Health Visiting – Sponsored by Nestle?

Unite-CPHVA is the Health Visitors’ union.  They have a conference every year, big affair, lots of important topics discussed.  Many of the individual sessions are sponsored by businesses.  I would hope that delegates ponder this when considering the quality of information that they are receiving.  I guess a conference is an expensive thing to stage and sponsorship comes in handy.  Nevertheless, I have huge concerns over two of the talks this year:

12:35 on Day 1

Feeding for the future

• Breastfeeding: The ideal start for a healthy future
• Assessing the importance of growth patterns
• Exploring optimal nutrition for optimal health outcomes

Professor Alan Lucas, Professor of Paediatric Nutrition, University College London

Supported by Nestle

10:30 on Day 2

Weaning the cows’ milk allergic infant

• Understand the nutritional challenges of weaning an infant with cows’ milk allergy
• Recognise the options for achieving a nutritionally balanced weaning diet for an infant with cows’ milk allergy
• Receive practical tips to pass to mums

Rachel De Boer, Paediatric Allergy Dietitian, St Thomas’s Hospital London

Supported by Danone Nutricia

Now, I know that some of you will immediately see the problem.  Not everyone will however, so let me explain my concerns.  It is easy for me to put them together, as I already contacted the professional officer at Unite responsible for these decisions.  I emailed him back in February as I was aware that these conferences often feature Nestle and Danone.  This is what I wrote to him:

Dear [NAME]

[NAME] kindly gave me your email address when I met with him before Christmas, as I have concerns regarding the advertising of infant formula at the Unite conference and in the CommPrac journal.

 

A quick summary of who I am, as I do not currently have a “professional capacity” being a stay at home mum.  I administer a support group for mums on Facebook (currently 1,500+ members).  I also run the #hospitalbreastfeeding campaign on Twitter and have set up www.heartmummy.co.uk to help HCPs to understand the importance of supporting breastfeeding on children’s wards.  I am not a trained breastfeeding peer supporter, but I have a total of 18 months of personal breastfeeding experience.

 

It was brought to my attention that your conference heavily featured infant formula companies.  This is a huge problem as the breastfeeding charities are bound by the WHO code, as is UNICEF Baby Friendly Initiative, so are unable to support events that promote infant formula.  The absence of the Association of Breastfeeding Mothers, La Leche League and the Breastfeeding Network from your conference is of huge concern, as they are the main sources of non-NHS breastfeeding support for mothers in the UK.  The Breastfeeding Network also runs the Drugs in Breastmilk Helpline which is a resource that all healthcare professionals need to be aware of.  The absence of UNICEF’s Baby Friendly Initiative is also of huge concern as it is this initiative which is driving forward NHS support for breastfeeding, including amongst health visitors.

 

The prevalence of infant formula advertisements in your journal is also of concern to me.  The opposition to infant formula advertising by those of us who wish to see improved breastfeeding support is often misunderstood.  We do not believe that formula should be hidden away or that parents and HCPs should be kept in the dark as to its properties and availability. Far from it – infant formula is a lifesaving product and many families have a genuine need for it.

 

However, healthcare professionals are just as susceptible to advertising and marketing messages as are the rest of us.  Proof of this can be found in the fact that many midwives and health visitors continue to tell mothers that Aptamil is the “closest formula to breastmilk” despite that claim being thrown out by the Advertising Standards Agency. (See http://archive.babymilkaction.org/press/press22july09.html and http://archive.babymilkaction.org/pdfs/lacorsonepage07.pdf).  Formula advertisements talk about “moving on” from breastfeeding, giving the impression that it is something for only young babies where in fact the WHO recommends children be breastfed for at least 2 years.

 

Health visitors, as you are only too aware, are incredibly busy people and they do not have the time to research every aspect of infant feeding and infant milk.  Formula advertising will give them the impression that infant formula is a reasonable substitute for breastmilk, when in fact this is clearly not the case.  It is nutrition for babies that do not have breastmilk, but it has hardly any of the properties of breastmilk and none of the additional benefits (see my website).

 

With this in mind, it is vital that health visitors obtain their information about infant feeding from unbiased sources such as the First Steps Nutrition Trust rather than the Infant and Toddler Forum which is funded by Danone.

 

An International Board Certified Lactation Consultant of my acquaintance posed these questions:

 

* How do HVs imagine they will be able to participate in the Baby Friendly Initiative (BFI) if the WHO code is so poorly valued and understood?

* How can Health Visitors in a BFI area understand the conflict between messages from UNICEF and messages from CPHVA? 

 

With the new emphasis from BFI on responsive bottle feeding it is particularly important that health visitors understand the way formula companies will try to gain access to parents through HVs.  Their marketing can be insidious, a prime example being the supposedly “supportive” video that has gone viral on social media, which is sponsored by a formula company.  The problems with this type of marketing are explored here: https://thelittlestranger.wordpress.com/2015/01/23/mommy-war-is-over-if-you-want-it/

 

Thank you for taking the time to read this email.  I look forward to hearing from you and discussing ways in which Unite can embrace the WHO code with regards to infant feeding.

___________________________________________________________________

The officer responded by asking me what specific questions I had for him so I asked “what plans does Unite have for significantly reducing the amount of formula advertising at its conference and in CommPrac?”  I was told that there are plans to reduce the percentage of advertising and exhibition space given to infant formula producers on both platforms.  This is due to updates to the union’s ethical policy as at summer 2014.

I also asked “with regards to the fact that WHO code compliant organisations cannot take stands at conferences where infant formula companies are exhibiting, are there plans to make future Unite conferences accessible to these organisations by removing the formula companies and replacing them with neutral organisations such as First Steps Nutrition?”  I was told that the mix of exhibitors is reflective of the union’s membership, which has a variety of opinion on this issue.

No doubt.  However, in the few conversations I have had with health visitors about this issue their main concern is that they need good quality information about infant milks and formulas.  Once they realise that this information is available via First Steps Nutrition (and is free from a marketing slant) they are less interested in the information that the companies themselves have to offer them.

Baby Milk Action has numerous resources explaining the unethical practices of Nestle, Danone and others, and why it is important for all of us to reject formula company sponsorship.  It is so easy for vested interests to encourage mothers and healthcare professionals to reject sentiments such as these on the basis of people “pushing” breastfeeding or being intolerant of others’ feeding choices.  So let me be very clear:

The use of formula is a valid parenting choice.  We need mothers and the healthcare professionals who support them to have a full understanding of the types of formula available, their contents, the best way to use them and their limitations.  We need mothers and the healthcare professionals who support them to have faith in breastfeeding so that when that is the chosen method of feeding it is not undermined by negative messages.

That is why I hope that Unite-CPHVA members call for a swift end to Nestle and Danone’s involvement in their conference.  Because their presence there restricts the access of HCPs to good quality information about formula.  It restricts their access to good quality information about breastfeeding.  And as a result it restricts the support that these professionals can provide to families.

It really is as simple as that.