Nestle - Breaking the Rules 2001

Nestlé

Peter Brabeck-Letmathe
CEO
Nestlé S.A.
Avenue Nestlé 55
CH-1800 Vevey
Switzerland
Tel: +41 21 924 2111
Fax: +41 21 924 2813
Website: www.nestle.com

Products include:
Infant Formula
AL 110, Alfare, Alsoy, Alsoy 1, Beba 1, Bona, Good Start, Guigoz 1, Guigoz Nativa 1, Guigoz Nativa HA, Lactogen 1, Nan, Nan 1, Nan AR, Nan H.A.1, Nan HA, Nan Lactose-free, Nan Nativa 1, Nativa, Nativa 1, Nestogen, Nidal, Nidina 1, Nidina Confort, Nidina HA 1, Pelargon 1, Preguigoz, Prenan, Prenativa

Follow-up Formula
Alsoy 2, Beba 2, Carnation Follow Up, Guigoz 2, Guigoz Nativa 2, Lactogen 2, Nan HA 2, Nan 2, Nan Nativa 2, Nativa 2, Nestlé Follow-up Soy, Nidina HA 2, Nidina 2 Confort, Nidina 2, Pelargon 2

Complementary Foods
Baby Cereal, Carnation Baby Cereal, Cerelac (at least 5 varities), Cérévita, Guigoz Cereal, Guigoz Milk Cereal, Infant Cereal, Infant Milk Cereal, Nestum

Nestlé claims to be the world’s largest and most diversified food company, marketing its products “in nearly every country around the world”. In 1985, Nestlé acquired Carnation in an attempt to win a lucrative share of the market in the USA. More recently, Nestlé bought the Wyeth division of breastmilk substitutes in Canada. In its consumer and shareholder publications and in reports to WHO, Nestlé claims that it complies with the International Code “ethically and responsibly”.

After a two-year investigation, the UK Advertising Standards Authority ruled in 1999 against Nestlé’s claim of Code compliance made in 1996 in the Oxford Independent newspaper. In November 2000, the European Parliament began a series of public hearings to judge the activities of European businesses against international standards. Nestlé, one of two companies in the dock during the first hearing, was asked to present information on how it ensures its activities were in line with the Code and Resolutions. Nestlé refused to attend.

In 1995, Nestlé filed a Writ Petition in India challenging the constitutional validity of national legislation that implemented the International Code. Between August 1997 and January 2001, the hearing was adjourned 18 times, of which 14 times were at the request of Nestlé. Pending the outcome of this case, other legal cases against Nestlé for Code violations are stalled, while the company continues to reap profits using offending marketing techniques.

In 1999, Nestlé was one of seven companies found liable for anti-competitive behaviour in Italy. Its formula market share in Italy is approximately US$ 22 million. Legal action was taken against Nestlé in Costa Rica in 1999 for the company’s failure to heed the local authorities’ warnings to change its infant formula labels. Nestlé was fined and required to bring its labels in line with local laws implementing the International Code. In July 2000, the Brazilian Ministry of Health reported on its own monitoring of compliance with the Brazilian law (which implements the International Code). Nestlé was one of three companies cited for violating Brazil’s regulations.

There is an ongoing and active consumer boycott against Nestlé in 20 countries as it is responsible for more violations than any other company and takes the lead in attempting to undermine implementation of the Code and Resolutions by governments and other bodies.

Code violations by Nestlé are condensed into a table format because the sheer volume of violations reported would take too many pages. All countries involved in this survey reported evidence of Nestlé violations.

Promotion to the public: Some highlights

Promotion in health care facilities, supplies and promotion to health workers: Some highlights

Adequate labelling

Stretching the rules

Reports from other countries

Score card

Free sample and magazine sent direct to pregnant women and new mothers in Canada.

While Nestlé states that it believes breastmilk is best, it still idealises breastmilk substitutes, for example, it includes a statement in its promotional material that idealises Alsoy, “…if you choose to use formula and your doctor recommends soy, you can feel good about Nestlé Carnation Alsoy…Alsoy provides babies with complete nutrition for the first year of life. Which makes Alsoy an ideal milk-free and lactose-free formula choice to help bring out the very best in your baby”. (emphasis added).

