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 and Resolution 58.32 calling for Member States to adopt measures to ensure that financial support for health programmes and 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 industrys 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.

• Many companies give gifts of calendars, posters, pens, notepads and growth charts bearing company logos and often brand names or pictures of products. One example from Breaking the Rules, Stretching the Rules 2005 states: "Abbott wins favour with health workers through gifts like calendars in China; clothing and bottles of whisky in the Dominican Republic, jackets and prescription pads in Peru, notepads, pens and deodorant pads in Thailand". 

• Hipp not only gives gifts such as this clock found in Latvia and Lithuania, but pays doctors in Armenia a commission on prescriptions for Hipp products; all they need to do is fill in their name, workplace and signature on special Hipp prescription forms.

* Hipp not only gives gifts such as this clock found in Latvia and Lithuania, but pays doctors in Armenia a commission on prescriptions for Hipp products; all they need to do is fill in their name, workplace and signature on special Hipp prescription forms.

* Nestle produces a range of promotions materials distributed to health facilities in Thailand, from tissue
boxes in the style of Nan infant formula to Nestle-branded organisers, booklets and growth charts.
This not only promotes the company and its products to mothers, but gives them the apparent
endorsement of the health facility.

* Wyeth invites health workers to its SMA-branded study days in the UK, including the chance to
win an expenses paid trip.

* Wyeth distributes leaflets for mothers for displaying in waiting rooms. In the display rack it is not clear they are produced by a baby food company, but inside they have the SMA brand and encourage mothers to contact the company and visit its website.

* The information provided to health workers is often promotional and the evidence for claims made for breastmilk substitutes frequently comes from the companys own evidence (held on file) or studies
sponsored by the company. The findings sometimes conflict with more comprehensive studies. For example, most companies are promoting Long Chain Polyunsaturated fatty acids in their formulas,
claiming these aid neurological development and increase intelligence, such as this Wyeth brochure
"The best start, start here" in Thailand for S-26 and S-26 Promil Gold which it claims have DHA and AA levels closest to breastmilk.

Yet, a systematic review of available research on Longchain Polyunsatuarated Fatty Acid (LCPUFA) supplementation was made by the Cochrane Library (review dated 15th June 2001) and concluded:

“At present there is little evidence from randomised trials of LCPUFA supplementation to support the hypothesis that LCPUFA supplementation confers a benefit for visual or general development of term infants."

* Nestles four-page leaflet found in health facilities in Vietnam and reported in Breaking the Rules, Stretching the Rules 2004 claims Lactogen infant formula benefits "brain, body and bones" and is distinctly lacking in scientific information.