Censoring choice? SNE concerned about Romanian infant formula plans

By Annie Harrison-Dunn

- Last updated on GMT

SNE says experts are increasingly questioning the benefit of strict communication rules in hospitals designed to encourage breastfeeding. ©iStock/Pilin_Petunyia
SNE says experts are increasingly questioning the benefit of strict communication rules in hospitals designed to encourage breastfeeding. ©iStock/Pilin_Petunyia

Related tags Infant formula Breastfeeding Eu

Restricting mothers’ access to information about infant formula may have negative public health consequences, trade group Specialised Nutrition Europe (SNE) has said following a draft Romanian law banning the marketing of formula for under-2s.

The Romanian law seeks to ban the marketing of infant and follow-on formula​ for children up to the age of two and sets out strict limits for the advice health workers can give to mothers and caregivers.

Under the draft law, health workers will have to educate women separately about breastfeeding and formula products and, if breastfeeding is not possible, they must clearly explain the risks posed by incorrect preparation or use of formula products.

Breaching these rules could constitute a criminal offence, and fines cited in the decree reach up to 100,000 RON (€22,216).

Yet SNE executive director Aurélie Perrichet told us it was “essential”​ parents and caregivers are “well-informed, and equipped”​ to make the best possible feeding decision for their personal situation.

Call for evidence 

The trade group, which represents formula giants like Nestlé and Danone on an EU-level, said it had not yet seen evidence or data demonstrating that reducing mothers’ and caregivers’ access to information has a positive impact on public health.

“In fact, increasingly, experts are questioning the benefit of strict communication rules in hospitals that are designed to encourage more women to breastfeed.”

SNE cited one study​ and an editorial​in the Journal of the American Medical Association​, which concluded there was in fact adequate evidence to recommend primary care interventions to support breastfeeding but also highlighted gaps in knowledge on the impact of such policies.  

The draft now submitted for EU scrutiny goes above and beyond that set on an EU level, leaving some to question whether it would be probed as a potential barrier to EU trade. Comments in this process are only open to member states and the Commission. 

Romania has been earmarked as a country of particular concern for breastfeeding rates.

According to the UN’s children’s charity UNICEF, only 12.6% of infants in Romania are exclusively breastfed for the first six months of life.

SNE said more research was needed on the potential impact of the law.

“In the Romanian context, SNE advocates for a comprehensive and objective impact assessment of the proposed restrictions, taking into account the impact that these measures would have on breastfeeding rates, and the nutritional status of infants and young children.  

“While SNE supports breastfeeding and the principles on which this law was drafted, we are concerned that the measures would not have the intended outcome, and could even result in negative health impacts.”

Above and beyond 

In 2014 an attempt from Malta​ to go beyond the EU standard on the marketing of formula products with a national law was derailed by the EU notification process. 

The Commission said it issued a detailed opinion and comments – which were not published – regarding “some aspects”​ of the Maltese draft.

eu europe brussels european commission parliament iStock artJazz

Since then the member state appears to have backtracked to the EU status quo.

Current EU law​ forbids the marketing of infant formula for children aged up to six months altogether.

Follow-on formula must carry the statement that the product is only suitable for particular nutritional use for infants over the age of six months as part of a varied diet.

SNE has consistently said these EU standards are solid​.

“The EU-level regulation currently in place provides strict, coherent and harmonised rules to govern these products across Europe. These rules represent an international reference point for third countries, by providing the highest levels of consumer protection,”​ it reiterated this week.

Inadequate safeguard? 

Yet a recent WHO report​ said laws protecting breastfeeding were “inadequate”​ in most countries and called for a blanket ban on marketing of all breast milk substitutes including follow-on formula, not just infant formula for younger babies.   

WHO and UNICEF recommend exclusive breastfeeding for the first six months of life followed by the introduction of appropriate complementary feeding alongside breastfeeding for up to two years of age or beyond.

This is in accordance with the WHO’s 1981 International Code of Marketing of Breast-milk Substitutes​, which aimed to counter aggressive and inappropriate marketing of breast-milk substitutes and reverse declining breastfeeding rates.

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1 comment

Negative public health effects of not promoting formula?

Posted by Alicia Dermer, MD, FABM, IBCLC,

Overwhelming scientific evidence demonstrates that exclusive breastfeeding for about 6 months followed by continued breastfeeding along with age-appropriate solid foods for as long as mutually desired is optimal for infant, young child and maternal health. Yet despite increasing early breastfeeding rates, the attrition of breastfeeding within weeks or months after birth is still marked in many countries. In view of the many barriers mothers face in meeting their breastfeeding goals, efforts should be focused on empowering mothers with correct information about the differences in health outcomes between breastfeeding and formula feeding, along with social policies that facilitate more mothers to continue breastfeeding as recommended. The SNE is showing its true colors as a promoter of infant formula. Since mothers who (after getting correct information) choose to formula feed or are unable to breastfeed, are given appropriate teaching on safe preparation of formula, there is no adverse health outcome from this educational initiative. The only adverse effect is on the bottom lines of the formula manufacturers the SNE represents.

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