Feed Review into the provision of infant formula at food banks in the UK
Aware of rising numbers of families living in food poverty, and the associated risks to infants when families can’t afford formula, we undertook a comprehensive review of access to infant formula across the UK.
Our aim was to highlight any barriers or risks associated with the current practice and to provide evidence based recommendations for a way forward. The review highlighted a number of inadequacies with the current provision routes, inequity of access to formula for vulnerable groups, and difficulties faced by some third sector organisations due to inadequate guidelines. Together this has resulted in a post code lottery of infant formula provision across the country meaning some babies are going without.
Our recommendations pave the way to addressing the inequity faced by formula feeding families living in poverty in accessing formula for their babies.
Summary of findings
Food poverty is a serious issue and the incidence is rising across Scotland and the rest of the UK
The number of families experiencing food poverty has significantly increased over the course of the Covid-19 pandemic with households with children being the hardest hit.
Health & social care professionals are ideally placed to recognise need and should be facilitated to signpost families to the relevant support services.
Every infant has the right to good nutrition in accordance with the UN Convention on the Rights of a Child and all families accessing a food or baby bank should be treated with dignity and their nutritional needs met.
Infant formula provides the main, or sole source of nutrition for the majority of babies in Scotland
In Scotland only 72% of babies in the most deprived areas are formula fed. Infant formula is the only food formula fed babies can have for the first six months of their lives
First infant formula is expensive, costing up to £30 a week for an exclusively formula fed infant of around four months of age.
Families report being unable to afford sufficient formula and lack of direct access results in increased risk to the caregiver and the infant.
Inappropriate feeding practices have immediate, short term and long term health consequences, and increase the divide in socio-demographic health inequalities.
Specific groups are particularly vulnerable
Formula feeding families living in areas of greater deprivation.
Families who have no recourse to public funds cannot access many of the current routes of infant formula provision.
British HIV Association guidance recommends exclusive formula feeding as a means of preventing vertical transmission of HIV. However, many women living with HIV find themselves unable to access sufficient infant formula.
Infants with a drug using parent are at risk of separation from their parents. Kinship carers are frequently of low income with 72% reporting financial hardship due to undertaking caring roles.
UNICEF UK guidelines for food and baby banks recommend against direct provision of infant formula, thus creating barriers to access for babies in need of food
International guidelines and UK law allow for formula provision, yet UNICEF UK recommend food and baby banks do not provide formula for formula fed babies living in food poverty.
There is significant variation in the interpretation of these guidelines, resulting in friction between health and social care providers and third sector organisations, and a post code lottery with regards to formula provision.
The guidelines create inequality of access for families living in poverty in the UK and thus don’t safeguard formula fed babies in poverty.
The absence of safe guidance creates risk and result in a time delay in access ing formula for hungry babies.
The guidelines confuse the immediate need for food with a requirement for longer term infant feeding support or financial support.
The guidelines recommend monetary provision in an emergency but food banks aren’t set up for this & money introduces additional risk. It is unclear how monetary provision negates risk or meets the requirement for consistency of supply.
The guidelines do not state which stakeholders were consulted in their development to ensure they are fit for purpose and are not explicit regarding conflict of interest. UNICEF UK’s Baby Friendly Initiative states a primary aim of promoting and protecting breastfeeding, and accreditation involves a financial transaction.
Current pathways for emergency access to formula are inadequate
Many local authorities do not have a formula provision pathway, and of those who do, over 60% rely on referrals to food banks.
Suggested financial provision routes have limitations
Many food and baby banks do not have the infrastructure to provide cash, and there are concerns regarding monetary provision.
Healthy Start or Best Start voucher schemes are not enough to cover the cost of infant formula and applications can take weeks to process. Vouchers are only available to pregnant women, so Fathers or other caregivers are ineligible and the scheme is not open to families with No Recourse to Public Funds.
Additional emergency funding schemes - section 22, Scottish Welfare Fund and Scottish Child Payment - can take time to access, and are not open to everyone.
Food and baby banks are a vital source of infant formula for formula fed babies living in food poverty
Staff and volunteers can meet the immediate bneed for food alongside signposting families to relevant services for long term support.
Food and baby banks can provide first infant formula and NHS literature on safe formula feeding.
Maximising routes of access to infant formula is crucial for ensuring equity and minimising the delay in access to food for hungry babies.
Recommendations
1
The government must take immediate action to clarify the current law on the provision of infant formula from food and baby banks.
A public statement that, in accordance with UK law, food and baby banks can receive and provide first infant formula for formula fed babies. This would mitigate the current confusion and misinterpretation of current UNICEF UK guidelines by health boards, local authorities and other organisations.
2
Food and baby banks and other such services should accept and provide First Infant Formula to parents and carers of formula fed babies up to one year of age.
Food and baby banks should receive and provide only first infant formula for formula fed babies.
3
The Government must take immediate action to remove current barriers to formula access.
Support Local Authorities across Scotland to continue the important work they are doing in offering a flexible approach to infant formula provision that can fulfil immediate and emergency need. Address current barriers to formula access. Ensure provision schemes are fair for all and open to families with no recourse to public funds
4
The government must continue to invest in longer term solutions to child food poverty.
Increase the value of Best Start Foods for infants to cover the costs of infant formula Address lengthy waiting times for benefits and support payments. Open support schemes to families with no recourse to public funds.
5
Guidance should allow for safe direct provision of first infant formula for formula fed babies in need and ensure equity of access for all.
Guidance should ensure equity of access.• Ensure Scotland is in line with international guidance. Ensure guidance is fit for purpose and meets the needs of those for whom it is intended to support, including consultation of key stakeholders. Guidance issued and adopted must be free from, or should be explicit about, any potential conflict of interest and show consideration and adequate measures to counter these.
