Channel 4 Dispatches asks if the £40billion infant formula industry is putting profit before babies?

18 March 2019

THE GREAT FORMULA MILK SCANDAL: CHANNEL 4 DISPATCHES

Monday 18th March, Channel 4, 8pm

Channel 4 Dispatches asks if the £40billion infant formula industry is putting profit before babies?

Key lines:

• Dispatches can reveal that - as of Monday 18th March -  the British Medical Journal will no longer accept formula milk adverts, vowing instead to ‘campaign against industry influence.’ 
• Dispatches has conducted the largest ever analysis of formula influence within our NHS to investigate how guidance surrounding sponsorship and gifting from companies is often broken.

• Dispatches found that since 2014 almost a third of 195 clinical commissioning groups in England had recorded a breach of the World Health Organisation guidance – such as a gift or sponsorship from a formula company.
• Sue Ashmore, Unicef UK Baby Friendly Initiative Director, said: ‘We need to make sure babies and parents are protected from commercial interests and misleading marketing practices. Dispatches have highlighted how powerful multi-national companies have been pushing the boundaries of existing legislation to promote their products. We urgently need better legislation to protect babies.’

Unnecessary cost of formula:

Formula milk can take a big chunk out of the family budget, and many families are paying a needless premium. 

• Sainsbury’s Little Ones formula - £175.99 buys six months of formula
• SMA Pro First Formula - £175.99 buys three and a half months of formula
• Aptamil Profutura Stage 1 - £175.99 bus two and a half months of formula
• Pre-mixed bottles of Aptamil Profutura – would cost £789.31 for six months.

Feeding experts tell Dispatches that these formula milks are nutritionally equivalent.

Sue Ashmore, Unicef UK Baby Friendly Initiative Director, said: ‘We need to make sure babies and parents are protected from commercial interests and misleading marketing practices. Dispatches have highlighted how powerful multi-national companies have been pushing the boundaries of existing legislation to promote their products. We urgently need better legislation to protect babies.’

Shel Banks, an Infant Feeding Specialists, who advises the NHS on some of their guidelines has some advice for parents, “So all we actually need in the first 12 months of life, according to our NHS, according to the World Health Organisation, is just these first stage infant milks. So these first infant milks - these are all nutritionally equivalent. There are very clear European Food Standards Agency guidelines on the maximum and the minimum levels of everything: the proteins, the fats, the carbohydrates. There's nothing to choose between them, to pick one over another in terms of nutrition at all.”

What many parents find confusing are the extra ingredients often highlighted on packaging, which makes some products appear better than others.

Shel Banks, “These different ingredients that the different companies add in - they’re trying to get us to buy them. They’re trying to get us to pick theirs’ over somebody else’s.  But the long and the short of it is: if there was a benefit that was actually proven by independent researchers to actually be beneficial for babies then they would all have to add it by law.”

The British Specialist Nutrition Association (BSNA), who represent the formula milk industry told Dispatches: “different formulas have varying levels of ingredients” and manufactures can add ingredients “beyond the legal minimum requirements.” The BSNA say they offer a wide range of formulas and “many factors go into determining the price.”

Sue Ashmore, Unicef UK Baby Friendly Initiative Director, said: ‘New mothers and families need more support and access to independent information - right from the very start – however they choose to feed their babies. Infant formula can be a significant proportion of a family’s weekly food budget. In a period where the cost of living has increased, but the wages in people’s pockets have not kept pace, some families are having to make difficult choices in order to feed their children.

Some of the parents interviewed by Dispatches say they were recommended Aptamil formula by Health Visitors and Midwives.
 

Misleading claims made about some Formula products:

Formula companies often pay for clinical research trials on their products. 

Dr Robert Boyle is a specialist in paediatric allergy at Imperial College, London. He’s previously conducted scientific research on behalf of formula companies.

Dr Robert Boyle: “I had a concerning experience, I guess. We had a trial which we were looking at whether an infant formula with some new additives in it might reduce risk of eczema and allergies. When we got the results of the trial, they were disappointing. So, the rate of eczema was exactly the same with a new formula as it was with the standard formula milk. What concerned me was that a year and a half later I noticed on the sponsors’ website the headline statement was that this formula milk was proven to reduce risk of eczema and allergies in infants and they were referencing the trial that we'd done. That didn't reflect the results of the trial in that way as was in our view totally misleading.”

Kate Quilton: “so your results said this particular formula did not have any beneficial effect on the rates of eczema. However, the formula company wrote the direct opposite on their website. Is this an anomaly?”

Dr Robert Boyle: “Unfortunately I don't think this is a one-off situation. Within the field, it's recognized that some of the things that formula companies say about their products in general have a very weak scientific basis.”