Promotion to the public: Some highlights

Nestlé provides shops with discounts, gifts and supplies of more products when the shops make cash purchases, sell greater volumes of their products, launch a new product or provide better shelf space than other products. Examples include rewards for the sale of Nan in Bolivia, Guigoz and Nativa in Côte d’Ivoire, Nan in Taiwan, and Bona in Russia.
Promotion of all Nestlé Infant Foods is found on advertisements with the new Blue Bear logo on road signs and billboards in a Mexican village near Xalapa.
Nestlé uses a variety of other Code-violating techniques to promote its products (many of which appear on Table I): discounts, special displays, coupons, samples, gifts with purchase, posters, special sales and tie-in sales.
A recent Internet ad, “brought to you by Nestlé Carnation Baby Formulas”, offers the winner of Nestlé New Mom Sweepstakes, a shopping binge, fancy dinner, as well as “three months supply of Nestlé Carnation Baby Formulas”. If the potential lucky mother happens to be breastfeeding, she is still encouraged to enter her email address because, instead of formula, she could get the “cash equivalent” (http://nbci.promotions.com/makeover/index.html). Seems generous? This marketing ploy not only advertises formula, but it “seeks direct contact with mothers of young children”, both forbidden by the Code.


Nestlé’s Blue Bear logo on billboards (above) and road signs (below) in a Mexican village near Xalapa.
Blue Bear on coupon.	Blue Bear in Canada.

I. Summary of Nestlé promotion to the public
Countries	Promotion in Shops	Other Forms of Promotion
Bolivia	Discounts for Pre-Nan (IF), Nan (IF), Cerelac (CF); leaflets on Alsoy (IF)	Direct contact with mothers at home to give information about infant feeding.
Canada	Publicity, discounts, tie-in sales for Good Start (IF)	Good Start (IF) samples and gift packs by mail and at baby shows; Good Start magazine sent by mail to parents; leaflet sent by mail advises mothers to “start solids when it seems breasts are empty after breastfeeding”.
Côte d’Ivoire	Special sales of Cerelac (CF); Posters for Nan (IF) and Nativa (IF); Special displays for Nan (IF), Nativa 1 (IF) and Guigoz (IF), Cerelac (CF); Gifts* in pharmacies	Company reps contact mothers at home to give samples of Nativa (IF), Cerelac (CF).
Ghana	Illuminated sign for Cerelac (CF) with shop name and another shopfront painted with Cerelac promotion.	Cerelac (CF) advertised on TV.
Hong Kong	Discounts for Nan HA (IF)	Baby clubs; magazine ad for Nan HA (IF), “For Baby’s sake, count his allergy score”
Italy	Discounts for Alsoy (IF), Guigoz (IF), Nan HA (IF), Nativa (IF), Nidina (IF) and gifts* with purchase of cereals.	Nestlé Cereal (CF) sample in a magazine.
Malaysia	Shelf talkers for Nestlé Cereal (CF); discounts with purchases of products .	Nestlé Rice cereal ad for babies from four months in national daily The Star.
Mexico	Promoters advise about infant feeding and Nan (IF), Nan 2 (FF), Bebe Menu (CF), Infant Cereal (CF); Gifts; Discounts for Pre-Nan* (IF), Nan Sin Lactosa (IF), Nan 2 (FF)	An ad for Nestlé Infant Foods reads “se busca …para ser el bebe Nestlé” (Looking for …the Nestlé baby). Another ad was in the magazine Mi Bebe y Yo
Russia	Nan (IF) and Bona (IF) publicity on infant feeding; discounts for Bona (IF).	Infant Milk Cereals (CF) at city registry office when registering newborn.
Taiwan	Samples of Nan (IF), Baby Rice cereal (CF).	Nestlé Cereals (CF) and towels by mail.
Togo	Guigoz (IF) and Cerelac (CF) publicity materials.	Advertisements in Parents and Enfant for several products.
The UAE	Shelf-talkers; Publicity titled, “Natural Way to Baby Health” , for Cerelac (CF)	Advertising by mail: “The Carnation Baby” and Carnation Alsoy (IF) advertised in parenting magazines.
The USA	Discounts for Good Start (IF)	Good Start (IF) by mail; Nestlé magazine and website, “The Very Best Baby”, promote Good Start (IF); website links from doctors’ websites.

* Gifts include: baby record booklets, bibs, bottles, calendars, placemats, plates, spoons and stickers.
IF: Infant formula
FF: Follow-up Formula
CF: Complementary food

Blue Bear in Hong Kong.
Blue Bear and coupon for sample in Singapore.	Are these hearts in the right place?

