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Issue 28: November 2000

The news items which appear on this page also appear in the printed version of Update.

Printed copies of Update are sent to members/subscribers.

Membership costs just £18 waged, £7 unwaged, £25 family, £50 organisations - for members outside the UK there is an extra postage charge. You can join on-line in the Virtual Shop.

If you would like to receive an e-mail alert when new information is posted to this website, send an e-mail to with the subject "e-mail alerts only"

Table of Contents

Patti Rundall, Baby Milk Action's Policy Director, received the Order of Officer of the British Empire (OBE) from Her Majesty, Queen Elizabeth II, for "services to infant nutrition" in June. Patti was also shortlisted for the European Woman of Achievement Award 2000, humanitarian category. (Photo:BCA Film - See Press Release 6 June 2000).
  • International policy
    • Mothers and babies need a corporate-free UN
    • The 'about 6 months' or '4-6 months' question
    • ...and from the archives
    • Eurodiet success
    • Tobacco Free Initiative prompts WHO Declaration of Interest
    • New research into cot death
    • Honduras study says 'about 6 months'
    • Dangers from plastic feeding bottles
    • Different tack for promotion
    • ILO success

  • Round-up

    • Amy's jump!
    • Calendar 2001
    • Overseas Training Programme
    • That's a good idea...
    • AGM 27th January 2001

Boycott news

Supplement with the latest on the Nestlé boycott

Editorial: Communication is the key

Members of Baby Milk Action received a questionnaire with Update 27 asking for feedback. The main findings are given here. We are making some changes as a result.

Baby Milk Action is the UK member of IBFAN

The survey has shown the need to make some clearer links between our work in the UK and our work in support of overseas partners. Baby Milk Action is the UK member of IBFAN, the International Baby Food Action Network. But that means much more than putting the IBFAN logo on our publications. We learn from the direct experience of our partners what baby food companies are doing around the world. There are over 150 IBFAN groups in more than 90 countries. Baby Milk Action targets marketing malpractice through company campaigns such as the Nestlé boycott and the Campaign for Ethical Marketing. These activities not only raise awareness of the issues, they support our partners and bring about changes.

In this issue we feature an IBFAN group with which we have been working closely - GINAN, the Ghanaian Infant Nutrition Action Network. Three years ago together we prevented a plot to launch a new infant formula in Ghana through the distribution of free supplies. There are infants alive in Ghana today who may have died, but for this success. Ghana has now introduced legislation regulating the marketing of baby food products after years of opposition from the industry. Charles Sagoe-Moses tells us about the work of GINAN.

Act locally and have a global impact

In the Boycott News supplement we report on demonstrations and protests against Nestlé in Bristol. Nestlé claims that it is "trusted around the world." The media coverage of protests in the UK is used by our partners to show that Nestlé's assurances should not be taken at face value.

The internet offers new possibilities

ZDF television in Germany has still not broadcast its report on Nestlé whistleblower, Syed Aamar Raza. While Canadian TV did cover the launch of the Milking Profits report there, newspapers did not - media consultants were waiting outside the press conference to grab journalists as they left. Newspapers carried Nestle advertisements, but not reports on the launch.

There are other ways for us to bring Aamar's documentary evidence to public attention. We now have a video of a presentation he made in Cambridge which you can borrow. You can follow the links given below to articles about Aamar in the British Medical Journal and elsewhere. You can even download an MP3 file to hear Aamar interviewed by Leeds Student Radio.

By reading this newsletter on-line, you can save the resources of Baby Milk Action and the world. Simply send an e-mail with the subject 'e-mail alerts only' to We will send you alerts when new information is posted. If you access the Campaign for Ethical Marketing on the website you can send complaints directly to the companies responsible for violations. The website now has a Virtual Shop so you can order on-line.

Fighting another round thanks to members

Baby Milk Action made several appeals for donations from members earlier this year. This was necessitated by the long delay in our European Union grant being processed. Our EU-funded project actually began in September 1999, but bureaucratic delays mean we have only just received the contract. Without the generosity of members seeing us through particularly lean times Baby Milk Action would have had to wind up its business. As it was, staff pay was delayed for 2 months. With the fall in the Euro, the sterling equivalent of the grant is less than budgeted.

