Baby Feeding Law Group UK: Misconceptions about the UK law on the marketing of infant formula

The Baby Feeding Law Group UK (BFLG-UK) has developed a briefing note to clarify misconceptions about the UK infant formula marketing laws.

This new briefing document is intended for use by journalists, policy makers, politicians, and health care professionals, including health visitors. It has been produced to clarify the intention of current UK law on the marketing of infant formula and to dispel some misinterpretations that have been seen recently in the media.

The current UK legislation on restricting the marketing of infant formula is informed by the WHO Code of Marketing of Breastmilk Substitutes. However, since the legislation contains only ‘some’ provisions and it is poorly enforced, the reality is that the current UK law provides limited protection for breastfeeding and does not properly enable safe and appropriate formula feeding.

The BFLG-UK briefing highlights how:
“misinformation can do damage, especially with regard to public health and the protection of the most vulnerable groups in the population, including infants and young children. Misinformation is false information that can be spread either by mistake or intentionally and has the potential to cause substantial harm to individuals and society”.

Promote the facts and clarify the misconceptions in your practice:

Fact: Legal restrictions on infant formula marketing exist to protect all babies, no matter how they are fed.
Misconception: Legal restrictions on infant formula marketing exist to protect and encourage breastfeeding only.
Fact: Restricting inappropriate marketing of infant formula does not limit its accessibility. It is inaccessible when its price is unaffordable.
Misconception: Legal restrictions on infant formula marketing limits its accessibility.
Fact: Restricting inappropriate marketing of infant formula does not cause high prices. High prices are largely the result of high profit margins and large marketing budgets.
Misconception: Legal restrictions on infant formula marketing are causing high prices.
Fact: Shoppers need to spend hundreds of pounds to accrue sufficient points to purchase a single tin of infant formula. This is not a means to improve accessibility to families on the lowest incomes.
Misconception: Not allowing rewards scheme points to buy infant formula is preventing families from accessing it.
Fact: There are no legal restrictions preventing families from using store gifts cards (and equivalents) issued by food banks to buy infant formula.
Misconception: Legal restrictions prevent families from using foodbank vouchers to buy infant formula.
Fact: Legal restrictions on infant formula marketing exist to safeguard the health of all babies, however they are fed.
Misconception: Legal restrictions on infant formula marketing are inappropriate.

Within the briefing, First Steps Nutrition Trust who are the current Secretariat for the BFLG UK make four specific recommendations, with important actions that the Government could and should be taking now, to ensure that all families using formula to feed their babies can be enabled to do so safely. These are:

Improvement of the Healthy Start scheme.
A public health messaging campaign around the nutritional equivalence of all first infant formula.
Enforcement of existing legislation designed to prevent inappropriate marketing of formula milks and to protect breastfeeding AND safe and appropriate formula feeding and strengthening of this legislation in line with the International Code of Marketing of Breastmilk Substitutes and subsequent World Health Assembly Resolutions.
Government establishment of pricing policies and practices to ensure infant formula is provided at lower prices on a long-term basis (e.g., through a price cap).

What is the Baby Feeding law Group:
The Institute of Health Visiting is a member of the Baby Feeding Law Group UK. The group brings together organisations and individual members who work together to protect infant, young child and maternal health by ending marketing practices that commercialise infant feeding, mislead consumers and threaten breastfeeding.

To read the full briefing and for more information see First Steps Nutrition Press release and Baby Feeding Law Group UK website.

Infant Feeding Survey to be reinstated this year

We were delighted to learn this week that the Department of Health and Social Care (DHSC) has commissioned Ipsos to run an Infant Feeding Survey in 2023.

The Institute of Health Visiting, alongside many organisations and charities working to support breastfeeding and responsive infant feeding, has been calling for the reinstatement of a national Infant Feeding Survey since it was stopped in 2010. Previously, the Infant Feeding Survey (IFS) was conducted every five years between 1975 and 2010. Valuable data on infant feeding trends were collected in the eight IFS reports that were published during this time.

