Issue 40: November 2007
(continued)

Contents

Philippines victory

Philippines Supreme Court rejects industry argument that regulations are a ‘restraint of trade’

In August 2006 the Supreme Court in the Philippines rejected a plea by the pharmaceutical industry to put a restraining order on marketing regulations for baby foods introduced by the Department of Health. However, the President of the US Chamber of Commerce, Mr Thomas Donohue, warned President Arroyo of “the risk to the reputation of the Philippines as a stable and viable destination for investment” if she did not “re-examine this regulatory decision” and the Restraining Order was imposed - four days after Mr. Donohue’s letter.

Now the long-awaited final Court ruling has been published and the Revised Implementing Rules and Regulations (RIRR) will come into force.

Restraining order on Department of Health Regulations lifted

While not supporting an outright ban on advertising of milks for infants and children and rejecting a schedule of fines proposed by the Department of Health, the Supreme Court upheld all other provisions against the challenge brought by the industry body, the Pharmaceutical and Health Care Association of the Philippines (which includes Abbott Ross, Gerber, Mead Johnson and Wyeth/SMA). Specifically the Court ruling (available on-line) found in favour of the Department of Health on the following:

• Coverage of products – scope including products for older children - upheld

• Department of Health’s right to issue regulations - upheld

• Labelling provisions - right to specify warnings and ban claims - upheld

• Powers with regard to regulating advertising - upheld

• Company information for women distributed through the health care system – ban upheld

• Independence of research – requirement for ethical clearance upheld

• Independence in policy making – ban on company involvement upheld

• Donations from companies – prohibition upheld

In its statement welcoming the Court’s decision, WHO Philippines said:

“We are delighted that amidst the many challenges in the past two years to find resolve on this matter, the DOH, along with local and international breastfeeding advocates, like UNICEF Philippines, Save the Babies Coalition led by Arugaan (a Filipino NGO), the World Alliance for Breastfeeding Action (WABA), IBFAN Network, Baby Milk Action UK, La Leche League, and many others remained faithful in their role to protect Philippine children’s health and welfare.”

Obstacle to trade? No

The industry argued: the RIRR “is unnecessary and oppressive, and is offensive to the due process clause of the Constitution, insofar as the same is in restraint of trade” [emphasis as in original].

The Court concluded: “The framers of the constitution were well aware that trade must be subjected to some form of regulation for the public good. Public interest must be upheld over business interests.”

• The campaign now moves to Congress to strengthen the primary legislation.

Dr Clavano - tiny woman who moved mountains

“We allowed the companies to touch the lives of our babies, not because we did not care, but because we did not realise the consequences of granting such a privilege. How to change all that? How to break the ‘friendly’ stranglehold that we had allowed the milk companies to have on our hospital? We closed the door of the nursery to the milk companies. We stopped giving our babies the starter dose of infant formula. Down came the colourful posters and calendars; in their place we hung the “baby killer’ posters which show an emaciated baby inside a dirty feeding bottle.”

IBFANers marked the death on October 4th of Dr. Natividad Relucio Clavano, Chief of Paediatrics, Baguio General Hospital, the Philippines. Natividad’s 10,000 baby study (which Nestlé tried to suppress) demonstrated the damaging impact that western medical practices can have on breastfeeding and child survival and gave foundation to the global movement that followed.

Her life took a dramatic turn in 1974 when she came to the UK to take Post-Graduate Studies in Pediatrics at the Institute of Child Health, London University. Initially keen to learn about asthma, she studied under Baby Milk Action Advisor, Prof David Morley. She returned home armed with practical information about how to change hospital practices and prejudices about infant feeding.

Her changes resulted in an increase of breastfeeding rates from 40% to 87%, a 94% reduction in the rates of diarrhoea and a 95% reduction in the rates of infant death. She spoke in Washington at the 1978 US Senate Inquiry under Senator Ted Kennedy which led to the Code and in 2005 at the Philippine Senate in support of the Department of Health. We send our love to her husband and sons.

See Guardian:
http://www.guardian.co.uk/obituaries/story/0,,2210404,00.html

How the gains in the Philippines were achieved

The Philippines has been at the forefront of the campaign to protect babies and mothers since before the International Code of Marketing of Breastmilk Substitutes was adopted in 1981. The country was inundated with commercial promotion from US companies and Nestlé when in 1986 President Corazon Aquino signed into law the Philippine National Milk Code - then the toughest law in Asia. This was followed with the 1992 Rooming-In and Breast-Feeding Act.

