Intended for healthcare professionals

Letters Calling time on formula milk adverts

When does a breast milk substitute become an essential medicine?

BMJ 2019; 367 doi: (Published 05 November 2019) Cite this as: BMJ 2019;367:l6285
  1. R M Beattie, consultant paediatric gastroenterologist1,
  2. A Batra, consultant paediatric gastroenterologist1,
  3. L V Marino, specialist paediatric dietitian2 3,
  4. M J Johnson, consultant neonatologist3 4
  1. 1Paediatric Gastroenterology Unit, Southampton Children’s Hospital, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
  2. 2Department of Dietetics/SLT, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
  3. 3NIHR Biomedical Research Centre Southampton, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
  4. 4Department of Neonatal Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  1. mark.beattie{at}

BMJ recently made the decision to stop publishing adverts from formula milk companies.1 This is an appropriate strategy to help with national and international initiatives to promote breastfeeding, but it has potentially complex and far reaching ramifications. This includes a potential vulnerability for the small group of infants for whom breastfeeding is not possible or appropriate because of underlying medical conditions.

In this highly selected group the promotion and advertising of specialist formula could be considered the same as the advertisement of any other drug that (like specialist feeds) needs to be prescribed, such as epilepsy drugs, monoclonal antibody therapy, treatment for attention deficit/hyperactivity disorder, antibiotics, and treatments for asthma, all of which are regularly featured in adverts in The BMJ and other medical journals. We agree that the decisions around advertising specialist products manufactured by formula milk companies are fraught with difficulties given the understandable perception of “over promotion” of specialist feeds such as breast …

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