bugs and infections. A strong immune system is one of currently on the UK market provide warnings and instructions the key ingredients for a happy and healthy baby.” to reduce risks of possible intrinsic contamination of powdered infant formula with harmful bacteria. New formula labels, still with prohibited claims, have been introduced for Comfort and Cow & Gate branded formulas this year, despite the industry’s claim in the High Court that it could not comply with the 2007 Regulations for 2 years because of the time it would take to change labels. As all labels on the market are non-compliant Trading Standards should advise the company to recall and replace the products immediately. Labels contain idealizing text which undermines breastfeeding. For example, Cow and Gate comfort states: BFLG UK formula marketing practices - May 2008 Quarterly report from the BFLG 7 Baby Feeding Law Group monitoring project
  • 8. Opinion from the European Commission “The use of the claim ‘contains prebiotics’ is a claim describing a function and therefore has to be considered as a health claim which is currently not foreseen in Directive 2006/141/EC and consequently is not permitted for use for infant formulae.” Letter to FSA, 4 October 2007, from European Commission Health and Consumer Protection Directorate (DG SANCO) Promotion to health workers In addition to the fact that the prebiotics claim is not permitted on infant formula, independent analysis of research by the Cochrane Library finds the claims are not substantiated. While the regulations on labelling follow-on formula are not so strict, the ASA has ruled against prebiotic claims used in follow-on formula advertising. Despite this the claimed benefits of prebiotics in formula are promoted to health workers in advertising, as in these examples targeting midwives in April 2008. Independent review of Prebiotics research “There is insufficient evidence to recommend the addition of prebiotics to infant feeds for prevention of allergic disease or food reactions.” Cochrane Database of Systematic Reviews Osborn DA, Sinn JK. Prebiotics in infants for prevention of allergic disease and food hypersensitivity. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD006474. DOI: 10.1002/14651858.CD006474.pub2. See:http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD006474/frame.html 8 UK formula marketing practices - May 2008 Quarterly report from the BFLG BFLG monitoring project Baby Feeding Law Group
  • 9. Heinz Brand: Farley’s Despite taking advantage of this change in the Regulations it Snapshot still does not comply with the other requirements, nor does it Heinz comply with the 1995 regulations whose labelling provisions Heinz/Farley’s UK address: remain in force following the industry challenge at the High Court. HJ Heinz Company Ltd Labels contain idealizing text (such as ‘our most advanced South Building formula ever’) and images, such as the teddy bear used in the Hayes Park free booklet shown below and other promotional materials to Hayes promote the full range of products (see past BFLG monitoring and consultation reports such as Hard Sell Formula and Middlesex Protecting breastfeeding - Protecting babies fed on formula). UB4 8AL Labels do not provide warnings and instructions to reduce the risks of possible intrinsic contamination of powdered infant Trading Standards Home Authority formula with bacteria. London Borough of Hillingdon, Environmental Health Department. The next report will give feedback on any action taken on the cases highlighted. Labels non-compliant with regulations Heinz/Farley’s pre-empted the introduction of the Infant Formula and Formula Regulations 2007 by introducing a ‘with Advertising of complementary foods omega-3 LCPs’ claim in a prominent banner on the front of the pack, as shown here. Heinz/Farley’s has advertised its formula brand on television and in print in the past. Its current advertising is focused on complementary foods. Government policy is that complementary foods are not needed until 6 months of age, but Heinz promoted foods for use from 4- 6 months of age in Practical Parenting in April 2008 as shown below. BFLG UK formula marketing practices - May 2008 Quarterly report from the BFLG 9 Baby Feeding Law Group monitoring project
  • 10. Hipp be produced. However, the agreed labels have reached Snapshot the final stage, they will be printed very soon and then the new labels will be used in production.” Hipp’s UK address: Hipp is unwilling to share the labels before they appear on the shelves. A future report will contain analysis. HiPP UK Ltd 165 Main Street Hipp labels are curious when it comes to warnings regarding New Greenham Park powdered formula not being sterile. Its infant formula labels Newbury are the only ones to give a warning, but it states: “Powdered baby milk formulas are not sterile and reconstituted feeds Berks are at risk of infection.” As the risk comes from possible RG19 6HN intrinsic contamination, it makes more sense to say: “a risk of infection.” Trading Standards Home Authority The instructions state: “Boil water and leave to stand until temperature reaches 50 - 60 Deg. C (30 - 40 minutes).” West Berkshire Council. Since November 2005 