We also greatly appreciate long-term supporters Save the Children, the United Reform Church, Christian Aid, Oxfam, World Vision, War on Want, SCIAF and Network for Social Change who maintained their support.

Readership survey

In May 2000 every Baby Milk Action member was sent a questionnaire with Update 27 in order to canvas views on various aspects of our work. This type of survey was last done in 1995. 388 (18%) of the 2160 questionnaires were returned. Overall, the Update newsletter, read in its entirety by the majority of respondents, is well received. We will consider all suggestions for improvements.


The most common introduction to Baby Milk Action (19%) was through the National Childbirth Trust (NCT). Others heard about us from other UK mother support groups, through work as a midwife and from the media etc.

Overall a huge variety of charitable organisations are supported by respondents. Human rights/development groups such as Oxfam, mother support groups such as NCT, and environmental groups such as Friends of the Earth often being cited.

Update newsletter

Respondents felt that the most important (and the most interesting) issue covered by Update was the Nestlé boycott (Boycott News). IBFAN issues were seen as least important (and least easy to understand), and there were many comments along the lines of 'unsure what IBFAN is'.

Over 100 suggestions were made by respondents about what they would like to see more of in Update. These, in order of popularity, included: UK issues and campaigns; reports of local campaigning successes, e.g. area contact activity; what the readers themselves can actually do to help; research and reviews and breastfeeding articles.

Criticisms of Update (although they were few in number) included the use of too much jargon and the layout being too cramped.

90% of respondents felt that Update was reader friendly. Of the 10% who did not, most commented that it was: 'too complex for my level of interest', or 'too detailed for general supporters'.

Update is currently produced 3 times a year - 53% of members felt that this was fine. 5% said it should be produced 'as often as funds allow', and that subscriptions should not be raised in order to do this.

Over half (61%) of respondents said they used Update for purposes other than personal interest, such as campaigning (mainly at work for spreading information about the Nestlé boycott), but also in their work as breastfeeding counsellors or midwives.

Respondents felt that the following ideas would make Update a better resource for campaigning: inclusion of a small (A4) poster/fact sheet which can be displayed/given out (as with recent centre-pages in Boycott News 24, Update 25 and Update 27); more action points; more information in the form of bullet points and the use of more graphs and charts. Respondents also felt that a summary of our work/aims should be repeated in the front of each edition of Update.

Only 8% of respondents said they accessed our website.

Logos and images

74% of respondents were not keen on the Baby Milk Action logo; there were comments such as: 'not immediately identifiable with babies, milk or action'.

31% liked the 'baby kicking' image, as it is friendly and attention grabbing. 5 respondents felt it was too light hearted and trivialised the issue.

The 'twins' photo provoked an interesting response with some respondents feeling that such a hard-hitting image was necessary. Others felt it was too extreme.

Over half (52%) of respondents were full of praise for the calendar, describing it as beautiful, excellent, very positive, and 'great - much appreciated in local health service premises'. Some (10%) felt it was inappropriate for 'home use'.

Many positive comments were made about our work, such as: 'big business seems invincible but you are making a difference' and 'I am extremely impressed by the achievements of Baby Milk Action and the publication Update'.

Thank you for your feedback! All the suggestions made will be considered by the staff team.


Why people joined:

A (46%) - Nestlé boycott

B (25%) - the problems associated with unethical marketing of breastmilk substitutes in less developed countries.

C (17%) - work to protect, promote and support breastfeeding in the UK and globally.

D (12%) - Other

17% of our respondents are breastfeeding counsellors.
12% are full-time mothers.
12% are midwives.
5% are health visitors.


New resource to sharpen critical faculties in a world of PR

  • the typical American receives more than 3,000 marketing messages daily

  • the Pope has asked Pepsi Cola to help deliver his message to the world

  • private companies provide over £23 million to UK schools, much of it through brand marketing aimed at children

Every day, without us being aware of it, our perception of the world is shaped by the multi-billion dollar Public Relations (PR) industry. How can we tell fact from fiction - genuine philanthropy from corporate cover-up?

Seeing through the Spin, written by Reading International Solidarity Centre and produced by Baby Milk Action is designed primarily for teachers and youth leaders for use in global citizenship, media studies and business studies curricula. However, anyone with an interest in health or human rights will find this pack useful. The pack includes a chart showing how it fits in with the UK National Curriculum.

