Experts have warned some baby formula products may be misleading parents over the need and ingredients of their products
Baby formula companies have been accused of endangering the health of infant children due to the advice and information they promote around their products.
Politicians and campaign groups are urging the Government to take action to restrict the marketing practices of baby formula companies, accusing them of “doubling down” on advertising that “hinders parents making informed choices”.
Campaigners claim that formula companies are making non-verifiable health claims on packaging. They also say that firms are promoting infant formula, which they are not allowed to advertise.
Examples of such claims include suggesting that certain ingredients are UK-made when the supply chain is global or so called processed “toddler milks” for development.
Due to this, Knowsley Council announced it is restricting the advertising of baby formula on sites it owns, to prevent the marketing of “health-harming or misleading products”.
Earlier this month, Liberal Democrat MP Jess Brown-Fuller asked when the Government would announce its decision on whether or not to accept 11 recommendations made by the Competition and Markets Authority (CMA) on the formula industry.
The CMA found that “parents are often in vulnerable circumstances when they first make choices about whether and which infant formula to use, their brand choice is often based on incomplete or unclear information”.
The CMA recommended the Government take steps to remove brand influence in healthcare settings, to prohibit formula health claims “that are intangible, or cannot be easily checked by parents,” and to ban all advertising for follow-on milks.
It also urged the Government to introduce rules ensuring “clear, accurate and impartial information on nutritional sufficiency of infant formula products on retail shelves,” so that parents understand that all brands contain the nutrients their baby needs.
In her response, health minister Ashley Dalton said that “it is vital that [families] get formula that is safe, nutritionally complete and affordable.”
She said that the Government is “supportive” of the CMA’s recommendations, and is “considering them”.
The rules on infant formula advertising
In the UK, marketing for infant formula – for babies up to 12 months when breastfeeding is not possible or desired – is restricted in order to protect breastfeeding.
- Advertising is prohibited.
- Healthworkers must provide only scientific and factual information on this formula, and there can be no claims implying bottle-feeding is superior to breastfeeding.
- Nutrition and health claims are prohibited.
- Labels for infant formula and follow-on formula must be distinct to prevent confusion and cross-promotion.
- Neither infant formula nor follow-on formula is allowed in product placement.
The rules on follow-on formula advertising
For follow-on formula – for babies over six months – marketing is less restricted.
- It should not suggest that formula feeding offers the same benefits as, or is superior to, breastfeeding.
- Non-verifiable health claims are prohibited, and any health claims must be supported by scientific evidence.
- Marketing efforts should not indirectly promote infant formula through the use of similar branding, packaging, or messaging.
Brown-Fuller said during the debate that “the claims on boxes of commercial infant formula are often unfounded. Parents have to choose between a £7 tin of formula and a £14 tin of formula, even though they are nutritionally equivalent.”
Dr Vicky Sibson, from charity First Steps Nutrition Trust, told The i Paper that this practice will “put babies’ health at risk”. She said watered down milk “is going to have less energy in it, less protein in it.
“We’re seeing infant formula being marketed with health and nutrition claims, which is illegal. We’re seeing labels on infant formula and follow-on formula becoming more similar instead of more distinct, which is what the law requires.
Dr Sibson added that companies market “growing up” and “toddler” milks – that are often high in sugar – as natural next steps to infant and follow-on formula, when after 12 months a baby can have cow’s milk.
The First Steps Nutrition Trust’s document looked at formula company marketing practices between June and July this year.
It claims that formula milk marketing remains “unclear, inaccurate and biased” and that companies are “doubling down on the marketing messages that their products are nutritionally better than other companies or brands,” so “distracting from the nutritional sufficiency across brands”.
It also says that marketing messages are also included on infant formula, which is against regulations.
The examples that it gives include:
- The Aptamil website states that its milks are made with “only high quality ingredients” and “have more GOS/FOS than any other brand,” which First Steps Nutrition alleges is a “non-verifiable message”.
- A Kendamil Classic First Infant Milk says it is “enriched by science” and “nutritionally complete,” even though all infant formula is required to be nutritionally complete by law.
On the packaging, the words “nutritionally comparable” are accompanied by a picture of a shield with a cross in it, which the document asserts suggests “health protection”.
First Steps Nutrition Trust also states that “wording around ‘our home’, ‘our family’ and text relating to British branding, milk and cows may lead the consumer to believe the product contains only UK ingredients when the ingredient supply chain is global”.
- An SMA First Infant Milk has a QR code on the packaging which will take parents to a website which the Trust says advertises infant formula.
