The motion was initially tabled by Charlotte Wright, professor of community child health at the University of Glasgow, and signed by 16 other paediatricians.
Put to a vote in the annual meeting, 66 delegates voted in favour of and 53 against the motion, which stated: “In order for RCPCH as a professional body to avoid institutional conflicts of interest and thus maintain its reputation as an unbiased, independent educator and advocate for child health, the College should decline any commercial transactions or any other kind of funding or support from all companies that market products within the scope of the [World Health Organisation (WHO)] Code on the marketing of breast milk substitutes.”
Professor Wright said by allowing formula firms to have stands at its conferences and clinical meetings, the UK professional body for paediatricians was selling access to doctors.
“[The College] is facilitating exposure of their paediatricians to the promotion of formula milk. I would never meet anyone from a formula milk company if I didn’t go to clinical meetings organised by the College,” she was quoted as saying in the British Medical Journal (BMJ).
“WHO has specifically advised that health practitioners should not meet with representatives of formula companies.”
One junior doctor told the meeting he was horrified to see infant formula giant Nestlé had a stand at a conference, something Wright told the BMJ had “moved” a lot of people in the audience.
What exactly this vote will mean will be considered at the next RCPCH council meeting in July, but Wright told us she was “confident” the RCPCH wanted to “do the right thing”.
RCPCH president and professor of neonatal medicine at Imperial College London, Neena Modi, said of the vote: “Breast feeding gives children the best start to life-long health. The RCPCH considers the promotion of formula over breast-feeding in healthy infants to be unacceptable.
“The RCPCH also recognises the importance of the availability of safe alternatives to breast feeding and specialised products for preterm and sick infants.”
Enough is enough?
Asked if such financial policies might jeopardise the College’s ability to do these conferences, professor Wright told us: “The income from these ties is actually very modest - less than 1% of college turnover - so there would be no question of not having college events as a result.”
RCPCH activities receive sponsorship for educational activities from formula manufacturers via trade stands and the College accepts “regular” funding from Mead Johnson and recently discussed funded collaborations with both Cow and Gate and Aptamil owner Danone and SMA nutrition owner Nestlé, according to the motion brief.
“While some individual clinicians work with FMMs [formula milk manufacturers] on valid product development, there is no need or justification for the body that publicly represents paediatricians to be linked to these companies, and a clear risk in terms of inappropriate influence,” said the motion document.
The composition and marketing of infant formula (0-6 months) and follow-on formula (6-12 months) is strictly controlled in the EU.
As such visitors to the 'Nestlé Baby' website are greeted with mandatory messaging about the superiority of breast milk over substitutes. "The World Health Organisation recommends exclusive breast feeding for the first 6 months and continued breast feeding thereafter for as long as possible. As babies grow at different rates, a health professional should advise you, on the appropriate time to introduce weaning foods to your baby. When introducing weaning foods, remember that they need to be suitable and safe to minimise risk to your baby’s health.
"The pages ahead and other subsequent communications we may have with you provide you with information on infant feeding and Nestlé products. If you continue, you will be accepting that Nestlé is supplying this information at your individual request. This is for information and educational purposes only and does not constitute advertising."
Nestlé: ‘We contribute to improvement of public health’
Responding to the final vote, a spokesperson for Nestlé told us all its activities were in “strict compliance” with UK laws as well as its own policy for the implementation of the WHO Code of Marketing of Breast-milk Substitutes.
The spokesperson added participation of health care professionals in these activities was voluntary.
“Nestlé contributes to the improvement of public health by providing access to scientific information and education for health professionals around the world. Events and activities with health care professionals only serve the purpose of disseminating scientific information.”
It said it would “adhere” to the decision of the RCPCH for future event participation or sponsorship.
A history of ‘breast is best’ pressure
Back in 2014 Nestlé sponsorship of a Scottish public health conference caused a stir among senior National Health Service (NHS) figures.
The Scottish Public Health Network – which brings together senior member of the UK's NHS – recommended the boycott of the conference because of the "decision, some would suggest error, in accepting sponsorship from a trans-national confectionery and breast milk substitute manufacturer”.
The boycott that led to the cancellation of the 'Building a Healthier, Fairer Scotland' conference was praised by so-called ‘breast is best’ group Baby Milk Action but lamented by the multinational and event organiser, which said the process had been aboveboard.
“Our intention was to promote the importance of breastfeeding and good nutrition throughout pregnancy and in early life, and ways of supporting parents with their feeding choices," Nestlé said at the time.
“We were not there to talk about any of our products and were open and transparent about our involvement throughout.”
Asked if she would consider such a boycott if July’s Committee meeting went against the motion, professor Wright said: “The problem with boycotts is that those who mind most lose all influence as they aren't there. If we had to do further campaigning it would be on the spot!”