Promotion in health care facilities, supplies and promotion to health workers: Some highlights

Nan 1 ready-to-feed sample.

Nestlé Booklet in Russia: advice on feeding.

In Bolivia, Nestlé distributes to health workers information about Nan and Alsoy that does not comply with the Code.
In Côte d’Ivoire, Nestlé reps donate samples of Guigoz, Nativa and Cerelac to health workers weekly or every two weeks. They claim the samples are for evaluation purposes, but there are no records of protocols, and most of these samples are passed on to mothers.
In Mexico, Nestlé donates drapes for baby cots.
In Mexico and Malaysia, Nestlé gives health care workers diaries showing pack shots of Nan.
In Côte d’Ivoire, the Guigoz brand name is on donated pens.
A glossy brochure in Togo promotes five varieties of Cerelac with pack shots and Blue bear graphics. It asks “Why not give the Cerelac advantage to babies?” This attractive brochure is “exclusively for the medical profession” but addresses mothers directly in the preparation instructions.
Nutritionists in Côte d’Ivoire receive Cérévita prescription sheets. A Cérévita factsheet calls the product a weaning food for use as of the fourth month. There is no mention of breastfeeding or any required warnings.
Other gifts given to health care workers in all regions include calendars, cups, torches, penholders and chocolates.
Nestlé also donates growth charts in Russia (showing Nestlé logo) and pens in the UAE (with Cerelac brand name) and equipment such as a scale in Côte d’Ivoire and a cordless telephone in Italy.
Nestlé reps give samples of products to health workers across the regions. None were found to be for scientific research or evaluation, and health workers pass them on to mothers. Brands distributed are listed in Table II.
Information to health workers in Côte d’Ivoire praises Nan-Nativa as “the best alternative” and states that Nativa 1 and Nativa 2 contain “micronutrients needed by the baby but which the human body cannot produce”, thereby, seemingly stressing the superiority of formula over breastmilk.
On a Cerelac leaflet for mothers in Côte d’Ivoire, it says: “… between 4-6 months, neither breastmilk nor infant formula are sufficient to cover (the baby’s) needs…” It urges mothers “not to start complementary foods too late”!

Free Nan supplies in the UAE.

The Internet is the new medium for promotion. Nestlé has a sponsorship agreement with Medem, a for-profit Internet service with financial backing from the American Academy of Paediatrics and other major physician groups. Patients who access educational sites and physicians’ homepages find links to Nestlé’s Carnation infant formula site. While physicians can sign up for a non-sponsored site, only 1% choose to pay the US$ 30 per month fee for a site without promotion links.

II. Summary of Nestlé promotion in health care facilities; free supplies, and promotion to health workers
Countries	Promotion in health facilities	Free or low-cost supplies	Promotion to health workers
Bolivia	Samples of Alsoy (IF), Cerelac (CF), leaflets on Cerelac (CF), posters, leaflets on Alsoy (IF), gifts*	Nan (IF)	Samples of Nan (IF), Lactogen (IF), Nestogen (CF)
Canada	Leaflets “Join the Good Start Programme”, “New Mom’s Bonus Club”	Good Start (IF), Alsoy (IF), Baby Cereal (CF)
Côte d’Ivoire	Company reps contact mothers in health facilities to promote products, give gifts, Nativa* (IF), Guigoz (IF) and Cerelac (CF) samples and leaflets.	Prenativa (IF), Guigoz (IF), Preguigoz (IF), Nativa (IF), Cerelac (CF)	Samples of Nativa (IF), Guigoz (IF), Preguigoz (IF), Prenativa (IF), Cerelac (CF), Nestlé Legumes (CF)
Ghana	Breastfeeding poster with Nestlé logo, poster with Cerelac (CF) on “Prevention of Home Accidents”
Hong Kong	Nan 1 (IF) and cereal samples, gift packs by company reps, leaflets on Nan HA 1 (IF), Nan 2 (IF), and Infant Cereals (CF)	Nan (IF), Nan HA (IF)
Italy	Nestlé calendars, clocks and posters (Guigoz)	Alfare (IF), Nestlé Infant Milk Cereal (CF)	Samples of Nidina 2 (FF), Nidina HA 2 (FF), Pelargon 2 (FF), Alsoy 2 (FF), Nestlé Milk Cereal (CF)
Malaysia	Nan (IF), Nestum (CF) samples, Nestlé height charts	Nan (IF), Nestlé Rice Cereal (CF)	Samples of Nestlé Rice (CF)
Mexico	Nestlé infant development chart, samples of Al 110 (IF), Nan (IF), Nestum (CF), leaflets on Nan HA & Alfare (IF)	Alfare (IF), Nan HA (IF), Nan Lactose-free (IF), Pre-Nan (IF)	Samples of Nan (IF), Nan 2 (FF), Nestum (CF) Diary 2000 promotes all products
Russia	Leaflet for Bona (IF), “Infant Nutrition for the First Year of Life”, Nestlé calendars		Samples of Nestogen (IF)
Taiwan	Gifts, samples of Nan* (IF)	Nan (IF)	Leaflet on Nan 1 “Nan 1* is a complete food”*
The UAE	Nestlé posters, clocks, height charts, samples of Nan (IF), Cerelac (CF)	Pre-Nan (IF), Nan (IF), Cerelac (CF)	Samples of Cerelac (CF)
The USA	Samples of Good Start (IF)	Good Start (IF)	Samples of Good Start (IF)
Uruguay	Nestum (CF) on Nestlé calendar

