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An independent public health nutrition charity that provides information and resources to support eating well from pre-conception to five years

What you can do

Challenging information provided in advertisments to healthcare professionals by breastmilk substitute manufacturer

#scientificandfactual

1

Write to the editors of journals and magazines that you read or subscribe to

If you regularly receive or read publications that carry advertising for breastmilk substitutes (BMS) or commercial milk formula (CMF), please write to the editor citing our reports, Scientific and Factual, and ask them to remove advertising for BMS/CMF from their pages. You can point out that some advertisements contravene the UK regulations and/or more recent global guidance. Advertising BMS to health workers may be permissible in law but creates conflict of interest and undermines the WHO International Code of Marketing of Breastmilk Substitutes and subsequent World Health Assembly (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

Below we have listed some of the magazines and journals that take advertising with the names of their editors.

Journal

Journal of Health Visiting
Editor: Polly Moffatt
jhv@markallengroup.com 

MA Healthcare Group, St Judes Church, Dulwich Road, London, SE24 0PB

Complete Nutrition
Editor: Anne Holdoway
info@cm-2.co.uk
faye@cm-2.co.uk

Nursing Times
Editor: Steve Ford

steve.ford@emap.com
emap Publishing Limited, c/o dsb, 3 Queensbridge, Northampton, NN4 7BF

Journal

Journal of Healthcare Assistants
Editor: Upasana Rajagopalan
upasana.rajagopalan@markallengroup.com
MA Healthcare Group, St Judes Church, Dulwich Road, London SE24 0PB.

Nursing Standard
Editor: Graham Scott
graham.scott@rcni.com
65 Lowlands Rd, Harrow, HA1 3AW

Dietetics Today
Editor:
editor@bda.uk.com
BDA, 5th Floor Charles House,
148/9 Great Charles Street, Queensway, Birmingham B3 3HT

Journal

Practice Nursing
Editor: Polly Moffat
polly.moffat@markallengroup.com
MA Healthcare Group, St Judes Church, Dulwich Road, London SE24 0PB.

Infant
Editor: Lisa Leonard
lisa@infantjournal.co.uk
Infant, 134 South Street, Bishops Stortford, Herts CM23 3BQ

Network Health Digest
Editor: Emma Coates, RD
editor@networkhealthgroup.co.uk
NH Publishing Ltd. Suite 1, Freshfield Hall, The Square, Lewes Road, Forest Row RH18 5ES

Journal

Pharmacy Magazine
Editor: Richard Thomas
richard.thomas@1530.com
Communications International Group. 162-168 Regent Street, London W1B 5TB

British Journal of Midwifery
Editor: Suzannah Hamilry
bjm@markallengroup.com
MA Healthcare Group, St.Judes Church, Dulwich Road, London SE24 0PB

Journal of Family and Child Health
Editor: Caroline Voogd
voogd@markallengroup.com
MA Healthcare Group, St.Judes Church, Dulwich Road, London SE24 0PB

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

If there is an issue with a specific product, then you should contact either the authority responsible for where the product is manufactured (i.e., the Trading Standards Service at the Local Authority where the manufacturer is based) and/or your own local authority or District Council.

 The Advertising Standards Agency (ASA) has a role in ensuring that advertisements adhere to the ASA’s codes, which for infant and follow-on formula are based on the UK regulations. The ASA works across the whole of the UK and could be an alternative route of action if inappropriate advertising of infant and follow-on formula is identified. A complaint to the ASA can be submitted by completing the ASA online form: https://www.asa.org.uk/make-a-complaint.html

 If the query is UK wide, then the Department of Health and Social Care (DHSC), based in England, would be most appropriate to contact as they are the UK lead government department. If an advert is seen in a health facility, or in a publication in either of the four countries of the UK, then the following contact details can be used to write letters or emails to:

England

Andrew Herd
Department of Health and Social Care
39 Victoria Road
London SW1H 0EU

E: andrew.herd@dhsc.gov.uk or nutritionlegislation@dhsc.gov.uk
T: 020 7972 1243

Scotland

Note that NHS Scotland has a Flow Chart: Reporting process for breach of the WHO Code, which involved reporting any breaches to the Advanced Public Health Practitioner or Infant Feeding Advisor/Coordinator, and /or the local Health standards department, depending on the type of violation.
E: goodfoodnation@gov.scot
T: 01224 285100

Wales

Health Improvement Division
Welsh Government
Cathays Park
Cardiff CF10 3NQ
E: customerhelp@gov.wales
T: 0300 0604400

Northern Ireland

Food Standards Agency (Northern Ireland) 
10c Clarendon Road
Belfast BT1 3BG
E: nutritionlegislation-ni@food.gov.uk

T: 0330 332 7149

3

Write to your MP or ask a Freedom of Information question

Ask your MP to ask the Parliamentary Under-Secretary of State for Prevention, Public Health and Prevention Ashley Dalton, what she plans to do to tackle advertising of breastmilk substitutes to health workers that breaks the law and is misleading. One MP is obliged to reply to another and they can ask this as a parliamentary question or in a personal letter. If you live in Scotland or Wales, please encourage your MP to contact Jenni Minto (Minister for Public Health and Women's Health in Scotland) or Jeremy Miles MS (Cabinet Secretary for Health and Social Care).

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

Ask a Freedom of Information request by following the instructions here

4

Approach your professional lead body

If you are a member of a professional body that accepts funding from breastmilk substitute companies, 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 misleading advertising of BMS. This could be by alerting their members in a newsletter about the issue, writing themselves to the Department of Health 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.

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. Write a Blog or share on social media (Facebook, Instagram, Bluesky, etc) 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, contact Baby Milk Action (part of IBFAN) who monitors the marketing of BMS to families in the UK. For details about how you can contact them please click here.

Unicef links/further reading

Unicef UK – A guide for healthworkers to working within the Code 2020
Baby Milk Action – conflicts of interest for health workers poster 

Mabel Chew, Catherine Brizzell, Kamran Abbasi and 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 harm’ Click here to access

Sample posts for social media

Please share the following to your followers, or direct to journals, conference organisers or your MP. 

Here are some suggested posts:

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

  • See @1stepsnutrition 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. #scientificandfactual #endexploitativemarketing

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 advertisements and this information can be found on their website www.firststepsnutrition.org and www.firststepsnutrition.org/reviews-of-claims. 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

Magazines aimed at health workers

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 advertisements and this information can be found on their website www.firststepsnutrition.org and www.firststepsnutrition.org/reviews-of-claims. 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

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 International Code of Marketing of Breastmilk Substitutes and subsequent World Health Assembly (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 advertisements and this information can be found on their website www.firststepsnutrition.org and www.firststepsnutrition.org/reviews-of-claims. You may be quite surprised by some of the information companies use to support their claims.

Yours sincerely

Name

Job Title