Cow&Gate claims to
solve "symptoms in 94%" of babies
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advertisers to make unpublished references.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
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.
Law Group (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:
of Breastfeeding Mothers (ABM)
for Improvements in the Maternity Services (AIMS)
of Radical Midwives (ARM)
Practitioners and Health Visitors' Association (CPHVA)
Information Service (MIDIRS)
Childbirth Trust (NCT)
of General Practitioners (RCGP)
of Midwives (RCM)
of Nursing (RCN)
UK Baby Friendly Initiative (BFI)
Development Agency (HDA) - observer
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
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.
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
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,
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.
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.
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."
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: http://www.bmj.com/
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 http://www.corpwatch.org/trac/globalization/un/tangled.html).
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
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 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
...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)
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.
New research into
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.
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."
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
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: firstname.lastname@example.org
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
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.: email@example.com
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:
leave from 12 to14 weeks
the right of women
to return to their same job after maternity leave
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 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
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.
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
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?