Following what has been described as ‘an extensive period of development’, on Monday 9 October, DHSC announced that the Infant Feeding Survey 2023 (IFS) for England will begin in mid-October. The reinstatement of the IFS is good news – the lack of evidence on infant feeding practices over the last 13 years has significantly limited our ability to track progress on the prevalence and duration of breastfeeding, and this has hampered policy and practice developments in this area. The main aim of the survey is to provide estimates on the incidence, prevalence, and duration of breastfeeding and other feeding practices adopted by mothers in the first year after their baby is born, as well as wider influences on feeding choices.

This will be the first IFS since the survey was last conducted in 2010 and will provide valuable information on infant feeding behaviours and related factors including:

internationally comparable data on prevalence and duration of breastfeeding
the use of foods and drinks other than breastmilk in infancy
infant feeding help and information received by mothers
information about bottle and breastfeeding in public places
parental leave, return to work, working hours and facilities provided for expressing and storing breastmilk, or breastfeeding at work

DHSC and the Office for Health Improvement and Disparities (OHID) have started sharing information on the survey to raise awareness among potential survey participants. This includes the placement of posters in maternity units and postnatal settings, and posts on social media channels. Through these channels, people will be directed to the IFS website where they can find further information on the IFS and opt out from taking part, if required.

Gail Barker, iHV Expert Adviser for Infant Feeding said:

“The IFS 2023 is a really exciting step forward. It will allow us to gain a current viewpoint on infant feeding practices, based on today’s parents, to help us influence and inform health visiting practice to better meet families’ needs. It is really positive to think about the opportunities this will provide for us in better understanding the influences on parents’ infant feeding decisions – the opportunity to consider infant feeding through the lens of today’s modern society with all of its digital influences, the post-COVID impact, the way we work, and the makeup of families in 2023.

“The survey findings will also provide valuable information on the extent of commercial influences and the marketing of other food and drinks on breastfeeding decisions, alongside the all-important service provision for families. These will all influence how we move forward with our Family Hubs and improve support for families.”

Who will take part in the survey?

DHSC and Ipsos will be contacting more than 20,000 mothers who have recently given birth to take part in this survey. Only individuals who have been selected for the IFS and receive an invitation letter will be able to participate in the survey. Ipsos will only be contacting a random selection of mothers who gave birth in Summer 2023, so not all mothers will be receiving a survey.

What does the IFS involve?

Individuals who have been selected to take part in the IFS will receive an invitation to complete a questionnaire that will be sent to them when their baby is around 9-12-weeks-old. If they complete the first questionnaire, and consent to further contact, they will receive a second questionnaire when their baby is around 4-6 months and a third at around 8-10 months after the birth.

Ipsos will start sending the IFS out in mid-October 2023. If anyone does not want to be included in the study, or receive a survey, they can complete the form on the opting out of the survey page.

How can you help?

Please promote the survey where you work and encourage women to complete it if selected.

You can find out more about the Infant Feeding Survey 2023 on the IFS website.

Get ready for National Breastfeeding Week (18-24 September 2023)

This year’s National Breastfeeding Week will be taking place from 18-24 September. The week is being promoted by the Department of Health and Social Care (DHSC) ‘Better Health Start for Life Breastfeeding’ team and builds on last year’s theme, ‘Everyone has a part to play in helping mums to breastfeed’. This will include daily themes and activities showing how families, community and health and education services all have a part to play in supporting mothers to have the feeding experience they hoped for.

The DHSC team have produced an extensive suite of free resources and campaign materials to help support any planned activity, to promote local activities and signpost your local population to their breastfeeding support tools, such as the Start for Life Breastfeeding Hub. There is still time to get involved.

The 2023 National Breastfeeding Week social media toolkit is available to help you promote the week in your area and through your social media channels. The toolkit contains:

9 x Images
Content calendar containing:
Suggested post copy
Web links
Suggested timeline for posts

Download the toolkit here and help spread the message of this year's theme 'Everyone has a part to play in helping mums to breastfeed'

To support National Breastfeeding Week at the iHV, we will have an infant feeding stand at our iHV Evidence-based Practice Conference on Thursday 21 September, with an extensive suite of free resources and campaign materials. If you are attending our conference in person, stop by and say hello to our team and Expert Adviser for infant feeding. We will be distributing free resources to support your work, including:

The ‘Off to the best start breastfeeding’ A4 leaflet and wallet card, as well as a wallet card dispenser
Empty belly posters to allow partners to add local information on breastfeeding
Editorial content for use in local publications

Follow #NationalBreastfeedingWeek on Twitter for all the latest activity.

iHV Insights – last week’s recording now available

Don’t worry if you missed last week’s iHV Insights webinar on “Inspiring excellence in breastfeeding support – the health visitor role”, as the recording and resources are now available for our members.

