March 2022

It’s a pretty grim time with war in Ukraine, a cost of living crisis in the UK and COVID causing more disruption than ever (or at least it seems so in our team!). We hope our March newsletter doesn’t add too much of a downer in this context.

By way of news, we share with you what’s happening with the digitisation of Healthy Start, a ‘joint statement’ on feeding support for mothers and babies affected by the war in Ukraine, an overview of the Better Health, Start for Life ‘Starting Solids’ campaign, and lastly an overview of the changes we have made in our newly updated Eating Well guide for pregnancy. In Infant Milk news we share with you some rebranding and news about product price rises. As secretariat of the Baby Feeding Law Group UK, we share with you an editorial in the BMJ about the WHO/UNICEF formula marketing report launched in February, highlights of a parliamentary debate on breastfeeding support lead by Alison Thewliss MP, and an overview of a feature published in the BMJ on industry marketing of hydrolysed formulas. Lastly, we have some HR changes to share with you.

News

Healthy Start Digitisation

Paper Healthy Start vouchers will no longer be accepted from tomorrow, April 1st, after which the system is meant to work through pre-paid cards. However, there are serious and ongoing issues with the functionality of the new digital system, including: a faulty online application system which rejects many eligible individuals; issues in activating and using the card and with accessing balance information; an inability to make part payments or online payments; a customer service system that is not fit for purpose (including long waiting times, calls being cut off and a charge of 55p a minute); and inadequate technical support for individuals and health professionals, which is leading public health teams, local authorities and community groups reluctant to promote the scheme.

First Steps was among a long list of signatories on a letter written by Sustain and the Food Foundation to the Health Secretary Sajid Javid on March 10th calling for an extension of this March switch over and prompt actions on a range of practical and specific recommendations to resolve the issues as outlined. Since then, Sustain have met with the Department for Health and Social Care and have resolved national issue of eligible claimants being rejected, and we are hopeful that more positive actions will ensue.

Infant Feeding in Emergencies joint statement by UNICEF, the Global Nutrition Cluster and Partners

On the 8th of March, UNICEF, the Global Nutrition Cluster, and partners issued a joint statement calling for “ALL involved in the response to the Ukraine Conflict Crisis to protect, promote, and support the feeding and care of infants and young children and their caregivers”. We’re sharing this in our newsletter because it’s relevant to all the UK-based individuals and organisations who have mobilised to support conflict-affected Ukrainian families and civil society organisations working with them, and observations that this has included calls for and donations of infant milks, bottles and baby foods. Whilst this type of support is likely well intentioned, it is against Ukraine regulations and experience in prior humanitarian responses indicates it can cause serious harm. The statement highlights the need to prioritise the protection of and support for breastfeeding, and also to provide an appropriate package of support to the families of infants who are not breastfed. It is recommended that this should entail adequate supply of an appropriate and Code-compliant powdered infant formula or ready to use infant formula (procured by UNICEF), equipment and supplies for its hygienic storage, preparation and for cup feeding, practical training on hygienic preparation and storage, counselling on responsive feeding and regular follow up by service providers such as UNICEF and the Red Cross, who have the appropriate skills.

The statement concludes that adherence to the recommendations are critical to support child survival, growth, and development and to prevent malnutrition, illness, and death.

Better Health, Start For Life Introducing Solids campaign

start solid foods until around the age of six months, having achieved developmental readiness. Parents are directed to the “weaning hub” on the Start for Life website for advice and recipes.

The campaign has also been informed by the results of an online survey with a nationally representative sample of 1,000 parents of children aged 3 to 18 months living in England. Key findings included that:

• 40% of parents feel unsure as to what age to start introducing solid foods and 64% have received conflicting advice on the same

• 41% of first-time mothers have already introduced solid foods by the time their baby is 5 months old

• 45% said they found how much food to give their baby confusing and 43% found when to progress from certain tastes and textures confusing

• 28% of first-time mums reported that their mother had the biggest influence on their decision to start weaning

Clearly many parents need more evidence-based, independent information on complementary feeding. As well as the Start for Life information offer, we’d like to remind our followers of our popular resource “Eating well: the first year. A guide to introducing solids and eating well up to baby's first birthday” which can be downloaded and printed for free, and hard copies can be purchased at cost price here.

Updated Eating Well in Pregnancy Guide

• Tips for eating well out of the home better recognise the increasing contribution of home food delivery to many pregnant women’s diets

• Edits to the resources section to reflect changes in contact details of relevant organisations

We will be updating our pregnancy resources for teenagers in the coming month and will let you know when these have been revised in a future newsletter.

Infant Milk News

Rebranded products

Following the rebranding of Aptamil Profutura products to an “Aptamil Advanced” range, Danone have rebranded their Aptamil range of products including their Aptamil infant formula, follow-on formula, toddler milk 1-2 years and toddler milk 2-3 years and hungry infant milk. The products themselves have not been changed, the only changes are in the packaging. These are some examples of the new pack design:

The law states that the labelling of infant formula and follow-on formula should avoid any risk of confusion between them. This requirement also serves to prevent cross promotion and the indirect marketing of infant formula, by advertising a product (follow-on formula), that looks almost identical. It is disappointing but not surprising that the problem of similar packaging styles for infant and follow-on formula, which is common across the infant milk market in the UK, is not changing despite the recent strengthening of the DHSC guidance around what is an acceptable degree of distinction.

