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Challenging information provided in advertisments to healthcare professionals by breastmilk substitute manufacturers #scientificandfactual


What you can do
1. Write to the editors of journals and magazines that you subscribe to, or read

If you regularly receive or read publications that carry advertising for breastmilk substitutes (BMS), please write to the editor citing our report and asking them to remove advertising for BMS from their pages. You can point out that some advertisements contravene the regulations. Advertising BMS to health workers may be permissible in law, but creates conflict of interest and undermines the WHO Code of marketing of breastmilk substitutes and subsequent WHA resolutions, which aim to protect health workers and the families they support. Anyone working in an area which is, or has been, working towards UNICEF Baby Friendly accreditation (over 90% of maternity services and over 80% of health visiting services in the UK) will have received training on how to work within the WHO Code and been advised to remove publications containing formula advertisements from their facilities and to avoid conflicts of interest on study days and at conferences.
Journals rely on subscriptions and losing readership could challenge their financial viability, so feedback from readers and subscribers is particularly important. A list of journals that take advertising and the editors’ details, and some example emails or letters you could send are shown below.

Click below to access example letters – please feel free to amend and adapt the wording to raise particular concerns you have with editors

Peer-reviewed journals
Magazines aimed at health workers
If you are in a Baby Friendly area

 
Some of the magazines and journals that take advertising and their editors: you may know others so do let us know so we can add to the list.
Journal Title Editor Editor's email Postal address
Journal of Health Visiting
Community Practitioner
Dietetics Today
Journal of Family Health
Complete Nutrition
Journal of Healthcare Assistants
Practice Nursing
Pharmacy Magazine
Nursing Times  
Nursing Standard  

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2. Write to the Department of Health regulators to complain about the infringements of the regulations and to ask what they plan to do to challenge the current adverts and protect health workers from exposure to misleading information

Contact details for the Department of Health regulators, and the competent authority offices in Scotland, Northern Ireland and Wales, are here:

England
Noel Griffin
Team Leader Nutrition Legislation, Obesity and Food Policy
Department of Health, 6S Wellington House, London SE1 8UG
E: noel.griffin@dh.gsi.gov.uk  T: 020 7210 6241

Derek Hampson
Nutrition Legislation Team
Obesity & Food Policy Branch, Healthier Lives
Public and International Health Directorate (PIHD)
Dept.of Health, 133-155 Waterloo Road, London SE1 8UG
E: Derek.Hampson@dh.gsi.gov.uk  T: 020 7972 4340

Scotland
Alison Taylor
Food Standards Agency (Scotland)
Parnuts Food Notification
Professional Advice Branch
6th Floor
St Magnus House
25 Guild Street
Aberdeen AB11 6NJ
Tel: 01224 288356
Fax: 01224 285110
E-mail: parnutnotification@foodstandards.gsi.gov.uk

In Wales
Health Improvement Division
Welsh Government
Cathays Park
Cardiff
CF10 3NQ
Tel: 02920 825724
Email: Lifestyles@wales.gsi.gov.uk

In Northern Ireland
Northern Ireland:
Food Standards Agency (Northern Ireland)
Parnuts Food Notification
Dietary Health Team
10c Clarendon Road
Belfast BT1 3BG
Tel: 028 9041 7708
Fax: 028 9041 7726

E-mail: parnutnotification@foodstandards.gsi.gov.uk


 

3. Write to your MP or ask a Freedom of Information question

Ask your MP to ask the Ministers of State for Public Health, Jane Ellison or Ben Gummer, what they plan to do to tackle advertising of breastmilk substitutes to health workers that breaks the law or misleads health workers. One MP is obliged to reply to another and they can ask this as a parliamentary question or in a personal letter.

You can find your MP here: www.theyworkforyou.com

Alison Thewliss
Karen Lumley
Julian Knight
Kirsty Blackman
Mark Durkan
Jim Fitzpatrick
Baroness Benjamin
Ian Austin
Nic Dakin
Nigel Dodds
Julie Elliott
Diana Johnson
Lord McColl of Dulwich
Caroline Nokes
Gavin Robinson
Tim Loughton
Frank Field
Caroline Lucas
Baroness Hollins
Earl of Listowel
Fiona Bruce
Norman Lamb

Ask a Freedom of Information question by following the instructions here

4. Approach your professional lead body


If you are a member of a professional body such as The Royal College of Midwives, CPHVA, British Dietetic Association, RCPCH etc., you can write to the president, chair or head of professional affairs and ask if they will be doing anything to protect their membership from advertising of BMS. This could be by alerting their members in a newsletter about the issue, writing themselves to the DH regulators, using their contacts in parliament to challenge the lack of action when rules are broken, or making a commitment to ensure members are protected from advertising at meetings, conferences, study days and so on.

