Marketing law gets wide support
A draft law which should ban baby milk advertising in the UK has received
overwhelming support from health professional bodies and the public. During
a consultation period on the proposals, the Ministry of Agriculture,
Fisheries and Food received over 200 letters of support. 48 health,
development and consumer bodies were in favour of the proposed law, the
majority suggesting that the advertising ban be extended to follow-up
milks. The Ministry received only 13 letters opposing the ban, 10 of which
were from company and advertising sources.
Campaign magazine has reported that Health Secretary Virginia Bottomley
opposes the advertising ban. Baby Milk Action hopes that this is a
reporting error and has written to Mrs Bottomley for clarification.
Adoption of the law is not expected before the end of the year.
BPA in funding row
The British Paediatric Association has become embroiled in a row over
sponsorship after accepting a gift of #140 000 from Nestle. Forty
paediatricians wrote to the British Medical Journal accusing the BPA of
taking the money covertly. The money was listed in the BPA annual report as
an anonymous donation: the International Code requires that payments from
companies are declared.
The letter to the BMJ states "It is true that a number of paediatric
research projects are funded, directly or indirectly, by Nestle. However,
individual paediatricians can choose whether to work with such projects. In
contrast, the British Paediatric Association is our only professional body;
we have no choice but to back it."
In a letter to the association, BPA member and Baby Milk Action director,
Dr. Anthony Costello, stated that many members were opposed to links with
companies which break the International Code and that BPA members should
have had a chance to debate the issue.
Breaking The Rules 1994 shows that neither Nestle nor any other major
infant formula manufacturer comes near to being in full compliance with the
Code.
Although Nestle does not sell baby food in the UK, BPA Treasurer Dr.
Christopher Nourse told the British Medical Journal there was
"Correspondence between Nestle and the BPA, making us think it was behaving
quite properly in this country." BPA policy refers only to national
legislation, not the International Code. The BPA has now convened a working
group to study the question of sponsorship.
By contrast, in February, the Indian Academy of Paediatrics refused a $500
000 donation from Nestle and resolved not to accept future payments from
the baby milk industry. In Britain, the National Childbirth Trust has
developed strict guidelines which ban the acceptance of money from any
company involved in the bottle feeding industry.
If any doubt remains about the intention of companies sponsoring doctors, a
survey reported in Marketing Globe magazine has found that doctors who
accept drug company research money are 19 times more likely to recommend
that company's product.
Physician's pledge
UNICEF Executive Director, James Grant, has written to doctors throughout
the world asking them to sign a pledge against free supplies of infant
formula to hospitals and in support of breastfeeding. Grant compares bottle
feeding with smoking and writes "Study after study now shows, for example,
that babies who are not breastfed have higher rates of death, meningitis,
childhood leukaemia and other cancers, diabetes, respiratory illnesses...
Despite these facts, today too few health care providers inform their
patients about a mother's extraordinary capacity to sustain and protect
human life - her children's and her own." If you want to ask your doctor to
sign up, copies of the letter and pledge are available from Baby Milk
Action.
Bedtime for Bed Timers
Farley's has stopped the production of Bed Timers, its chocolate drink for
infants which contains 43% sugar, after a two-year protest by the Baby
Drinks Campaign. The families of 1200 children who suffered painful dental
caries after bottle feeding with sweetened baby drinks are suing the 5
major drink manufacturers.
The Baby Drinks Campaign aims to combat the health risks posed by sugared
drinks for infants and toddlers. It is led by Action & Information on
Sugars (AIS) and includes Baby Milk Action, the NCT and several other
health groups. Since the campaign's launch, sales of sugared drinks have
fallen by 22%. A training & information pack is planned for the immediate
future.
AIS, PO Box 190, Walton on Thames KT12 2YN.
