Q. (14 August 2007) What is the substantiation for the claims on your Give Nescafé the boot flier?
A. Our flier is based on research findings and monitoring evidence.
Each of the statements on the leaflet, as last printed, are given below with background information.
Monitoring on the ground by members of the International Baby Food Action Network (IBFAN) finds Nestlé to be responsible for more violations than any other company. Monitoring evidence is provided in the codewatch section of the Baby Milk Action website.
In 1999 the UK Advertising Standards Authority ruled against a Nestlé anti-boycott advertisement in which it claimed to market infant formula ‘ethically and responsibly’ and that ‘The Nestlé Charter concerns Nestlé's commitment to the WHO International Code in developing countries.’
Nestlé was warned not to repeat these claims. Nestlé also lost its appeal against the ruling. Click here for further information. While it does not make them in advertisements, it does make them in public relations materials and public statements, which are not subject to the same requirement that they be ‘legal, decent, honest and truthful.’
Nestlé has long disputed IBFAN's evidence of on-going malpractice. Over ten years ago this prompted the Church of England to join together with other faith, development and academic organisations to conduct independent research. The 27-member Interagency Group on Breastfeeding Monitoring (IGBM) published the report Cracking the Code in 1997, noting 'systematic' violations by Nestlé and other companies (click here). UNICEF commented that IBFAN's monitoring was 'vindicated'.
This quote is from the State of the World’s Children 2001. Available at: http://www.unicef.org/sowc01/maps/maps/map1nf.htm
It has been given in various other forms by UNICEF and WHO. The UNICEF website states (on 14 August 2007):
In a 1997 press release responding to the Cracking the Code report referred to above, UNICEF stated:
However, the figures are disputed by Nestlé (see Your Questions Answered).
In 1995 Baby Milk Action was required to defend the statistic before the Advertising Standards Authority after stating in a Nestlé boycott advertisement shown above:
We did so successfully and, as the ASA report notes, this was with the support of WHO.
A 2003 study in the Lancet examined the question “How many child deaths can we prevent this year?” and concluded that promotion, protection and support of breastfeeding is potentially a more effective health intervention than provision of save water, sanitation and vaccination. Improved breastfeeding rates could prevent 13% of under-5 deaths in the 42 countries where most occur, amounting to 1.3 million. Appropriate introduction of complementary foods could prevent 6% of deaths.
The original reference for the '25 times' figure is the following paper. The words 'up to' are used because of risk factors and findings of other studies giving a lesser figure.
Why promote breastfeeding in diarrhoeal disease control programmes? Isabelle de Zoysa, Marina Rea and José Martines. Diarrhoeal Disease Control Programme, WHO, Switzerland. Health Policy and Planning; 6(4): 371-379. http://heapol.oxfordjournals.org/cgi/content/abstract/6/4/371
Findings from another peer-reviewed paper:
Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis WHO Collaborative Study Team on the Role of Breastfeeding in the Prevention of Infant Mortality. The Lancet. Vol 355: 451-455.
The impact of the cost of baby foods has been documented since the Baby Killer report in the 1970s, which noted:
Bringing it bang up to date, in 2007 the financial impact of artificially feeding a child was reported in a film from UNICEF Philippines.
Looking back to the early history, The Baby Killer booklet quotes the UN Protein Advisory Group:
Studies on the appropriateness and safety of using infant formula in interventions to improve health outcomes for infants of HIV-infected mothers have provided more recent data. A study by Dr. Mickey Chopra et al of the University of the Western Cape Public Health Programme found:
Summary of the Findings and Recommendations from a Formative Research study from the Khayelitsha MTCT Programme, South Africa. Chopra M, Shaay N, Sanders D, Sengwana J, Puoane T, Piwoz E, Dunnett L. University of the Western Cape Public Health Programme; USAID/SARA Project; DoH Provincial Authority of Western Cape. May 2000. See: http://www.linkagesproject.org/media/publications/Technical%20Reports/
A WHO paper for South East Asia on action in an economic crisis, updated 4 September 2006 noted http://www.searo.who.int/EN/Section1243/Section1310/Section1343/
“Rather than the protective effect of exclusive breast-feeding (and the fact that breast milk is free), infants will potentially be weaned to an infant formula that may be overly diluted (because of its expense, even if subsidized) and prepared with contaminated water (because of the difficulty and expense of boiling or using bottled water for proper formula preparation) in situations with unsafe water supplies.”
