by Marion Nestle

Currently browsing posts about: Infant-formula

Aug 4 2022

USDA on the job: feeding kids

I’ve been trying to keep up with USDA press releases, especially those related to food assistance for children.   Here are a few from the last couple of weeks.

Effective July 1, 2022, the reimbursement schools receive for each meal served will increase by approximately $0.68 per free/reduced-price lunch and $0.32 per free/reduced price breakfast. Other reimbursement rates, including rates for paid school meals and child care meals, are available online.

With this comes:

II.  USDA Awards over $70 Million in Grants, Increases Access to Local, Healthy Foods for Kids, Jul 25, 2022  

The U.S. Department of Agriculture (USDA) announced it is awarding more than $10 million in Farm to School grants to 123 projects across the country…[these] will serve more than 3 million children at more than 5,000 schools in 44 states and the District of Columbia.

Grants by state are here.    Grant awardees with project descriptions are here.

III.  USDA Extends Flexibility that’s Helping Manufacturers, States get Formula to WIC Families Jul 28, 2022

Under this flexibility – which is now extended through the end of September – USDA is covering the added cost of non-contract formula to make it financially feasible for states to allow WIC participants to purchase alternate sizes, forms, or brands of infant formula.

This has to do with the infant formula shortage.  About half the infant formula in America is purchased by the WIC program, which usually contracts with one formula company to serve participants.  The USDA has relaxed restrictions on brands and imports to help deal with the shortages.  For example, it:

  • Provides a toolkit and guidance to WIC state agencies to assist with distributing imported formula.
  • Calls on states to take advantage of all available WIC flexibilities…Now, nearly all state agencies have applicable waivers in place.
  • Provides guidance to Child and Adult Care Food Program operators to help them navigate the shortage.
  • Provides an Infant Formula Shortage Response webpage

Cheers to USDA for taking action.  Action is what our kids deserve.

May 17 2022

Infant formula: what’s the shortage really about?

The White House says it is taking steps to alleviate the nationwide shortage of infant formula.

House speaker Nancy Pelosi has written a letter to democrats demanding action.

Nationwide shortage of infant formula?

As CBS News explained,

At retailers across the U.S., 40% of the top-selling baby formula products were out of stock as of the week ending April 24…Prices of baby formula, which three-quarters of babies in the U.S. receive within their first six months, have also spiked…Supply-chain snarls related to COVID-19 are contributing to the shortage of formula around the U.S. They include manufacturers having more difficulty procuring key ingredients, packaging hangups and labor shortages…In addition, a major baby formula recall in January exacerbated shortages.

I wrote about the Abbott recall earlier, on February 22 and March 8.

Politico’s Helena Bottemiller Evich has been following this story closely in Politico.  You can find her articles here.

Her writing is getting action.

For example, Representative Rosa deLauro released a whistleblower report warning about food safety concerns months before infants died and the FDA investigated.

Food safety lawyer Bill Marler posted a link to the redacted  whistleblower report.

He says: Mr. Abbott, you are going to jail for manufacturing tainted infant formula.

The legal jargon aside, if you are a producer of food and knowingly or not manufacturer and sell adulterated food, you can (and should) face fines and jail time.  For Abbott, at least 4 kids were sickened and of those two died, from drinking infant formula.

Here is the most recent inspection report at the plant – APPLIED – FOI II – BR Abbott Nutritions- FEI# 1815692 9-2021 EIR.

In the meantime, Bottemiller Evich keeps the focus on how hard this situation is for parents of infants with special nutritional needs.  She also has a Twitter thread on this “slow-moving train wreck.”  She reproduces this graphic from @erindataviz/@datasembly:

 

The Seattle Times has a particularly useful guide to what to do—and what not to do—if you can’t find the formula you need.

As to what this is really about, see:

The Morning.  This New York Times column attributes this particular shortage to general shortages, monopoly concentration in the formula business, bureaucratic inflexibility, and, most of all, American gerontocracy and overall indifference to the welfare of young children.

A blogger about the politics of monopoly, Matt Stoller, expands on these themes:  baby formula monopoly, FDA collusion, and USDA’s methods for dealing with infant formula in the WIC program (this last alone is reason to read this piece).  In response, the USDA says it is granting states flexibility in apply the WIC rules.

And the Cato Institute has an informative piece on trade restrictions that prevent import of formula from other countries, including the European Union; this pieces also discusses the WIC problem (Government is major buyer; Abbott is major supplier).

Comment: This is a really bad situation that is finally starting to get attention.  Babies are completely dependent on infant formula if they are not being breastfed.  It needs to contain all the right nutrients, but it also needs to be safe.

The FDA says it is taking steps to alleviate the formulat shortage.

Why hasn’t it acted more swiftly?  Perhaps because of what Bottemiller Evich wrote about previously?  See The FDA’s Food Failure.