* Gifts include: baby record booklets, bibs, bottles, calendars, placemats, plates, spoons and stickers.
IF: Infant formula
FF: Follow-up Formula
CF: Complementary food

So doctors remember Cerelac.

Adequate labelling

Editorial note: Nestlé’s interpretation of the Code differs from the way UNICEF, the World Health Assembly and IBFAN interpret it. The following remarks may help to better understand the debate over interpretation.

Nestlé says the Code applies only to infant formula. The company has certainly improved on its infant formula labels in many countries but not in North America and Europe. There are occasional direct imports from these regions into developing countries and monitors have caught some of these differences. This underlines the need for universality in Code compliance. The Labelling table shows complaints about claims on labels which all imply equivalence or proximity to breastmilk, thereby minimising the obligatory ‘Breast is Best’ message.

The Code itself is silent on labelling requirements for follow-on milks simply because in 1981 such formulas hardly existed. By 1986, however, the World Health Assembly stressed that “the practice being introduced in some countries of providing infants with specially formulated milks (so-called follow-up milks) is not necessary”. Other WHA Resolutions have underlined the importance of sustained breastfeeding and it is clear that any milk product marketed to replace breastfeeding is a breastmilk substitute. Nestlé tries to exempt follow-on formulae from the Code but its own Instructions for Code Implementation stress that “follow-up formulae which have the same brand name as starter formula (e.g. Nan 1 and Nan 2) … are subject to the same marketing restrictions as starter formula”. All European Union laws and most other national regulations include both classes of formulae.

Many labelling complaints in this survey are about complementary foods such as cereal products and formula thickeners. These products become breastmilk substitutes when they are labelled and promoted for use under six months. Exclusive breastfeeding is recommended as the optimal way to nourish infants. The World Health Assembly in 1994 stressed there should be “…appropriate complementary feeding practices from the age of about 6 months’. The Assembly also states that “any food or drink given before complementary feeding is nutritionally required… should not be promoted” (WHA 1986). They may be sold but should not be advertised, given as samples or promoted in any other way.

Nestlé’s Code interpretation allows the company to promote many other products far too early for use. Alete infant teas, for example, are advertised for use from as young as one week of age. This undermines exclusive breastfeeding and increases the risk of infection. It considers cereals like Cerelac and Nestlé Infant Cereal, to fall outside the scope of the Code, even though it promotes three varieties of Cerelac for use as of four months of age, some two months before the time complementary foods become necessary. Nestlé also refuses to accept that the International Code is universal, i.e. that it applies in ALL countries.

Similar labels: same marketing restrictions.

Nestlé has a huge number of follow-on formulas, which carry the same names as the starter formulas with very similar package colouring. Nan 2 in Bolivia, Malaysia and the UAE; Nativa 2 and Guigoz 2 in Côte d’Ivoire and Togo; and Pelargon 2 and Alsoy 2 in Italy resemble infant formulas of the same names. Despite the Nestlé Instructions, despite the Code, these brands are widely promoted.