The 14 participatory activities and a host of appendices address sponsorship, public relations, fairtrade and the role of businesses and NGOs in health and development. The pack will develop the skills students need to deconstruct public relations messages and to become questioning, aware 21st century citizens. While some exercises use the baby milk issue as a case study, other industry sectors and campaigns are also examined (such as food, mining, clothing and tobacco).

The pack contains 172 pages, 57 photos and cartoons, and, with the printed version, a selection of PR and campaign materials. It is available as a hard copy for £15 + £3 p&p in the UK (available soon via the on-line Virtual Shop) or as a free download from this website.

"Persuasion, by definition, is subtle. The best PR ends up looking like news. You never know when a PR agency is being effective; you'll just find your views slowly shifting." PR Executive.

Breastfeeding - from Parliament to Pakistan

Candidates for Speaker of the UK Parliament were invited to attend a fringe meeting at the Labour Party Conference on 26th September 2000. Controversy has reigned since the retiring speaker, Betty Boothroyd, banned breastfeeding in committee meetings. MPs Julia Drown and Julie Morgan spoke of their support for breastfeeding in the UK and worldwide. UNICEF UK Director, David Bull, spoke about the Baby Friendly initiative. Richard Howitt MEP announced that public hearings into the European baby food industry will take place shortly. Patti Rundall of Baby Milk Action spoke about the case of Syed Aamar Raza and welcomed moves by the Pakistan authorities to regulate the marketing of breastmilk substitutes. The meeting was also introduced to the "Seeing through the Spin" school's pack.

Pakistan latest

Nestlé whistleblower attends World Health Assembly

Former Nestlé employee, Syed Aamar Raza, attended the World Health Assembly in May and presented his documentary evidence of company malpractice in Pakistan at a meeting with the Press (order Milking Profits or read the summary in Update 27).

At the meeting Dr. Timothy Stamps, Minister of Health, Zimbabwe, explained how Nestlé used economic threats to try to stop legislation being introduced in his country. Aamar met the Director-General of WHO and the Minister of Health of Pakistan, and raised his concerns.

Going to the top - Syed Aamar Raza with Dr. Gro Harlem Brundtland, Director-General of WHO. (Photo: Patti Rundall)

Pakistan moves ahead with legislation

Following the publicity surrounding Aamar's evidence, the Ministry of Health in Pakistan has announced that it is moving ahead with legislation to regulate the marketing of baby foods. A draft has been in existence since 1992, but has been opposed by the industry, principally Nestlé.

Please write to the Minister, supporting strong, independently monitored measures. The March 2000 Campaign for Ethical Marketing action sheet gives a model letter.

Audit finds violations

An audit of Nestlé Pakistan, commissioned by Nestlé, was launched in May. The auditors, Emerging Market Economics (EME), agreed with Nestlé not to consult independent experts and instead only questioned Nestlé staff and doctors from a list provided by Nestlé. The interpretation of the marketing code used is incorrect, but EME still found violations. For example, Nestlé admits to paying travel expenses for doctors and not declaring this to the appropriate authorities.

Nestlé has used the audit, which is generally complimentary, to dismiss Aamar's evidence, but the auditors clearly state that it: "does not represent an attempt to investigate any of the allegations made, either by the Network [publisher of Milking Profits] or by Mr. Raza." In a letter to the British Medical Journal (see the auditors go further: "First, it should be clarified that we did not investigate allegations made by Syed Aamir Raza [sic]. We have made clear that the methodology used is not suitable for the investigation of specific allegations concerning events that may have taken place some years ago." (emphasis added).

Our partner organisation in Pakistan, The Network, has published Masking the Truth an analysis of Nestlé's audit (order it from the Virtual Shop).

Shareholders hear all about it

The Nestlé shareholder meeting in May was once again dominated by questions about the baby food issue, this time about Aamar Raza. As Helmut Maucher stepped down after 20 years, his successor as CEO, Peter Brabeck, made an 11-minute attack on Aamar, repeating defamatory statements which Nestlé has refused to substantiate, and mis-using the EME audit to dismiss his evidence.

The Canadian launch of Milking Profits in September was broadcast on television there, though the print media was more reticent. Syed Aamar Raza's voice can now be heard on video and on the internet (see Leeds Student Radio).