Basically, we are seeing the results of unregulated monopolies and captured government.  With the most vulnerable members of society—and society’s future—at risk.

Additional links

Additional links that came later

Mar 8 2022

The Abbott infant formula recall: an update

I posted about this recall on February 22.

A quick review: The FDA is advising consumers not to use certain Abbott’s powdered formula products because they might be contaminated with  Cronobacter sakazakii or Salmonella Newport.

To date, one infant is ill with Salmonella Newport, and four ill with Cronobacter sakazakii with two deaths.

This is a shocking tragedy.  Formula-fed babies are entirely dependent on those products.  They are heavily regulated, or supposed to be.

The three powdered formula brands at issue are Similac, Alimentum, or EleCare.  The FDA says not to use them if:

  • the first two digits of the code are 22 through 37; and
  • the code on the container contains K8, SH or Z2; and
  • the expiration date is 4-1-2022 (APR 2022) or later.

Abbott’s recall announcement has more information about the specific products.

Politico’s Helena Bottemiller Evich is following this case closely.

She interviewed parents of children harmed, sometimes terribly, by consuming contaminated formula.

In an earlier report, she detailed the history of FDA’s inspections of the Abbott laboratory and the agency’s surprising delay in getting Abbott to do a “voluntary” recall.

Food safety lawyer Bill Marler also has questions about the quality of production and FDA’s surprising lack of action.

Fortunately, House Appropriations Chair Rosa DeLauro has called on the Department of Health and Human Services’ Inspector General to invesigate whether the FDA “took prompt, appropriate, and effective action” in this situation.

As for Abbott, its statement says:

The company said all of its finished products are tested for the pathogens before they’re released, and samples it retained tested negative for the infections related to the complaints.  “We value the trust parents place in us for high quality and safe nutrition and we’ll do whatever it takes to keep that trust and resolve this situation.”

I have my own question: Why isn’t there far more media attention to the formula recalls?  Babies’ lives are at stake.  Parents, understanably, are frantic.

What should they do?

  • Feed liquid formula.  It, at least, is sterile.
  • Scream for federal action (if enough people do, it might get some).
Mar 3 2022

Infant formula marketing: an update

As the WHO/UNICEF report I posted yesterday makes clear, the marketing of infant formula—impossible for new mothers to avoid—interferes with breast feeding and, therefore, is a public health concern.

I posted about the Abbott Labs infant formula recall last week.

Here are some additional items I’ve collected on this topic.

I.  What the marketing looks like.

II.  Study finds no benefit of enriched infant formula on later academic performance: Children who are given nutrient or supplement enriched formula milk as babies do not appear to have higher exam scores as adolescents than those fed with standard formula, suggests a study published by The BMJ, leading researchers to argue renewed regulation is needed to better control infant formula promotional claims…. Read more

III.  IBFAN, the International Baby Foods Action Network, writes that it is:

launching a PETITION calling for an immediate halt to a new study  –  funded by the Gates Foundation and led by researchers from the University of California – that is randomly allocating infant formula to breastfeed in low-birth-weight babies in Uganda and Guinea-Bissau on assumption that this might prevent wasting and stunting.

The study, which has been cleared by ethics committees in the USA, Uganda and Guinea -Bissau – uses purchased ready-to-use infant formula made by Abbott, a US pharmaceutical corporation operating in 160 countries.  Abbott is a major violator of the International Code and is currently at the centre of a media storm in the USA because of contamination in its powdered formula. (NB. The formula used in the trial is liquid Ready-to-Feed).

IV.  IBFAN issued an earlier statement: The baby food industry’s destruction of an irreplaceable natural resource.

The International Code of Marketing of Breastmilk Substitutes was adopted forty years ago by the World Health Assembly, the world’s highest health policy setting body…Today 70% of countries have adopted laws based on the Code, however far too many are limited in scope and full of loopholes as a result of industry interference. As a consequence predatory marketing of baby food products continues throughout the world.  and the global Baby Food Drink Market is forecast to rise more than 30% in 5 years (from $68bn in 2020 to $91.5bn by 2026)….Aside from its crucial role in child survival (more than 800,000 children die each year because they are not breastfed and many more do not reach their full potential, ­­ breastfeeding is the most environmentally friendly way to feed an infant, resulting in zero waste, minimal greenhouse gases, and negligible water footprint. As a renewable natural food resource, mother’s milk makes an important contribution to local food and water security.the baby food industry lost no time in exploiting the fear and confusion during the pandemic: falsely claiming their products build immunity; that their  ‘donations’ are humanitarian; encouraging the needless separation of mothers and babies and pretending that they are essential ‘partners’ who are genuinely working to address the problems.

V.  The Access to Nutrition Initiative (ATNI) assesses nine formula companies’ adherence to WHO recommendations.  Its report is here.

