1. The Consumer Council ("the Council") is pleased to provide views to the Taskforce on Hong Kong Code of Marketing of Breastmilk Substitutes, Department of Health ("DH") on the Hong Kong Code of Marketing and Quality of Formula Milk and Related Products, and Food Products for Infants & Young Children ("Hong Kong Code").
Mandatory Hong Kong Code by Legislation
2. In the interest of the healthy growth and development of infants and young children, the Council supports the Hong Kong Code which is based on the World Health Organisation's International Code of Marketing of Breast-milk Substitutes and subsequent relevant World Health Assembly resolutions, whilst taking into account the local situation.
3. However, the Council is concerned that the Hong Kong Code will only be implemented in the form of voluntary guidelines in tandem with a monitoring mechanism on un-named basis (that is, the names of companies violating the Hong Kong Code will not be disclosed). Its overall effect and impact are under question. The Council is of the view that compliance with the Hong Kong Code should be mandated by legislation. Resources should be provided for monitoring and to deal effectively with cases of non-compliance.
Product scope of the Hong Kong Code
4. The Council supports covering under the Hong Kong Code infant formula, follow-up formula and related products as well as foods for infants and young children up to the age of 36 months.
5. Nevertheless the Hong Kong Code prohibits the promotion of only formula milk and formula milk related products up to 3 years old. Advertising of follow-up formula, picky-eating formula, and food for infants and young children will still be allowed under the Hong Kong Code.
6. The Council considers that the marketing tactics of some suppliers of idealizing the use of follow-up formula, picky-eating formula, as well as related food products and promoting them as alternatives to a balanced diet are undesirable, as they will impact adversely on the feeding practice of parents and the dietary pattern of infants and young children. The Council therefore recommends extending the prohibition of promotion to cover not only formula milk and formula milk related products up to 3 years old but also other food products for infants and young children in Hong Kong.
Food labelling and marketing activities
7. For successful implementation and effective monitoring of the Hong Kong Code, the Council considers it acceptable for the Government to adopt a phased approach in implementation of the Hong Kong Code, for instance, providing for requirements on food labelling to be complied with for Phase 1 and regulation of food marketing for Phase 2. The Council notes that the Government has put forward some legislative proposals relating to formula products and foods intended for infants and young children under the age of 36 months. It may be necessary at a later stage to review where provisions in the Hong Kong Code may overlap with the proposed legislation and therefore trimmed down. In any event, the Council recommends that the Government should regulate exaggerated and misleading advertising and marketing claims and activities at the next stage very soon.
8. As far as labelling is concerned, whilst efforts should be made towards educating parents on reading labels of the relevant products, publicity on the benefits of breastfeeding to babies should be stepped up to promote wider adoption of the healthy mode of feeding.
Information and education of breastfeeding and formula milk feeding
9. The Hong Kong Code does not allow provision of information and / or education on breastfeeding and formula milk feeding and nutrition to the general public by the trade. The Council understands that DH and other professional bodies will produce these materials which can be obtained from DH's website, healthcare facilities and professionals. To ensure that the materials are easily accessible to parents and prospective parents, and that parents are only exposed to reliable and unbiased information, the Council is of the view that the Government should explore multiple dissemination channels so as to extend the reach of education.
10. There is also a need for the Government to strengthen the support for breastfeeding in the community. The lack of a mother-&-baby-friendly environment in many maternity units and child health care facilities, most workplaces and public areas at large poses challenge to breastfeeding. The Council recommends that the Government devises cross-departmental policies and measures to promote a mother-&-baby-friendly environment and atmosphere conducive to breastfeeding in Hong Kong.
Monitoring and approval of claims
11. The Council has from time to time raised concerns with the exaggerated and misleading advertising and marketing claims made by some formula milk suppliers (see for example a report published in issue # 421 of Choice magazine in November 2011).
12. The Hong Kong Code allows health claims to be made on follow-up formula and food for infants and young children provided that they are based on scientific substantiation and permitted by recognised international / national authorities. The Council considers that consumers may not be able to discern whether the claims made are indeed substantiated or permitted. As it is now proposed, the Centre for Food Safety (CFS) will be monitoring the labelling requirements and quality standards of formula milk and food products for infants and young children. The Council is of the view that CFS should also be tasked to examine the health claims at the same time that it monitors the labeling requirements. That is, when CFS looks to see whether the products are properly labeled during its surveillance and regular surveys, it takes the occasion to evaluate whether the health claims on the designated products (if any) are based on scientific substantiation.
13. The Council also considers that it will benefit both the industry and consumers if the Government could make accessible to the public information on health claims which are considered scientifically substantiated (a "white list" of health claims). Moreover, the Council urges the Government to consider whether the industry would be required to submit their health claims to the Government for comment or approval prior to making and / or labelling them in relation to the products introduced into the Hong Kong market.
The complaint form
14. The Council notes that the draft complaint form provides for complaint against marketing activities. It is not clear if there will be different complaint forms for different types of complaints. If the current draft form is designed for lodging complaints on all matters related to the Hong Kong Code, it is recommended that the complaint form should include relevant sections on Labelling and Quality by, for example, adding a box in the form for complaints on nutrition claims and health claims and leaving room for completion of particulars.
Regulation of marketing of unhealthy food to children
15. According to statistics by DH, the obesity rate of primary school students in Hong Kong increased from 15.9% in 1996/97 to 21.4% in 2010/11. That is to say, more than one in five primary school children in Hong Kong are obese. Evidence from WHO shows that advertising of food high in fat, sugar and salt has a direct effect on children wanting and eating these unhealthy foods which lead to obesity.
16. At present, there is no particular policy or local code on food marketing and advertising to children. In face of the rising trend of childhood obesity in Hong Kong, the Council proposes that in the long run, the Government should consider measures to regulate the marketing of unhealthy food to children, for example restricting all types of marketing of energy dense, nutrient poor foods that are high in fat, sugar or salt targeting children under 16 years old [1] .
Footnotes:
1. Consumers International's International Code on Marketing of Foods and Non-Alcoholic Beverages restricts all types of marketing of energy dense, nutrient poor foods that are high in fat, sugar or salt targeting children under 16 years old .
