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Take action to stop these violations of the International Code of Marketing of Breast-milk Substitutes. The people responsible have names and addresses - call on them to market their products ethically.

The tables below give details of some recent violations. The date when the violation was last reported to Baby Milk Action or confirmed to be current is given. The violation reference is for Baby Milk Action's records. Please quote it if forwarding correspondence to us, if possible.

Read company responses received so far

Companies exposed for violating Vietnam’s regulations


Monitoring conducted by Save the Children (SCF - UK) and the Ministry of Health in Vietnam documents widespread violations of the governments measures implementing the International Code and Resolutions. Monitoring took place over 7 days between 19 and 27th June 2001 in Hanoi, but release of the results was delayed while companies were invited to respond to the findings.

Vietnam has a tradition of breastfeeding but SCF notes:

“However social and economic changes are impacting on the choices women make about how they feed their children. South-east Asia is also a growing market for multi-national companies and the numbers of companies marketing breastmilk substitutes in Vietnam has increased rapidly over recent years.”

Baby Milk Action noted that in its third-quarter statement commenting on increased profits (20th October 2000) Nestlé, the global market leader, stated: "Milks and nutrition saw good progress, mainly as a result of infant nutrition sales in Asia and of the powdered milk business." Between 1996 and 2000 global sales of baby food increased by 13.6% by volume, with the Asia-Pacific region growing faster than any other region (ref: Euromonitor 2001 - see Press Release "African and Asian campaigners urge support for Nescafé boycott as Nestlé announces increased baby milk sales" 24th October 2000).

The Vietnamese government first moved to regulate the marketing of breastmilk substitutes with a Prime Ministerial decision in 1994. This was strengthened by a Decree in December 2000. According to the SCF/MoH report, of the 30 brands of breastmilk substitute reviewed, not one fully complied with the labelling requirements set out in the legislation. The labels on feeding bottles were also assessed and only 1 out of 13 brands was found to meet the legal requirements.

Advertisements by 5 companies in a popular newspaper were found to violate the legislation which requires a statement at the beginning of adverts for follow-on milks confirming that breastmilk is the best food for infants (Article 5.1 of the Code bans advertisements for all breastmilk substitutes, the Decree presently only bans advertisements for infant formula).

In Vietnam violations include:

“promotional literature, which is not scientific and factual, and contains company and brand names given to hospital staff. Abbott Gain and Nestlé Baby World and infant feeding leaflets.”

(SCF report)

A range of violations were found in health facilities, indicating that companies are continuing to contact hospital staff and providing them with inappropriate material.

Failure to abide by these measures endangers infant health. For example, one mother is quoted in the report: ”the instructions are not in Vietnamese so I guess how to make up the formula.”

Companies violating the government’s regulations included: Abbott, Dumex, Australia Milk, France Bebe Nutrition, Friesland, Heinz (Camera feeding bottles), Mead Johnson, Meiji, Nestlé, Nuk and Snow. SCF notes that four companies responded to the report and agreed to change their labels, although they disputed other violations. Nestlé, which claims it invites reports of violations: “Disputed the authority of Save the Children to undertake the assessment of companies’ marketing practices.”

Nestlé, Wyeth and Snow Brand campaigned against the Vietnamese legislation last year. In particular they objected to the requirement to show cups rather than bottles for using formula. Numerous studies have shown that cups can be a safer feeding option, especially when sanitation and water are a problem. The companies falsely claimed that no other countries require cups rather than bottles on labels.

Suggested letter of support to the Vietnamese Ministry of Health. Please address: The Minister of Health, Vietnam, via Baby Milk Action, 23 St. Andrew’s Street, Cambridge, CB2 3AX. Fax: 01223 464417 (in the UK) +55 1223 464417 (outside UK). Or email to

We will arrange presentation of the letters at an appropriate time in the near future.

I wish to inform you of my support for your implementation of the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions of the World Health Assembly. I am aware that baby food and bottle and teat companies have been violating the government Decision of 1994 and Decree of 2000 (Decree 74/2000/ND-CP). I encourage you to continue monitoring company practices and to take appropriate action to call these companies to account.