EU Parliament to investigate

The public hearings into the European baby food industry did not take place in July, but are now scheduled for 22 November. The Pakistan group, The Network, has been invited to attend to present evidence of its in-depth and widespread monitoring and campaigning activities.

STOP PRESS: See Press Release 23 November 2000: MEPs shocked as Nestlé and Adidas snub Public Hearings on corporate responsibility and reports in The Independent , The Guardian and The Scotsman.


Focus on Ghana

Dr. Charles Sagoe-Moses was elected Chair of the IBFAN Africa Advisory Committee at the IBFAN Africa Regional Meeting in Swaziland in September 2000. Dr. Sagoe-Moses is also Chair of the Ghanaian Infant Nutrition Action Network (GINAN). He was interviewed by Mike Brady.

What are the main focuses of GINAN's work?

Our main focus is community work - mother support groups - training them, forming them and using them to monitor the International Code of Marketing of Breastmilk Substitutes. There are over 30 groups spread all over the country. Also we have been very strong advocates of the enactment of the International Code into law in our country. I am very pleased to say that this year on 9th May Parliament enacted the Code into law.

Does being part of the global IBFAN network help you?

It is very important in terms of providing some technical know-how and also countering the pressure from industry. There have been many times when IBFAN Ghana has worked with other IBFAN groups to complain about violations. For example, with some of the violations by Nestlé and by a company called SAR from the US which was planning to flood the West African market with its baby milk products. It was networking between GINAN and Baby Milk Action which really stopped this marketing violation which could have done terrible damage to health (see Update 23).

Do you think campaigns such as the Nestlé boycott help you with your work?

It shows that it is not only people in Ghana who are saying "No" but there are also people in the UK. Sometimes people think that people in the advanced world are using formula and are happy with formula and we are able to show them that breastfeeding is good for everyone and the people there are campaigning because they want what is good. The people there are campaigning because they think they have a voice and they want to use their voice to help some people in the developing world who do not have a voice.

Is HIV having a great impact on your work?

I must confess that the HIV situation has caused a scare really and some of the gains that we have made in our campaign appear to be threatened by the HIV situation because sometimes other people suggest that every mother has HIV and that is not the true situation.

There are those who say mothers with HIV must artificially feed. Are there other options for mothers?

Oh I think so. I think the problem is that various options like exclusive breastfeeding, milk banks, milk donations, wet-nursing, the use of other milk, maybe home prepared milk etc. have not been given sufficient research. Everybody thinks it is easier to hand people tins of formula and that solves the problem. It's not. I believe in some cases it creates a bigger problem for the family than one would have thought.

We should look at the problem from a realistic point of view not just trying to say let's do something so doing anything that we think is easy to do. It is easy to count how many tins have been distributed and to say we have done so much, but what is going to be the health outcome of this, if mothers choose not to breastfeed? I would encourage that we look at the ways that people traditionally use to support those who do not breastfeed for whatever reason.

Are children dying in Ghana because of unsafe bottle feeding?

I can't put figures on it, but certainly a lot of the malnutrition that we have can be traced to inappropriate feeding practices.

Swazi Health Minister comments on HIV

Dr. P. K. Dlamini, Minister of Health, Swaziland, addressed the IBFAN participants. Her comments on HIV included:

" I do happen to have seen as a young doctor hundreds of babies die because of improperly made artificial feeds and poor hygiene. But we cannot keep ignoring evidence that HIV may be transmitted in many routes and one of them is breastfeeding. Nevertheless the evidence is also that even with an HIV positive mother exclusive breastfeeding for the first 4 to 6 months can protect the child. ...the best way is to provide the women, the families, with all the information at hand at the moment and allow them to make informed decisions, support them and facilitate support for the baby so that at the end of the day whatever is done is in the best interests of the child.

"This is where we are at at the moment. Countries of the West should not prescribe interventions that may not be practicable in our communities in total disregard of the situation on the ground."

UK News

Cow&Gate claims to solve "symptoms in 94%" of babies

Artificially-fed infants, even in the best of conditions, are at greater risk of health problems. Baby food companies are seizing on the problems to expand the market. But are mothers, perhaps unaware of the benefits of breastfeeding, being misled into using "specialised" milks unnecessarily? Health workers are concerned about the basis for health claims used by companies. Ethical questions arise over whether those taking part in trials are truly giving 'informed consent' and the way trials are being used for commercial purposes.

