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Press release: Report reveals how formula milk companies differentiate products and use misleading and unscientific statements to promote products and maximise profits

Hong Kong-based NGO Globalization Monitor released the findings from its research report Deceit, Rule-bending, and Other Malpractices on 9thApril through a press conference. The report formula milk companies' problematic, irresponsible and Code-violating product development and promotional practices in Hong Kong and mainland China and identifies inadequacies in existing regulations of the industry.

Globalization Monitor’s spokesperson emphasised that the World Health Organisation (WHO) recommends that infants should be exclusively breastfed for the first six months of their lives, and thereafter receive nutritionally adequate and safe complementary foods while continuing to be breastfed up to two years of age or beyond. Globalization Monitor explains that they have written the report to hold formula milk manufacturers accountable for their inappropriate promotional practices and prompt the government to strengthen its measures to better protect and promote optimal breastfeeding practices.


Nestlé fails to keep its word

The report reveals that Nestlé has failed to fulfil the promises it made to the Changing Markets Foundation and Globalization Monitor in March 2018. Nestlé had promised to remove sucrose and vanilla flavourings in formula milk products for infants under 12 months old and remove confusing nutritional advice on NAN PRO. However, as of February 2019, the report found that Nestlé still sells at least three products (stage two S-26 Ultima Promil in Hong Kong, and stage two Wyeth illumaand S-26 Goldin mainland China) with vanilla flavouring and continues to market NAN PROas not containing vanilla flavourings, ostensibly “for babies’ healthy growth”. Vanilla flavourings are an unnecessary ingredient in formula milk that could burden infant and young children’s metabolism. By Nestlé’s own admission, it has failed to completely phase out all products containing sucrose from the market. Sucrose in formula milk can lead to severe symptoms, including poor feeding, vomiting and overall failure to thrive in some infants, as well as increase their preference for sweet tastes.



Formula milk manufacturers exaggerate product quality, misleads carers

The report also discovered that, to premiumise their products, formula milk manufacturers often rely on promotional statements that exaggerate their benefits and nutritional value. Manufacturers may distort scientific findings or reference research of dubious rigour and quality to support these statements. For example, to promote its products with the “European Patented Prebiotics Mixture scGOS:lcFOS (9:1)”, Danone cited only scientific studies conducted by its own research institutes (including Numico Research BV. (Numico is short for Nutricia, Milupa, and Cow & Gate, all Danone brands) and Danone Research, Center for Specialised Nutrition) on its product information website. Globalization Monitor argues that presenting the research produced by scientists working for them as the evidence supporting their nutrition and health claims amounts to a serious conflict of interest, especially given the commercially sensitive nature of the research. According to the Codex Alimentarius Commission, only claims that are substantiated by current relevant science and recognised by generally accepted scientific review can be used to promote formula milk products; since Danone is unable to reference any impartial sources or scientifically rigorous studies, Danone’s promotional statements are likely to be in breach of Codex standards.



Do Nestlé’s promotional practices violate the WHO Code?

Globalization Monitor argues that the statements Nestle use to promote its illumaproducts are likely to violate the WHO Code, as Nestle explicitly compares its product with breastmilk. Nestle unreservedly uses phrases like “ever closer to lactating secretion”, “replicating as nature intended”, “human affinity” and “unleash self-immunity” on its product packaging, online promotional material and advertisements. However, Globalization Monitor’s report referenced a study by the Public Library of Science’s peer-reviewed journal, which reveals that the human milk oligosaccharide used in illuma, which Nestle claims can support infants’ immune system, has no direct immunomodulatory effects. Another study conducted by a research team comprising scientists from Nestlé nutrition and health science research centres, was only able to conclude that the use of 2’-FL in formula is safe, and conservatively suggested that “more prospective, randomised trials in infants comparing formula without and with HMOs are still needed to evaluate the clinical effects of this supplementation.”

Globalization Monitor argues it is irresponsible and unethical for Nestle to overlook the research findings of its own scientists and prematurely introduce HMO-supplemented products to the market. Given that more than 150 different HMO structures have been identified so far, it is hardly accurate for Nestle to claim that it is “replicating as nature intended”, which may easily mislead carers and consumers.

Globalization Monitor points out that the Guidance on Ending the Inappropriate Promotion of Foods for Infants and Young Children, adopted in 2016 by the World Health Assembly, expressly states that the material used to promote foods for infants and young children “should not include any image, text or other representation that is likely to undermine or discourage breastfeeding, that makes a comparison to breast-milk, or that suggests that the product is nearly equivalent or superior to breast-milk”, and must contain accurate, details, full, and honest information on their labels.



Arbitrary product differentiation to maximise sales and profits

Formula milk companies often reproduce very similar recipes under different product lines to achieve price discrimination and raise their profits. For example, Mead Johnson’s Enfamil A+and Enfamil Platinumhave the same composition and extremely similar nutritional content, but this is masked by the presentational inconsistency of the nutritional value of the products, thus allowing Mead Johnson to price Enfamil Platinum 17% higher than Enfamil A+. Globalization Monitor argues that Mead Johnson is deliberately misleading consumers into thinking that Enfamil Platinumhas higher nutritional value, which is unethical and violates carers’ trust.


Call for better regulations

Globalization Monitor argues that Hong Kong and mainland Chinese formula milk markets have been a haven for BMS manufacturers in recent decades not least because the regulations have not been responsive enough to how BMS makers’ product development and promotional practices have evolved. The organisation therefore urges policymakers to make prompt improvements and recommends the Hong Kong government to devolve more power to the Committee on Promotion of Breastfeeding or establish a new agency tasked with educating the public, building support for stronger regulations, mobilising other ministries to support its regulatory efforts, and monitoring their implementation.

Globalization Monitor argues the agency must have the mandate to take punitive action against companies that violate the Hong Kong Code and threaten breastfeeding. This include the power to remove problematic products from shelves, take down problematic advertisements, impose sizeable penalties (greater than any direct financial benefit the offender realises from the violation and at least equal to the cost of enforcement), suspend or revoke production or retail licenses and product registrations.

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