Nestlé and Danone under fire for infant formula allergy claims in Russia and China

17 Mar 2022 --- Despite a “growing consensus” in the scientific community that specialized infant formula cannot reduce risk of allergies, products with such claims are still found in different markets across the globe, a feature published in The BMJ has revealed.

EU, UK and US regulations have tightened the noose around companies, however the issue appears to be rampant in regions such as Russia and China. The report names Nestlé and Danone specifically for their practices.

“As a consequence, parents are unable to make informed decisions about what they are buying and risk being persuaded into paying a premium for products that don’t work as advertised. These over-marketed products also threaten breastfeeding,” Rebecca Coombes, head of journalism at The BMJ, tells NutritionInsight.

“For decades, the formula industry has claimed that certain breast milk substitutes can reduce the risk of allergies, but the science underlying these claims has been largely revealed to be fraudulent or flawed,” says author Melanie Newman.

“Yet today, Nestlé and Danone are still advertising those claims in some countries with high rates of acute malnutrition, morbidity and mortality, where how babies are fed is critically important.”The International Code on Marketing of Breast Milk Substitutes states there should be no promotion of any breast milk substitutes marketed for young children.

Delving into regulatory effects
In the UK and EU, new rules came into force in 2020 banning nutrition and health claims about infant formula. Though the rules are not as strict for follow-on formulas marketed for babies aged 6-12 months, manufacturers are now required to make a clearer distinction in labeling, presentation and marketing between these products and infant formulas.

Though in the UK the changes initially excluded hydrolyzed formula, new rules came into force last month, which require manufacturers to provide evidence that claims about reduced allergy risk have been: “scientifically evaluated by an authoritative or scientific body.”

A UK study last year revealed the overdiagnosis of Non-IgE-mediated cow’s milk allergy in children could be leading to unnecessary prescriptions of specialized formula milks.

Tougher regulations led to one case where Nestlé was prevented from claiming that a hydrolyzed product reduced the risk of eczema in infants with a family history of allergy, according to a scientific opinion by the European Food Safety Authority (EFSA). 

“These restrictions don’t apply in China, for example, where there are remarkably few restrictions on advertising,” Coombes explains. 

Danone emphasizes guideline compliance
“Cow’s milk protein allergy is a complex medical condition and Danone continues to conduct research with external partners in this field, a Danone spokesperson tells NutritionInsight.

“Many international guidelines have recommended using partially hydrolyzed formula to prevent cow’s milk allergy,” they continue.

“However, the science and understanding of how to reduce risk of allergies continues to evolve, while at the same time, regulations and guidelines in the EU relating to the use of partially hydrolyzed formulas will change this year. Danone will of course comply with these new guidelines and regulations.”

Nestlé has not responded to a request for comment. 

Questionable practices?
The report outlines that in China – the largest and the most rapidly growing formula market in the world –  Nestlé heavily promotes its Nan hypoallergenic infant-milk product as one that will reduce the risk of allergies.

In one example, the Chinese parenting website Babytree: “asked mothers to talk about using Nestlé’s partially hydrolyzed formula in exchange for prizes. Mothers talked about how the formula apparently treated their babies’ allergies and eczema.” 

Danone is also described as being “vigorous in its promotion of partially hydrolyzed formula for allergy prevention.”

The company’s 2018 policy for marketing breast milk substitutes outlines it will not advertise or promote infant or follow-on formula for children under 12 months of age in higher-risk countries such as Russia and Ukraine, Newman notes.

Nonetheless, Danone advertises Nutrilon 1 and 2 HA on women’s lifestyle websites in Ukraine. It also advertises its infant formula Nutrilon Hypoallergenic 1 with the tagline: “Helps to reduce the risk of allergies and in the development of the immune system” on the company’s Nutriclub.ru page on VK.com, a major Russian social network.

The Danone spokesperson tells NutritionInsight it is the first and – so far – only company not to advertise or promote formulas for children aged 0-6 months, anywhere in the world on any channel, digital or otherwise, even if permitted by local law. 

“We extend this restriction to 12 months in countries with high rates of acute malnutrition and infant mortality. We also carry out regular, independent audits of how our marketing policy is being implemented to ensure if we’re not getting something right, we correct it.”

Evidence used to support claims is exceptionally poor but presented in a way that is convincing, The BMJ says.

Buying influence: Journal takes position
Commenting on how companies have been promoting products that research has highlighted to be “fraudulent or flawed”, Coombes notes: “Formula milk manufacturing is a US$55 billion industry with deep pockets to buy influence at a governmental level but also in healthcare.”

As a result of The BMJ’s concern over “the substantial harms caused by the promotion of breastmilk substitutes and the biases introduced into research and clinical practice by industry influence,” the journal decided to stop carrying advertisements in 2018. 

This applies to The BMJ and other BMJ journals, including Gut, Frontline Gastroenterology and Archives of Diseases in Childhood. 

“We chose a complete ban because previous attempts to implement a due diligence approach have failed. It has led to a loss of an estimated £300 000 (US$400,000) in annual revenue.”

In 2019, Danone opened a €240 million (US$271 million) Nutricia Cuijk production facility in the Netherlands, aiming to tackle rising allergy rates. Industry has focused on allergy demands from consumers, also eying potential in the Chinese market.

By Andria Kades