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Health claims, medical foods and 6 months in the spotlight at CodexAt the end of November, Baby Milk Action and our IBFAN partners took part in an important meeting in Berlin, Germany: the Codex Committee on Nutrition and Foods for Special Dietary Uses sets global standards for the composition and labelling of foods for infants. The standards under discussion will take many years to finalise, mainly because the rich producer nations (many with delegations stacked with baby food industry representatives) lobby for weak measures. In Codex, IBFAN and countries such as India, Brazil, Indonesia, Tanzania, Kenya, Romania, Bulgaria and Bolivia are calling for recognition of the World Health Assembly Resolutions so that governments can carry out their responsibilities under them without being challenged in a trade dispute. Codex and the World Health AssemblyThe World Health Assembly Resolution passed this year (see Update 29) should have settled one hotly disputed issue - the ideal age for exclusive breastfeeding and the labelling of complementary foods.
Cup feeding and trade
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Baby
Milk Action Question
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Commission
Answer
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1 | Do Member
States have the sovereign right to bring in and retain legislation
which they believe is necessary for human rights and health protection? |
Yes, if non-discriminatory, and ultimately, science-based. |
2 | Does the
Commission agree that trade agreements should not be allowed to
undermine implementation of the International Code and subsequent
relevant WHA Resolutions? |
In principle yes: the Commission subscribes to the view that international agreements, particularly, but not exclusively those related to protection of the environment or human health, and international trade rules should be mutually supportive. |
3 | In matters of health will WTO defer to the decisions of the World Health Assembly? | "International agreements/ organisations should be mutually supportive, and their relationship clarified where necessary and useful." |
4 | Will WTO
dispute panels involving infant feeding include health experts?
Will each panel member be required to make a public declaration
of interest? |
Currently, panelists are selected from WTO Members, in principle from those who have no interest in the dispute. Proposals have been made for a professionalisation of panels, but this is not accepted by all Members. There are already rules on conflicts of interest in the Dispute Settlement Body, and Panels have the right to consult whichever expert they deem appropriate and necessary to fully understand the issues of the dispute in question. |
5 | Will the
EU support the International Code and subsequent relevant WHA
Resolutions at the November Codex meeting in Berlin, specifically
the WHA Resolution 54.2 regarding 6 months? |
The Commission supports the principle that breast feeding should be used until 6 months, in line with the conclusions and recommendations of the WHO expert consultation on the subject. However, this should not compromise infants for which breast feeding is insufficient. The Commission recognises that some infants may need complementary food from the age of 4 months. The Commission will therefore seek a solution in Codex which supports the principle but also ensures that the particular needs of individuals are taken into account. |
6 | For the
optimum health in infants everywhere, EU legislation should be
brought into line with the International Code and WHA Resolutions. |
To the extent that the EU and its Member States subscribe to them - to a large extent, these are issues of Member State competence. Baby Milk Action
comment: |
The European Commission, has observer status at Codex, like consumers and industry, but its comments are given much weight. So we were pleased that the EU officially supported the inclusion of the WHA Resolution (WHA 54.2) into the standard and provided some useful text to support 6 months exclusive breastfeeding. However, the EU Commission representative also conveyed some negative messages about other aspects. For example, while attention focussed on the 6 months issue, the EU Commission, with France, Germany and the baby food industry, pushed forward a proposal to take medical foods for infants out of the main infant formula standard (which refers to the International Code) and greatly exaggerating the need for special medical foods. The EU strategy was opposed by Canada and many other countries. Baby Milk Action prepared briefings showing how the EU model would increase the use of health claims and promotion of special formulas, many of which have no proven value. (See Update 25)
The UK supports the WHA Resolution. (Thank you to everyone who supported our recent letter writing campaign - see Your Questions Answered).
People in Afghanistan are seeking less dangerous places to live while fighting continues. Many infants will be affected. What is the best way to respond? IBFAN has worked with leading UN agencies and development organisations to bring together best practice guidelines. Infant Feeding in Emergency Situations is one of the useful booklets which have been produced.
Mother and Baby Tents are special shelters in refugee camps where mothers with children under two years of age can find a safe and secure place to rest, eat and receive support.