Our iHV Insights webinars are available to iHV Members only, just one of the many perks of being part of the iHV.

On 28 October, we were joined by a fabulous panel of experts who were able to provide an update on the evidence and lots of helpful tips on supporting families with breastfeeding.

Our expert panel of speakers:

Alison Spiro – Independent breastfeeding advisor Honorary Lecturer, Brunel University – Building parental self-efficacy in breastfeeding
Gail Barker – Health Visitor Professional Lead for Devon Public Health Nursing – Infant Feeding. A wider public health approach needed
Phil – A dad’s perspective of breastfeeding (interview with Gail Barker)

As with all our iHV Insights webinars, resources are available for iHV members to access as a free member benefit after the event.

So, if you are already a member head over to our iHV Insights page now and check out our latest iHV Insights Or join us today and gain access to future iHV Insights webinars, as well as the recordings of past sessions.

Go to iHV Insights

We hope this library of iHV Insights will provide a valuable “bite-sized” CPD resource for all members to use as part of your ongoing learning and revalidation.

iHV Insights* – Dates for your 2022 Diary

20 January 2022 15:30 – 16:30
17 February 2022 15:30 – 16:30
24 March 2022 15:30 – 16:30

* Our iHV Insights are regularly scheduled. Whilst we’d like to publish topics in advance, we will confirm those closer to the time to ensure that they are the topics that are current. When booking your member place via Eventbrite – don’t forget you’ll need your membership number as the access code.

Bookings now open for October iHV Insights

Our 12th iHV Insights webinar takes place on Thursday 28 October 2021 from 3:30 to 4:30 pm.

This will cover the topic of: “Inspiring excellence in breastfeeding support, the health visitor role”.

We are pleased to announce that our expert panel of speakers includes:

Alison Spiro, Independent Consultant
Gail Barker, Health Visitor Professional Lead for Devon Public Health Nursing
Father’s voice, pre-recorded talk.

The webinar will also be recorded and will be available to iHV members on our website after the event.

Please join us.

How to book for iHV members

Go to our EventBrite booking page and please use your iHV membership number as your access code. If you have any problems or enquiries please email [email protected] and we will be happy to help.

Once you have submitted your details, you will be able to select your ticket and proceed to checkout – please note that this webinar is free to iHV members.

Go to EventBrite booking page

Previous iHV Insights

The great news is that recordings of all the iHV Insights webinars are available for iHV members to access as a free member benefit after the event.

Click here to catch up on our fabulous iHV Insights sessions – don’t forget to log in to access.

About iHV Insights

iHV Insights are webinars run just for our members.

These live online sessions are of interest to frontline health visitors and student health visitors, as well as service leads, commissioners and wider members of the health visiting team, both in the UK and with lots of transferable learning for our international members too.

If you are not an iHV member, join us today to access these resources and many other member benefits.

COVID-19 vaccines, pregnancy, fertility and breastfeeding webinar

The Royal College of Obstetricians and Gynaecologists (RCOG) and The Royal College of Midwives (RCM) are hosting a webinar tomorrow (Wednesday 14 April) for maternity staff on COVID vaccines – however, all are welcome to attend by registering via the link below.

This RCOG and RCM event is a fantastic opportunity to hear and ask questions about the latest advice, research and guidance on how to counsel pregnant women offered a COVID-19 vaccine. Vaccine hesitancy among healthcare professionals and in those with concerns about fertility or breastfeeding will also be covered.

This webinar is essential viewing anyone working in primary care and maternity services, as COVID-19 vaccines are offered to more pregnant women at higher risk of serious illness, including those with gestational diabetes.

Wednesday 14 April 2021 | 19:30 – 21:00

Register here for – COVID vaccines, pregnancy, fertility and breastfeeding webinar

A Public Health Nursing Infant Feeding Service during COVID-19 – World Breastfeeding Week 2020

This week is World Breastfeeding Week 2020, running from 1-7 August. The week aims to raise awareness of the links between good nutrition, food security, poverty reduction and breastfeeding, and galvanise action to increase breastfeeding rates.

