How breastfeeding is undermined 2/2

Promotion to mothers and pregnant women

Companies violate the International Code and Resolutions by promoting to mothers in a variety of ways:

• Advertising
• Free samples
• Discounts
• "Help" lines and "parent clubs"
• Visits at home or at health facilities
• "Educational" materials on infant feeding
• Posters in hospitals, brand names and logos on equipment, pens, pads etc.
• Information on other products
  

Some examples from IBFAN's monitoring report Breaking the Rules, Stretching the Rules 1998:

All major manufacturers were found to have given samples of infant formula to mothers.

• Health care facilities displayed posters, calendars, clocks and stickers with product brands. These give the impression that the health care system endorses the products. Increasingly companies donate materials which only have their company name or logo. This may be a concession to the International Code but is nonetheless a way of using the health care facility for promotion.

This calendar produced by Coberco Omefa was distributed in Bangladesh. It shows pack shots of infant formula and follow-on formula and has the slogan "Nutritious food for young and old." Source: Breaking the Rules, Stretching the Rules 1998

• Sales representatives from all major companies were reported to have had contact with mothers or pregnant women. In the Philippines Nestlé employs nurses as "Health Educators" who visit pregnant women and mothers in their homes to promote Nestogen infant formula. When this was reported on television in July 1997 Nestlé threatened to withdraw its advertising from the television station.

Free samples distributed to mothers in Bangladesh and Indonesia. Source: BTR98.

• Nestlé received a business award in 1997 for the imaginative way in which it undermined Denmark's breastfeeding promotion programme. Nestlé set up a "Parents' Club" and carried out quarterly promotional campaigns in supermarkets across Denmark. Information about infant nutrition and the club was placed in hospitals and maternity clinics. In less than one year, membership increased from under 10% of Danish parents to over 75%.

Infant formula and follow-on formula are often packaged similarly. Advertising the follow-on formula also serves to advertise the infant formula. Source: BTR98.

• Advertising of infant formula still occurs in some countries, but more often companies advertise other products such as follow-on formulas. Often these products have the same name as the infant formula and so effectively promote the infant formula as well.

IMead Johnson distributes these "information leaflets" to health professionals in the UK and asks, "Please give one of these to parents when you suggest Enfamil AR." Source: Campaign for Ethical Marketing, September 1997

Promotion to health professionals

Promotion to health workers is banned by the International Code Articles 6.2 and 7.2 and information provided must be limited to scientific and factual matters.

In 1996 the World Health Assembly adopted Resolution WHA49.15 calling for Member States to adopt measures to ensure that financial support for health workers does not give rise to conflicts of interest. The International Code Article 7.5 requires that any funding provided by a manufacturer or distributor of breastmilk substitutes is reported.

Health professionals are an important target for the baby food industry's promotion. If a company succeeds in persuading a health worker, it can influence the infant feeding choices of many mothers.

Companies continue to provide gifts to health professionals and offer sponsorship to them and their professional organisations.

• In August 1997 the International Nutrition Conference in Montreal, Canada was sponsored by Nestlé, Wyeth and Abbott-Ross. In a speech at the conference UNICEF Deputy Director commented, "UNICEF is, frankly, uncomfortable about these international gatherings... some of whose funding comes from the infant formula companies. I wish it would be otherwise."
  
  
• Many companies give gifts of calendars, posters, pens, notepads and growth charts bearing company logos and often brand names or pictures of products.  
  
  
• Conferences are arranged in luxurious conditions. For example, Milupa entered the baby food market in Mauritius in November 1993 and built support amongst health professionals through a series of meetings at a 5-star hotel.
  
  
• Nestlé organised a conference on a cruise liner for Brazilian paediatricians in 1993.

• SMA, part of Wyeth, distributed the above card at the May 1997 conference of the Royal College of Midwives in the UK. It offers midwives beauty products if they meet with an SMA representative and the chance to win a £100 prize if they provide details of mother classes held at their place of work and a work contact address and telephone number.

Undermining implementation of the International Code

Member States of the World Health Assembly are called on to implement the International Code and Resolutions in national measures. Here are a few examples of how baby food companies have opposed this process.

• Philippines - 1989. Several manufacturers lobby the government to oppose the adoption of a bill which would encourage mothers to breastfeed and sleep with their babies - The Rooming-in Bill.
  
  
• Pakistan - 1992 and 1997. Nestlé lobbied for babymilks and baby foods to be removed from the Government drug list in 1992, so that sales are not restricted to pharmacies, but can be sold in any grocery or market. In 1997 Nestlé opposed many provisions of Pakistan's draft law.
  
  
• India - 1995. After Nestlé is taken to court it files a Writ Petition against the Indian Government challenging the provisions of the Infant Milk Substitutes Act under which it is being prosecuted.
  
  
• Guatemala - 1995. The US Government puts pressure on Guatemala to allow Gerber to use baby pictures on its packaging.
  
  
• Russia - 1996. Nestlé offers to translate the weak UK infant formula and follow-on formula regulations as the basis for legislation instead of the International Code and Resolutions.
  
  
• South Africa - 1997. Baby food companies in South Africa form the "Freedom of Commercial Speech Trust" to campaign against regulation of advertising.
  
  
• Sri Lanka - 1997. Nestlé opposes a revision of the Sri Lanka Code which would bring it into line with the 1996 WHA Resolution.
  
  
• Zimbabwe - 1998. Nestlé threatens to disinvest if Zimbabwe does not revoke its strong law.
  
  
• Europe and the UN - ongoing. The industry attempts to stop the International Code and Resolutions from being used as the basis for international trading standards.

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