Human milk products in the National Health Service: a cross-sectional survey of use and industry contact across England's trusts
Summary Objectives Commentators and professional organisations note that an expanding market in human milk-based products (HMBPs) could reduce breastfeeding, compromising maternal and infant health, and undermine public milk bank donations. We investigate whether English NHS trusts purchased these p...
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Published in | JRSM open Vol. 15; no. 5; p. 20542704241237658 |
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Main Authors | , |
Format | Journal Article |
Language | English |
Published |
London, England
SAGE Publications
01.05.2024
Sage Publications Ltd |
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Abstract | Summary
Objectives
Commentators and professional organisations note that an expanding market in human milk-based products (HMBPs) could reduce breastfeeding, compromising maternal and infant health, and undermine public milk bank donations. We investigate whether English NHS trusts purchased these products and whether HMBP companies have marketed to them.
Design
Freedom of Information (FOI) requests asking: (1) whether trusts obtained human milk; (2) if so, how; and (3) whether HMBP companies had approached them. We analysed trusts’ responses qualitatively. In 2023, an FOI request to the Food Standards Authority (FSA) following a product recall.
Setting
England.
Participants
One hundred and ninety-four NHS trusts, the FSA.
Main Outcome Measures
Obtaining human milk, approaches by companies, and trust responses to approaches.
Results
One hundred and seventy-six trusts responded, 102 reporting human milk from milk banks. No trusts reported purchasing from companies in 2022. In 2023, the FSA confirmed six English hospitals used HMBPs from one company; an FOI for trusts’ names was refused on law enforcement grounds. Two trusts reported participating in clinical trials funded by companies. Twenty-one reported approaches, using several strategies, including uninvited ward visits. Trusts rejected marketing based on guidance from: (1) trust dieticians or physicians; (2) regional regulatory bodies; (3) professional bodies; and (4) perceived application of an International Code on breastfeeding.
Conclusions
Companies market to trusts, adopting methods previously used by the formula industry. Trusts express confusion over whether this infringes agreements designed to promote breastfeeding. We encourage clarification and guidance for professionals and trusts to ensure safety, infant and maternal health, and protect public provision. |
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AbstractList | Summary Objectives Commentators and professional organisations note that an expanding market in human milk-based products (HMBPs) could reduce breastfeeding, compromising maternal and infant health, and undermine public milk bank donations. We investigate whether English NHS trusts purchased these products and whether HMBP companies have marketed to them. Design Freedom of Information (FOI) requests asking: (1) whether trusts obtained human milk; (2) if so, how; and (3) whether HMBP companies had approached them. We analysed trusts’ responses qualitatively. In 2023, an FOI request to the Food Standards Authority (FSA) following a product recall. Setting England. Participants One hundred and ninety-four NHS trusts, the FSA. Main Outcome Measures Obtaining human milk, approaches by companies, and trust responses to approaches. Results One hundred and seventy-six trusts responded, 102 reporting human milk from milk banks. No trusts reported purchasing from companies in 2022. In 2023, the FSA confirmed six English hospitals used HMBPs from one company; an FOI for trusts’ names was refused on law enforcement grounds. Two trusts reported participating in clinical trials funded by companies. Twenty-one reported approaches, using several strategies, including uninvited ward visits. Trusts rejected marketing based on guidance from: (1) trust dieticians or physicians; (2) regional regulatory bodies; (3) professional bodies; and (4) perceived application of an International Code on breastfeeding. Conclusions Companies market to trusts, adopting methods previously used by the formula industry. Trusts express confusion over whether this infringes agreements designed to promote breastfeeding. We encourage clarification and guidance for professionals and trusts to ensure safety, infant and maternal health, and protect public provision. Commentators and professional organisations note that an expanding market in human milk-based products (HMBPs) could reduce breastfeeding, compromising maternal and infant health, and undermine public milk bank donations. We investigate whether English NHS trusts purchased these products and whether HMBP companies have marketed to them. Freedom of Information (FOI) requests asking: (1) whether trusts obtained human milk; (2) if so, how; and (3) whether HMBP companies had approached them. We analysed trusts' responses qualitatively. In 2023, an FOI request to the Food Standards Authority (FSA) following a product recall. England. One hundred