Cow & Gate's marketing of Omneo 1 and 2 - infant and follow-on formulas thickened with starch and sweetened with glucose syrup - illustrates some of the dangers. C&G (owned by the Dutch company, Numico) is using claims such as: "Now for the 56% of babies who present every month with minor feeding problems. There's a proven formula...Significantly improves symptoms in 94% of babies." This claim is based on a study of only 51 babies and C&G would not supply the 'data on file' or the 'Health Visitor Survey' cited as references. C&G claimed the survey was 'independent' and at the same time funded by C&G. They said it was common practice for advertisers to make unpublished references. The Oxford Dictionary definition of 'symptom' is: "aspect of physical or mental condition as sign of disease or injury..." but C&G says Omneo is not a 'medical food' and would not say what diseases Omneo cures. Let us know of trials going on in your region.

SMA bring on the clowns

The SMA stand at the Royal College of Midwives' conference in Jersey earlier this year caught the eye because of the pair of jugglers performing there (see Campaign for Ethical Marketing action sheet October/November 2000). Article 7.2 of the International Code states that "Information provided by manufacturers and distributors to health professionals...should be restricted to factual and scientific matters." We're unsure which 'factual and scientific' aspect of infant feeding juggling portrays. Contact SMA via the action sheet and ask them why they repeatedly violate the Code in this manner.

Baby Friendly makes an impact

Nationwide breastfeeding initiation rates showed no increase from 1980 to 1995. But when a hospital becomes Baby Friendly rates have increased by 10% in the following four years. The average breastfeeding initiation rate for Baby Friendly hospitals is 70.6%, with the largest increases being found in hospitals in inner-city or deprived areas. For example, Queen's Park Hospital in Blackburn now has an initiation breastfeeding rate of 66% as compared with only 27% in 1991. (See

UK changes in sight

LACOTS - the Advisory Body for Local Trading Standards Authorities - will meet the members of the Baby Feeding Law Group in the near future to discuss ways to improve UK legislation. The Department of Health and the Food Standard's Agency will also attend the meeting.

Baby Feeding Law Group (UK)

BFLG (UK) is a group of professional and voluntary organisations who meet on a regular basis to discuss baby food marketing and work to bring UK legislation into line with UN Resolutions. It now has 16 member and one observer organisations:

  • Association of Breastfeeding Mothers (ABM)

  • Association for Improvements in the Maternity Services (AIMS)

  • Association of Radical Midwives (ARM)

  • Baby Milk Action

  • Community Practitioners and Health Visitors' Association (CPHVA)

  • Food Commission

  • Lactation Consultants (LCGB)

  • La Leche League (LLLGB)

  • Maternity Alliance

  • Midwives Information Service (MIDIRS)

  • National Childbirth Trust (NCT)

  • Royal College of General Practitioners (RCGP)

  • Royal College of Midwives (RCM)

  • Royal College of Nursing (RCN)

  • The Breastfeeding Network (BfN)

  • UNICEF UK Baby Friendly Initiative (BFI)

  • Health Development Agency (HDA) - observer


HIV fuels the 'partnership' debate

Our concerns about the involvement of for-profit industries in public health research are illustrated by the HIV/infant feeding dilemma. The UN (see below) and many other agencies are sharply aware of the need for solutions which are affordable and appropriate for those who need it most - the people who can least afford to pay.

The EU Commission for Trade is also looking at these issues and has started a series of meetings with 'civil society' including NGOs such as IBFAN to discuss EU policy. The discussions follow the resignation of the EU Commission and the breakdown of World Trade Organisation talks in Seattle last year.

Together with NGOs such as Health Action International, Oxfam and Medicins sans Frontieres, we have been asking the EU to ensure that trade rules do not prevent developing countries from ensuring their citizens have access to appropriate drugs when necessary.

IBFAN expressed additional concerns about marketing and the use of 'partnerships' as incentives for industry. We are callimg for truly independent research in the public interest, including on HIV/AIDS (with no 'wealth generation objectives.') Industry involvement in research and health services can mean that primary prevention, the needs of the mother, counselling, good nutrition, safer breastfeeding and the risks of artificial feeding are given less attention than the delivery of 'products' and high-tech solutions.