RELIEF AID
Concern over inappropriate food aid
Baby milk being provided as relief aid is of such concern to agencies such
as UNICEF, WHO and UNHCR that it was the subject of a three-day debate at
May's World Health Assembly. Guidelines drafted by internationally
respected infant feeding experts discourage the distribution of breastmilk
substitutes and state that cups should be used rather than feeding bottles.
Baby milk companies ignore these guidelines, donating milk and bottles
which carry brand names and which are often labelled in an inappropriate
language. Well-meaning but inexperienced relief agencies, who are willing
to transport and distribute these products, are a natural target for
companies eager to open up new markets.
Japan pushes its baby milks
Japan may be pressuring the Red Cross to distribute infant formula in order
to support the Japanese formula industry in central Asia, despite Red Cross
policy against the inappropriate use of baby milk. In 1993, the Japanese
government gave 1566 tons of breastmilk substitutes, worth US$5.4m, for
distribution in Eastern Siberia and the Far Eastern region, and 1344 tons
($4.4m) for the Central Asian Republics (Kazakhstan, Kyrgyzstan,
Tadjikistan, Turkmenistan and Uzbekistan). The Red Cross/Red Crescent has a
long-held policy of using breastmilk substitutes in emergency situations
only when absolutely necessary. However, Japan appears to have made it
clear that any objections to the free infant formula will jeopardise
funding for essential hospital kits containing pharmaceuticals and basic
medical appliances.
One maternity hospital in Kazakhstan with 3400 births per year received 140
cartons of Snow Brand infant formula in June 1993, of which only 22 had
been used by January 1994, mainly for abandoned babies. The free supply of
milk is not appreciated as the hospital is committed to promoting
breastfeeding.
A workshop on UNICEF's Baby Friendly Hospital Initiative in St. Petersburg
in 1993 concluded that "Donors should be urged not to send breastmilk
substitutes indiscriminately to countries in central and eastern Europe."
Charity changes damaging TV ad
Feed the Children, a charity which provides aid to eastern Europe, has
changed a TV advertisement, shown on Channel 4 in Scotland, after
complaints about its negative portrayal of breastfeeding. The ad carried
the logo of baby milk company Cow & Gate (which paid for the broadcast).
Although Feed the Children claims that baby milk forms less than 5% of its
aid, the advert focused on infant feeding. It included a shot of a Bosnian
mother breastfeeding her healthy-looking baby, with a voice-over saying,
"How must that mother feel, knowing her baby is aching with hunger?" The ad
suggested that breastfeeding does not protect against infection and that
there is an urgent need for baby milk. Boxes of food were shown being
unloaded while the voice-over claimed "#20 can supply a life saving baby
box for Bosnia." All the baby boxes contain bottles, teats and branded baby
foods. Some contain baby milk.
The charity has now apparently changed the ad and removed the Cow & Gate logo.
Breast still best
As breastfeeding saves the lives of many babies, agencies such as WHO,
UNICEF and UNHCR are working hard to discourage bottle feeding in emergency
situations. They are providing breastfeeding training for health workers
and have asked other agencies to limit their donations of baby milk.
The UN agencies are sending breastfeeding experts to former Yugoslavia in
an effort to address the problems arising when food, water and energy
supplies are disrupted. In 1987, less than 30% of Sarajevo's mothers
started breastfeeding. Following the UN initiative, 60% of babies are now
breastfed for 12 months.
Aileen Robertson, a WHO nutritionist working in Bosnia since October 1992,
reports that there is no evidence of widespread malnutrition and that
mothers want to breastfeed. They need support and encouragement for this,
not donations of baby milk.
INTERNATIONAL NEWS
World Health Assembly '94:
Global consensus on Code--
industry is defeated
After 13 years of opposition, the USA has joined the rest of the world in
an historic consensus decision to support the International Code. A
resolution condemning company donations of baby milk to all parts of the
health care system worldwide followed a heated three-day debate at the
World Health Assembly in May. Countries representing the industry view had
attempted to weaken the resolution.