the Food Standards Agency has been The next report will give feedback on any advising: “the risks associated with using powdered infant action taken on the cases highlighted. formula milk are reduced if [inter alia]: feeds are made up using boiled water that is greater than 70°C; in practice, this means using water that has been left to cool for no more than half an hour.” The Guidance Notes accompanying the Regulations state in section 24: The Agency recommends that these instructions should include information noting that: • Powdered infant formulae and follow-on formulae are not sterile, and as such can contain harmful bacteria. It is therefore important to be very careful when preparing formula to reduce the risks. Boiled tap water (not bottled water) cooled for no more than 30 minutes should be used to prepare infant feeds. • All equipment used for feeding and preparing feed must be thoroughly cleaned and sterilised before use, Labels non-compliant with regulations and bottles should be made up fresh for Hipp labels contain idealizing images and make much of its each feed, as storing ‘organic’ claim. Hipp has responded to a Baby Milk Action made-up formula campaign calling on companies to bring labels into line with milk may increase regulation by stating: the chance of a baby becoming ill. “Hipp has been working very closely with the FSA and our local Trading Standards Officer to ensure our milks The FSA advice packs conform with the new Infant and Follow-on formula to parents was Regulations (2007), which has not been easy in the introduced nearly 3 absence of any finalised guidance notes from the FSA. years ago, but still companies have “Obviously, changes take a while to implement as we need not brought their to ensure that all the changes are correct and then the instructions into line. labels/packs have to be printed before the products can 10 UK formula marketing practices - May 2008 Quarterly report from the BFLG BFLG monitoring project Baby Feeding Law Group
  • 11. Good night milks Hipp, like Danone/Cow & Gate, has launched a Goodnight milk (see BFLG briefing on these new products). This is promoted in a way that undermines breastfeeding with the advertisement shown right from Mother and Baby magazine, March 2008, suggesting that thanks to the milk “Now everyone can get a good night’s sleep.” It also describes it as: “the ideal end to a busy adventure filled day.” Targeting mothers Hipp makes much of its company ‘careline’ and website. Baby Milk Action monitoring of the HIPP company careline found that the information given directly contradicted that from FSA and WHO. Hipp The website promotes the full range of Hipp formulas, including infant formula. In a bid to encourage mothers to visit and to look to Hipp for information, Hipp is offering mothers web space for a blog on their babies and a free gift if they sign up to the Hipp baby club. The advertisement shown below appeared in Mother and Baby magazine in March 2008. For example, the advertisement shown below from Pregnancy and Birth March 2008 includes a pack shot for apple and pear baby food labelled for use from 4 months of age. Undermining advice on complementary feeding The free gift offered to mothers signing up to the Hipp baby club is a ‘weaning pack’. Experience shows that Hipp encourages weaning before the age of 6 months, despite it being the position of the Department of Health and World Health Organisation that, as a general health recommendation, babies need only breastmilk or formula before 6 months. BFLG UK formula marketing practices - May 2008 Quarterly report from the BFLG 11 Baby Feeding Law Group monitoring project
  • 12. Nestlé about breastfeeding, it has been criticised as presenting a very Snapshot negative view of it. Under the Infant Formula and Follow- on Formula Regulations 1995, in force when the video was Nestlé’s UK address: produced, educational materials should only be produced in accordance with government guidelines or on the written authority of the Secretary of State for Health. As there were no Nestlé UK relevant guidelines produced, questions were raised regarding St. George’s House whether the video had approval. It is understood that Nestlé Park Lane attempted to gain approval retrospectively, but this does not Croydon appear to have been given. CR9 1NR In more recent developments, the same midwife, Chris Sidgwick, contacted health journalists with an invitation from Trading Standards Home Authority Dr. Miriam Stoppard, a well known author and broadcaster on child care. The invitation was for journalists to join an all- London Borough of Croydon. expenses-paid trip to Nestlé’s Swiss headquarters in February 2008. Perhaps similar articles to that run in the British Journal of Midwifery will result. Dr. Stoppard’s message said: The next report will give feedback on any action taken on the cases highlighted. I’m helping the educational division of the Nestle Nutrition Institute to organise a trip that would encompass fact finding, an introduction to Nestlé research and presentations on topics such as obesity, infant nutrition Nestlé’s dubious strategy for entering the UK and pre and probiotics where Nestlé scientists are mass market engaged