"With donor assistance, places where mothers can receive care and support can become a regular feature of emergency response programmes."
BFHI News,
UNICEF, Sept/Oct1999
Such facilities have been provided in refugee camps in Albania for refugees from the Kosovo conflict and in Honduras following Hurricane Mitch. The report describes the approach in camps in Tanzania for refugees from Burundi:
Breastfeeding corners, built of poles and plastic sheeting, were erected as close as possible to the maternity units in the refugee camps. Breastfeeding information materials in the appropriate language were provided for use in the "corners". Specially trained breastfeeding corner assistants collaborated closely with the community workers and the feeding programme staff.
WHO, UNICEF, LINKAGES , ENN and IBFAN-GIFA have developed short training modules on infant feeding in emergencies. See www.ennonline.net or the report for further information.
Donations of breastmilk substitutes can do more harm than good. If substitutes are needed, agencies can buy them and ensure that they are labelled appropriately with no brand promotion.
If you see appeals for baby foods for Afghanistan or anywhere else, ask the organisors to contact Baby Milk Action for information on more appropriate ways to help.
See IBFANs multi-lingual website www.ibfan.org for Infant Feeding in Emergency Situations. Also available in the Virtual Shop.
While all governments are being encouraged to protect exclusive breastfeeding for 6 months, the Heinz Infant Food Corporation is funding a global Humanitarian Project To Reduce Global Childhood Anaemia." Heinz, which violates the International Code with its marketing of Farleys and Heinz baby milks and foods, is producing a product called "Supplefer Sprinkles" - single-serve sachets of tasteless dry powder containing encapsulated iron and Vit C. Will Heinz exploit concerns about the prevalence of anaemia in ways that will undermine breastfeeding? Clinical trials have taken place in Ghana and further trials are planned for Inuit populations in North Canada, as well as Mongolia, India, Pakistan, China, South East Asia, South America and Indonesia.
Although anaemia is a very real problem, the cause is often related to poor infant feeding practices such as inadequate exclusive breastfeeding. The early introduction of complementary foods compromises optimal absorption of iron from breastmilk. It can also increase gastric infections and affect trace mineral ratios and absorption. Contact us if you see sprinkles in your region.
The European Commission is inviting comments on an important new Green Paper, Promoting a European Framework for Corporate Social Responsibility. The paper is on the Commission website: http://europa.eu.int/comm/employment_social/soc-dial/csr/csr_index.htm
This is a short suggested letter:
Dear Sir, I am writing to welcome the EU Green Paper, Promoting a European Framework for Corporate Social Responsibility. I am pleased that the paper mentions the need for adherence to international codes, but feel there should be more emphasis on regulatory measures. UN codes, such as the International Code of Marketing of Breast-milk Substitutes exist as minimum standards for such binding regulations. I do not consider that the private voluntary initiatives being proposed by companies can provide adequate safeguards for infant health. |
Letters (with copies to Baby Milk Action) should be sent by December 31st to csr@cec.eu.int or to the European Commission CSR Green Paper Consultation, Rue de la Loi/Wetstraat 200 B - 1049 Bruxelles/Brussel.
New guidelines on Commercial Activities in Schools - best practice principles, have been published by the Consumers Association (CA), the Dept for Education and Skills (DFES) and the Incorporated Society for British Advertisers (ISBA). The working group lists the Meat and Livestock Commission, LOreal (part owned by Nestlé) and other companies as members.
These industries - at the centre of national and global debates about food safety and animal and human rights - are now, in effect, advising teachers.
The guidelines aim to encourage best practice and empower teachers, but are weaker even than previous guidelines drawn up by the National Consumer Council. Few arguments are given to help teachers refuse materials and the promotion of product brand names is not even discouraged - teachers are just asked to make sure branding is appropriate to the activity.
Nothing is said about salt, sugar or fat, nothing about globalisation or ethics and nothing about how an increased commercial presence in schools might distort the curriculum itself.
Important new guidelines have been produced by Stockton-on-Tees Town Centre Marketing Initiative regarding commercial sponsorship. One year ago Stockton-on-Tees rejected a £300,000 sponsorship deal from Nestlé because it was not able to satisfy itself that the companys record on infant feeding was sound. (See Boycott News No 28).
