Paediatricians criticise college survey on links with formula milk firms

Paediatricians campaigning for their royal college to sever its links with infant formula milk manufacturers have criticised the wording of the college’s survey of members.

Delegates at the annual general meeting of the Royal College of Paediatrics and Child Health in April voted in favour of a motion urging it to “decline any commercial transactions or any other kind of funding or support” from all companies that market and manufacture breast milk substitutes.1

The college discussed the motion at its July council meeting and agreed to survey its members on the issue. The survey was sent to members in August.

Those campaigning for the college to change its policy say, however, that the wording of the survey is confusing and that college members “lack the background information necessary to understand the complexity of the issues” and have written their own briefing for members.2

The survey is split into six sections covering general donations; attribution and branding; advertising; conference stands; events with company involvement; specific educational projects; and specific research projects. There are three questions in each section.

Charlotte Wright, professor of community child health at the University of Glasgow and one of the members campaigning for the change in the policy, told The BMJ that she had no objection to the college surveying its members given that the numbers who voted at the annual general meeting were so small—66 delegates supported the motion and 53 were against it.

She added, “The college is expecting people to fill the survey in without any background information about what the college’s current position is and how much income they get from formula manufacturers.”

Each section of the survey begins with a question on due diligence—for example, “RCPCH should accept funding after due diligence has been completed and assured.”

Wright said that this implied that if a formula company abided by ethical codes then “it was okay to take money from them.”

However, the World Health Organization has recently tightened up its code on the marketing of breast milk substitutes, and in May the World Health Assembly recommended that health professional associations and non-governmental organisations should not “accept gifts or incentives from such companies . . . or allow such companies to sponsor meetings of health professionals and scientific meetings.”3

Wright said, “This implies that it doesn’t matter if companies are adhering to this or that code. They make formula milk and that’s the top and bottom of it.”

The college survey offers the option of only accepting funding related to specialist milk products. Almost all of the companies making these products, however, derive most of their profits from breast milk substitute products marketed to parents of healthy children, said the campaigners.

The consultation with members closes on 6 September and will be discussed by the college’s executive committee two days later. The committee will then make a recommendation to council for its next meeting on 27 October.

In a statement the college said that it wanted to get the views of members “on the basis of their personal expertise, without undue influence or prompting.”

“The consultation aims to assist in reaching a decision on any changes to the existing [college] code on interactions with industry and ensure that the college’s approach to this issue commands as much support as possible from its members. For this reason, it was felt that a single yes or no question was not the best way of capturing the range of opinions held by members,” it said.