Whilst the company did eventually take down reference to his study – these products still carry similar claims.

The BSNA, who represent the formula industry, say they “respect the role and integrity of clinicians and scientists.”

Consultant Neonatologist, Dr Laura De Rooy, is concerned; “If a mum came to me with a baby who has colic. We would go through a number of different treatment strategies, but it really wouldn't include one of those milks because the NHS doesn't actually recommend these milks - there is insufficient evidence to really substantiate those claims.”

The NHS also doesn’t recommend hungry baby milk – which is harder for babies to digest – and “goodnight milks” advertised as a bedtime feed. They say “that there’s no evidence that babies settle better or sleep longer” after having these milks.

Dr Laura De Rooy, “I think that they shouldn't be available just to buy off the shelf. And if you have these feeding difficulties or feeding issues with your baby I would really recommend that you talk it through with your doctor.”

The BSNA said infant formula is highly regulated, adding: “we are only allowed to make legally approved claims and we believe it is irresponsible to suggest to parents and carers that they cannot trust these”

Marketing by Formula companies:

Formula companies spend £5 billion worldwide every year on marketing. That’s £36 spent for every single baby.

Danone dominate the formula industry in the UK, they sell under two brands. Cow and Gate and Aptamil. Two different brands, from one company.

Dispatches has obtained leaked documents from Danone’s UK marketing agency, they reveal that for every £1 they spend on marketing they get a remarkable £4 back.

A recent government report found widespread evidence of parents struggling with the high cost of formula.

Kendal Nutricare boss, Ross McMahon, has previously spoken out against the wider industry.

“I think the formula industry was dominated by pharmaceutical companies for many years making big pharma margins. Now they're owned by massive corporations who still want to make super normal profits. We do need more independent clinical work carried out. The body that represents the big manufacturers have recently set up their own code of practice – they’re controlling their own industry. You know that's like the fox looking after the chicken coop quite frankly.”

NHS Doctors promoting branded milk:

Kate Quilton: “Are there any doctors out there or health care professionals that might recommend these milks?”

Dr Laura De Rooy: “I think yes there are. It's important to remember that some of those health care professionals have been through training events or training days that are sponsored by formula milk companies.  And so all those training days are not necessarily providing those health care professionals with unbiased information.

The other really important point is that if there is advertising of those brands to those health care professionals, paediatricians they are more likely to prescribe those brands to you. And so even the advertising that is directed at a scientific audience, a paediatrician audience can be misleading.”

The World Health Organisation says doctors and medical organisations should not accept gifts, money or sponsorship from formula companies.

Dispatches has conducted the largest ever analysis of formula influence within our NHS to investigate how often this guidance is broken.

We contacted all 195 clinical commissioning groups in England – the bodies responsible for spending your local NHS money.

• We found that since 2014 almost a third had recorded a breach of the world health organisation guidance – such as a gift or sponsorship from a formula company.
• Five out of the seven local health boards in Wales had also recorded such breaches. 

Paediatrician Professor Anthony Costello – a former director at the World Health Organisation:

“I think it's outrageous. If you're a company and you want to promote your products you want to reach the people who are most influential. So that will be paediatricians. It will be dietitians. It will be nurses, midwives, health visitors. Companies are now right in the NHS and that is extremely worrying.”

“Clearly, they want to be present at these events firstly to get their products noticed and prescribed by the people attending the courses. More worrying it’s almost co-branding themselves with the NHS and they’re essentially advertising their products, it’s quite confusing for the health workers. “

The BSNA say, “we believe we have a responsibility to provide information [to healthcare professionals] so that they can advise parents about feeding their babies” 

A Department of Health and Social Care spokesperson told Dispatches: “parents have a right to accurate, unbiased advice from healthcare professionals.”

Some organisations are starting to worry about the influence formula money has over them.

Dispatches can reveal that - as of today, Monday 18th -  the British Medical Journal will no longer accept formula milk adverts, vowing instead to ‘campaign against industry influence.’

Fiona Godlee, Editor in Chief, The British Medical Journal, “As a result of a recent review, in which we consulted advisers and canvassed readers, we have decided to stop carrying advertisements for breastmilk substitutes in The BMJ as soon as possible. Our decision is based on our desire to support the WHO code, actively promote breastfeeding, and campaign against industry influence in this area.”  

The Great formula milk scandal: channel 4 dispatches, mon 18th march, channel 4, 8pm

Reporter: Kate Quilton

Assistant Producer: Matt Quinton

Executive Producers: Vicki Cooper & Sara Ramsden

Producer and Director: Danielle Johnson Cutts