Stockton is still keen to attract corporate funds but does not want this to be used to cover up bad practice. The guidelines address ethical and moral issues and could provide a model for those who want to make informed decisions about sponsorship.
The new trade rules being proposed for services (GATS) could threaten the right to information free from commercial influence, enshrined in the International Code and Resolutions. Domestic regulations could be made to encourage competition and favour the corporate provision of the health and education 'services'. Already in Finland complaints have been made that government subsidies to non-governmental organisations are anti-competitive for corporations.
In the UK, ethical and moral issues can be considered under the 1999 Local Government Act which stipulates best value when it comes to awarding contracts, rather than competitive tendering.
Baby Milk Action is a member of Sustain, the Alliance for Better Food and Farming, which has a new campaign calling for legislative controls to restrict the promotion to children (including through schools) of unhealthy foods (processed foods high in fat/sugar/salt).
The UK 2000 National Diet and Nutrition Survey found that:
92% of children have intakes of saturated fat which exceed the maximum recommended dietary level for adults. 83% of children have intakes of added sugars, and more than half of children have intakes of salt, higher than the maximum adult recommended levels.
Contact: Charlie Powell, Sustain: 0207 837 1228 or www.sustainweb.org
Q5 SMA withdrew some batches of products earlier in the year due to incidences of botulism. Which company responded immediately by writing to health visitors telling them that its milks were made to the highest possible level of safety?
Q6 Mead Johnson claims that its milk Nutramigen can reduce crying time in colicy babies by 8 times. How many babies were in the study which apparently showed this?
Q7 Which baby bottle manufacturer claims its bottle reduces risk of middle ear infection, maintains vitamin C delivery and eliminates well known causes of colic?
Q9 How much does it cost (milk and equipment only) to artificially feed a baby (in the UK) for one year from birth?
Q10 The Sales Director of which company, when talking about how to maximise sales, said: We suggest milk is merchandised on the left hand side of the fixture, followed closely by an early weaning block - jars and packet foods from 4 months - to stop mums drifting into home-made foods? (Check Out, 1/9/97)
Top Ten BooksBaby Milk Action stocks a number of publications, some of which are produced by IBFAN. Below, we review 10 key titles. All the books can be purchased from our online Virtual Shop. (Prices include postage in the UK).
ResearchBaby Friendly Initiative increases breastfeedingA randomised trial (referred to as PROBIT) in the Republic of Belarus assessed the effects of breastfeeding promotion on breastfeeding duration and exclusivity and various illnesses (such as gastroenteritis). The study took place in 31 hospitals and clinics, with a total of 17,046 mother-infant pairs. At 15 of the research sites the usual infant feeding practices were continued. At the other 16 sites an intervention modelled on the UNICEF Baby Friendly Hospital Initiative was introduced, emphasising health worker involvement with initiation and maintenance of breastfeeding. The results found that women in the intervention sites were more likely to exclusively breastfeed at 3 and 6 months and were more likely to be breastfeeding at 12 months. Their infants were at significantly less risk of getting gastroenteritis and atopic eczema. There was no significant reduction in incidence of respiratory infection. The authors concluded this study provides an essential scientific underpinning...for future breastfeeding promotion programmes in both developed and developing country settings. Ref: Kramer M.S et al (2001) Promotion of Breastfeeding Intervention Trial (PROBIT), Journal of American Medical Association 285(4)UK infant feeding surveyEvery
5 years (since 1975) a large survey has been conducted in the
UK to look at infant feeding practices. The preliminary results
of the 2000 survey were published in August. The breastfeeding
rate for England and Wales is 70%, an increase of 2% from 1995.
Scotland and Northern Ireland, although having lower rates overall,
have had larger increases, 55% to 63% and 45% to 54% respectively.
