Baby Milk Action - CEM June 1998

The average annual per capita income in Pakistan is only US$430. Only 47% of the population has access to adequate sanitation and only 74% to safe water (source: State of the World's Children, UNICEF, 1997). But, with over 5 million infants born every year, there is a massive potential market for baby food companies and Nestlé is at the forefront in pushing artificial feeding at new mothers and health workers to boost its own profits. A new monitoring report, the Feeding Fiasco, produced by our partner organisation, the Network of Association for the Rational Use of Medication in Pakistan, describes how:
Nestlé offers discounts to shopkeepers and organises product display competitions.

Nestlé promotes its products aggressively through the health care system by: gifts to Doctors, posters and wall charts in hosptials and trips for health professionals.
Free samples of Nestlé cereal baby foods and infant formulas are routinely distributed. The Feeding Fiasco reports: "Nestlé's representatives, called medical delegates by the company, have to fill a daily report form at the end of every working day.... the representative are required to record...their stock of samples of Al-110, Cerelac, Neslac and four other unspecified products.... A former Nestlé representative said in an interview with The Network that he witnessed cartons of Lactogen 1 being delivered to at least two hospitals, including the Pakistan Institute of Medical Sciences in Islamabad, and had knowledge of area managers making other such donations."

Unsafe water can make bottle feeding deadly. Yet Nestlé promotes 'al 110' infant formula with a leaflet headed "A nutrition that helps control diarrhoea"

A Nestlé growth chart distributed to health workers. It is headed "Road to better health"

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.

Company	Item	Date	Violation Reference
Nestlé	Widespread code violations	March 1998	comp/98/15

In January 1998 we reported on this sheet how Nestlé was attempting to weaken Pakistan's draft baby food marketing law. The World Health Organisation (WHO) and the United Nations Children's Fund (UNICEF) support the Government's draft law.

In response to the January 1998 action sheet Nestlé stated: "...we would be very grateful for any concrete information regarding Code violations; we can assure you that our company will comply in every respect with all its obligations."

Nestlé's statement is clearly for Public Relations purposes. The two examples pictured below, show how Nestlé's violations are deliberate policy and it is well aware of what it is doing.

Nestlé's well-planned marketing activities demonstrate how it views its obligations and why it must be subject to the rule of law. Ask Nestlé to stop all its violations of the International Code and Resolutions and not to oppose Pakistan's draft law

Violation	Complain to
Widespread violations of the International Code.	Mr. Peter Brabeck, CEO Nestlé, 55, av. Nestlé, 1800 Vevey, Switzerland. Fax: 41 21 922 6334

Company	Item	Date	Violation Reference
Mead Johnson	Promotional leaflets for Nutramigen	June 1998	comp/98/16

Article 6.2 of the International Code states that, "No facility of a health care system should be used for the purpose of promoting infant formula or other products within the scope of this Code."

Yet Mead Johnson calls on health professionals to hand out information leaflets to parents. The example shown here is for Nutramigen, promoted as the way to "stop dietary colic". Mead Johnson makes great claims for this product, but analysis of the references shows that these are based on a 1989 study involving just 24 infants. The information states that infants fed on Nutramigen cried on average for 0.7 hours/day compared to 5.6 hours/day for those fed on cow's milk formula. Nowhere is it stated that Nutramigen is also based on cow's milk and no comparison is made with breastfed infants.

Article 7.2 limits companies to providing "scientific and factual" information to health workers. Mead Johnson gives incomplete information to create the belief that Nutramigen is superior to breastfeeding.

Ask Mead Johnson to abide by the International Code and stop using the health care system to promote its products

Violation	Complain to
Mead Johnson encourages health workers to promote its products in breach of Article 6.2.	Mr. Peter R. Dolan, President, Mead Johnson Nutritional Group, Bristol-Myers Squibb Company, 2400 W. Lloyd Expressway, Evansville, Indiana 47721

Company	Item	Date	Violation Reference
Nestlé	Nestlé "Health Educators" promote products to mothers	June 1998	comp/98/17

On the March 1998 action sheet we published a photograph of a Nestlé Health Educator in the Philippines. Nestlé employs nurses and uses them to promote artificial feeding directly to mothers at home.

In response to the action sheet Nestlé has said: "...direct contact of these persons with pregnant women or mothers is explicity forbidden - because it does not conform to the Code - and Nestlé verifies that these restrictions are strictly followed."

Yet our partner organisation in the Philippines interviewed some of Nestlé's Health Educators and confirmed they were following Nestlé's instructions. Their supervisors also require them to conduct surveys of product use so they can better target their marketing activities.

When Nestlé's Health Educators were exposed on television in the Philippines last year, Nestlé threatened to withdraw its advertising from the television station. (See September 1997 action sheet)

Appealing to Nestlé to change is achieving nothing in this case. Please encourage your friends and family to boycott Nestlé products, if they are not doing so already, and write to Nestlé explaining why.

Violation	Complain to
Direct contact with mothers is in violation of Article 5.5 of the International Code	Mr. Peter Brabeck, CEO Nestlé, 55, av. Nestlé, 1800 Vevey, Switzerland. Fax: 41 21 922 6334