and ninety-four NHS trusts, the FSA. Obtaining human milk, approaches by companies, and trust responses to approaches. One hundred and seventy-six trusts responded, 102 reporting human milk from milk banks. No trusts reported purchasing from companies in 2022. In 2023, the FSA confirmed six English hospitals used HMBPs from one company; an FOI for trusts' names was refused on law enforcement grounds. Two trusts reported participating in clinical trials funded by companies. Twenty-one reported approaches, using several strategies, including uninvited ward visits. Trusts rejected marketing based on guidance from: (1) trust dieticians or physicians; (2) regional regulatory bodies; (3) professional bodies; and (4) perceived application of an International Code on breastfeeding. Companies market to trusts, adopting methods previously used by the formula industry. Trusts express confusion over whether this infringes agreements designed to promote breastfeeding. We encourage clarification and guidance for professionals and trusts to ensure safety, infant and maternal health, and protect public provision. Summary Objectives Commentators and professional organisations note that an expanding market in human milk-based products (HMBPs) could reduce breastfeeding, compromising maternal and infant health, and undermine public milk bank donations. We investigate whether English NHS trusts purchased these products and whether HMBP companies have marketed to them. Design Freedom of Information (FOI) requests asking: (1) whether trusts obtained human milk; (2) if so, how; and (3) whether HMBP companies had approached them. We analysed trusts’ responses qualitatively. In 2023, an FOI request to the Food Standards Authority (FSA) following a product recall. Setting England. Participants One hundred and ninety-four NHS trusts, the FSA. Main Outcome Measures Obtaining human milk, approaches by companies, and trust responses to approaches. Results One hundred and seventy-six trusts responded, 102 reporting human milk from milk banks. No trusts reported purchasing from companies in 2022. In 2023, the FSA confirmed six English hospitals used HMBPs from one company; an FOI for trusts’ names was refused on law enforcement grounds. Two trusts reported participating in clinical trials funded by companies. Twenty-one reported approaches, using several strategies, including uninvited ward visits. Trusts rejected marketing based on guidance from: (1) trust dieticians or physicians; (2) regional regulatory bodies; (3) professional bodies; and (4) perceived application of an International Code on breastfeeding. Conclusions Companies market to trusts, adopting methods previously used by the formula industry. Trusts express confusion over whether this infringes agreements designed to promote breastfeeding. We encourage clarification and guidance for professionals and trusts to ensure safety, infant and maternal health, and protect public provision. ObjectivesCommentators and professional organisations note that an expanding market in human milk-based products (HMBPs) could reduce breastfeeding, compromising maternal and infant health, and undermine public milk bank donations. We investigate whether English NHS trusts purchased these products and whether HMBP companies have marketed to them.DesignFreedom of Information (FOI) requests asking: (1) whether trusts obtained human milk; (2) if so, how; and (3) whether HMBP companies had approached them. We analysed trusts' responses qualitatively. In 2023, an FOI request to the Food Standards Authority (FSA) following a product recall.SettingEngland.ParticipantsOne hundred and ninety-four NHS trusts, the FSA.Main Outcome MeasuresObtaining human milk, approaches by companies, and trust responses to approaches.ResultsOne hundred and seventy-six trusts responded, 102 reporting human milk from milk banks. No trusts reported purchasing from companies in 2022. In 2023, the FSA confirmed six English hospitals used HMBPs from one company; an FOI for trusts' names was refused on law enforcement grounds. Two trusts reported participating in clinical trials funded by companies. Twenty-one reported approaches, using several strategies, including uninvited ward visits. Trusts rejected marketing based on guidance from: (1) trust dieticians or physicians; (2) regional regulatory bodies; (3) professional bodies; and (4) perceived application of an International Code on breastfeeding.ConclusionsCompanies market to trusts, adopting methods previously used by the formula industry. Trusts express confusion over whether this infringes agreements designed to promote breastfeeding. We encourage clarification and guidance for professionals and trusts to ensure safety, infant and maternal health, and protect public provision. |
Author | Steele, Sarah L. Cooke, Noah C.A. |
AuthorAffiliation | 5 Hughes Hall, 2152 University of Cambridge , Cambridge, UK 1 Health and Social Care, 2591 University of Essex , Colchester, UK 2 Cambridge Public Health, Forvie Site, 98947 University of Cambridge, Cambridge School of Clinical Medicine , Cambridge, UK 3 St Edmund's College, Cambridge, UK 4 Department of Social and Political Sciences, Bocconi University, Milan, Italy |