Rising cost of infant milks and implications for formula choices

On March the 17th, the food industry trade magazine, The Grocer, reported “Baby milk prices on the rise as brands battle cost inflation”. We are shortly about to undertake the scheduled update of our infant milk costs report, in which we will share as usual comparable cost data for all infant milks on the UK market, which will shed more light on what’s going on. Given what is being reported about food price rises more generally, we anticipate that infant milk prices will have risen across all brands. In the context of the looming ‘cost of living crisis’, and given what we learnt from the enquiry in to formula costs First Steps led for the APPG on Infant Feeding in Inequalities in 2018, it becomes even more pertinent to share with formula-feeding families the information that, because of UK regulations, all first infant formulas have a comparable nutrition composition; the implication being that premium products are not worth the extra cost. Our resources on infant milks for parents may be useful for sharing in these challenging times.

Looking for information about infant milks? Check out our website www.infantmilkinfo.org. Still got questions about infant milks? Contact susan@firststepsnutrition.org

Baby Feeding Law Group news

Editorial: “It’s time to stop infant formula marketing practices that endanger our children”

On March 9th, Helen Clark, former prime minister of New Zealand and Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, responded to a the WHO/UNICEF report “How the marketing of formula milk influences our decisions on infant feeding”, which we reported on in our February newsletter. Their view is that current unethical marketing of formula milk “represents one of the most underappreciated risks to the health of infants and children.”

The role of social media in accelerating the proliferation of misleading advertising is also addressed. Despite the introduction of the International Code of Marketing of Breastmilk Substitutes over four decades ago, companies continue to mis-represent scientific evidence across a range of child health topics including brain development and immunity.

The editorial concludes by calling on governments, health professionals, investors and social media platforms to play their unique role in stopping the unethical marketing of formula milk in order to protect child health.

Read the editorial here and if you haven’t done so already, sign the petition to #EndExploitativeMarketing

Highlights from Parliamentary debate on support for breastfeeding

On March the 8th, Alison Thewliss, MP, chair of the All Party Parliamentary Group on Infant Feeding and Inequalities, led a debate on Government support for breastfeeding in which she talked at length about the need to tackle inappropriate formula marketing. The full transcript of can be accessed here, and highlights include the following:

Alison Thewliss stated: “…the international code of marketing of breastmilk substitutes is 41 this year. It was written in response to the aggressive marketing of infant formula, which is of course to the detriment of breastfeeding… I believe that formula is an essential item that must be available to those who need it. People using formula deserve to receive impartial support and advice, not marketing and advertising”.

She stressed: “[the] … need to regulate the factors that can dissuade and diminish breastfeeding, such as aggressive marketing of infant formula—a global issue, but one on which the UK Government can play a leading role… I would like the Minister to agree to look seriously at the funding of all services and at the full implementation of the international code of marketing breastmilk substitutes, as the World Health Organisation and UNICEF have called for. She has the power to make this change to protect, promote and support breastfeeding now and in the future… There is an opportunity here to take the findings of the World Health Organisation and UNICEF report [which Alison spoke to in detail], and for the Minister to have a roundtable discussion with all the experts in this field—there are many—to see what more the UK can do and how we can move forward to make sure that everybody, whatever their feeding choices are, feels supported and that breastfeeding is protected and promoted within the whole of the United Kingdom”.

New article: “Formula milk companies push allergy products despite flawed evidence”

It reports that after heavy campaigning, the UK, Europe and US have taken steps to clamp down on these claims. In the UK this has involved changes in legislation in February of this year which prohibits the use of allergy claims unless manufacturers could prove the efficacy of each product. As we reported in February’s newsletter, this seems the logical reason for the withdrawal of SMA HA from the UK market.

The feature goes to highlight how BREXIT creates “an opportunity for the UK to become a global leader in responsible marketing” by upgrading UK laws to better reflect the International Code of Marketing of Breastmilk Substitutes. This would put an end to the advertising and promotion to the general public of all breastmilk substitutes, including not just infant formula but any milks (or products that could be used to replace milk) specifically marketed for young children up to the age of 3 years.

There is also a specific comment on the marketing of ‘Foods for Special Medical Purposes’, about which BFLG-UK independent member Dr Robert Boyle states: “The science behind these milks is generally very weak. Some do have an effect but most claims are spurious, for example, products that claim to help colic and crying but with no evidence that they do that. They are meant to be given under medical supervision but are freely available online and in shops the stated medical indication on FSMPs becomes another way that companies can effectively make claims for their baby formula products.”

Watch this space for news about BFLG-UK’s work advocating for improvements in the marketing of infant milks as FSMPs.

You can follow the work of the Baby Feeding Law Group on twitter @BflgUK

Staffing Update

Happy retirement to Pauline Styles

This month we’re saying a fond farewell to Pauline, who for many years undertook many of the administrative tasks required to keep First Steps functional on a day to day basis, and who in the last few years has been managing the distribution of our Eating Well resources through her business (a task that Siân is now taking on as we transition to moving this in house). We wish Pauline a happy retirement and lots of fun on the slopes.

Introducing our new nutritionist, Rachel Childs