The issue of exclusive breastfeeding and the risks of replacement feeding were hot topics at the 13th International Aids Conference held in Durban, South Africa, in July. Only one study has looked at transmission rates when mothers exclusively breastfeed and only a few small projects have looked at ways to make breastfeeding (or the use of breastmilk) 'safer', for example, simple heat treatment of expressed breastmilk. Although feeding expressed breastmilk is not ideal for many reasons (for example, contamination, stigma, loss of some of the anti-infective properties and difficulties of expressing long term) it is far too early to abandon it and/or exclusive breastfeeding, as strategies. Apart from the obvious cost and distribution benefits, breastmilk is rich in anti-infective and anti-viral substances, such as lactoferrin and human milk fat globules (products now being patented by companies for the treatment and prevention of HIV).

For further information see

Further reading: Understanding Business-NGO partnerships, World Vision paper10 Summer 2000

Don't forget: Donations benefit companies in many ways. Tax rebates based on high retail prices can be far greater than production costs.


UNICEF on sponsorship

The British Medical Journal has carried many articles and letters about the baby food industry, WHO and UNICEF. Here Carol Bellamy, UNICEF's Executive Director explains UNICEF's position.

"Let me get right to the crux of the matter:..UNICEF does not accept donations from manufacturers of infant formula whose marketing practices violate the International Code of Marketing of Breast Milk Substitutes and subsequent WHA resolutions. Moreover, UNICEF stands firmly behind the Code and will continue its long- standing support for breastfeeding programs world-wide. Over the past few months there has been considerable discussion within UNICEF regarding our relationships with the corporate community, including infant formula manufacturers. This internal discussion emerged principally because UNICEF is one of the co-sponsoring agencies of UNAIDS and has, at the request of the UN Secretary-General, been among those involved in discussions with five large pharmaceutical companies on the possibility of obtaining a variety of drugs to fight HIV/AIDS at discounted prices on behalf of developing countries. One of these companies is widely viewed as violating the Code. Some inside and outside of UNICEF have misinterpreted our involvement in these UNAIDS-led discussions as a sign that we are weakening our support for breastfeeding and the Code. Nothing could be further from the truth. In fact, UNICEF believes that in the face of AIDS our support for breastfeeding must be strengthened, not diminished.

"Nonetheless, where we think a company Ð any company Ð may offer a compelling solution to a crucial child health problem such as HIV/AIDS, we will not shy away from exploring how to get that company working on behalf of children and women. At the same time, UNICEF will uphold its support of the Code and will continue to publicly call violators of the Code to account.

"Are the issues complex? Yes. Is the growing calamity of HIV/AIDS forcing us all to consider new approaches to our work? Absolutely. That's why there is a spirited debate within UNICEF. But regardless of our soul- searching on how best to navigate through the sometimes conflicting policy issues raised in part by AIDS, UNICEF remains resolutely committed to breastfeeding and the many benefits it provides to both mother and child. At the same time, UNICEF recognizes that mothers infected with HIV face an agonizing dilemma on how best to feed their infants and strongly supports the efforts of researchers to better understand this crucial area of transmission.

"Finally, as has been the case throughout the ten years since the ratification of the Convention on the Rights of the Child, UNICEF will strive to base its actions and programs on the best interests of the child."

Sincerely, Carol Bellamy Executive Director UNICEF 18 July 2000.

10 other letters, a response from Baby Milk Action and 3 articles appear in the British Medical Journal. BMJ Vols 320 (20 May) 321 (9 Sept, 14 Oct 2000) or search archive:

International policy

Mothers and babies need a corporate-free UN

An Alliance of international environmental and human rights groups, including IBFAN, have written to UN Secretary General Kofi Annan, asking him to reconsider his `Global Compact' initiative, launched in July. Over 40 companies have made promises to abide by certain criteria in exchange for the limited right to use the UN logo. NGOs are asking Kofi Annan to focus instead on establishing a legally binding framework to oversee the conduct of multinational corporations. See Tangled Up in Blue (in our Schools Pack or on the Internet at

The 'about 6 months' or '4-6 months' question

The controversy surrounding the recommended duration for exclusive breastfeeding and the labelling of baby foods shows how companies seek to influence UN bodies and the democratic process and how this can affect infant health.

