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Response to RB’s response to Globalization Monitor’s exposé of formula milk companies’ product development strategies and promotional practices in Hong Kong and mainland China

Re: Reckitt Benckiser’s response to Globalization Monitor’s exposé of formula milk companies’ product development strategies and promotional practices in Hong Kong and mainland China

We welcome RB’s willingness to have an open dialogue with GM regarding the product development and promotional practices of Mead Johnson Nutrition in Hong Kong. We note that RB claims to be a responsible company “committed to marketing Breast-milk Substitutes (BMS) products ethically” and “being transparent in our marketing practices”. We hope to see these commitments genuinely reflected in RB and Mead Johnson’s business practices and that appropriate corrective actions regarding the issues our report and this message raise will be taken promptly.

We raised two issues in our initial correspondence with RB:

Firstly, we asked RB to explain the reasons behind developing Enfamil A+ and Enfamil Platinum and for charging a higher price for the latter (+17.1%), when they are nearly identical compositionally and nutritionally.

RB explained that “Enfamil Platinum reflects an upgraded formulation versus Enfamil A+ due to the different nutritional profile of a key ingredient, a unique Whey Protein Concentrate.”

We must point out that this supposed upgrade is not reflected on the labelling of the said products, as “whey protein concentrate” is listed on both products’ ingredients list (see p.9). We reiterate that the two products contain the same ingredients at nearly identical levels. On the other hand, RB had tried to create the impression that Enfamil Platinum is a premium product compared to Enfamil A+ by highlighting the inclusion of GOS and PDX only in the former, even though both products contain the nutrients (see p.10). That fact that this is misleading for consumers has not been addressed by RB.

If it is the case that Enfamil Platinum contains a “unique whey protein concentrate”, then it becomes unclear what makes Enfinitas superior to Enfamil Platinum, given that containing “a unique whey protein concentrate rich in MFGM” is a central promotional focus of Enfinitas (see p.10). This only reinforces our initial conclusion that Mead Johnson’s product development decisions are driven by the desire to differentiate their products and achieve price discrimination and thus higher revenues.

Secondly, we questioned the validity of a study by Timby et al. (2014), cited by Mead Johnson to support its use of MFGM in its formula products.

RB did not address the fact that two systematic reviews co-written by Timby in 2016 and 2017, which are more recent than all of the literature cited by RB in its response to our report, concluded that “because of the small number of studies conducted and the heterogeneity of interventions implemented, no firm conclusions regarding the effects of MFGM supplementation on the health and development of infants can be drawn” (see p.11).

RB cited several studies which it claimed prove the benefits of adding MFGM into formula products. This does not seem to always be the case upon closer inspection. In Gurnida et al. (2012), researchers conceded that “it is difficult to attribute the observed cognitive development benefits in the present study to increases in gangliosides (a component of milk fat membrane lipids) alone”, and that their findings needed “further investigation and confirmation in larger studies.” Newburg et al. (1998) studied the role of human lactadherin in protection against certain infections. It must be noted that the efficacy of an ingredient found in human breastmilk may not be easily replicated by synthesised substances in formula products because human breastmilk contains bioactive components. Billeaud et al. (2014) concluded that MFGM supplementation is safe but did not investigate its supposed benefits. Zavaleta et al. (2011) compared the “diarrhoea, anaemia, and micronutrient status” in infants receiving complementary food with MFGM as its protein source and infants receiving complementary food with skimmed milk as its protein source. Since all Mead Johnson’s infant formula products in Hong Kong use whey and not skimmed milk as a protein source, this study is not useful in demonstrating the supposed nutritional superiority of Enfinitas.

We reiterate that the current general scientific consensus is that MFGM supplementation in formula milk is safe, but there is not enough evidence proving its benefits, or for a general recommendation on which MFGM fraction to use and at what concentration as formula supplement for a given outcome.

If, as RB claims, there are upcoming clinical studies on the “might be expected” benefits of MFGM, then it is clearly premature for MFGM to be introduced into formula products now. We believe a responsible formula manufacturer should always ensure the benefits of the optional ingredients that it uses are already generally accepted by the scientific community.

We urge RB and Mead Johnson to address these issues promptly and appropriately.

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