My fellow listmother Karleen Gribble writes: "So a paper published in the International Breastfeeding Journal, funded by the company that owns Br Brown's is being used to market bottles in breach of the International Code of Marketing of Breastmilk Substitutes. How can this be?? How did this get past the reviewers?"

The study was published in the journal in 2008.  The marketing is happening now.  We know nothing about the ownership structures of Dr Brown's and Handi-Craft at the time, but even if Handi-Craft did own Dr Brown's then, the declaration of competing interests should be sufficient to satisfy reviewers that the research could be evaluated on its own merits. The authors' disclosure of competing interests at the time includes the information, published with the article, that Jimi Francis had "served as a resource regarding breastfeeding issues for Handi-craft Company" and the others declare no competing interests.  Further we can read that "the authors declare that none of them own stock or shares in any organization that could benefit from this study. Nor do any of the authors hold or are applying for any patents relating to the content of this manuscript."  Handi-Craft provided the grant to fund the research but it was carried out by scientists without a vested interest in the findings.  Can we ask for more transparency than that?  (Yes, we can ask that public, independent institutions act as stewards for research funding, so even this degree of competing interest would be unnecessary - but while we wait for that day, this is likely the best we can expect.)

Once an article is published, a company that stands to benefit from its findings would be foolish not to flaunt it.  I don't think there is any reason to criticize the reviewers in International Breastfeeding Journal.  They can not control who cites articles published in the journal, after the fact.  

I heard Jimi speak last year at a breastfeeding conference in England, a conference absolutely free of industry sponsorship with the exception of Blackwell Publishing.  She did not mention specific bottle brands or even obliquely refer to 'vented' bottles.  In fact, the emphasis of her talk was on the importance of keeping babies fed at the breast.  Her research shows that the more expressed milk comes in contact with air, the more the content of oxidation-labile nutrients is diminished.  This is something we should be informed and concerned about, especially in places where maternity leave has not progressed to the point of allowing mothers to breastfeed their children full time for more than a few weeks.  Like much research funded by Medela and research funded by formula industry, this research has relevance for us.  The reason that good journals require authors to disclose competing interests is so that in cases where the competing interests do not completely disqualify the research, the readers can judge the findings in light of those interests.  

If Jimi Francis has now become clinical director of Simplisse, I hope for her sake the financial compensation is enough to make up for the loss of respect any of her future research will get as long as that connection remains.  I could not find anything on the Simplisse site to show who is involved in the company.

Rachel Myr
Kristiansand, Norway

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