support nearly all mothers are capable of breastfeeding. Yet
in many countries breastfeeding rates are low and artificial
infant feeding has become part of the culture. In this section
we look at examples of company promotional methods in order to
understand how the baby food industry undermines breastfeeding
and encourages artificial infant feeding.
using free supplies
were restricted by the International Code and were finally banned
in all parts of the health care system by the World Health Assembly
in 1994 (Resolution
Despite the ban companies continue to use free supplies as a
means of promoting their products. Giving bottles to newborns
interferes with lactation. If a mother stops producing milk
she has to purchase the company's products once she leaves the
hospital and it is no longer free. IBFAN has campaigned on this
issue for many years and has raised awareness of the promotional
nature of free supplies.
- In July
1996 Nestlé was reported to be providing free and low-cost
supplies of infant formula to hospitals in Kunming Province of
China. In a public statement Save the Children said:
has made Lactogen widely available in six hospitals in Kunming,
where it has targeted health professionals with both free and
discounted supplies of the formula. This helps to create an incentive
for the health workers, not only to use the formula within the
hospitals, but actively to encourage its use among mothers of
new-born children. Lactogen has been displayed in some of the
hospitals for sale. The report prepared by our China staff and
local health workers alleged that there had been an increase
in the consumption of Lactogen and that breastfeeding rates had
that belong to the International Association of Infant food Manucaturers
(IFM) pledged as far back as 1991 to work towards the goal of
ending free and low-cost supplies. Yet IBFAN's monitoring report
Breaking the Rules, Stretching the Rules 1998 shows there were
instances of supplies of infant formula being given to health
care facilities in 19 of the 31 countries surveyed. Donations
of follow-up formula and complementary foods have also been taking
conducted by the IBFAN group in Pakistan and published in
the report Feeding Fiasco in March 1998 found widespread distribution
of free supplies. A former company representative describes
in the report how hospitals receive free supplies and doctors
are "purchased by companies...after which the doctor
or hospital is bound to recommend the company's formula."
Norway promotion of artificial infant feeding does
not occure and 98% of mothers leave hospital breastfeeding.
After 3 months 90% are still doing so.
9.2 of the International
requires that labels are in a language appropriate to the country
where the products are sold.
monitoring finds many countries where this is not respected.
One long-running case concerns Malawi in Central Africa. Both
Nestlé and Wyeth were reported in Breaking the Rules
1994 for violating this provision of the Code in Malawi. Both
claimed English was the appropriate language, although Nestlé
had earlier said:"Due to cost restraints of small
runs it has not been viable to change languages for specific
checking the situation a few years later IBFAN received a
letter from the Malawi Ministry of Health saying: "The
Ministry discussed the need to include Chichewa. - [the national
language] - with Nestlé ...in mid 1994...not received
a reply...nothing has happened." Government statistics
show that of those women who could read, 43% could not read
English, the language on the label.
companies include under-lid leaflets in other languages. This
will only be read after buying the product. Even parents who
choose to breastfeed should be able to understand the warnings
on a breastmilk substitutes so that their choice is not undermined.
"humanitarian aid" to create markets
and relief situations it is important that babies are breastfed,
if possible. Artificial feeding in these conditions is difficult
and hazardous and can lead to increased infant mortality rates.
The basic resources needed for artificial feeding, such as water,
fuel and sufficient quantities of breastmilk substitutes are
scarce in emergencies. Furthermore breastmilk substitutes donated
as humanitarian aid often end up in the local market and can
have a negative influence on feeding practices generally.
food industry has used emergencies generally to promote its products
and used "humanitarian aid" as a way of entering into
the emerging markets of Europe and the former Soviet Union.
quantities of baby milks were donated by the European Union
to the countries of the former Soviet Union. The tins carried
a company brand name, the EU logo and an inscription, "Gift
from the European Union to the people of Russia."
This gives the impression that the product appears to be
endorsed by the EU.
German baby food company, Humana, donated baby milks to
health centres in Russian villages. The boxes carried a
baby picture and a notice saying "like breast milk",
both violations of the International Code.
workers in Kazakhstan received so much free infant formula
that they used it in their coffee!
- Dr Anahit
Demirchyan, Coordinator of the UNICEF Baby Friendly Hospital
Initiative in Armenia, said that "The distribution of
breastmilk substitutes as humanitarian aid almost destroyed our
is actively working with aid and development organisations on
issues surrounding infant feeding in emergencies.
See the resources
sheet for information on the IBFAN publication Crucial Aspects
of Infant Feeding in Emergency and Relief Situations.
tin was distributed in Russia as aid from the European
Union and purchased at an open market in Estonia. IBFAN
labelling (that is, labels without brand names) of products
when there is a genuine need for them.
which undermine breastfeeding
9.2 of the International Code requires labels to be in the appropriate
language and to include specified text warning that breastfeeding
is best for babies and that the products should only be used
on the advice of a health professional. In addition there should
be no pictures or text which might idealize the use of infant
says that labels should not discourage breastfeeding.
pack shot on the right is for Nestlé's Bona infant
formula. Nestlé adds to the text of the Important
Notice: "Infant formula can be used from birth
onwards when breastfeeding is not possible, or as a
supplement to breastfeeding."
breastfeeding interferes with lactation and makes an
early end to breastfeeding more likely. The feeding
guide on the pack states that mothers should continue
to use the formula "in the case of lack of breastmilk."
Bona, distributed in Russia, demonstrates that it is
possible to idealize the use of infant formula without
using baby pictures.
THE ISSUE: History, Overview.