Delegates to the WHA (the decision-making body of the World Health
Organisation) were debating a resolution urging governments "to ensure that
there are no donations of free or subsidised supplies of breastmilk
substitutes and other products covered by the International Code of
Marketing of Breastmilk Substitutes in any part of the health care system."
The European Commission and the USA, protecting their industry interests,
initially tried to weaken the resolution with suggestions that it would
cause legal problems. They proposed amendments mirroring the industry's
position, which would have allowed supplies to be channelled into hospitals
and made the monitoring of donations impossible.
Speaking on behalf of all African countries, the Swaziland delegation
called for the original resolution to be strengthened. African delegates
vehemently rejected the assumption that Africa needs donations from baby
food companies, stressing that such donations are nothing more than a
promotional technique. Kenya stated that if the issue came to a vote, it
would insist on a roll call of member states "so that those who are unfair
to babies would be known by name."
Baby Milk Action's Patti Rundall represented Save the Children at the
debate: speaking on food aid and free supplies, she told delegates, "The
real need for breastmilk substitutes is greatly exaggerated by the
companies who need to convince us all that health services cannot manage
without their help and that lactation failure is normal. Donations of
proprietary brands are an excellent way to open up new markets and create
dependency on imported products."
The African position was supported by several European countries including
the UK, as well as by UNICEF, UNHCR and the pro-breastfeeding NGOs. The
mounting concern resulted in a compromise whereby all sides withdrew their
amendments and agreed to the original text. This led to a vote in favour of
the International Code by the USA, the only country to vote against when it
was adopted in 1981, moving the issue into a new era of global consensus.
The resolution's adoption was greeted with near- universal applause - only
the industry lobbyists remained silent.
To date, the baby food industry has failed to respond positively to the
resolution, which clarifies the International Code. Nestle has failed to
mention it at all in the huge volume of new literature it has produced.
Insufficient milk or insufficient support?
Disturbing press articles and television programmes are appearing in the
USA and the UK, linking breastfeeding with dehydration of babies and even
death. The first such article appeared in the Wall Street Journal just
before World Breastfeeding Week in August, highlighting what was termed the
"Yuppie syndrome" of mothers harming their babies who didn't receive enough
milk from breastfeeding before being "saved" by infant formula.
This was followed by similar pieces in the Mail on Sunday, Time magazine
and on US TV. While the stories state that breastfeeding is best, the
underlying message is so horrific that it promotes bottle feeding. The
media coverage focused on US mothers who had little or no support from the
health care system after leaving hospital. Such care is provided free to
all mothers in the UK by health visitors and community midwives.
One alarming consequence of the absence of post-natal care was that mothers
did not know to check the wetness of their babies' nappies. Dry nappies are
a warning sign that something is wrong.
Dow Jones - the parent company of the Wall Street Journal, whose article
sparked the other stories - uses the same public relations firm as US
formula companies, Mead Johnson and Abbott Ross.
Another story in the Sunday Times reports that a US mother has been accused
of murdering her baby by breastfeeding while taking drugs. No test was
carried out to check for the presence of drugs in the mothers' milk, while
the autopsy found that the baby suffered cot death. The case will make
legal history and is likely to frighten mothers who smoke, drink alcohol or
use drugs.
This spate of stories can only undermine breastfeeding. It appears at the
same time as the baby milk industry has abandoned any pretense of
supporting the Code in industrialised countries, continuing to perpetuate
the myth of the bottle being the solution to insufficient milk. In the US,
companies have threatened legal action against hospitals considering Baby
Friendly Hospital status, citing breach of contract.
Cairo supports breastfeeding
International Baby Food Action Network campaigners from Swaziland, the
Philippines, Guatemala and Switzerland attended the recent International
Conference on Population and Development in Cairo, succeeding in having the
contraceptive effect of breastfeeding recognised in the final document.
Sandoz buys Gerber, introduces double standards
Swiss pharmaceutical company Sandoz has bought US baby food company Gerber.