The “famous” Cerelac baby and so many varieties...as of four months.

In the USA, an “infant formula” is confusingly called Carnation Follow-up and is marketed for use from four months of age, when baby is “eating cereal and other baby foods”.
The labels of Nestlé’s Infant Cereal and Infant Cereal with Milk are so similar that mothers are easily confused and may add milk where they should not and vice versa.
In many countries, Nestlé labels indicate that complementary foods are suitable for use as of four months of age (meaning when the baby has completed its third month of life, far too early according to scientific evidence). This is the case in Côte d’Ivoire (Cerelac Maïs), Bolivia (Nestum, Cerelac), Hong Kong (Infant Milk Cereal), Italy (Nestlé Cereal), Togo (Cerelac), UAE (Cerelac Dates), Uruguay (Nestum Maiz), Malaysia (Nestlé Rice, Nestlé Infant Milk Cereal) and Ghana (Cerelac). In Côte d’Ivoire, Cerelac Riz, Cerelac Maïs and Cerelac Ble-Miel are labelled for babies from three months of age.
Nestlé capitalises on brand recognition using its Blue Bear character on many of the labels of complementary foods and promotional materials. Catchy slogans such as “Give your baby the Cerelac advantage” and “Cerelac: the complete start for solid food” also encourage purchase.

An infant formula that follows-up?

Large colourful brochure about the Cerelac advantages.- Côte d’Ivoire.

III. Summary of Labelling Claims
Countries	Product	Violation
Bolivia	Lactose-free Nan	“…contains vitamins for normal development…”
Canada	Good Start	“next best alternative to breastmilk”, “…easier for your baby to digest”
Côte d’Ivoire	Nativa 1	“Its composition is based on mother’s milk”
Ghana	Lactogen 1	“Composition is based on that of breastmilk”
Italy	Nidina 1	“Similar to mother’s milk”
Mexico	Nan Nan HA	“Based on mother’s milk” “can be used from birth since it contains all nutrients required by the infant for adequate growth”
Russia	Nestogen Nan	“Provides all essential vitamins and minerals” “Mothers trust Nestlé”
The USA	Good Start Alsoy	“100% whey protein, the primary type of protein in breastmilk” “…ideal formula choice to bring out the best in your baby” “You can feel good about Nestlé Carnation Alsoy”
Uruguay	Nan	“Composition qualitatively and quantitatively based on mother’s milk”

Stretching the rules

Nestlé promotes Nido whole milk widely. In Côte d’Ivoire and Bolivia, health and community workers encourage mixed feeding as of four months by giving mothers free samples of Nido. Nido is promoted as follow-up formula. There is no age recommendation on Nido.
Neslac is marketed for use from baby’s first birthday, whereas breastfeeding should continue up to at least two years of age. In Malaysia and the UAE, Neslac is promoted widely for babies from one year of age. Nestlé uses posters and gift offers and advertisements in the media, including TV, to promote Neslac.
In Mexico, Nestlé promotes its anti-reflux and hypoallergenic formulas with materials that read, “Regurgitation is a typical problem for the first year of an infant’s life”.
In Mexico and in other countries, Nestlé provides paediatricians and nurses funds for congresses and other professional events.
In Taiwan, Nestlé sponsored boxed lunches for workers attending educational sessions and contributed to a baby room fund.
In Italy, Nestlé sponsored meetings and conferences under the brand name Guigoz.

Reports from other countries

In Bulgaria, Nestlé labels do not give essential information in Bulgarian. Nan 1 is promoted in 9 Months, a parenting magazine, where an ad asks: “Is there a substitute for breastmilk?” and Nan is the suggested alternative. Nestlé in Bulgaria also has a club for parents called “Mother’s Caress”
In Cambodia, maternity ward staff are given pens, booklets and leaflets promoting Nestlé baby foods.
In Pakistan, Cerelac is advertised on large posters in the market place. Feeding bowls are given as promotional items with the purchase of Cerelac and building blocks with the purchase of Neslac.
The ‘Code of Ethics on the Sale of Infant Formula Products in Singapore’ explicitly bans baby clubs as part of “mothercraft” services and the infant milk industry has been advised by the Ethics Committee to refer mothers requesting nutrition advice to health workers. Nestlé begins before birth by targeting pregnant women in Singapore for membership to its “Baby World Club” in violation of the Singapore Code of Ethics and the International Code.