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5. If you are a health worker who belongs to a local network, branch or group, ask to have this as an agenda item at your next meeting

Encourage others to think about this issue and complain if they are unhappy. Blog, Tweet or share on Facebook to highlight the issue to other health workers.

6. Say no to study days or events where makers of breastmilk substitutes are sponsors, or allowed to advertise.


Wherever possible avoid going to events and study days where there is marketing of BMS. If you can, write and say why you are not going so that the organisers are aware. If attending an event is unavoidable, write to the conference organiser and express your dismay at this advertising. You could ask whether the conference pack could include details of where health workers can obtain independent information on BMS and a statement that some advertising and marketing by BMS companies may not be in line with current UK policy.

7. Tell us about adverts or other marketing activities that you see aimed at health workers.

We will continue to collect examples of marketing to health workers, examine the science cited to support claims, and publish the results.

If you see adverts or other activities aimed at the general public, rather than health workers, Baby Milk Action (part of IBFAN) monitors the marketing of BMS to families in the UK, so you can contact them and use their letter-writing information, which you can find here

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Useful links/further reading

Unicef – A guide for healthworkers to working within the Code
Baby Milk Action – conflicts of interest for health workers poster
LIFIB http://lifib.org.uk/
Fiona Godlee on conflicts of interest in the British Medical Journal (BMJ): conflicts of interest policy developed because ‘making clinical decisions based on information biased by commercial interests can cause harmClick here to access

Sample Tweets
Please Tweet to your followers, or direct to journals, conference organisers or your MP.
Here are some suggested Tweets:


Advertising of breastmilk substitutes in professional journals is misleading, emotive and not #scientificandfactual @1stepsnutrition report

See @1stepsnutrition new report for flawed science behind ads for breastmilk substitutes in journals for health workers. #scientificandfactual

Companies that make breastmilk substitutes target health workers to recommend products, but claims made in ads are misleading, not #scientificandfactual @1stepsnutrition

Fed up with ads for breastmilk substitutes in journals? @1stepsnutrition report exposes misleading science behind ads. Tweet journal eds! #scientificandfactual

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Sample letters

Peer-reviewed journals

Dear [Editor],
As a regular reader of your journal, I would like to ask what the rationale is for including adverts for breastmilk substitutes. Although companies are legally allowed to provide scientific and factual information to health workers, the adverts are often based on flawed science and many claims do not support current health policy in the UK. I do not believe that these adverts are helpful for your readers since they undermine the otherwise evidence-based, peer-reviewed articles that are provided. I am sure you do not wish to mislead your readership, or knowingly allow inaccurate information to be placed in your journal.  If you want to see a review of how advertising is often misleading and out of step with current policy and scientific thinking First Steps Nutrition Trust have reviewed some of the current advertisements and this information can be found on their website www.firststepsnutrition.org. You may be quite surprised by some of the information companies use to support their claims.

I hope you will discuss this issue with your editorial board.

Yours sincerely

Name

Job Title

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Magazines aimed at health workers

Dear [Editor],
As a reader of your magazine I am writing to ask about the inclusion of adverts for breastmilk subsitutes. I understand that the companies are legally allowed to provide scientific and factual information to health workers, but the adverts are often based on flawed science and do not support current health policy in the UK. If you want to see a review of how advertising is often misleading and out of step with current policy and scientific thinking First Steps Nutrition Trust have reviewed some of the current advertisements and this information can be found on their website www.firststepsnutrition.org. You may be quite surprised by some of the information companies use to support their claims.

I do not believe that the ‘information’ in these adverts is helpful to readers, and their inaccurate content undermines evidence-based information that may appear in other articles in your magazine. I am sure you do not wish to create conflicts of interest or mislead your readership. Would you consider adopting an advertising policy that reflects these concerns?

Yours sincerely

Name

Job Title

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If you are in a Baby Friendly area

Dear [Editor],
I am an [insert job title] in [insert area]. We are working towards Baby-Friendly Initiative accreditation and have recently received training on how to work within the WHO Code of marketing of breastmilk substitutes and subsequent WHA resolutions. We have been advised to remove publications containing advertisements for breastmilk substitutes from our facilities and to avoid conflicts of interest on study days and at conferences.
We are thus no longer able to have your magazine in the office, which is a shame because many of the articles you publish are of interest to me and my colleagues. Would you consider changing your advertising policy? Many of the adverts for breastmilk substitutes contravene regulations that say that they should be ‘scientific and factual’, and the science behind them is often flawed. If you want to see a review of how advertising is often misleading and out of step with current policy and scientific thinking First Steps Nutrition Trust have reviewed some of the current advertisements and this information can be found on their website www.firststepsnutrition.org. You may be quite surprised by some of the information companies use to support their claims.

Yours sincerely

Name

Job Title

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