Nutrimum: new product, same old formula company tactics

This morning the First Steps Nutrition Trust newsletter hit my inbox (if you don't get this already I highly recommend it). They've issued a statement on nutrimum, a new product on the market that I'd heard about thanks to a Facebook post from Michael Walne at Your Nutrition Matters (who is busy writing evidence-based nutrition books for the Pinter and Martin Why It Matters series at the moment).

Nutrimum is a range of cereal bars and granola aimed at pregnant and breastfeeding women, made by Nutricia, owned by Danone, which makes Cow & Gate and Aptamil infant formula. The new products are currently available through Boots stores and are heavily marketed on the Boots website, with advertorials accompanied by 'buy now' prompts. The advertorials stress the importance of maternal nutrition during pregnancy and breastfeeding; the clear implication is that the nutrimum bars and cereals can form part of the healthy diet that is being discussed. Associating general nutrition information with specific products is a deliberate strategy. Marketing products that combine food
and supplements through a store such as Boots, which although it has dropped 'the chemist' from its name still has a reputation for selling pharmacy products, also helps to support the idea that these products are somehow 'scientific' or 'beneficial' (they aren't). Using partner organisations for 'reputation transfer' is a tactic often used by formula manufacturers: for example in 2013 Danone sponsored a 'Big Toddle' in aid of Barnardos to promote its Cow & Gate brand.

The First Steps Nutrition Trust statement on nutrimum explains how the products undermine public health by stating that women should stop taking other supplements (which will have been recommended to them by midwives or health visitors in accordance with current guidelines) while consuming the products. Folic acid (which is recommended for those who are planning a pregnancy and pregnant women) and vitamin D (recommended for all pregnant and breastfeeding women) supplements are widely available in supermarkets and pharmacies at low cost, or may be free on the Healthy Start scheme. The nutrimum products are expensive: the cereal bars cost £4.99 for five bars, or £1 a day. A large part of the cost of the product will go on marketing. (As with infant formula, the marketing is paid for by those who buy the product.) Equivalent vitamin D and folic acid supplements cost just pennies per day. The cereal bars and granola are highly processed and high in sugar; the main ingredient (listed first in the ingredients list) in the bars is glucose syrup (sugar). A crucial difference between granola/cereal bars and vitamin supplements is that the granola/bars are food - they will fill you up, and increase your blood sugar levels, potentially displacing more nutritious foods (vegetables, fruit, nuts, eggs, meat) in your diet. Tablets and liquid supplements do not have this effect.

When formula companies stress the importance of nutrition while breastfeeding, they do so in order to make breastfeeding seem difficult, expensive and inconvenient - an unachievable ideal. Mothers who doubt the quality of their breastmilk may turn to formula for 'reassurance' that their babies are getting all that they need. In reality there is little difference in the nutritional profile of breastmilk worldwide: mothers everywhere, despite wide variations in diet, produce milk that will nourish their babies and keep them healthy. A mother needs good food for her own health, not to support breastfeeding. Mothers in the UK (where nutrimum is marketed) have access to better, cheaper food than these highly processed cereal products that are high in sugar and expensive. As First Steps Nutrition say:

'Good nutrition from food is perfectly possible for pregnant and breastfeeding mums and we show how nutrient requirements can be met through simple, cost effective menu choices in practical eating well resources. The money spent on these supplements could be more wisely used buying fresh and minimally processed foods for the household.'

Formula companies target medical and health workers to promote their products. Perhaps the most disturbing part of the First Steps Nutrition statement on nutrimum is the section about how company representatives have contacted infant feeding coordinators and NHS staff. An email to an infant feeding coordinator in February 2015 states that the product is:

‘designed to meet all the nutritional requirements for mum during pregnancy…and that neonatal nurses are particularly interested in Nutrimum for breastfeeding mums with babies in special care baby units’

It's this that makes me actually want to scream. For the last few months I've been working on a short book about the politics of breastfeeding, and this type of contact with health professionals, implying that the product is beneficial for mums breastfeeding special care babies (for which there is certainly no evidence), is reminiscent of all the marketing abuses I've been writing about. That this isn't infant formula doesn't matter. These products offer no benefits, play on fears mothers have about their own and their babies' nutrition, and the profits will line the pockets of the world's second biggest baby milk manufacturer. Thank goodness for the work of First Steps Nutrition and other organisations like Baby Milk Action that scrutinise and monitor the companies. Do visit their websites and join or donate to support their work if you can. And if you work with mothers, tell them that these products are unnecessary, expensive and heavily marketed (and that if they buy them, they are paying for the marketing).

Exciting times...

My desk today.

I've not written as many blog posts as I'd like over the last few months. It's not for want of material - there's always plenty to comment on in the world of birth and breastfeeding - but other projects have been taking up most of my work time (which is squeezed in around the demands of the three small people in my house). But now, as the the pile of work on my desk grows ever higher, I can reveal what I've been up to.

I've done quite a bit of work for Pinter and Martin in the last couple of years, in my freelance editorial capacity - editing and proofreading some of their most recent titles. Earlier this year Martin Wagner asked me to go a step further and commission a new series of books: to be called the Why It Matters series. So I've been hard at work finding and talking to authors, finalising titles and overseeing the first few books in the series, and it's now starting to come together. A formal announcement, and new website, will be coming from Pinter and Martin very soon - but for the eagle-eyed the books are already listed (albeit without jackets) on both the Pinter and Martin site itself and other bookselling websites.

The first three books in the series are Why The Politics of Breastfeeding Matters by Gabrielle and Palmer and Susan Last (eek!), of which more below, Why Doulas Matter, by Maddie McMahon, and Why Hypnobirthing Matters, by Kat Berry; these will be published in March 2015. The next three, to be published in summer 2015, are Why Pre-conception and Pregnancy Nutrition Matters, by Michael Walne (of Your Nutrition Matters), Why Breastfeeding Matters, by Charlotte Young (aka The Analytical Armadillo) and Why Baby-Led Weaning Matters, by the pair of them working together. I am so excited to be working with all these wonderful authors, each one passionate about the vision of the series - to provide evidence-based, clear information that will genuinely help new parents, and anyone involved with them, to make properly informed decisions. More titles are planned for next autumn and beyond... watch this space!

The manuscript for one book has been delivered, the second is well advanced... and I find myself, as joint author of Why The Politics of Breastfeeding Matters, with Gabrielle Palmer, with a lot of work still to do on my own manuscript. In fact I've realised that I've been procrastinating about getting on with it and I've had to address a whole heap of doubts: about my ability as a writer/editor, about my time management skills and about whether I actually know enough to do justice to Gabrielle's work - it has been hard to buckle down. I hope I've turned a corner with it... let's see. It would be ironic if I failed to deliver my own manuscript on time, given that I've spent a good proportion of my career coaxing authors through the writing process! I need to take my own advice, I think, and just get on with it. Please feel free to nag me.

Another project I've been involved with is Laura Dodsworth's fabulous photograph/interview book Bare Reality - which you may have seen in the press or online as she ran a phenomenally successful Kickstarter campaign in September. I'm editing the text of the book and am delighted that Laura has actually now linked up with Pinter and Martin to publish and distribute the book - the jacket has just been announced and it looks amazing.

As if all of the above wasn't enough, I'm thrilled that Milli Hill's book Water Birth: stories to inspire and inform for my own tiny company, Lonely Scribe, has reached the proof stage and should be published very soon. It's been a long time since we started the project - and in the meantime she's set up the Positive Birth Movement, had a third baby and become a columnist for Best - but it's wonderful to finally be approaching publication. Here is a sneak peek of the jacket - watch out for news of when the book is published.