What is the problem?

According to the World Health Organisation (WHO) 1.5 million infants die every year because they are not adequately breastfed. Despite this, companies continue to promote artificial feeding in ways that undermine breastfeeding. IBFAN works to protect breastfeeding and to ensure that mothers receive correct information about infant feeding free from commercial pressure. IBFAN also works to improve the safety of artificial feeds. Click here to download this document as a pdf file "Use my picture if it will help," said this mother at the Childrens Hosptial, Islamabad, Pakistan. Photo: UNICEF.

A baby dies every 30 seconds from unsafe bottle feeding

The photograph above tells the tragic story of the fatalities that occur due to unsafe bottle feeding.
The babies are twins: the child with the bottle is a girl - she died the day after this photograph was taken -
but her brother was breastfed and thrived.

The mother was told that she wouldn’t have enough milk for both children, and so breastfed her son while
the grandmother bottle-fed her daughter. But she would almost certainly have been able to feed both babies, since the more a baby suckles, the more milk is produced.

Breastfeeding: the best start in life.

Breastfeeding is free, safe and protects against infection. It is extremely rare for a woman to be physically unable to breastfeed.
Breastfeeding reduces the risk of illness in all countries. Even in the UK, a bottle-fed baby is up to 10 times more likely to be hospitalised with gastro-intestinal illness than a breastfed one.

Where water is unsafe, babies are up to 25 times more likely to die if they are bottle fed.

Breastfed babies need no other food or drink for about the first 6 months of life. They also have reduced
risk of diabetes, pneumonia, ear infections, and some cancers. Studies show that women who breastfeed
may have a lower risk of breast and ovarian cancers and that their babies are less likely to die of cot death
or suffer from allergies or obesity in later life.

A mother has a right to independent information and freedom from pressure from companies. If she
chooses to bottle feed she should be aware of the risks and costs.

Bottle feeding can kill

Companies that make baby foods or bottles and teats are well aware that infants die from unsafe bottle feeding. However, they continue to put profits before health by encouraging mothers and health workers to use their milks and equipment. Others are left to count the cost.

"Marketing practices that undermine breastfeeding are potentially hazardous wherever they are pursued: in the developing world, WHO estimates that some 1.5 million children die each year because they are not adequately breastfed. These facts are not in dispute."

United Nations Children’s Fund (UNICEF)

Millions more babies become seriously ill and the cost of baby milks impoverishes people who are
already poor, affecting whole families.

How does bottle feeding kill babies?

The water mixed with baby milk powder can be unsafe and it is often impossible in poor conditions to keep bottles and teats sterile. Bottle feeding under such circumstances can lead to infections causing diarrhoea, the biggest killer of children worldwide.

Baby milk is also very expensive, often costing more than half the entire family income. This means that bottle feeding will contribute to family malnutrition. Furthermore, poor mothers trying to make the milk go further sometimes overdilute the powder or use cheaper alternatives, such as powdered whole milk or animal milks, and the baby may not then receive the nutrition he or she needs.

Bottle baby disease is the name given to the deadly combination of diarrhoea, dehydration and malnutrition which is the result of unsafe bottle feeding.

How companies get babies on the bottle

To increase profits, baby milk companies try to persuade health workers and mothers to bottle feed. Their tactics range from advertising and misinformation to sending sales reps into hospitals to promote their milks
to sponsoring health workers, conferences and even health facilities.

The International Code

The International Code of Marketing of Breastmilk Substitutes was adopted by the World Health Assembly
in 1981. The Assembly is the policy-setting body of the World Health Organisation.

The International Code aims to protect all mothers and babies from inappropriate company marketing practices. The Code does not ban the sale of baby milk, but addresses how it is marketed. It bans all promotion of breastmilk substitutes, bottles and teats. It aims to ensure mothers receive accurate information from health workers. Subsequent Resolutions of the World Health Assembly have clarified and amplified the International Code.

Baby food companies may not:

• Give free supplies of baby milk to hospitals;
• Promote their products to the public;
• Use baby pictures or other idealizing picture or text on their baby milk and bottle and teat labels;
• Give gifts to mothers or health workers;
• Give free samples to parents;
• Seek direct or indirect contact with pregnant women or mothers of children up to three years of age;
• Promote baby foods or drinks for babies under 6 months old;

Labels must be in a language understood by the mother and must include a prominent health warning.
Companies are limited to providing scientific and factual information to health workers, who are responsible under the Code for advising parents.

The Code is intended as a minimum requirement for countries in both the North and the South.

So what’s happening now?

In countries where the International Code and subsequent, relevant Resolutions have put into a law which is monitored and enforced aggressive marketing is controlled, sales of baby milk are falling and breastfeeding rates are recovering. Elsewhere, however, most baby food manufacturers are continuing their unethical promotional activities whilst claiming to abide by the International Code.

Health workers are targeted with inaccurate information, gifts and conferences as companies know that persuading a health worker to recommend their milk is much more cost effective than persuading mothers individually. Promotion in hospitals implies that the product is endorsed by the health service: coupled with misinformation, this has created the false impression amongst mothers and health workers that many women cannot breastfeed.

Even more effective is the practice of giving free or subsidised supplies of baby milk to hospitals and maternity wards. This encourages artificial infant feeding, which interferes with lactation. Once a mother leaves hospital formula is no longer free, the company has another captive customer, and the mother and baby are denied
the best start in life.