Volume 4: The Southwood Working Party, 1988-89
10. Discussion
The baby food recommendation
Susceptibility of babies

10.42 What we have described as 'the baby food recommendation' is strictly a misnomer. The Working Party made no recommendation in respect of baby food; they dealt with it in the body of the Report, at paragraph 5.3.5. After observing that clinically affected cattle were being slaughtered and destroyed, they gave this advice:

We consider that manufacturers of baby foods should avoid the use of ruminant offal and thymus; the latter can currently be described on food labels as meat.

10.43 The Working Party's discussion in relation to the baby food recommendation was recorded by Dr Pickles as follows:

Research on offal in baby food was presented, including specimens in cans/jars. It appeared that, contrary to the impression given recently in the Guardian, a magazine article and a recently published book, if offal were included it would have to be labelled either as 'offal' or more specifically. However, these regulations permitted thymus to be included as 'meat' and this tissue is known to be infected in scrapie. However, it appeared the scrapie agent has also been isolated from liver and kidney, and unlike other offal these organs are often included in baby food. Since the evidence of risk was slight and indirect it was agreed that in the body of the report there was to be a remark that manufacturers should avoid offal and thymus in baby food and note that thymus can currently be described as meat, but there would be no direct comment about liver or kidney (which can also be labelled as 'meat', although specific labelling is more usual). No remarks about baby food were to be included in the summary. ¹

10.44 Neither this record nor the terms of the recommendation in the body of the Report made it plain whether it was the Working Party's wish to prevent or at least discourage the incorporation of liver and kidney in baby foods. As to this, Sir Richard told us:

. . . I think after the meeting was over, as was very customary, we would all rush away and look things up and discuss things, and we reached the conclusion that that bit about liver and kidney was erroneous. So I was able to advise the Chief Medical Officer that we were not concerned about liver and kidney. We were concerned about brain and lymphatic tissue. I remember making that point very much to the Minister when we met him subsequently. ²

10.45 Thus MAFF and Ministers were told that the Working Party had clarified this recommendation by explaining that they intended 'offal' to have the meaning ascribed to that term by the Meat Products and Spreadable Fish Products Regulations 1984: that is, brain, spinal cord and lymphoid tissue, but not liver and kidney. ³

10.46 The baby food recommendation shows that the Working Party considered that:

1. There was a possibility that certain tissues in cattle infected with BSE but not yet showing clinical symptoms of the disease ('subclinically infected animals') might be infective.
2. The tissues most likely to carry a risk of infectivity were those which had been shown experimentally to be infective in sheep infected with scrapie.
3. The risk was sufficient to justify attempting to prevent the incorporation of these tissues in baby food.
4. The appropriate means of doing this was advice to manufacturers in the body of the Report without any recommendation in the Summary.
5. Inferentially, oral ingestion of these tissues by humans other than babies did not pose sufficient risk to justify any precautionary measures. Labelling of products containing brain and spleen had already been expressly stated to be unjustified.

10.47 The possibility that tissues of subclinically infected animals might be infective was addressed both by the baby food recommendation and by the concern shown by the Working Party in relation to medicinal products of bovine origin. We consider that the Working Party are to be commended for identifying these tissues as a potential hazard. Experimental work in relation to scrapie had demonstrated a development of infectivity in certain tissues in sheep before clinical symptoms became apparent, and it was logical to anticipate that if BSE were transmissible to humans, the same tissues in cattle might prove infective. Our concern has been to explore, first, whether it was reasonable to conclude that babies might be particularly at risk of infection; second, whether it was reasonable to conclude that precautionary measures should be taken in relation to baby food rather than measures designed to protect all humans; and finally, and more generally, whether the Working Party was in a position to form a reliable conclusion as to which measures were appropriate to meet this risk.

Susceptibility of babies

10.48 On 24 March 1996, SEAC, at the request of the Government, considered whether susceptibility to the BSE agent was likely to be age-related. It had wide-ranging discussion of the changes in the physiology of the human gastrointestinal tract and host defences during life. It was assisted in these discussions by three leading experts covering the fields of paediatrics, gastroenterology, and infection and immunity. They considered what was known of TSEs in natural infections and animal model systems. They concluded that there were no data to support the suggestion that children were more likely to be susceptible to infection by the BSE agent than adults. ⁴

10.49 The Southwood Working Party, when considering baby food nearly seven years earlier, did not have the benefit of the knowledge that had accumulated by 1996 of TSEs in general and BSE in particular. They were addressing what seemed to be no more than an unlikely possibility that the BSE agent, whose nature was uncertain, might be transmissible to humans. They explained to us the factors that led them, in these circumstances, to conclude that there was an enhanced risk that BSE might be transmissible to babies as a result of the ingestion of baby food:

1. An article by Hadlow and others suggested to the Working Party that lambs exposed from birth were more readily infected with scrapie than lambs first exposed after weaning. ⁵
2. Wilesmith's epidemiological work had indicated that calves had an 'effective exposure' that was 30 times as high as that of adult cattle (see Annex, answer to question 7).
3. The Regulations permitted any part of the animal that was fit for human consumption to be incorporated in baby food.
4. Baby food was largely homogenised and might contain offal without this being apparent.
5. There are many infections to which the young are more susceptible than adults. Also infants have lesions in their gums which could provide an easier entry.
6. There had been a fashion, at least in the 1930s, to feed sheep brains to infants. ⁶

10.50 Bearing in mind the limitations of the scientific data available to the Southwood Working Party, their conclusion that the risk of infection by oral ingestion of food containing potentially infective bovine tissues might be greater in the case of babies than for the rest of the population was, in our view, reasonable.

10.51 When discussing this recommendation at the meeting with Mr John MacGregor on 14 February, Sir Richard commented that the likelihood of problems arising through the use of these products in baby food was very low indeed and the suggestion was a course of 'extreme prudence'. ⁷

10.52 The Working Party considered that the enhanced risk to babies was sufficient to justify advising the exclusion from manufactured baby food of potentially infective tissues. This contrasted with their attitude to the risk posed to humans other than babies from the ingestion of these tissues, which they considered to be so slight as not to justify any precautionary measures. We now turn to examinethe latter conclusion.