Letters

Government secrecy

EDITOR,--The government's recent decision not to ban advertising of infant formula milk products emphasises Martin McKee and Tim Lang's concern that public health policies may fall prey to interests of government and industry.¹

Throughout the formation of the two European directives and draft proposals, the British government advocated that such advertising be restricted to professional and scientific journals alone. Last year, the decision to adopt a law allowing baby milks to be advertised in hospital in effect enables expansion of the baby milk market. Such brand name advertising contravenes the World Health Organisation's international code, which clearly states that breast milk substitutes should not be promoted. This code has been supported by the British government since 1981.

During the passage of this law the Ministry of Agriculture, Fisheries, and Food received 210 letters in favour of an advertising ban and 13 against, of which 10 were from baby food companies and advertising agencies. The law came into effect before the issue was debated fully in parliament. In the eventual debate, in April 1995, the main arguments in favour of the government's position came from industry. For example, David Faber, MP for Westbury, speaking on behalf of Cow and Gate, stated, "I should have thought that is exactly what we are here for in the House of Commons--to represent business in our own constituencies and to speak up for them and their interests."

Failing to ban advertising for infant milk products rests uneasily with the government's expert working party on infant feeding, which states that breastfeeding provides the best infant nutrition.² The working party recommended government health departments to encourage all healthy mothers to breastfeed their babies. Guidance from the Department of Health³ and the British Paediatric Association's standing committee on nutrition identifies the many benefits for mother and child associated with breastfeeding. A randomised trial in the United States showed that removing advertisements for formula milk improved breastfeeding rates more than did intensive efforts to train staff in breastfeeding support.⁴

The Health of the Nation white paper encourages breastfeeding of infants. It has been recommended that departments of public health should set and monitor targets for breastfeeding incidence, prevalence, and duration.⁵ Allowing companies to promote formula milk products in the health care system inevitably undermines breastfeeding rates and associated infant health. McKee and Lang are right to be unsure "that the government acts in the interest of the public rather than those of the corporate backers of the party in power."

Senior registrar in public health medicine, East London and the City Health Authority, London E3 2AN

International coordinator Baby Milk Action, Cambridge CB2 3AX

Nicholas Banatvala, Patti Rundall 

1. McKee M, Lang T. Secret government: the Scott report. BMJ 1996;312:455-6. (24 February.) [Free Full Text]
2. Department of Health and Social Security. Present day practice in infant feeding: third report. London: HMSO, 1988. (Report on health and social subjects 32.)
3. Department of Health. Breastfeeding: good practice guidance to the NHS. London: DoH, 1995.
4. Frank DA, Wirtz SJ, Sorenson JR, Heeren T. Commercial discharge packs and breast-feeding counseling: effects on infant-feeding practices in a randomized trial. Pediatrics 1987;80:845-54. [Abstract/Free Full Text]
5. Faculty of Public Health Medicine of the Royal Colleges of Physicians of the United Kingdom. Promoting breast feeding. London: RCP, 1995. (Guidelines for health promotion No 41.)