I agree that it would not be appropriate for dieticians to work for 
formula companies in either an educational or promotional aspect.  I was 
thinking of the need for HCPs to work for formula companies in an 
*advisory* aspect - i.e. on the research and development side of things, 
advising on nutrient quantity of formula.  It seems to me to be entirely 
ethical for appropriately qualified persons to do this - after all, the 
alternative is for formula to be produced *without* any advisory input 
from anyone qualified in infant nutrition, which doesn't strike me as a 
great idea.


Best wishes,

Dr Sarah Vaughan
MBChB MRCGP


On 10/05/2012 15:28, Renee Hefti wrote:
> In response to my concern, that it is a conflict of interest for a health professional (RD) to work for a formula company, Sarah Vaughan wrote:
>
> "Because the reality is that many babies, for whatever reason, are going
> to be fed either completely or partially on formula (and that this would
> be true even if we could magically make every hospital Baby Friendly and
> give every new mother full access to a properly-trained lactation
> consultant overnight) and that it is not going to help those babies if
> the people making the formula don't even have advice from someone
> trained in infant nutrition.  Let's keep working towards the day when
> barriers to breastfeeding are as few as possible and breastfeeding as
> widespread as possible... but let's not be so focused on that that we
> lose sight of the needs of the babies who get formula."
>
> I am not saying health professionals should not know what formula is made from, what is in it and how to instruct mothers to use it (if it is needed or is how the mother chooses to feed her baby).
>
>   The point I was trying to make is, that it appears many RD's say they promote and support breastfeeding  but know little about lactation or marketing.  When they work for industry they fall back on industry materials which, at this point in time, and until the companies comply with the International Code of Marketing of Breastmilk Substitutes, are frequently unscientific and designed to undermine breastfeeding. A health professional trained in infant nutrition, can mean a person trained only in formula use, instead of someone who can give unbiased information, so  mothers can make informed feeding decisions.
>
>   The Code of Ethics of the Academy of Nutrition and Dietetics states the RD: "considers the health, safety&  welfare of the public at all times" (how can they do this if they don't have unbiased information?).  The Code of Ethics also states the RD: "promotes or endorses specific goods or products only in a manner that is not false and misleading" and "does not engage in false or deceptive advertising of his or her services".  Again, it seems RD's are unwittingly, endorsing products and engaging in false and deceptive advertising (although I find it surprising that as a health professional today they don't seem to read the literature or the newspapers). These are only a few of the articles from the Academy's Code of Ethics which sound excellent except the formula companies, where RD's may be working, don't embrace the above attributes.
>
> We recently had an RD who worked for industry, (Nestle) teaching prenatal breastfeeding classes at the largest maternity in Canada.  She taught in Cantonese and Mandarin.  It was only when a mother showed the head of the education department the translation of the materials she had received that concerns were raised.  The materials stated, "Breast is best but ...." and that was the last mention of breastfeeding.
>
> How wonderful that we have a profession of people interested in health and diet but they need information about breastfeeding (which is what Angela is attempting to do).
>
> Renee (in Vancouver)
>
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