2020 has brought new challenges as infant feeding support services have needed to quickly adapt to the restrictions of COVID-19 lockdown and physical distancing. However, these conditions have also provided the opportunity for services to innovate and work together to ensure that women and babies receive the support that they need to successfully breastfeed.

We are delighted to be able to showcase the innovative work of the health visiting infant feeding service in Devon led by Gail Barker, Infant Feeding Coordinator Devon Public Health Nursing. This peer-reviewed case study has been selected for inclusion as part of our “Making History: Health Visiting during COVID-19” collection of case studies due to be published later this month.

Gail’s case study presents 12 learning points that contain a wealth of transferable tips gathered by the health visiting service in Devon during the first 12 weeks of the implementation of their adapted support service. Their experiences will resonate with others facing similar challenges which Gail outlines, “Staff were scared, families vulnerable. We needed to continue to keep everyone, families and staff alike safe, informed and supported with infant feeding challenges. We needed to be able to assess latch, build peer relationships, support growth and development, promote, protect and support breastfeeding, all whilst working in an integrated manner with our partners and parents”.

Commenting on the importance of supporting breastfeeding during these challenging times, Gail Barker said:

“Improving the UK’s breastfeeding rates is acknowledged as a key factor in improving the health of a population. Through being able to continue to support infant feeding via video teleconferencing at such a challenging time, we were able to support and promote the health of each baby and mother supported by our service. We know that infant feeding supports not only the building of close and loving relationships, which in turn promotes mental health of both mother and baby (Unicef, 2019), but it also has significant health impacts and reduces health inequalities (Victora et al 2016). At this time of COVID-19, it has never been more important to focus on children in view of these considerations for now and for the future, not just in the UK, but globally”.

Read Gail Barker's case study

Please see further resources and blogs to support breastfeeding during COVID-19:

Download iHV Parent Tips: Supporting breastfeeding during COVID-19

Read Dr Alison Spiro’s Voices blog published during England’s breastfeeding awareness week in June 2020 – Breastfeeding during the COVID-19 crisis

COVID-19 exposes fragility of infant feeding support in the UK

With breastfeeding support under strain, service providers propose plan to tackle inequalities

This World Breastfeeding Week (1-7 August 2020), the Institute of Health Visiting joins the voice of the Breastfeeding Network who are calling on the UK government to address the fragility of breastfeeding support services.

Our organisations have seen first-hand how the COVID-19 crisis has exposed the fragility of infant feeding support available for women, parents and families.

Over the past few months, the need to support babies and families has escalated and support services have been stretched beyond anything in our experience.

Existing variations in provision for infant feeding support have increased as services have been cut, health visiting teams redeployed and provision moved online, leading to unknown outcomes on infant nutritional health, worsening maternal mental health and widening health inequalities.

Tremendous efforts from the NHS and Third Sector organisations, including many volunteers on the National Breastfeeding Helpline and other charity-run helplines, along with swift adaptation to offer online support, have provided many families with support but this is not sustainable without a longer term strategy.

Meanwhile, the need to protect infant and young child feeding in pandemic emergencies has not previously been considered and has been entirely missing from the Scientific Advisory Group for Emergencies’ reports

Investing in the health of new families, including supporting and protecting breastfeeding and supporting safe and responsive formula or mixed feeding, enables children not just to survive, but to thrive.

Rebuilding infant feeding support for communities after Covid-19 and giving important attention to the needs of mothers and children from Black, Asian and minority ethnic backgrounds will help tackle inequalities.

Infant feeding is a critical component of first 1001 Days and Early Years Health

We welcome the appointment of Andrea Leadsom MP as the Government’s Early Years Health Adviser and the announcement of a review at a time when infant feeding support services for women, parents and families have been stretched to an unprecedented degree.

Protecting breastfeeding and ensuring safe and responsive formula and mixed feeding during those first 1001 days would make a significant contribution to reducing inequalities in health. As a result, it also upholds the work of the NHS and helps build a healthier population.

While COVID-19 has undoubtedly placed a strain on support systems, it has also highlighted a huge omission in UK policy on planning for the care and feeding of infants and young children in case of emergencies, leaving our youngest members of society vulnerable.