In 1989, Manila, the capital city, was host to IBFAN’s 10th anniversary and saw campaigners from all over the world parading in decorated jeepneys through its streets to Nestlé’s HQ (right), calling for a boycott of the four main violators of the Code: Wyeth, Nestlé, Abbott Ross and Mead Johnson.

One of the tireless campaigners then and now is Ines Fernandez of the Philippines IBFAN group, ARUGAAN (a Filipino word for nurturing fully with commitment).

Continued exposure of malpractice in IBFAN’s Breaking the Rules reports and dedicated work by WHO, UNICEF and health campaigners in the Philippines led to the development of the Revised Implementing Rules and Regulations (RIRR) for the Milk Code by the Department of Health, which were introduced in July 2006 and almost immediately challenged by the pharmaceutical companies.

An international campaign exposed the pressure on the Philippines Government. Here are a selection of actions taken (click on images for larger versions):

Our IBFAN colleagues at a health conference in Sweden - the ‘What next forum’ - became aware of the US Chamber of Commerce letter and participants at the conference put their names to a letter calling for restraint from the business community and an independent decision from the judiciary.

Philippines groups Arugaan and Piglas ng Kababaihan called for mothers to attend a mass demonstration on 1 September 2006. Over a thousand turned out with decorated umbrellas.

Patti Rundall, Policy Director of Baby Milk Action, and Elisabeth Sterken, Director of INFACT Canada, visited the Philippines in November 2006 giving media interviews on TV and radio which broke through a virtual media reporting blackout on the issue.

Campaigners in the Philippines began a petition and we ran a petition of solidarity, signed by individuals, organisations and celebrities, such as actress Emma Thompson, which generated front-page stories in the Philippines and coverage elsewhere. See the campaign launch press release, which links to other media coverage at:
http://archive.babymilkaction.org/press/press9nov06.html

We showed examples of Nestlé’s aggressive marketing practices at our annual demonstration at Nestlé (UK) HQ in May. For further information see:
http://archive.babymilkaction.org/press/press19may07.html

UNICEF Philippines launched a DVD (available from Baby Milk Action), exposing aggressive marketing practices and their impact.

George Monbiot wrote about the attack on the regulations in The Guardian.

A bare breast protest was staged outside the Supreme Court on the last day of the hearings in June 2007 and caught the attention of the tabloids in the Philippines (Ines in the thick of campaigning again, on the right). For further information see our Campaign Coordinator's blog:
http://boycottnestle.blogspot.com/2007/06/
brave-breasts-protest-in-philippines.html

Campaigners organised several mass breastfeeding events and entered the Guinness book of records. See our Campaign Coordinator's blog at:
http://boycottnestle.blogspot.com/2007/05/
philippines-mothers-go-for-mass.html

International News

Lansinoh owned by Code breaker

The question of who owns Lansinoh, a manufacturer of nipple cream, has been raised by groups who have looked to it for funding. Lansinoh was taken over by Japanese bottle and teat company, Pigeon, in 2004. The Breaking the Rules monitoring report that year rated the company as the worst of the bottle and teat companies in terms of the provisions of the Code and Resolutions being broken.

Pigeon’s year report sets out its strategy of building its bottle and teat market in China and complementary food market in South Korea. See our Campaign Coordinator's blog for more details at:
http://boycottnestle.blogspot.com/2007/10/lansinoh-pigeon.html

Can a bottle-and-teat company comply with the Code?

The Code and Resolutions are measures that companies are called on to abide by independently of government measures. Where these are enforced violations are stopped. But can a company comply voluntarily in an aggressively competitive market such as the United States? That is the task Evenflo has set itself. It has removed all promotion of bottles and teats from its website in favour of its breastfeeding equipment and materials.

We will be monitoring the situation closely and exploring tricky questions around brand promotion, contact with the public and the legitimacy of a branded website for providing product safety information, such as the recall notices given on the site.

US Congress investigates industry weakening of breastfeeding ads

The US former Surgeon General Richard Carmona told a Congressional Hearing in July, “the Bush administration repeatedly allowed political considerations to interfere with his efforts to promote public health”.

Congress went on to investigate how the US Government’s breastfeeding promotion campaign was weakened following industry pressure.

The industry also increased its formula advertising spend from $30m in 2000 to $50m in 2003/4 and as a result an Abbott Ross survey found that instead of rising, breastfeeding rates in hospital fell from 70% in 2002 to 63.6 %in 2006. (See Washington Post :www.washingtonpost.com/wp-
dyn/content/article/2007/08/30/AR2007083002198_pf.html )

World Breastfeeding Week call to save one million lives

The theme the World Alliance for Breastfeeding Action (WABA) promoted for World Breastfeeding Week in August was breastfeeding in the first hour and its potential to save one million lives.