in cutting edge research. There will be trips to the laboratories and the opportunity to chat to researchers Nestlé currently sells only specialised formulas in the UK, such first hand. There will also be seminars where you can as Nan HA or hypoallergenic formula. The hypoallergenic term question the decision makers in Nestlé about any topic you is misleading as the formula should not be used with allergic wish. infants. In the US and Canada, following legal action, Nestlé is not permitted to use the term. After discussions with the UK We will be housed in the Nestlé Research Centre, nestled Department of Health, Nan HA packs should carry a warning in the hills just outside Lausanne. It will be a very pleasant that the formula should not be used with allergic infants. social occasion as well as giving you the opportunity to get to know Nestlé, its work and its programme of corporate The launch of the Nan HA formula in the UK in 2004 was seen social responsibility in some detail. as the start of a strategy for entering the mass market. Given widespread concern about its aggressive marketing practices I do hope you’ll be able to join us, if so please let me know in other countries, Nestlé is first attempting to improve its as soon as possible and I will organise your flights and relationship with health workers by a media campaign and accommodation. offering sponsorship. Training days for midwives are also being organised by the In 2006 Nestlé paid for a group of health workers to visit same midwife and due to commence in October 2008 with: its head quarters in Vevey, Switzerland, which resulted in an article regarding its baby food marketing practices in the Zelda Wilson a State Registered Dietician specialising in British Journal of Midwifery, a magazine sold in WH Smiths. human interaction and behaviour. The article was much criticised by Baby Milk Action, which was attacked in the article. Baby Milk Action was given a Zelda Wilson is the Nestlé Nutritionist who organised the substantial right to reply in a subsequent issue. trip resulting in the British Journal of Midwifery article. Her connection with Nestlé is not mentioned, though small print The conclusion of the article stated: does indicate the event is sponsored by Nestlé. “Nestlé have financial and education resources available In an attempt to gain influence with the Department of Health, which would improve services to women and, as a result Nestlé has awarded a ‘fellowship’ to the Parliamentary Private of fact finding, we see no reason not to tap into those Secretary of a government minister and taken her and other resources at a time when most Trusts and educational MPs on an expenses-paid trip to South Africa to show off establishments have very limited funds available.” humanitarian projects. Ironically, Nestlé is in the spotlight in South Africa for advertising infant formula in supermarkets One of the authors of the article, Chris Sidgwick, had already and using labelling claims that breach national regulations. worked with Nestlé to produce a video for midwives. Although 12 UK formula marketing practices - May 2008 Quarterly report from the BFLG BFLG monitoring project Baby Feeding Law Group
  • 13. Advertising targeting pregnant women and new mothers At present Nestlé’s marketing strategies are directed at health workers. However, in May 2008 it was advertising in Mother and Baby magazine. Curiously the product being advertised was Nestlé milkybars, so outside the scope of the Infant Formula and Follow-on Formula Regulations. However, as chocolate is inappropriate for babies, the choice of magazine is curious. Is Nestlé wishing to raise the profile of its name in the context of pregnancy and motherhood? Interestingly, Nestlé is also making claims about milk: “Only the best is good enough for Milkybar kids. And that means only natural ingredients like fresh milk.” While this is not a breach of the Regulations, it may well be part of the long-term strategy of its formula launch. In other countries Nestlé is particularly aggressive with its formula advertising. When it entered the US market in the 1980s it broke a voluntary ban on advertising and took the companies party to it to court for restrictive practices. Nestlé Trading Standards need to be alert to Nestlé driving practices to a new low as its launch strategy progresses. BFLG UK formula marketing practices - May 2008 Quarterly report from the BFLG 13 Baby Feeding Law Group monitoring project
