The fight for the mouths of babesBMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7082.760 (Published 08 March 1997) Cite this as: BMJ 1997;314:760
- Heather Welford, freelance journalist and writer, Newcastle upon Tyne
“Women want choice and information,” said the press release detailing a Mori survey on attitudes towards infant feeding. Well, yes. But the release is from Inform, a new campaign launched by the British formula milk companies' body. Even a non-cynical observer may wonder what they're up to.
To some people, the formula milk industry is a bunch of fat cats making millions at the expense of babies' health. Like Allison Pearson, writing in the Evening Standard, this lot believe “with breast milk on tap, the baby milk manufacturer is like the shyster standing on the front at Brighton, flogging bottled Eau de Mer.” To others, breast feeding is a faintly disgusting quirk, indulged in by the lentil eating middle class. While most of us are somewhere between the extremes, wherever we are we can't argue with the industry here—women should have the information they want. But from whom?
The Inform campaign, launched last week in the House of Commons, had sessions with MPs and with the press. Why now? “We feel the feeding debate is polarised, and mothers' voices haven't been heard,” says Inform's Helen Messenger. “The survey was done by December 1996, and we felt now was the time to publish, before the papers became full of the election.”
In fact, newspaper response to the campaign has been virtually nil–”We're a bit surprised and disappointed,” reports the woman from Inform's PR wing. “We've had some interest from the nursing press, but not much from elsewhere.” Yet journalists are unlikely to thrill over an apparently bland survey which “reveals” that a quarter of women want more information about infant feeding—both types. Pardon me for not holding the front page.
As often, the real story's been missed: the formula industry feels under pressure, and it's fighting back. They fear that existing laws governing promotion could become more restrictive. In addition, they say, they detect anti-formula bias among health professionals. “There's anecdotal evidence some professionals won't talk about formula, even when mothers ask, in case they're seen as promoting it,” says Helen Messenger. “And there's discussion about whether we can continue responding to mothers' requests for product information.”
It's true, according to Baby Milk Action's Patti Rundall, that health professionals may edit what they say about formula. “Mothers should be told it's intrinsically problematic, and about all the health hazards associated with it,” she says. Yet it's unlikely the industry has this sort of frankness in mind when it calls for more informed choice. Ms Rundall also says the industry is anxious to defend its large consumer databases. Once a mother sends a card asking for more information, she starts a chain of regular, frequent, and branded mailings on all aspects of baby care, including feeding and weaning. It's a fair bet “all the health hazards” of artificial feeding aren't mentioned here, either.
But manufacturers, it could be argued, have a duty to respond to customer requests for advice. It's a possibly uncomfortable fact that their freephone numbers, open all hours, make it easier for mothers to do this than to reach their overworked, hard pressed health visitors.
The real issue is a political one, of money and resources. Breast feeding has a poor “brand image,” says marketing consultant Tina Durdle, whose research shows the difficulties of choosing breast feeding in an essentially pro-bottle society. Promotion of breast feeding needs enough cash for an intelligent advertising, promotion, and education campaign using every aspect of the media. “The positive aspects of breast feeding would be highlighted, rather than the negatives of formula,” says Ms Durdle. “Good market research should hit the right motivational triggers, to set up a series of campaigns with high production values.”
Of course, it will cost more than the annual £150 000 the government currently allocates to promoting breast feeding. Ms Durdle's colleagues calculate that, to target young women alone, a weekly advert in every teen magazine would cost £700 000. A middle weight television campaign would cost £1.5m. A mere drop in the bottle, of course, compared with the NHS bill for formula milk related illness—and far less than the formula industry spends on its own promotion. Women would still be free to choose—and they would also have the extra information the industry says they want.