I am also concerned that companies have attempted to undermine the Decree, by, for example, opposing the requirement to show feeding with a cup rather than a bottle on the labels of breastmilk substitutes. Other countries, such as Tanzania and Malawi require cups to be shown for good health reasons. I urge you to continue to put infant health first.


Marketing war using “new improved” formulas threatens breastfeeding


Breastmilk is a complex, living substance and its constituents are still being discovered. Inert artificial milks cannot replicate the anti-infective factors in breastmilk. However, efforts are made to synthesize and add to formula other substances found in breastmilk. Often, the formula is then promoted as ‘closer to breastmilk’, even if there is little evidence that the substances will act in the same way and give the same benefits as in breastmilk.

On 10th January 2002, Martek Biosciences Corporation announced that two of its products would be used in an Abbott formula. Docosahexaenoic acid (DHA) and arachidonic acid (ARA) are found in breastmilk and are claimed to benefit neural development. In a press release that did not acknowledge that breastmilk remains superior to formulas containing these products, the CEO of Martek, Henry Linsert, Jr., claimed: “American babies won a big one today.” The source of the acids is not revealed, though it is known that Martek has previously sourced long-chain fatty acids from tuna fish eye sockets and genetically modified mould.

Within two hours of the Martek press release, Mead Johnson struck back, issuing a press release claiming that a new Enfamil product was the “first and only infant formula to contain additional nutrients important to babies’ mental and visual development”, referring to the same DHA and ARA fatty acids. Mead Johson’s strategy worked, and it was named alongside Abbott in a subsequent report from Reuters.

According to Martek, fatty-acid fortified formulas have been shown to improve the mental and visual development of formula fed babies. This suggests that babies fed on formula to date have had their mental and visual development compromised because of the shortcomings of the products. Whether that is appreciated by mothers reading the ‘Breast is Best’ message on labels is open to question. As Mead Johnson acknowledges in its press release: “Experts agree that breast milk is the gold standard.” Hence, even the “new-improved” formulas fall short and the development of infants fed on them is not optimal. This fact is likely to be lost in the hype which is about to surround the new formulas as Abbott, Mead Johnson and the rest of the industry embark on a new marketing war.

Whether the claims made by manufacturers can be believed is also open to question. A systematic review of available research on Longchain Polyunsatuarated Fatty Acid (LCPUFA) supplementation was made by the Cochrane Library (review dated 15th June 2001). This 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. Minor effects on VEP [Visual Evoked Potentials - measuring visual development] acuity have been suggested but appear unlikely when all studies are reviewed. A beneficial effect on information processing is possible but larger studies over longer periods are required to conclude that LCPUFA supplementation provides a benefit when compared with standard formula. Data from randomised trials do not suggest that LCPUFA supplements influence the growth of term infants.”

Suggested letter to the men ultimately responsible for the way these products are marketed:

Miles D. White, CEO, Abbott Laboratories, 100 Abbott Park Road, Abbott Park, Illinois 60064-3500, USA. Fax:1 847 938 6277

Peter R Dolan, CEO, Mead Johnson, Bristol-Myers Squibb Company, 345 Park Avenue New York, NY 10154, USA. Fax: +1 212 546 4020.

Your company is understood to be marketing or preparing to market infant formula containing Docosahexaenoic Acid (DHA) and Arachidonic Acid (ARA). According to a press release referring to your product, these long-chain fatty acids improve the mental and visual development of formula fed babies.
I would be grateful if you could respond to the following points:

1. Studies have suggested no benefit is conferred by supplementation with Longchain Fatty Acids, but your information disregards such findings. Do you have any scientific grounds for ignoring studies that do not support your marketing strategy?

2. Do you accept that infants fed on previous versions of your products not containing DHA and ARA have had their mental and visual development compromised?

3. Breastfed babies have been benefiting from DHA and ARA throughout history. Do you feel that the warnings on your product labels sufficiently informed mothers of this fact?

4. Breastmilk is the gold standard and contains factors as yet undiscovered which make it the optimal way to feed an infant. Will you ensure that your product labels and information materials, including those for the new formulas, acknowledge this fact and do nothing to idealise the formulas?




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