Tesco, the UK supermarket behemoth, is under rising criticism for its experimental in-store infant feeding advice service, which involves Danone-funded midwives wearing branded uniforms and receiving formula industry training. According to an exclusive report published by The BMJ, opponents see this endeavour as a backward step, reminiscent of the 1970s "milk nurses" controversy, in which formula industry salespeople dressed up as nurses to push Formula Milk to parents. 

One Danone-hired midwife quit the pilot at Tesco's Cheshunt, Hertfordshire, store last month due to ethical concerns. "Because of the history, I simply do not want to be associated with formula companies that violate the International Code of Marketing of Breast-Milk Substitutes." It is unethical. "That was the line I couldn't cross: women trust me because I am a midwife," she told The BMJ.

In 1981, the World Health Organisation and UNICEF established the International Code of Marketing for Breastmilk Substitutes to protect breastfeeding from commercial pressures. It expressly stipulates that "marketing personnel" should avoid direct or indirect contact with pregnant women, as well as mothers of infants and young children. While more than 100 countries have adopted the code as national law, UK regulations fall short of completely adopting it. Despite this, the Tesco-Danone collaboration has raised major questions about corporate involvement in maternity healthcare. 

A representative for Danone UK & Ireland defended the programme, claiming it aimed to provide "impartial, nutritional expertise." They clarified that branded uniforms were optional and stated, "We fully comply with the WHO Code as implemented in UK regulations, and this trial does not violate that." Tesco also said that the experiment was meant to help customers even more than the expert advice they get from chemists in the store. This confirmed that the company was following UK law when it comes to marketing infant and follow-on formula. 

However, public health experts say that the effort exploits gaps in UK regulations that do not properly enforce WHO principles. Vicky Sibson, director of First Steps Nutrition Trust, criticised the approach, saying, "They're not breaking UK laws, but they are breaking the International Code of Marketing for Breast-Milk Substitutes, which clearly advises against marketing personnel seeking direct or indirect contact with pregnant women or mothers." The problem is that British laws fall short of what they should be. Danone uses its Infant Club name and logo to market its service, indirectly promoting its products. 

Sibson encouraged Tesco to cut links with Danone, pointing out that most UK mothers want to breastfeed but face several difficulties. Available data points out that though most UK women want to breastfeed, and this undermines their confidence in their ability to do so. It is incompatible with Tesco's goals of boosting the healthfulness of their retail offering. It's time they took a closer look at the infant food aisle. 

According to World Health Organisation research, aggressive formula marketing has a major impact on feeding decisions and frequently discourages breastfeeding. The Lancet's 2023 infant nutrition research found that formula industry strategies contribute to decreased breastfeeding rates, increasing the risk of childhood obesity, infections, and long-term health issues. According to WHO projections, universal breastfeeding might avert 823,000 child deaths and 20,000 maternal deaths per year. 

Robert Boyle, of the Imperial College London Healthcare NHS Trust, emphasised the historical durability of formula firms' marketing methods. He challenged Tesco to keep the clinics going while removing Danone's participation and allowing midwives to use independent NHS information instead. "Formula corporations have been operating in this manner for generations. Tesco should keep the clinics running but remove Danone from the picture and allow midwives to use impartial NHS information." 

The midwife who left the trial programme repeated her decision, claiming that the project largely benefitted Danone rather than women and infants. "The bottom line is that we are helping Danone appear positive by raising their revenue and product likability, which is not our duty. "As midwives, we should protect and advocate for women." 

The outcry over Tesco's pilot reflects persistent global worries about formula marketing methods. WHO and UNICEF have long cautioned that industry-led marketing discourages breastfeeding, particularly among vulnerable people. Their joint statement for 2022 asked for tighter regulation and enforcement, emphasising that formula marketing frequently incorporates deceptive health claims and direct involvement with mothers under the pretence of support services.