The 2007 film from UNICEF Philippines also refers to the risks from over-dilution of formula.
A report prepared for the 15th anniversary of the Innocenti Declaration on breastfeeding support in 2005, suggested breastfeeding saves 6 million lives every year. See our report in Update 37 which has links.
According to UNICEF: "If a mother is moderately malnourished, she will continue to make milk of good quality, better than infant formula. If she is severely malnourished, the quantity of breastmilk produced for each feeding may be diminished. In both cases, for the health of the mother and the child, it is safer and better to feed the mother adequately while helping her to continue breastfeeding."
IBFAN actively works with the Emergency Nutrition Network to ensure that field staff are trained to support breastfeeding mothers and to ensure that locally-sourced breastmilk substitutes are used safely should they be necessary.
The idealizing nature of Nestlé's marketing can be seen from the monitoring evidence cited above.
There have been many studies showing the impact of promotion on infant feeding advice and decisions.
Office prenatal formula advertising and its effect on breast-feeding patterns. Howard C et al. Obstetrics and Gynaecology Vol 5, No 2, Feb 2000 p296-303 This study of 547 pregnant women, compares the effect of formula company-produced materials about infant feeding to breast-feeding promotion materials without formula advertising on breast-feeding initiation and duration. Although breast-feeding initiation and long-term duration were not affected, exposure to formula promotion materials increased significantly breast-feeding cessation in the first 2 weeks. Additionally, among women with uncertain goals or breast-feeding goals of 12 weeks or less, exclusive, full, and overall breastfeeding duration were shortened. The study concludes that formula promotion products should be eliminated from prenatal settings.
the 10 Steps to successful breastfeeding, Tables 1.1,
and 6.4 and 6.5. WHO Geneva 1998 This (and many other useful
documents) can be downloaded from WHO’s website:
of Infant Food Advertising on infant feeding practices in St
Vincent, International Journal of Health Services Vol
12 No 1 1982 p 53 to 75.
Breastfeeding in Norway – where did they go right? A Gerrard, British Journal of Midwifery, 2001 May, vol. 9, no. 5, p: 294-5, 297-300, (21 ref), http://www.cinahl.com/cgi-bin/refsvc?jid=1450 ISSN: 0969-4900. This comparative paper between Scotland and Norway, analyses the historical, social and cultural factors that influence the prevalence of breast-feeding. It concludes that the strong cultural norm to breast-feed in Norway is partly because of a more relaxed attitude towards the naked human body, a healthier lifestyle in general but also because strategies to reverse the effects of commercial promotion of formula milk, and inconsistent advice by health professionals were implemented at an early stage of the declining trends.
Do consumer infant feeding publications and products available in physicians' offices protect, promote, and support breastfeeding? Valaitis RK, Sheeshka JD, O'Brien MF. School of Nursing, McMaster University, Hamilton, ON, Canada. J Hum Lact. 1997 Sep;13(3):203-8.
Commercial hospital discharge packs for breastfeeding women (Cochrane review). Donnelly A., Sonwden HM, Renfrew MJ, Woolridge MW. In: The Cochrane Library, Issue 2, 2002 Oxford: Update Software.
The U.S. infant formula industry: is direct-to-consumer advertising unethical or inevitable? Cutler BD, Wright RF. Health Mark Q. 2002;19(3):39-55. T, Until Nestle's entry into the U.S. infant formula market in 1988, there was little direct-to-consumer promotion of infant formula. This article provides a historial background of infant feeding in the United States and looks at how mothers' make their infant formula selection.
Violations of the international code of marketing of breastmilk substitutes: prevalence in four countries. Taylor, A BMJ 1998;316:1117-1122. This study by Anna Taylor of the Interagency Group on Breastfeeding Monitoring (IGBM) is based on interviews of 3050 women and 466 health professionals in 165 health facilities in Bangladesh, Poland, South Africa, and Thailand. See above.