Britain's formula milk industry has faced down a new wave of criticism from senior paediatricians, who accused it of dodging a ban on direct advertising by snuggling up to doctors and health professionals.
Roger Clarke, director general of the Infant and Dietetic Foods Association, rejected claims from doctors that infant formula milk companies (IFMCs) were overstepping the line in their relationships with health workers.
"There is nothing wrong or shady in industry paying for paediatricians to get together with industry to discuss in a safe and sensible manner how infant formula can contribute to infant nutrition," he told DairyReporter.com.
Complaints from doctors captured mass media attention in the UK recently, adding fuel to the flames of a long-running debate on the ethical business practices of IFMCs.
Some studies have suggested that babies fed on formula milk rather than breast milk may have a higher risk of ill health in adulthood, and may have lower IQs.
IFMCs have been pouring money into support for paediatricians in the UK, according to an opinion article published by senior doctors in the Archives of Disease in Childhood journal.
"We paediatricians must learn to recognise the elaborate web woven around us by formula manufacturers, which currently ensures our goodwill and support for a product that we may acknowledge, but would mostly not wish to actively promote," said professor Charlotte Wright and Dr Tony Waterston in the article.
The pair criticised a culture of sponsorship and gift-giving, which, they claimed, meant doctors involved had a "subtly enhanced respect for that company and its products".
One formula firm, Cow & Gate, offered health workers £250 of Marks & Spencer shopping vouchers in a leaflet last autumn.
The view that paediatricians have got too close to IFMCs is, however, not shared by everyone in the medical profession.
Professor Lawrence Weaver, a colleague of Charlotte Wright, wrote in the same journal edition that safe alternatives to breast feeding could only be found if IFMCs and paediatricians collaborated.
Weaver said that, while breast feeding was best, it was vital to have safe infant milk formulas for mothers who chose not to breast feed and the small number of babies who could not be breast fed.
Still, Wright and Waterston argued that sponsorship from IFMCs, such as SMA Nutrition, Nestlé and Numico, added to the suppression of breast feeding rates through latent promotion of formula products.
Infant formula was prominent in helping sales of baby food, milk and drinks rise by 6.4 per cent in 2004 to reach almost £320m, according to the latest figures from market research group Mintel. It predicted a similar growth rate for 2005.
In the UK breast feeding rates have stagnated recently, despite government support and a ban, passed in 1995, on the direct advertising of formula milk products to consumers.
More than half of mothers and pregnant women questioned by the UK Department of Health last year claimed to have seen adverts for infant formula.
The World Health Organisation (WHO) advises mothers to breast feed their babies up to six months.
But, in last year's UK government survey, a third of British mothers with babies under six months said they used only infant formula, compared to 28 per cent who said they only breast fed. The survey predicted breastfeeding would rise, however.
The European Commission is set to vote on a new Directive for the formula milk industry this summer. It is likely to address, among other things, scientific developments over the last decade, product claims and the relationship between the industry and health workers.
The WHO has already established a code on marketing breast milk substitutes, which discourages advertising to the general public and financial inducements to promote products offered by manufacturers to health workers.