According to its press release,

Despite the World Health Assembly (WHA) adopting ‘The International Code of Marketing of Breast-milk Substitutes’ forty years ago and passing 18 associated resolutions since (collectively referred to as ‘The Code’), the BMS/CF Marketing Index 2021 found that none of the companies it assessed fully abides by The Code’s recommendations and most fall well short.

The summary: 

  • Danone retained first place with a score of 68%, up from its 2018 score of 46%
  • Nestlé, the market leader in sales value, retained its second place with a score of 57% – also a substantial improvement on its score of 45% in 2018
  • KraftHeinz achieved the greatest improvement, ranking third, with a score of 38% compared to in 2018 when it didn’t score at all
  • Reckitt (previously RB) substantially improved its BMS Marketing policies which led to a big jump in its score from 10% in 2018 to 32% in 2021 and climbing one place to fourth in the ranking.

VI.  A study: Conflicts of interest are harming maternal and child health: time for scientific journals to end relationships with manufacturers of breast-milk substitutes.  Pereira-Kotze C, et al.  BMJ Global Health. 2022 Feb;7(2):e008002. doi: 10.1136/bmjgh-2021-008002

The promotion and support of breastfeeding globally is thwarted by the USD $57 billion (and growing) formula industry that engages in overt and covert advertising and promotion as well as extensive political activity to foster policy environments conducive to market growth. This includes health professional financing and engagement through courses, e-learning platforms, sponsorship of conferences and health professional associations and advertising in medical/health journals…journal publishers may consciously, or unconsciously, favour corporations in ways that undermine scientific integrity and editorial independence—even perceived conflicts of interest may tarnish the reputation of scientists, organisations or corporations.  Such conflicts have plagued infant and young child nutrition science for decades.

Comment: As I mentioned yesterday, we now have more than enough evidence to put a stop to this.

Mar 2 2022

Marketing infant formula: an important report from WHO and UNICEF

WHO and UNICEF have issued a new report: “Examining the impact of formula milk marketing on infant feeding decisions and practices.”

The website summarizes the main message: “More than half of parents and pregnant women [are] exposed to aggressive formula milk marketing.

The report finds that industry marketing techniques include unregulated and invasive online targeting; sponsored advice networks and helplines; promotions and free gifts; and practices to influence training and recommendations among health workers. The messages that parents and health workers receive are often misleading, scientifically unsubstantiated, and violate the International Code of Marketing of Breast-milk Substitutes (the Code) – a landmark public health agreement passed by the World Health Assembly in 1981 to protect mothers from aggressive marketing practices by the baby food industry.

The press release explains:

The largest ever study of its kind, it draws on surveys with over 8 500 pregnant women and mothers of young children (aged 0-18 months) across eight countries, and more than 300 health professionals. The study…conducted in eight countries…exposes the aggressive marketing practices used by the formula milk industry, and highlights impacts on families’ decisions about how to feed their infants and young children.

The report begins with this prose poem:

The report’s main findings:

  1. Formula milk marketing is pervasive, personalized, and powerful.
  2. Formula milk companies use manipulative marketing tactics.
  3. Formula milk companies distort science and medicine.
  4. Industry systematically targets health professionals.
  5. Formula milk marketing undermines parents’ confidence in breastfeeding.
  6. Counter-measures can be effective.

Videos posted on Twitter.

  1.  Images of what you see
  2.  Misleading claims from the formula industry
For Infographics, scroll down on this link.
Comment: This is an important, timely report. Advocates have been complaining about the ways infant formula companies market their products for decades.  It’s way past time to intervene.
More on infant formula marketing tomorrow.
Feb 22 2022

Urgent! Recall of infant formula: check those product numbers now

The FDA is advising consumers not to use Similac, Alimentum, or EleCare powdered infant formulas if:

  • the first two digits of the code are 22 through 37; and
  • the code on the container contains K8, SH or Z2; and
  • the expiration date is 4-1-2022 (APR 2022) or later.

The FDA and CDC are investigating.

[They have received] four consumer complaints of infant illness…All of the cases are reported to have consumed powdered infant formula (IF) produced from Abbott Nutrition’s Sturgis, MI facility. These complaints include three reports of Cronobacter sakazakii infections and one report of Salmonella Newport infection in infants. All four cases related to these complaints were hospitalized and Cronobacter may have contributed to a death in one case.

Bill Marler’s Food Poison Journal has more about Cronobacter sakazakii (formerly known as Enterobacter sakazakii) in infant formula.

The FDA reports:

On 2/17/2022, Abbott Nutrition initiated a voluntary recall of certain powdered infant formulas. Products made at the Sturgis facility can be found across the United States and were likely exported to other countries as well. Canadian health officials have also issued a recall warning.

Helena Bottemiller Evich, writing in Politico, is right on top of this situation.