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Cites_doi | 10.1080/09692290.2020.1864757 10.1186/s13006-015-0034-9 10.1186/s12992-021-00708-1 10.1017/S136898001700307X 10.1108/IJHRH-07-2019-0058 10.1111/mcn.13310 10.1111/mcn.13097 |
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References | Newman, Nahman 2022; 29 Serôdio, McKee, Stuckler 2018; 21 Klotz, Wesołowska, Bertino 2022; 18 Baker, Santos, Neves 2021; 17 Steele, Hernández-Salazar 2020; 13 Smith 2015; 10 Baker, Russ, Kang 2021; 17 bibr9-20542704241237658 bibr11-20542704241237658 bibr21-20542704241237658 bibr14-20542704241237658 bibr24-20542704241237658 bibr27-20542704241237658 bibr4-20542704241237658 bibr17-20542704241237658 bibr1-20542704241237658 bibr7-20542704241237658 bibr8-20542704241237658 bibr15-20542704241237658 bibr18-20542704241237658 bibr25-20542704241237658 bibr28-20542704241237658 bibr5-20542704241237658 bibr22-20542704241237658 bibr12-20542704241237658 bibr2-20542704241237658 bibr23-20542704241237658 bibr10-20542704241237658 bibr29-20542704241237658 bibr3-20542704241237658 bibr30-20542704241237658 bibr19-20542704241237658 bibr20-20542704241237658 bibr26-20542704241237658 bibr13-20542704241237658 bibr6-20542704241237658 bibr16-20542704241237658 |
References_xml | – volume: 29 start-page: 1967 year: 2022 end-page: 1986 article-title: Nurture commodified? An investigation into commercial human milk supply chains publication-title: Rev Int Polit Econ contributor: fullname: Nahman – volume: 18 year: 2022 article-title: The legislative framework of donor human milk and human milk banking in Europe publication-title: Matern Child Nutr contributor: fullname: Bertino – volume: 10 year: 2015 article-title: Markets, breastfeeding and trade in mothers’ milk publication-title: Int Breastfeed J contributor: fullname: Smith – volume: 17 start-page: 58 year: 2021 article-title: Globalization, first-foods systems transformations and corporate power: a synthesis of literature and data on the market and political practices of the transnational baby food industry publication-title: Global Health contributor: fullname: Kang – volume: 17 year: 2021 article-title: First-food systems transformations and the ultra-processing of infant and young child diets: the determinants, dynamics and consequences of the global rise in commercial milk formula consumption publication-title: Matern Child Nutr contributor: fullname: Neves – volume: 21 start-page: 1594 year: 2018 end-page: 1607 article-title: Coca-Cola – a model of transparency in research partnerships? A network analysis of Coca-Cola's research funding (2008-2016) publication-title: Public Health Nutr contributor: fullname: Stuckler – volume: 13 start-page: 171 year: 2020 end-page: 183 article-title: A very lucrative liquid: the emerging trade in human milk as a form of reproductive exploitation and violence against women publication-title: Int J Hum Rights Healthc contributor: fullname: Hernández-Salazar – ident: bibr12-20542704241237658 – ident: bibr24-20542704241237658 – ident: bibr17-20542704241237658 – ident: bibr9-20542704241237658 – ident: bibr3-20542704241237658 doi: 10.1080/09692290.2020.1864757 – ident: bibr4-20542704241237658 doi: 10.1186/s13006-015-0034-9 – ident: bibr19-20542704241237658 – ident: bibr2-20542704241237658 – ident: bibr7-20542704241237658 – ident: bibr10-20542704241237658 – ident: bibr21-20542704241237658 doi: 10.1186/s12992-021-00708-1 – ident: bibr15-20542704241237658 – ident: bibr27-20542704241237658 doi: 10.1017/S136898001700307X – ident: bibr22-20542704241237658 – ident: bibr1-20542704241237658 doi: 10.1108/IJHRH-07-2019-0058 – ident: bibr5-20542704241237658 – ident: bibr11-20542704241237658 – ident: bibr20-20542704241237658 doi: 10.1111/mcn.13310 – ident: bibr13-20542704241237658 – ident: bibr18-20542704241237658 – ident: bibr25-20542704241237658 – ident: bibr26-20542704241237658 – ident: bibr29-20542704241237658 doi: 10.1111/mcn.13097 – ident: bibr30-20542704241237658 – ident: bibr6-20542704241237658 – ident: bibr14-20542704241237658 – ident: bibr8-20542704241237658 – ident: bibr23-20542704241237658 – ident: bibr28-20542704241237658 – ident: bibr16-20542704241237658 |
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Objectives
Commentators and professional organisations note that an expanding market in human milk-based products (HMBPs) could reduce breastfeeding,... Commentators and professional organisations note that an expanding market in human milk-based products (HMBPs) could reduce breastfeeding, compromising... Summary Objectives Commentators and professional organisations note that an expanding market in human milk-based products (HMBPs) could reduce breastfeeding,... ObjectivesCommentators and professional organisations note that an expanding market in human milk-based products (HMBPs) could reduce breastfeeding,... |
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SubjectTerms | Breastfeeding & lactation Donations Public services Research Paper |
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Title | Human milk products in the National Health Service: a cross-sectional survey of use and industry contact across England's trusts |
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