It also contains links to live chats and carelines with nutritionists and midwives, which First Steps Nutrition Trust claims “suggest[s] parents should go to SMA for healthcare and infant feeding advice rather than their healthcare professionals.”
- A Cow and Gate First Infant Milk also has a QR code leading to a website including testimonials about follow-on formula, which First Steps Nutrition Trust says is cross-promotion.
- The First Steps Nutrition Trust found examples of a Bonya (by Kendamil) First Infant Milk being advertised in a paid partnership on Instragram.
- The document alleges that companies cross-promote their infant and follow-on formula by using the same colours, designs and graphics on the packaging of the different milks.
“Too many families are currently being let down by the infant formula industry while the Government stands by and watches,” Brown-Fuller said.
“It’s immoral. And it’s not just happening on supermarket shelves.”
She added: “Now it’s time for Wes Streeting to act. Accept the CMA’s recommendations. Implement them fully. And show that building the ‘healthiest generation ever’ starts with making sure every child, regardless of background, has a fair start in life.”
Nigel Rollins, who is a paediatrician and former member of the WHO’s Department of Maternal, Newborn, Child and Adolescent Health, told The i Paper that follow-on formulas around the world juxtapose images with ingredient information to imply a certain health outcome.
“You will have imagery that shows a young child or a baby with a pair of glasses on and maybe a pen in their hand, and it’ll say ‘with added DHA’. DHA is a type of fatty acid that is essential for brain development.”
He added that companies will emphasise that their product contains certain vitamins, when these vitamins are often obligatory, and will be present in all formula milks.
The First Steps Nutrition Trust’s document gives the example of Nanny Care Goat Follow-On Milk, saying it contains “vitamins A, C, D & iron,” which are all required by law, as well as intangible messages like “gently made” and “made by those who care”.
What do the companies say?
A spokesperson for Danone UK & Ireland, which owns Aptamil and Cow and Gate, said: “Parents have a right to access accurate, unbiased information to make an informed decision about feeding their child. This includes information on the differences between formula milks, how to use and prepare them, and the products available.
“We regularly benchmark the presence and quantity of GOS & FOS in follow-on milk in the UK & Ireland to ensure the accuracy of our claims.
“The QR code on our Cow & Gate pack links to our sustainability commitments on our Cow and Gate Club website. Elsewhere, we provide support and expertise so parents can make informed choices to support their babies’ growth and development. This includes feedback from parents about our products.
“In the UK, information related to formula milks is highly regulated and we comply with these regulations. Ultimately, Danone is committed to supporting all parents and babies on their feeding journey. Following on from the CMA’s recommendations, we look forward to engaging with the Government and all stakeholders to ensure parents in the UK are supported as much as possible.”
Nannycare told The i Paper that as a company with around 1 per cent of the market share, its survival depends on dedication, scientific credibility, and compliance with strict regulations.
It said it always strives to be compliant but occasionally follow some key trends of the larger dominant companies, so as to maintain a level playing field.
It said that the reference to vitamins A, C, D & iron is a legally permitted nutrition claim, widely used across the category.
Nannycare added that “gently made” refers factually to our low-heat production process using fresh whole goat milk – not a health claim. “Made by those who care” is a reflection of the firm’s ethos and brand identity, not a marketing tactic, it said.
Nannycare said that it believes there to be a “serious issue of uneven enforcement in this sector”.
Claire Magee, founder of Nannycare, said: “This imbalance creates a playing field where companies like ours, who follow the rules, face major disadvantages. We welcome the CMA’s recommendations and hope to see stronger, faster enforcement across the industry to ensure fairness for businesses and clarity for families.”
Kendamil and Nestlé (owner of SMA) have also been approached for comment.
Patti Rundall, who has been campaigning for safe infant feeding since 1980 and is the policy director of Baby Milk told The i Paper that no matter how subtle, marketing messages “really matter. We think it’s small, but it penetrates. If parents don’t have all the other information that tells them why this is nonsense, then they’re going to believe it.
“The main reason why a mother should bottle feed is because they want to, and that’s absolutely fine,” she said, arguing that over the years “we’ve deskilled parents” and made it seem that “breastfeeding is physiologically difficult, that it is likely that their body will fail them, that breastfeeding is really painful, difficult, joyless (miserable) and impossible to do in the 21st century.
A Department of Health and Social Care spokesperson said: “There are many benefits of breastfeeding but for those mothers that cannot or choose not to breastfeed, it is vital parents can access infant formula that is affordable and high quality. Families should not be paying over the odds to feed their babies.
“As part of our Plan for Change, we’re determined to ensure every child has the best start to life. We are working closely with the devolved governments to carefully consider the CMA’s recommendations and will respond fully in due course.”
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