The FDA first received a report of a foodborne illness suspected to be linked to infant formula in September — four months before issuing a recall of three major brands this week after four babies were hospitalized and one died, according to a state agency.

The [recall]…comes after reports of illnesses came to FDA and the Centers for Disease Control and Prevention between September and January. The Minnesota Department of Health investigated a case of an infant who was sickened by Cronobacter sakazakii in September 2021, the state agency told POLITICO.

She also Tweeted:

I’ve gotten a bunch of reports that the formula recall includes these (often unsolicited) packs that formula companies send new parents. So check those, too!

Warning to parents: if you are using any Abbott formula products, check the labels.  Do not feed recalled products to your infant.

Comment: Anything wrong with infant formula is a terrible problem because that’s all infants are fed and they are completely dependent on those products.  We will have to wait and see why the FDA:

  • Did not push Abbott to recall these products four months ago.
  • Did not mention the gift pack of formula given to new mothers.

And Bill Marler writes: “I have some questions about the Cronobacter and Salmonella infant formula outbreak: Why are illnesses not universally reportable and why was there a two year gap in FDA inspections at plant?”

Also worrying is that the FDA still does not have the authority to demand immediate recalls of potentially harmful products.

The Food Safety Modernization Act gave the FDA recall authority, but tied its hands.

FSMA’s mandatory recall authority allows the FDA to mandate a recall when a responsible party chooses not to conduct a voluntary recall when the criteria under section 423 of the FD&C Act are met. The FDA can use its mandatory recall authority when the FDA determines that there is a reasonable probability that an article of food is adulterated under section 402 of the FD&C Act and/or misbranded under section 403(w) of the FD&C Act and where there is a reasonable probability that the use of or exposure to such food would cause SAHCODHA.

You will be amused to know that SAHCODHA stands for Serious Adverse Health Consequences or Death to Humans or Animals.

Oct 7 2021

Yes, you can make ice cream from infant formula and breast milk

Last week, I posted a list of articles about odd ice cream flavors, mostly Lithuanian.  Several readers pointed out that the links all went to the same article (oops, my bad).

They particularly wanted to see the ones about ice cream made from infant formula and breast milk.

Really?  People do this?  Yes, they do.

Especially in the UK.

If you are in the UK, you can buy commercial products, like one “made with love in the Lake District.”

Or you can make your own with breast milk or formula.  A company tried this in 2011, but got into trouble over safety issues.

It’s pretty easy to do this at home.

Have on hand:

  • A banana or other fruit, sliced.
  • 2 ounces of breast milk or formula.
  • A blender.

Freeze the fruit.

Aug 2 2021

Unethical food marketing ad of the week: infant formula, organic no less

When my partner, Mal Nesheim, showed me this ad in Sunday’s New York Times, I had two immediate questions.

Question #1: Who paid for this?

The answer: Bobbie’s Infant Formula “inspired by a mom’s choice.”

When I went to the website, I learned that Bobbie’s infant formula is organic.  I am greatly in favor of organics, but just as organic junk food is still junk food, organic infant formula is still infant formula.

Breast feeding isn’t easy in today’s society and yes, some mothers (and fathers, of course) can’t do it.

But breast feeding is unquestionably best for babies.  Mothers who can breast feed need all the help and encouragement they can get.

That’s why this week has been designated World Breastfeeding Week.

Breastfeeding mothers do not need to be undermined by infant formula marketing.

If Nestlé (no relation) or the other leading infant formula manufacturers put an ad like this in the paper, the result would be worldwide outrage.  This leads to my second question.

Question #2: Doesn’t this ad appear to violate the World Health Organization’s International Code of Marketing of Breast-milk Substitutes?

OK, so the ad does not display infant formula products or even say that Bobbie’s is an infant formula company, let alone an organic one.  But it doesn’t take much to figure both out.

Recall the Nestlé boycott of  the 1980s, a worldwide boycott of the company because of the way it marketed infant formula to women in low-resource countries without clean water supplies.  The women were unable to use the products safely; contaminated or improperly diluted infant formula sickened and killed babies.

Opposition to Nestlé’s marketing strategies led to development of Marketing Code, now ratified by all WHO member nations (the United States and South Africa were the two holdouts, but both eventually agreed).

The boycott was so damaging to Nestlé’s sales and reputation that the company discusses it and defends its current marketing practices on its website.

If you have any concerns about our breast milk substitutes marketing practices, we encourage you to raise them with us so that we can continue to improve.

I’d say this Bobbie ad is morally and ethically wrong on four counts:

  • It undermines breast feeding
  • It directly undermines the intent of World Breastfeeding Week.
  • It violates the spirit if not the letter of the International Marketing Code.
  • It organic washes—it implies that because its products are organic, this company is above the Code.

This is the kind of marketing that gives organics a bad name.

Bobbie’s should not be doing this.

Time for another boycott?