SINGAPORE – Infant formula firms will soon be barred from providing both financial and in-kind inducements to hospitals to promote their brands to mothers, under changes to guidelines that govern the sale of infant foods in Singapore.

While cash payments were already disallowed, sponsorships in the form of hospital dinner and dance functions, for example, have been highlighted as problematic.

Public hospitals that offer maternity services – KK Women’s and Children’s Hospital (KKH), National University Hospital and Singapore General Hospital – are already prohibited from entering into such arrangements with formula companies.

The new rules for formula companies are part of the revised code of ethics by a committee administered by the Health Promotion Board.

Making the announcement on Friday (Jan 11), Senior Minister of State for Health Amy Khor said that the scope of the code has been expanded to cover formula milk for infants aged up to 12 months, compared to six months previously.

More sponsorship restrictions have also been imposed as part of efforts to “reduce the reliance on infant formula by mothers”, Dr Khor said.

Formula milk companies will have a year’s grace period to abide by the revised code for their promotion and distribution practices. Adherence to the code is considered obligatory, though there are no penalties for breaching it.

The review comes two years after the rising prices of formula milk prompted the formation of a government task force to tackle the issue, such as by tightening regulations on labelling and advertising and facilitating imports of more affordable options.

A report by the Competition and Consumer Commission of Singapore released in May 2017 highlighted sponsorship and payment arrangements between manufacturers and private hospitals as “conflict of interest” deals that should be reviewed.

Examples included sponsoring conference and training course fees and materials as well as shuttle buses for staff.

In return, their brands would be offered as the default formula milk in maternity rooms for a longer period, giving them a leg up as parents tend not to switch after leaving the hospital, the report said.

Thomson Medical Centre said then that its suppliers paid for their brands to be part of the hospital’s monthly rotation, and that most of the money was channelled to support activities that benefit patients.

In response to queries from The Straits Times on Friday, a spokesman said that the hospital is “progressively reviewing our partnerships with all major milk companies” as part of its move towards becoming Baby-Friendly Hospital Initiative certified.

It procures ready-to-feed formula from all major milk suppliers on rotation for mothers who cannot breastfeed due to medical reasons, it said.

Raffles Hospital announced last year that it would stop accepting sponsorship agreements with formula milk companies and do more to support breastfeeding as part of plans to attain certification, awarded by the World Health Organisation and Unicef, by mid-2019.

It has not been accepting such sponsorships from milk companies since July 2017, it told ST on Friday.

Dr Chua Mei Chien, who heads KKH’s neonatology department, said that having stricter governance and greater transparency will help to prevent conflicts of interest between the formula companies and healthcare institutions.

The Singapore Infant Food Industry Self-Regulatory Committee, made up of the six major milk manufacturers here including Nestle and Abbott, welcomed the revisions to the code.

Its executive director Venetta Miranda told ST that the committee was heartened that a collaborative approach was taken in refreshing the code “whilst taking into account the national context and needs of mothers and infants in Singapore”.

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