Tesco’s new infant feeding service draws criticism for ethical concerns

UK supermarket giant Tesco is being urged to drop an “unethical” pilot of an in-store infant feeding advice service in which midwives are expected to wear branded uniforms and undergo training by the formula company, reveals an exclusive news report published by The BMJ.

Critics say that the initiative, running in Tesco’s flagship store and set to be rolled out shortly, is a backward step and reminiscent of the “milk nurses” scandal of the 1970s, where formula industry salespeople dressed as nurses and promoted formula milk to parents.

One midwife hired by Danone quit the pilot last month at the Tesco store in Cheshunt, Hertfordshire, telling The BMJ she couldn’t be associated with an “unethical” service.

“Because of the history, I just don’t want to be associated with formula companies breaking the International Code of Marketing of Breast-Milk Substitutes. It’s unethical. That was the line I couldn’t cross—women trust me because I am a midwife,” she told The BMJ.

The code, adopted by the World Health Organization and Unicef in 1981, and as law in more than 100 countries, states that “marketing personnel” should avoid direct or indirect contact with “pregnant women or with mothers of infants and young children.” UK law covers some but not all the provisions of the code.

A spokesperson for Danone UK & Ireland said it only intended to provide “impartial, nutritional expertise,” that the branded uniforms were optional, and it was happy to “take on board feedback.” The company added, “We adhere fully to the WHO Code as implemented in UK regulations, and this trial is not in breach of that.”

A Tesco spokesperson explained that the pilot was intended to offer customers “additional support.” They said, “This complements the professional advice available from our pharmacists in-store. We comply with the UK Regulations governing infant and follow-on formula that cover some parts of the WHO Code.”

But Vicky Sibson, director of First Steps Nutrition Trust, a charity that promotes healthy eating in children up to five years, said that Danone was using a tried and tested marketing tactic.

“They’re not breaking UK laws, but they do break the International Code of Marketing of Breast-Milk substitutes, which clearly advises against marketing personnel seeking direct or indirect contact with pregnant women or mothers. The issue is that UK laws fall short of what they should be. Danone is using its baby club name and logo to promote its service, and so indirectly promoting its products,” she told The BMJ.

Sibson called on Tesco to end its partnership with Danone. “What we know is that most women in the UK want to breastfeed in some ways and this is an example where they undermine women’s self-efficacy to breastfeed. It is at odds with Tesco’s objectives around improving the healthfulness of their retail offer. It is time they took a better look at the baby food aisle.”

Robert Boyle at Imperial College London Healthcare NHS Trust, said formula companies had been behaving this way for centuries. He challenged Tesco to keep up the clinics “but remove Danone from the picture and allow midwives to use independent NHS information.”

The midwife who was involved in the pilot had no regrets about walking away from the job. “The bottom line is we’re making Danone look good, we’re increasing their revenue and product likability, when actually that’s not our role. As midwives, we should protect women and advocate for them.”

UK supermarket giant Tesco is being urged to drop an “unethical” pilot of an in-store infant feeding advice service in which midwives are expected to wear branded uniforms and undergo training by the formula company, reveals an exclusive news report published by The BMJ.

Critics say that the initiative, running in Tesco’s flagship store and set to be rolled out shortly, is a backward step and reminiscent of the “milk nurses” scandal of the 1970s, where formula industry salespeople dressed as nurses and promoted formula milk to parents.

One midwife hired by Danone quit the pilot last month at the Tesco store in Cheshunt, Hertfordshire, telling The BMJ she couldn’t be associated with an “unethical” service.

“Because of the history, I just don’t want to be associated with formula companies breaking the International Code of Marketing of Breast-Milk Substitutes. It’s unethical. That was the line I couldn’t cross—women trust me because I am a midwife,” she told The BMJ.

The code, adopted by the World Health Organization and Unicef in 1981, and as law in more than 100 countries, states that “marketing personnel” should avoid direct or indirect contact with “pregnant women or with mothers of infants and young children.” UK law covers some but not all the provisions of the code.

A spokesperson for Danone UK & Ireland said it only intended to provide “impartial, nutritional expertise,” that the branded uniforms were optional, and it was happy to “take on board feedback.” The company added, “We adhere fully to the WHO Code as implemented in UK regulations, and this trial is not in breach of that.”

A Tesco spokesperson explained that the pilot was intended to offer customers “additional support.” They said, “This complements the professional advice available from our pharmacists in-store. We comply with the UK Regulations governing infant and follow-on formula that cover some parts of the WHO Code.”

But Vicky Sibson, director of First Steps Nutrition Trust, a charity that promotes healthy eating in children up to five years, said that Danone was using a tried and tested marketing tactic.

“They’re not breaking UK laws, but they do break the International Code of Marketing of Breast-Milk substitutes, which clearly advises against marketing personnel seeking direct or indirect contact with pregnant women or mothers. The issue is that UK laws fall short of what they should be. Danone is using its baby club name and logo to promote its service, and so indirectly promoting its products,” she told The BMJ.

Sibson called on Tesco to end its partnership with Danone. “What we know is that most women in the UK want to breastfeed in some ways and this is an example where they undermine women’s self-efficacy to breastfeed. It is at odds with Tesco’s objectives around improving the healthfulness of their retail offer. It is time they took a better look at the baby food aisle.”

Robert Boyle at Imperial College London Healthcare NHS Trust, said formula companies had been behaving this way for centuries. He challenged Tesco to keep up the clinics “but remove Danone from the picture and allow midwives to use independent NHS information.”

The midwife who was involved in the pilot had no regrets about walking away from the job. “The bottom line is we’re making Danone look good, we’re increasing their revenue and product likability, when actually that’s not our role. As midwives, we should protect women and advocate for them.”