While the benefits of breastfeeding are well-evidenced, merely stating these benefits does not ensure breastfeeding is protected or supported. At a time of global health crisis, and increasing recognition of the impact of human behaviour on the health of our planet, support for breastfeeding is also an environmental imperative.

10-point Infant Feeding Action Plan to address Inequalities

We call on the UK government to adopt the following 10-point Infant Feeding Action Plan below which has a particular focus on working to reduce inequalities:

1. For the new Government Early Years Advisor to appoint a permanent, multi-sectoral maternal, infant and young child nutrition strategy group to implement a national strategy to support good nutrition across the first 1001 days.

2. To commission and sustainably fund universal, accessible, confidential breastfeeding support delivered by specialist/lead midwives, health visitors and suitably qualified breastfeeding specialists, recognising the role of charitable organisations and community groups and their strong links with communities.

3. Ensure there are children’s centres or family hubs, disproportionately located in areas of disadvantage, offering joined-up universal services from pregnancy onwards, that include breastfeeding peer support, guidance on the introduction of solids and eating well in the early years.

4. To ensure that health visiting services are properly funded and the number of health visitors increased to ensure consistent timely nutritional support for all families to support good maternal and infant mental and physical health.

5. To integrate planning to support infant and young child feeding in emergencies into legislation, the Civil Contingencies Act, and Local Resilience Forums across the country.

6. To recognise the importance of breastmilk for preterm and vulnerable babies and the need for equitable access to donor breastmilk for these babies through the establishment of a fully funded regional donor milk banking service.

7. To implement the Unicef UK Baby Friendly Initiative across community, hospital and neonatal services, building on the recommendation for all maternity services to be accredited in the NHS Long Term Plan.

8. To make it a statutory right of working mothers to access a private space and paid breaks to breastfeed and/or express breastmilk and manage its safe storage.

9. To support the commitment to re-instate the quintennial Infant Feeding Survey which builds on data previously collected every five years since 1975, most recently in 2010.

10. To protect babies from harmful commercial interests by bringing, as a minimum, the full World Health Organisation International Code of Marketing of Breastmilk Substitutes into UK law and enforcing this law.

For enquiries, please email [email protected]

Shocking gaps in emergency preparedness for Europe’s babies

During #BreastfeedingCelebrationWeek, the first European report on infant and young child feeding policies and practices was launched yesterday. It compares 18 countries and identifies the considerable improvements they need to make in supporting mothers who want to breastfeed.

The COVID-19 pandemic has shown how important it is for countries to protect their citizens from illness. Babies who are breastfed have better health and resistance to infection, and most mothers want to breastfeed. Yet many European mothers stop or reduce breastfeeding in the early weeks and months, and bottle feeding is prevalent, due to inadequate support from health systems and society.

This new report, Are our babies off to a healthy start?, compares the implementation of WHO’s Global Strategy for Infant and Young Child Feeding by 18 European countries. The comparisons show clearly that inadequate support and protection for breastfeeding mothers is a Europe-wide problem. The health of babies, mothers and whole populations loses out as a result. However, countries do differ considerably. Turkey rates highest overall; the five countries with the lowest scores belong to the European Union.

The scope of the assessment is wide-ranging, with ten policy and programme indicators, including national leadership, hospital and community practices, marketing controls on breastmilk substitutes, health professional training, emergency preparedness and monitoring. There are also five feeding practices indicators, such as exclusive breastfeeding for 6 months, a WHO recommendation.

The indicators with the poorest overall scores are national leadership and, shockingly, emergency preparedness, where the UK scored 0/10.

Read the summary report published in the International Breastfeeding Journal

Read the full report - Are our babies off to a healthy start?

New resource for parents – Supporting breastfeeding during COVID-19

A new addition to the Parent Tips series to help parents during these times – “Supporting breastfeeding during COVID-19“.

Like other mammal babies, it is natural for a human baby to be breastfed, but many people in the UK have lost confidence and skills in breastfeeding. Breast milk contains anti-viral factors and antibodies which are likely to offer your baby some protection against COVID-19. There is no evidence that the virus can be transmitted through breastfeeding. If you have any concerns, you can discuss them with your midwife or health visitor (online or over the phone).

The new Supporting breastfeeding during COVID-19 Parent Tips includes: