BMJ Article Raises Concerns About Formula Sponsored Survey Circulated by Midwifery Journal
On 25 March 2026, The British Medical Journal published a news article after we raised concerns about an industry-led survey circulated to midwives and health visitors by the British Journal of Midwifery. The survey, sent out in February, was sponsored by SMA infant formula (owned by Nestlé) and included entry into a prize draw for £100 Amazon vouchers.
Dr Victoria Thomas, consultant paediatrician and co-chair of the Hospital Infant Feeding Network, said: “I do not think it is appropriate for a scientific journal to send out a survey such as this. It does constitute marketing, and I suspect the company is also trying to obtain additional marketing levers to use with professionals and consumers.”
While the survey states that breastfeeding is the best feeding option, all questions focused on formula feeding and infant gut health. One question asked respondents to rank SMA in comparison with four other formula brands, without the option to state that all are nutritionally equivalent. Dr Victoria Thomas said this was a “deeply misleading omission”, given NHS guidance that all infant formula sold in the UK is regulated to the same standards, regardless of brand or price.
Our senior nutritionist Katie was also quoted in the article: “This constitutes promotional marketing by the company to health professionals, a problematic practice that has been documented by researchers as a way for companies to create brand awareness, thereby influencing healthcare professionals to use and recommend their products.”
UK legislation and international guidance set clear limits on how infant formula companies can engage with health professionals, restricting this to factual and non-promotional information. These safeguards exist to protect breastfeeding and to help ensure that families receive clear, reliable advice that does not increase confusion or place unnecessary financial pressure on parents. Professional journals and organisations therefore play an important role in maintaining ethical standards in maternal and infant health.
The British Journal of Midwifery, which is published by the Mark Allen Group, has previously been criticised for accepting funding and sponsorship from infant formula companies in relation to professional events. Such arrangements create conflicts of interest, particularly where international guidance, including the World Health Organization International Code of Marketing of Breastmilk Substitutes, seeks to keep professional education separate from commercial influence. Clear boundaries are needed to support consistent, evidence based infant feeding practice.
Our advice: If you care about protecting infant feeding from commercialisation, we suggest you avoid this publisher, this journal and this survey.
We at First Steps Nutrition Trust act as secretariat for the Baby Feeding Law Group UK, which campaigns for stronger UK regulation of breastmilk substitute marketing in line with the Code and resolutions. Health professionals who want to ensure their practice aligns with the Code can find practical guidance in Unicef UK Baby Friendly’s ‘Guide to working within the International Code of Marketing of Breastmilk Substitutes’. In addition, comprehensive, independent information on all infant milks on the UK market can be accessed for free on our website, www.infantmilkinfo.org as an alternative to relying on company websites.