  • 14. Wyeth Brand: SMA While the small print states that the product is not intended to Snapshot replace breastfeeding it also states: “When used in conjunction with solid feeding, it provides the nourishment essential to a Wyeth’s UK address: baby’s healthy and sustained growth.” [emphasis added]. This undermines the recommendation from the World Wyeth Health Organisation and Department of Health for continued Huntercombe Lane breastfeeding after 6 months with the introduction of South Taplow complementary foods and the position that follow-on formulas Maidenhead are ‘not necessary’. Berkshire The advertisement states: “See our Progress range at SL6 0PH www.smanutrition.co.uk” Trading Standards Home Authority In fact the website promotes the full SMA range, including the similarly packaged infant formula. Buckinghamshire County Council. Progress was again promoted in OK celebrity magazine in April 2008 as shown below, again directing people to the The next report will give feedback on any website where infant formula is promoted. action taken on the cases highlighted. Magazine advertising Last year Wyeth advertised its SMA Progress formula in OK Magazine alongside an article with model Jordan/Katie Price, who was pictured using ready-to-feed formula. The ASA was asked to investigate the advertising strategy, but did not rule against it. Promotion of Progress continues in parenting magazines, with idealizing claims. The example shown here is from Practical Parenting March 2008. Last year Wyeth ran a television advertisement containing only emotional content and the SMA name, which generated many complaints but was cleared by the Advertising Standards Authority (ASA). As in the television advertisement, in these print advertisements Wyeth promotes itself as a source of expertise of infant feeding. The advertisements carry the slogan “Understanding parents. Understanding babies”, attempting to replace the health service and mother support groups as sources of information. 14 UK formula marketing practices - May 2008 Quarterly report from the BFLG BFLG monitoring project Baby Feeding Law Group
  • 15. Use of health claims on labels and promotion to health workers Wyeth introduced new labels in 2007 after being reminded by the Food Standards Agency that claims such as ‘now even closer to breastmilk’ are not on the permitted list. The new labels contained other claims and idealizing text that are permitted by neither the 1995 nor 2007 versions of the Infant Formula and Follow-on Formula Regulations. Examples include: “New improved protein balance.” “Easily digested.” “Love the milk you give.” Point of sale promotion “Gold.” Generally discounts on SMA formula in retail outlets are The label also has idealizing images: limited to the follow-on milk as in the example shown here in Morrison’s. A new logo incorporating a breastfeeding mother now that the ‘closer to breastmilk’ slogan has been removed. A mother’s face. The idealizing health Wyeth claims made on the labels are combined with targeting health workers to encourage them to communicate the claims to mothers. The examples shown here are directed at midwives. Such promotions do appear Significantly when Wyeth/ alongside the infant formula, SMA has been invited something the Guidance Notes that to provide scientific accompany the 2007 Regulations are substantiation for its seeking to stop. claims for review by a committee of one health Other promotional strategies are trust it has apparently been reluctant to do so. used to draw attention directly to the infant formula, as shown in Morrison’s and Babies’R’Us. BFLG UK formula marketing practices - May 2008 Quarterly report from the BFLG 15 Baby Feeding Law Group monitoring project
  • 16. It is time to enforce the law! This report shows some of the methods the main baby milk companies in the UK are using to promote their products. They boost sales by undermining breastfeeding and idealising their products. Parents that use formula are misled. Companies are advertising on televison and in magazines. They encourage parents to visit websites which suggest their products protect against infection, help in the development of intelligence and ensure babies sleep through the night. They provide free gifts if mothers join baby clubs to receive company promotional materials. They use telephone ‘carelines’ to idealize their products and undermine independent advice from health workers. They compete to have the most appealing cuddly animal images on their labels and the most impressive sounding ingredients. But they do not warn that powdered formula is not sterile or the simple steps required to reduce health risks. The examples selected for this report are not necessarily the worst cases of companies undermining breastfeeding and misleading parents who use formula. They have been selected because they are believed to break the UK Infant Formula and Follow-on Formula Regulations. These are weak measures that allow many other aggressive practices to take place. To date, the Regulations have not been enforced - since being introduced in 1995 there has only been one prosecution, for illegal advertising. Though successful, similar practices continue unpunished. Hopefully the situation is about the change. The Regulations have been updated. New Guidance Notes have been introduced to assist Trading Standards officers in taking action. Further monitoring reports will be produced as resources allow to show if the enforcement system is now working. Ideally these reports will appear every three months. Find out more about the monitoring project coordinated by Baby Milk Action on behalf of the Baby Feeding Law Group at www.babyfeedinglawgroup.org.uk You can denounce aggressive marketing practices via the website. You just might find your information used in a future report! 16 UK formula marketing practices - May 2008 Quarterly report from the BFLG BFLG monitoring project Baby Feeding Law Group