These figures represent the breastfeeding initiation rate which
means that an infant who breastfed after birth but was subsequently
artificially fed is included in these figures. The good news is that in low income households in England breastfeeding rates have increased from 50% to 62%. The Government has been specifically trying to increase breastfeeding rates amongst these families, and has funded some local breastfeeding promotion projects. However, even with this increase, the government spend on breastfeeding promotion (£1.60 per baby born) is dwarfed by the spend of the artificial baby milk companies (£18 per baby born). The full report is expected to be published in mid-January and will contain details of feeding practices after 10 weeks of age. The survey did not look at exclusive breastfeeding rates. More details available from: www.doh.gov.uk Dummies disrupt breastfeedingTwo studies, both published this year, looked at the effect of pacifier (dummy) use and breastfeeding. One of them was a prospective cohort study in New Zealand (1) and the other was a double blind randomised controlled trial in Canada (2). The New Zealand study (n=350) found that nearly 80% of the mothers offered a pacifier during their babys first year of life, and half of the mothers used a pacifier on a daily basis at some stage in the first year of life. Daily pacifier use was associated with increased perceived milk insufficiency and earlier cessation of breastfeeding. The Canadian study (n=281) confirmed the observation between pacifier use and early weaning, but found that pacifier use was often a marker of breastfeeding difficulties. 1.
Vogel A et al (2001) The impact of pacifier use on breastfeeding:
a prospective cohort study. Journal of Paediatrics and Child
Health, 37(1):58-63
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Environmental campaigners, Friends of the Earth, are calling for tougher regulations on commonly used chemicals, including those found in baby food containers and babies bottles. Plastic bottles made from poly-carbonates contain bisphenol A which is known to affect the hormone system. Research shows that small quantities of this chemical can leak into milk in the bottle, particularly if the plastic is worn or scratched. Dr Michael Warhurst, Safer Chemical Campaigner at Friends of the Earth, said: Evidence shows that bisphenol A presents a potential risk to human health. We advise parents not to use scratched or worn bottles when feeding babies, and to look out for bottles made from glass or other types of plastic if they can. |
With kind
permission: Robert Thompson, |
He also warned of concerns over baby food products as the cans and bottle lids may also leak bisphenol A.
A survey of retailers found that only Sainsburys* own brand and Nutricia were able to say that their products did not contain bisphenol A.
Further
information on risky chemicals, including a free pack for parents
and a colourful height chart, is available from Friends of the
Earth. Call (UK) 0808 800 1111 to request a copy.
* Sainsburys no longer produce an own brand artificial baby milk, but do still produce own-brand complementary foods.
After nearly five years at Baby Milk Action Tessa Martyn, our Health Campaigns Co-ordinator is leaving. She will be greatly missed by everyone at Baby Milk Action, not least for helping us to build up the wide network of support we now enjoy with UK health workers. We wish her all the best for the future and hope she will return soon. Here she is answering a call from a midwife on her last day. |
Congratulations to IBFAN Argentina (LACMAT Foundation) for being awarded the Magnus prize for NGO's which are recognized as Agents of Social Change.
Hannah Jefferies, 16, from Dunston near Lincoln has had her hair cut off to raise money for Baby Milk Action. Hannah's hair cut reduced her 1m long hair to a short bob! She has raised nearly £150. Well done Hannah, we hope you're happy with your new hair-style! |
Eamonn Dunne from Liverpool cycled 60 miles to raise money for our work and also raised £150. Thank you Eamonn!
Ella Cole, Rachel Totterdell & Kate Tophill, aged 15 from Sheffield, presented £90 to Baby Milk Action at our stall at the Womad Festival in July. They had been sponsored to drink from babies bottles for a week. Thirteen year old Georgina Pravda from Reading also donated £11.56 by being sponsored to dress up as a hippy for a day.
Total for Helen Websters Marathon is £880. Thanks to Helen and all those who sponsored her.
If you have an idea for a sponsored event to raise money for Baby Milk Action let us know and we will do all we can to help.
Baby Milk Action, in conjunction with IBFAN partners, has produced a breastfeeding calendar for the 7th successive year. It is a very useful resource for health workers, campaigners and breastfeeding mothers. It still only costs £5 and can be ordered from the on-line Virtual Shop. (Contact us for prices for bulk or overseas orders.)
If you have any interesting or unusual photographs of breastfeeding mothers which may be suitable for the 2003 calendar please send them to us with your name and address marked clearly on the back.
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