Under Article 18 of WHO's Constitution, the Assembly's Resolutions determine WHO's Policy. Despite this, the baby food industry and on occasion WHO's Secretariat, fail to mention a key Resolution passed in 1994 (WHA 47.5). This urged member states to foster "appropriate complementary feeding practices from the age of about 6 months." This is causing worldwide confusion and is undermining policy makers in the 61 countries whose policies refer to 'about 6 months'. Industry, meanwhile, continues to promote foods labelled for use at 4 months around the world, including in developing countries where the risks to health are high.

In March 2000, at its expert Global Technical Consultation (Update 27, BMJ, Vol 321,14 Oct, letters) WHO attempted to censor all discussion of this topic. In May, at the World Health Assembly, when the Brazilian Government proposed a Resolution reaffirming 'about 6 months,' James Akré, a WHO Technical Officer, lobbied against this. In the event, the Assembly referred the Resolution for adoption in 2001 (WHA 53 Agenda item 12.4.), a decision which James Akré referred to in the British Medical Journal, as a 'diversion from WHO's cyclical mandate' (BMJ 9 Sep'00).

Meanwhile, global standards for the labelling of complementary foods are being debated at the Codex Alimentarius Commission. At the meetings India, Mexico and Brazil have stressed the increased mortality and morbidity associated with early complementary feeding. Brazil asked WHO how its Multi-Centred Growth Study (MGS), which are intended as a growth reference standard for breastfed infants, could resolve the issue of age of introduction of complementary feeding. WHO referred to a Review of Literature (ready in March 2001) and admitted that the MGS (not ready till 2003) was not designed to resolve the issue.

The Association of Infant Food Manufacturers (IFM) appears to be fearful that the age issue may be clarified once and for all at the next Assembly, in time for the Codex meeting in June 2001. IFM sent a paper to member companies in July, setting out its message for Assembly preparatory meetings: "Any action dealing with Infant and Young Child Nutrition should be delayed until the World Health Assembly 2002."

...and from the archives

In 1987, when industry was pushing for a Codex Standard for follow-on milks at 4 months, WHO stressed the dangers of early complementary feeding and argued strongly in favour of 'about 6 months': "breastmilk alone satisfies the energy requirements of infants to around six months ...the addition of other foods can result in a decrease of up to 75% of iron absorption.." (CX/FSDU/87/5 add 1)

Eurodiet success

Our campaign to improve EU legislation achieved a major success at the Eurodiet Conference in Crete in May, a two-year project supported by the European Commission for Health and the University of Crete. Despite fierce opposition from the food industry, Eurodiet recommended strong population goals for the consumption of fruits and vegetables, for sugar, for exercise, for exclusive breastfeeding for 'about 6 months.' The PolicyWorking Party also considered that EU legislation should give effect to the International Code and WHA Resolutions. 14 members of the Baby Feeding Law Group (UK) wrote in support. (See the report in Public Health Nutrition in your library).

Tobacco Free Initiative prompts WHO Declaration of Interest

In its struggle to pursue the Framework Convention on Tobacco Control, WHO has carried out a major investigation into the way that the tobacco industry has infiltrated the UN, and caused tobacco control to fall into 'historic neglect'. WHO has implemented one of the 58 recommendations in the Inquiry's 260 page report (published on Aug 2) by introducing a Declaration of Interest Form for all its experts and prospective advisors. We hope this will also apply to staff.

Research and reviews

New research into cot death

Researchers from Manchester Royal Infirmary studying cot death, discovered a link with the gut bacteria Helicbacter pylori, and stressed the importance of good hand hygiene and breastfeeding as preventive measures. Unlike the New Zealand Government, the UK Department of Health has not included breastfeeding in its advice to parents on minimising risk of cot death.

Ref: Archives of Disease in childhood 2000, vol. 83 p 429-434.


Honduras study says 'about 6 months'

A study in Honduras has concluded that: "from the perspective of infant growth, exclusive breastfeeding for about 6 months can be recommended, even among full-term, low-birth-weight infants in a developing country such as Honduras." This conclusion was reached after studying 128 low-birth-weight babies who had been exclusively breastfed for 4 months and then randomly divided into two groups. In one group the babies continued to breastfeed exclusively until the age of 6 months, and in the other they were fed twice daily with complementary foods. "There was no growth advantage of complementary feeding of small-for-gestational-age, breastfed infants between 4 and 6 months of age."