Sandoz already makes Wander and Sandoz baby milks, sold primarily in
Switzerland and Spain: this acquisition makes the company a much larger
player in the world market.
Sandoz also sells Parlodel, its brand name for bromocriptine, a drug used
to suppress lactation. In August, Sandoz announced that it would no longer
indicate that Parlodel could be used for lactation suppression in the USA
because of the danger of hypertension, seizures and stroke. However, this
step has not been taken in any other country except Canada. "If this drug
is too risky for US women, it is also too risky for European, Latin
American, African and Asian women" said Barbara Mintzes of the rational
drug use campaigning network Health Action International. Nineteen US women
have died since 1989 after using bromocriptine.
C & G claims to be better than the breast
Cow & Gate/Nutricia is promoting its baby milk to health workers and the
public in the Cayman Islands using inaccurate information on vitamin D. A
leaflet promoting Nutrilon baby milk is riddled with false claims such as
"Breastmilk always contains too little vitamin D," "When only breastfeeding
is given, it is absolutely necessary to give a vitamin D supplement" but
"Vitamin supplementation is not necessary when using Nutrilon premium."
Despite stating that "Breastmilk is perfect," the leaflet makes the
extraordinary claim that Nutrilon is superior:
"Nutrilon premium is a complete alternative, as it closely resembles
breastmilk, not only in composition, but also in absorption
characteristics. The only important difference, which makes Nutrilon
premium the perfect complete infant formula, is the optimal vitamin D
content."
In fact, vitamin D is a hormone which is activated by sunlight -- exposure
to the sun for 30-120 minutes a week will provide enough vitamin D (meaning
that deficiency is virtually unknown in the Caribbean). Dietary sources may
provide too much of the vitamin and can lead to illness. Please complain to
Cow & Gate, Newmarket Avenue, Trowbridge BA14 0XQ, UK.
Gabon bans baby milk imports
The Government of Gabon has banned the importation of foods for babies
under 6 months old. The ban was provoked by the "extreme marketing tactics
of the food multinationals and their effects on infant malnutrition." One
hospital in the capital Libreville reports "the total disappearance of
diarrhoea and general infections..." since introducing its policy of
exclusive breastfeeding, as well as "a significant reduction in the rate of
digestive infections, which are very serious in babies. The rate has
dropped from 25% to 1%."
Breaking the Rules 1994 reports International Code violations in Gabon by 5
baby milk and 2 bottle companies.
Malawi labels still in wrong language
Following requests from the Malawi Ministry of Health, and after a long
campaign by Jim Bloomfield, a Baby Milk Action supporter in Malawi, Nestle
has finally agreed to change the language on its baby milk labels. However,
Lactogen 1 & 2 are still being sold with label text in English and
Afrikaans rather than Chichewa, the local language. The Ministry of Health
has requested that the text is in Chichewa and English. It is not clear
when Nestle will make the changes. The English/Afrikaans labels originate
in South Africa, where they may also violate the Code's requirement that
they should be in an appropriate language.
In June 1994, S-26 infant formula made by Wyeth/SMA was found in Malawi -
the label text is in English and Swahili and therefore incomprehensible to
75% of the population. The company has not responded to complaints.
Breaking the Rules 1994 reports labels in an inappropriate language by
Nestle in 8 countries and by Wyeth in 6.
Doctors discourage breastfeeding in US
A US study has found that by providing free formula samples and coupons,
obstetricians unintentionally discourage breastfeeding and "are functioning
as advertising and marketing agents for a commercial product." This
practice also implies to the mother that her doctor does not consider
breastfeeding to be important. The US infant formula industry is now
targeting health professionals to help in the prenatal marketing of infant
formula.
Howard FM et al., The physician as advertiser: the unintentional
discouragement of breastfeeding, Obstetrics and Gynecology 1993; 81:
1048-1051.
[log in to unmask] (Arly Helm, LC)
|
