rose to move, That an humble Address be presented to Her Majesty praying that the regulations, laid before the House on 20 December 2007, be annulled.
The noble Baroness said: My Lords, I start by welcoming the Government’s commitment to increase the level of breastfeeding in this country by 2 per cent per annum, particularly among disadvantaged groups, as the benefits of breastfeeding, especially in the first six months, are beyond doubt. The issue today is the regulation of infant formula and follow-on formula, specifically SI 2007/3521, which gives effect to the relevant European Union directive. The directive updates requirements on the composition, advertising and labelling of infant formula products.
I have tabled the Prayer because these regulations do not go far enough to promote breastfeeding as best practice for new mothers. Broadly speaking, the statutory instrument will achieve four key measures: first, better labelling will clarify that follow-on formula should be used only by infants from six months of age, rather than four months as at present, and labels should promote breastfeeding; secondly, it restricts advertising and promotion of formula; thirdly, it stipulates the nutritional content of formula, which must be clear on the label, and says that the product must require only clean water to reconstitute the powder; and, fourthly, it ensures that formula exported to developing countries is of EU standards, although, sadly, a lack of universal clean water in those countries is often an infection source. However, the regulations do not go far enough.
The health benefits of breastfeeding are widely accepted. The World Health Organisation states: "““Breastfeeding is the ideal way of providing young infants with the nutrients they need for healthy growth and development””."
It says: "““We can now say with full confidence that breastfeeding reduces child mortality and has health benefits that extend into adulthood””."
Breastfeeding is clean and safe; breast milk contains antibodies that reduce the risk of acute infection, such as diarrhoea, pneumonia, ear infections, haemophilus influenzae, meningitis and urinary tract infection. Moreover, benefits carry on into later life, as breast milk confers some protection against allergies, diabetes and even ulcerative colitis.
The National Childbirth Trust has said that, "““all parents need reliable information on all the different methods of baby feeding—this information should be clear, accurate and based on research evidence, so that parents have the opportunity to make informed decisions””—"
and an informed decision must be free of commercial pressures.
Mothers, especially first-time mothers, need help and encouragement to breastfeed. They need preparation in antenatal care and a calm, supportive environment, with encouragement to maintain their own fluid intake as feeding is established. I recall having to justify carrying on breastfeeding in the face of comments such as, ““Are you sure the baby’s getting enough?””, ““Why don’t you give a bottle from time to time”” or ““You must be exhausted, breastfeeding””. I had to argue that I did not want to introduce solids at four months because of a strong family history of eczema. Sadly, I hear over and over again that such fights to breastfeed continue today.
We must improve the flow of information to women in pregnancy so that they realise that breastfeeding is easy, enjoyable and bonding and will help them to get their figure back quickly, too. It is the most natural and healthiest way in which to feed a child. Sadly, some mothers cannot breastfeed, but infant formula should be a fallback choice if breastfeeding is not right for them. Of course, such mothers must not feel stigmatised and safe formula products have been important for many women.
Those mothers need clear information on what is contained in formula products and how to prepare the formula safely. For example, current World Health Organisation guidelines recommend that the water used to mix the formula powder should be 70 degrees centigrade or higher to kill any bacteria and that the formula should then be allowed to cool. However, that information is not on labels, even though the WHO says that it is the single most effective step to reduce the risk of bacterial contamination and that contamination with Enterobacter sakazakii is found in some tins of formula, even before they are opened.
The Royal College of Midwives and the World Health Organisation support exclusive breastfeeding in the first six months without other solids or liquids. Although the NHS Information Centre’s most recent survey, from 2005, showed initial breastfeeding rates of 78 per cent, by six weeks breastfeeding rates had fallen to 48 per cent and by six months to 25 per cent. However, the figures for exclusive breastfeeding are worryingly lower, at 45 per cent at one week and 21 per cent at six weeks following delivery. The issue is not simply one of ceasing to promote formula; it is one of education and support. This study found that mothers who received advice, usually from the midwife, prior to the birth of the child, were more likely to breastfeed than those who had not received advice.
So what is wrong with these regulations? At first sight, they look excellent. The Baby Feeding Law Group and the Breastfeeding Coalition, which represents the views of 38 organisations, including five royal colleges, suggest that the regulations should also: ban all promotion of formula, both infant and follow-on; prohibit baby-feeding companies from seeking direct or indirect contact with pregnant women and mothers, including through company carelines; ban baby-feeding companies from setting sales targets and giving incentives to their employees; ban marketing complementary foods that could undermine breastfeeding; and prohibit formula gifts to healthcare workers.
The Royal College of Midwives has also called for the regulations to: prohibit the use of the image of a feeding bottle to indicate baby-changing areas in public places; ban the use of pictures of bottle-feeding babies in magazines that are aimed at pregnant women and new mothers; prohibit company-produced or company-sponsored material on infant feeding; and prohibit the promotion of names associated with breast-milk substitutes.
I call on the Minister to ensure that the Government make moves to adopt the suggestions and keep a close eye on the formula companies, as some have in the past found and exploited loopholes. There need to be clear distinctions between infant and follow-on formula products, so that companies cannot advertise by reverse association. Yes, I am calling for gold-plating of the EU regulations.
Interestingly, the companies that produce formula products claim that the timeframe to comply with the regulations is so short that they took a court injunction to stay the implementation date, which had been brought forward from January 2010, as originally planned, to 11 January 2008, although no other EU country has shortened the transitional arrangements. A judicial review is now scheduled, so it may be helpful for the Minister to clarify the English position.
The principle of these regulations is to be applauded. Infant-formula companies should not be allowed to undermine breastfeeding by heavily promoting their own products. It is an opportunity not to be missed. We have a chance to raise breastfeeding rates in this country, but these regulations need strengthening to achieve that. I beg to move.
Moved, That an humble Address be presented to Her Majesty praying that the regulations, laid before the House on 20 December 2007, be annulled.—(Baroness Finlay of Llandaff.)
Infant Formula and Follow-on Formula (England) Regulations 2007
Proceeding contribution from
Baroness Finlay of Llandaff
(Crossbench)
in the House of Lords on Monday, 18 February 2008.
It occurred during Debates on delegated legislation on Infant Formula and Follow-on Formula (England) Regulations 2007.
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699 c81-4 
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2007-08
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