I. The Problem: Infant Formula

II. The Code

III. Corporate Response

IV. Bibliography

I.

It is estimated that one million infant deaths per year can be prevented by using the worlds most economical and effective health protection: breast milk."(Bromberg Bar-Yam)

There are many problems concerning the use of artificial formulas to feed young infants. To begin with, baby formulas are very expensive, especially when used in third-world countries. Once the child is using the artificial milk it creates a need to continue the purchasing of the formula. In some cases the formula accounts for 50% of the families income. Many of these families can't afford to pay for it, and problems occur from there. Sometimes the mother tries to make the formula last longer by diluting the formula, which in turn, can starve a baby and promote malnutrition. Other times other family members will go hungry because of the lack of money.

Another problem is the lack of clean water. In a lot of third-world countries there is a severe lack of quality drinking water. Yet by using these formulas it exposes the child to large amounts at an early age. Even if they do know to sterilize it, most families don't have enough fuel to burn to even practice this. Plus the fact that a lot of the parents who use the formula can't read well enough to follow the directions properly anyway. On top of all this many children are allergic to the lactose (cow's milk) of which most of the formulas are based.

Can a healthy baby be raised in an environment with all these discouraging conditions? Of course the answer to this question is no. So why don't these mothers breast feed instead of using the inferior bottle-feeding method? There are many reasons attributed to this. One is the lack of information. It has been proven numerously that a breast fed child on average is going to smarter, healthier, and happier than one fed from the bottle. In addition to this breast milk is cheap, sterile, and readily available. However, many people, including nurses are ignorant to the exact benefits breast feeding gives. They often promote artificial milk feeding through lack of current information on the exact benefits to be gained by breast feeding and the correct methods to use. Another reason why bottle feeding is continuing is the effect of a culture that views breast feeding as something to be done in private, which basically discourages any type of steady breast feeding for a working mother. We see pictures of babies with bottles on everything from billboards to posters in hospitals designed to install bottle-feeding as the regular and form of infant-feeding.. "Our modeling and display of formula in the hospital has a greater impact on mothers than our verbal messages supporting breast feeding." (Green, Jones '91) We should learn to accept breast feeding as the most efficient, economical, and most natural way to feed your infant. Then, and only then, can we begin to reverse the unneeded deaths caused by the over-sale and over-use of artificial milk formulas.

II.

The Code:

There were many international and non-governmental organizations that responded to the discovery of this problem and in a variety of ways. The World Health Organization was the primary actor in regulating the marketing of breastmilk substitutes. The WHO adopted the International Code of Marketing Breastmilk Substitutes in 1981 in an effort to counteract the powerful influence of the multinational formula companies on the dramatically declining rates of breast feeding in both developed and developing nations. The Code received

118 out of 119 votes; the sole dissenting vote belonged to the United States.

*Code Summary:

-No public advertising of breastmilk substitutes, bottles or nipples.

-No free formula samples to new mothers.

-No promotion of formula products in health care facilities.

-No nurses employed by formula manufacturers to advise new mothers.

-No distribution of formula gift packs or samples to health care workers.

-No words or infant pictures on product labels idealizing formula feeding.

-Only scientific and factual information on feeding methods should be given to health care workers.

-All information on formula feeding , including labels should explain the associated costs and hazards.

-Unsuitable products, such as sweetened condensed milk, should not be promoted for

infant feeding.

-All formula products should be of high quality and take into account the climatic and storage conditions of the country where it might be used.

*Taken from "Who Code? Who Cares?", Canadian Nurse, January 1991, p. 28. Corporate response

III.

Corporate Response

Before the WHO Code in 1981, there was no regulation on the marketing of breastmilk substitutes. UNICEF and Save the Children were moderately effective in reactive limitation of formula companies by encouraging the boycott of Nestle products. Nestle the largest distributor and marketer of breastmilk substitutes worldwide. Baby Milk Action is the international coordinator of the Nestle boycott and have regular updates.

Even with the WHO code in place pressure from WHO, UNICEF , international breastfeeding action groups, the International Baby Food Action Network and the International Nestle Boycott Commission has lead to conformance with the CODE only when governments have legislated marketing restrictions.

The major formula companies have found loopholes in some cases, and since the code is only a resolution in many countries, there is little that is done to punish any corporation that breaks the Code. While Nestle is usually the main focus of public outcry, there are many manufacturers out there that are also not acting in accordance with the Code. But, Nestle is the largest and most aggressive of them all. There is a long list of violations that the company has been blamed for, all of which have occurred after the Code was introduced. Just in 1997, there have been numerous incidents where the Code was broken by corporations.

December 1996:

In Singapore, an advertisement for baby formula is placed in a pediatric journal, it was paid for by Nestle.
May 1997:

At the annual conference of the Royal College of Midwives, most of the major infant formula distributers were present. This alone was a violation. But, if a midwife were to fill out a card containing addresses, and phone numbers of recent mothers, they were entered into a 100 pound drawing to be held later. Wyeth

June 1997:

In Malaysia, the labels of the infant formula were still not in the local language, in direct violation of the Code. Also, Nestle continues its process of buying bottled water distributers in Russia and other locations. Valvert water in Russia is just one company owned by Nestle. Nestle now owns over 10% of the world market. With this new medium, they advertise infant formula on their water, since it can be used for the process. This is breaking the Code's philosophy on no public advertising of the formula.

July 1997:

Free supplies and samples are given out in Thailand by Nestle.

October 1997:

In Kenya, labels are not in the native language, Kiswahili. Nutricia, Mead Johnson and Abbott-Ross were all responsible. In England, infant formula is promoted directly to mothers in a magazine add, placed in a national weekly magazine.

November 1997:

Infant formula is promoted in Armenia, including complimentary foods, leaflets, advertisements. This was done by Wyeth, Nutricia, Mead-Johnson, and Abbott-Ross Nido, whole milk powder was also advertised, despite being unsuitable for infants.

Nestle and others have stuck to their guns and given little ground. In most cases they either deny any wrongdoing, or simply point out that due to financial problems they can't fix everything all at once. But, they have admitted that there is a problem with their marketing of their products. In the past, they have been asked directly whether the use of formula in developing countries is possible. Nestle admitted that it was not due to thel evels of sanitation, illiteracy and poverty. Yet, they continue to market their product in just thattype of area around the world.

But, Nestle also has written on its bottles water and infant formula packaging that "Infant formula can be used from birth onwards when breast feeding is not possible, or as a supplement to breast feeding ." This was published at the Baby Milk Action homepage.

It is this type of disregard for the code and the ethical issues at hand that prompted us to caught our interest and inspired this web page.

Bibliography

1. "Yes the Nestles Boycott Is On!" www.io.org.

2. "Background to the Nestle Boycott." shell.ihug.co.nz"

3. "Killer in a Bottle". Economist. May 9, 1981. v279. P.50.

4. "Baby Bottle Killer." Far Eastern Economic Review. July/August 1981. P.26

5. "The Nestle Boycott". Mothering. Winter 1995.

6. Green, Marina and Jones, Frances. "WHO Code? Who Cares?". Canadian Nurse. January 1991. P.26-8.

This page has been created as a research project for an introductory politics class at Earlham College in Richmond, Indiana. It was created by Jordan Taylor, Justin Truitt, and Chris Wilson.