RCPCH supplementary statement and FAQs on formula milk

This statement gives further details of the College's position on engaging with formula milk companies, including answers to some commonly asked questions.

On 13 February 2019, following a Council decision, the Royal College of Paediatrics and Child Health (RCPCH) declared in a statement that it would no longer accept any further funding from formula milk companies. It also reiterated the importance of promoting breastfeeding as the best possible method of infant feeding, and its strong support for the provision for advice and support for women, and national policies, practices and legislation that are conducive to breastfeeding.

Furthermore, it stated that in the case of babies who cannot breastfeed, specialist formula milks are crucial in protecting their health, and in many cases their lives. These milks are prescribed by paediatricians and can be vital for pre-term babies, young patients with allergies or gastrointestinal conditions and those whose mothers cannot breastfeed. It is for these reasons that the RCPCH seeks to continue to engage and work in partnership with formula milk companies with regards to specialist formula milks.

The RCPCH now wishes to clarify its position in relation to this engagement.

Direct payments from formula milk companies to the RCPCH will no longer be accepted. The RCPCH will maintain its due diligence process in respect of all corporate relationships, through which it will seek to influence formula milk companies’ marketing behaviours around the world and will continue regularly to engage with them in order to further improve communication and understanding. The RCPCH resolutely believes that through this engagement it will generate the best opportunity to improve the health and wellbeing of infants and young children.

The RCPCH recognises that the flow of “scientific and factual information” is a vital element in the provision of specialist milk to babies who need it, as acknowledged in the World Health Organisation Code of Marketing of Breastmilk Substitutes 1981, Article 7.2, and in the World Health Assembly Resolution 69.9 2016, Recommendation 6. It fully supports robust and scientifically rigorous education programmes and research which generate greater knowledge and further improve the science of specialist milk products.

The RCPCH respects the discretion of its partner organisations to exercise their independence to engage appropriately with formula milk companies and does not seek to influence their collaboration. The RCPCH will always recommend that its partner organisations reject any inappropriate marketing of formula milk products at their events or alongside their activities.

The funding of specialist formula milk research by a formula milk company which is carried out within an academic or clinical institution under its own due diligence arrangements, and from which is drawn the funding of salaries, including those of our members, is not in any way affected by this statement.

In line with the World Health Organisation Code, Article 7.5, the RCPCH believes that where conferences and meetings are delivering “scientific and factual information to assist [members] in ensuring optimal infant and young child feeding”, the appropriate funding of individual members to attend such meetings, openly declared by both parties, is acceptable, and is supportive of this. Any conflicts of interest should be declared. The RCPCH respects the right of each individual member to exercise their own discretion in deciding whether or not to accept such funding. 

The RCPCH strongly supports the provision of breast feeding whenever that is possible, agrees with the principles of the World Health Organisation Code and World Health Assembly Resolution 69.9, and encourages its partner organisations to follow these codes.

Frequently asked questions

Why has the College taken the decision to no longer accept funding from FMCs?

The RCPCH Council made the decision to no longer accept any funding from formula milk companies following ongoing discussions with members and our commitment to the WHO code of practice.

We have always strongly supported breastfeeding, the promotion of breastfeeding, the provision of advice and support for women, and national policies, practices, and legislation that are conducive to breastfeeding, and we will continue to do so.

For some babies who cannot breastfeed, specialist formula milks are crucial in protecting not only their health, but in many cases their life. These milks are prescribed by paediatricians and can be vital for young patients with allergies and gastrointestinal conditions.

It is for this reason that the RCPCH will seek to continue to engage and work in partnership with formula milk companies with regards to specialist formula milks. It was decided to continue this engagement into 2019 and beyond but without accepting any funding.

Can a doctor going to a College event accept formula milk company (FMC) money?

Any health professional can accept funding from FMCs to attend an event at which “scientific and factual information” is being shared. This is enshrined in the WHO Code Article 7.5.

Do you put financial limits on sponsorship by FMCs of other events which have RCPCH input?

The RCPCH will not support or be involved in events which receive sponsorship from FMCs.

Do the new rules apply to all FMCs?

Yes, they do. Currently the RCPCH has a business relationship only with Danone and Nestle, as they are FMCs that have been accepted under our due diligence procedures. We are not taking money from these companies, but will continue to engage and work in partnership with them with regards to specialist formula milks.

How does the new position affect your due diligence rules?

It does not affect the operation of the RCPCH’s due diligence process; this process applies to all commercial organisations with which the RCPCH has dealings, and will remain in place, including for FMCs.

What’s your position on RCPCH partner organisations engaging with FMCs?

It is up to individual organisations whether or not they accept money, or indeed engage, with FMCs. However, we hope that they will take note of the RCPCH’s position.

Will you review the position in a year's time?

The RCPCH will review its ongoing relationships with FMCs regularly, and certainly within a year, but it does not envisage reviewing the non-acceptance of direct payments from FMCs in the near future.   

How are you going to improve the marketing practices of FMCs if you no longer work with them?

Although the RCPCH will no longer accept direct payments from FMCs, it sees the future engagement of FMCs as a very necessary part of protecting the development of specialist formula milks. Through the due diligence process, there will be regular review meetings of the FMCs’ ongoing marketing practices through which the RCPCH will influence policy and decision-making within their organisations.   

Should the NHS stop taking FMC money?

In taking this recent decision, the RCPCH believes it is acting in the best interests of child health and the broad interests of its members. It cannot speak for others, but we hope that the NHS will take note of our latest statement and position.

If you have any further questions, please contact us on jonathan.miall@rcpch.ac.uk.