On 23th of September, 2019 the Ministry of Health publicised on their website the list of members of the new National Breastfeeding Commitee which should, according to the Minister of Health, „focus on ensuring quality care for new mothers, both in hospital and after leaving hospital“. [1]
We are on the whole glad that this new working group was established because we can see its potential to guide policy within the Ministry of Health towards necessary systemic changes, whether through the implementation of the 2018 Baby-friendly Hospital Initiative (incl. full implementation of the International Code of Marketing of Breast-milk Substitutes and relevant World Health Assembly resolutions), or in ensuring the availability of high quality post natal care for both woman and children after they leave the hospital.
As we made explicitly clear last week, however, in order for the National Breastfeeding Committee to carry out its role effectively, it must be free of any conflict of interest, either apparent or perceived. This, unfortunately is not the case.
MUDr. Anna Mydlilová was appointed vice-chairwoman of the commitee. As head of the National Lactation Centre (Národní laktační centrum) and the Lactation League (Laktační liga), she is in long-term conflict of interest. In that role she co-authored the brochure about the International Code of Marketing of Breastmilk Substitutes. She recently received financial support from Philips Avent, manufacturers of pacifiers and bottles, for Laktační liga’s periodical MAMITA [2], and the provision of refreshments during conferences and training sessions for lactation consultants [3]. In the past, she has accepted financial support from producers of breastmilk substitutes.[4]
In MUDr. Mydlilová, the National Breastfeeding Commitee has among its leadership the person who is responsible for the current state of the Baby-Friendly Hospital Initiative and responsible for the lack of control over the quality of care in hospitals carrying the Baby-Friendly Hospital Certification – of which only one achieved recertification. For over 8 years there have been serious doubts about the standard of breastfeeding assistance offered by hospitals carrying the Baby-Friendly Hospital Certificate.[5]
Also among the nominees to the committee is doc. MUDr. Jiří Bronský, Ph.D., who has established connections to Nestlé [6] and Nutricia – both producers of breastmilk substitutes – and in particular the Nutricia ‚1000 Days‘ initiative which according to the ICDC IBFAN “hijacked the UNICEF 1000 days initiative“. To this day, Doc. Bronský is a member of the management board of the endowment fund known as „1000 days into life“, which was founded by Nutricia.[8]
MUDr. Bohumil Procházka is similarly connected to the Nutricia 1000 days initiative and has also presented the publicly available Nutrition for Toddlers workshop that is also under the Nutricia banner. This places him, along with doc. Bronský, among the Czech doctors who actively cultivate the image of manufacturers of breastmilk substitutes as experts in infant health and nutrition, and enchance their credibility both within the medical community and the wider public.
A commitee established by what criteria?
It remains unclear how certain members of this working group were chosen, and what led to the omision of representatives from certain other groups. Particularly serious is the lack of actual care beneficiaries, who are the most integral to the whole discussion. Their views cannot be adequately substituted by the survey commisioned by the Ministry of Health. If the Ministry of Health is serious in wanting to improve the post natal care provided after leaving hospital, then the National Breastfeeding Commitee is missing front-line professionals, especially lactation consultants working outside hospitals, as well as infant nurses, community midwives and professional doulas.
The current composition of the National Breastfeeding Commitee is not adequately representative to fulfill the remit defined by the Ministry of Health. Added to this the conflict of interest present in at least three members, including the Vice-Chairwoman means that the committee cannot be relied upon to be beyond the influence of producers of breastmilk substitutes, feeding bottles and teats. It is for this reason that we call upon the Ministry of Health to revise the composition of the membership of the National Breastfeeding Commitee.
[1] Vojtěch, A.: 98% of woman think, that breastfeeding is important, Facebook, 23. 9. 2019.
[2] For example MAMITA, n. 68/2019.
[3] Statements of participants on conference that Laktační liga organized 30. May 2019 and fotodocumentation of Philips Avent stand on this conference. Philips Avent stand was also at conference for National Breastfeeding Week, 17. September 2019
[4] For example MAMITA, n. 34/2010, where you can find advertising from Philips Avent, Medela, Nestlé and Nutricia.
[5] Mrázková, J.: Zhodnocení fungování iniciativy Baby friendly hospital v ČR z pohledu andragoga, diplomová práce, Univerzita Jana Amose Komenského Praha, 2011.
[6] Nestlé Baby CZ/SK: Prvních 1000 dnů: doc.MUDr.Jiří Bronský, Ph.D., YouTube, available online: https://www.youtube.com/watch?v=sZSQkSjLKic.
[7] International Code Documentation Centre IBFAN: Breaking the Rules, Stretching the Rules: Evidence of violations of the International Code of Marketing of Breastmilk Substitutes and subsequent resolutions, compiled from June 2014 to June 2017, s. vii.
[8] Department (Ministry) of Justice: Extract from endowments register from 23. 9. 2019: 1000 dní do života, endowment fund, available on: https://or.justice.cz/ias/ui/rejstrik-firma.vysledky?subjektId=736053&typ=PLATNY.
[9] Iniciativa 1000 dní: Video Workshop „Výživa batolat“, available on: https://www.1000dni.cz/pro-pediatry/videa/.
[10] International Code Documentation Centre IBFAN: Breaking the Rules, Stretching the Rules: Evidence of violations of the International Code of Marketing of Breastmilk Substitutes and subsequent resolutions,compiled from June 2014 to June 2017, s. vii.