Ref: Dewey K et al (1999) Age of introduction of complementary foods and growth of term, low-birth weight, breast-fed infants: a randomised intervention study in Honduras. American Journal of Clinical Nutrition, vol 69(4):679-686

Dangers from plastic feeding bottles

A report published by the World Wildlife Fund highlights the dangers of some plastic feeding bottles because of exposure to Bisphenol A (BPA) - an industrial chemical used to manufacture polycarbonate and other plastic items. The level of exposure in a bottle-fed infant is less than the tolerable daily intake, but greater than the quantity found to cause effects in studies on animals. WWF are particularly concerned about younger infants, perhaps using their siblings' bottles which are older and have had more exposure to dishwashing and bottle brushing. Manufacturers are asked to include advice to consumers on the label to change bottles every 6 months. WWF adds that "a change to safer materials is preferable". Contact: Elizabeth Salter at WWF, tel: 01483 412518, email:

Babies are less likely to be left alone with glass bottles or cups and this can reduce other health risks, e.g. dental caries, choking, otitis media - and isolation.

Different tack for promotion

A systematic review of all the available literature on breastfeeding promotion has been published by the NHS Centre for Reviews and Dissemination in the UK. The researchers found that the use of written material alone is likely to be ineffective, while peer support programmes and small health professional-led classes have been shown to increase breastfeeding rates. Initiatives should be aimed at those least likely to breastfeed - women in lower socioeconomic classes.

REF: Effective Health Care, July 2000, 6(2) For further info.:

ILO success

In June governments from around the world voted to adopt a new maternity protection Convention (No. 183). (The UK abstained from the vote due to a maternity review which is underway in this country.) The new Convention includes the following provisions:

  • extended maternity leave from 12 to14 weeks

  • the right of women to return to their same job after maternity leave

  • provision for breastfeeding breaks at work - "which shall be counted as working time and remunerated accordingly."

Although IBFAN had hoped that maternity leave would be extended to 26 weeks (to facilitate exclusive breastfeeding for about 6 months) the extension from 12 to 14 weeks is welcomed. Also in June the National Childbirth Trust launched a campaign to help mothers continue to breastfeed when they return to work. A booklet is available for mothers from the NCT. Contact NCT : 0141 636 0600


Amy's jump!

Amy Forbes successfully completed a tandem skydive from 12,000 feet in September. We are delighted that Amy jumped 'in aid' of Baby Milk Action. So far nearly £800 has been raised by Amy's friends, family and Baby Milk Action supporters. We are trying to reach a target of £1,000. This money would pay for vital grassroots work, for example, it would enable Baby Milk Action to have stands at the major UK health professional conferences, to increase awareness of the baby milk issue, both in the UK and overseas. If you would like to make a contribution please see the Virtual Shop or send a cheque to us made payable to "Baby Milk Action."


The Baby Milk Action/IBFAN calendar is an ideal resource for NGOs, health workers, campaigners and breastfeeding mothers. It costs £5 in the UK and can be ordered from the Virtual Shop or by telephone. We are now collecting photographs for the 2002 calendar. If you have an interesting colour photo of a breastfeeding mother (particularly twins, premature babies or an unusual situation) please send it to us clearly marking your name and address on the back of the photograph.

Overseas Training Programme

Jenny Beard has returned from a one-year posting with our partner organisation, IBFAN Brazil. This was financed by the Voluntary Service Overseas initiative for students, known as the Overseas Training Programme (OTP). This year we have two OTPs with IBFAN groups - Vanessa Hall is with our partner organisation in Burkina Faso and Liz Spence is in Swaziland. Contact us if you are interested in a similar postings - you must be self-financed.

Baby Milk Action will be saying goodbye to Aurélie Robin, who has been here for 11 months on a French work scheme. Aurélie has been particularly active in updating the website, attending demonstrations and stands, researching company product lines and helping us to evaluate our work.

Baby Milk Action is hoping to take on someone to concentrate on UK campaigning activities. Please contact us if you have campaigning experience and are interested in a one-year post.

AGM 27th January 2001

This is date of the next Baby Milk Action AGM. The venue is undecided at present, but will probably be either London or Cambridge. Every member is welcome to attend and will be sent full details in December.

That's a good idea...

There is not always the time or inclination to tackle the manager of a shop over displays or special offers which promote breastmilk substitutes, bottles or teats. So why not write a quick note on a comments slip?