As an example of events the photo below shows campaigners from our Cameroon partner organisation promoting the week. There, an official ceremony was attended by Urbain Olanguena Awono, the Minister of Public Health. Find more information and pictures on our Campaign Coordinator's blog:
http://boycottnestle.blogspot.com/2007/08/partners-in-cameroon.html

UNICEF calls for end to free formula distribution in Iraq

According to UNICEF about one in ten children under five in Iraq are underweight and one in five are short for their age. In August, UNICEF supported calls for free formula to be removed from the Public Distribution System (PDS), stating in its press release:

“Dr. Nidhal, Manager of the Breastfeeding Programme for Iraq’s Ministry of Health, noted that Iraq’s rate of exclusive breastfeeding was worryingly low, at just 25 per cent for infants under six months. The free distribution of infant formula through the PDS is a negative factor in contributing to these low rates, discouraging the traditional and much better exclusive breastfeeding.”

See:
http://www.unicef.org.uk/press/news_detail_full_story.asp?news_id=1008

China taking action on aggressive formula marketing

China is strengthening its regulations for baby food marketing. Dai Yaohua, a senior researcher with the Beijing-based Capital Institute of Paediatrics and a counsellor with the World Health Organisation told the China Daily (7 August), :

“Efforts to promote breastfeeding are lagging behind the promotion of formula milk. The society also needs to strengthen the caring and protection system for mothers and encourage them to continue breastfeeding.”

Australian Parliament calls for action on breastfeeding

A hearing of the Australian Government’s Health and Ageing Committee said in August that it had significant evidence of marketing in Australia that would discourage breastfeeding, such as doctors becoming ‘surrogate marketers’ by giving out free infant formula sample packs.

The inquiry concluded (Report in The Australian):

“The committee considers it is time to make a decisive and clear statement of the importance of breastfeeding to the Australian community by implementing the full WHO code.”

• A Nestlé advertisement in Australia for Nutritional Advisors in June demonstrates the extent of the problem. The job description states:

“Your ability to communicate effectively at all levels will ensure health professionals warm to you as you gain their trust as an expert in this dynamic field. As a result, you’ll be able to identify and convert opportunities within hospital and community health settings to health professional recommendation.”

Find out more in our Campaign Coordinator's blog at:
http://boycottnestle.blogspot.com/2007/06/
converting-opportunities-into-health.html

Infant feeding advice during floods in the UK

Floods in the UK in July disrupted water and electricity supplies. In one county 340,000 people lost access to water. In such conditions breastfeeding provides not only safe food, but protection against infections in the environment. The Food Standards Agency (FSA) issued guidance on how to mix up formula for those using it. The need to boil water and to avoid repeat boiling, which can concentrate contamination, was stressed, along with the need for care using bottled water.

Guidance stated:

“Some bottled water labelled as ‘natural mineral water’ may have high levels of sodium. When buying bottles of natural mineral water, look at the label and check that the figure for sodium or ‘Na’ is not higher than 200mg a litre. If it is, then try to use another water. If no other water is available, then use this water for as short a time as possible.”

In consultations on bottled water labelling Baby Milk Action has called for warnings to be added to bottled water if it is unsuitable for making up formula, but this has gone unheeded. Had the FSA taken this step it would have reduced the risk of formula being made up with unsafe water.

Danone swallows Nutricia, Milupa and Cow & Gate

French company Danone is taking over NUMICO, parent company of Nutricia, Milupa and Cow & Gate, in a deal worth 12.3 billion euros according to Reuters. Danone was exposed in a study published by the British Medical Journal in 2003 as being worse than Nestlé for labelling violations in the West African countries surveyed. NUMICO is particularly problematic in Asia. Globally Nestlé is the worst of the lot of them. Find further information and links on our Campaigns Coordinator's blog at:
http://boycottnestle.blogspot.com/2007/11/danone-numico.html

Nestlé swallows Gerber

Nestlé has bought Gerber from Novartis for US$5.5 billion. According to Promo Magazine, Nestlé Nutrition’s Richard Laube: “praised Gerber’s marketing expertise with mothers, via geographically targeted ads, as well as direct mail that segment babies by age.”

Find further information and links on our Campaigns Coordinator's blog at:
http://boycottnestle.blogspot.com/2007/04/
little-hope-for-gerber-changes-with.html

Progress with the Breastfeeding Manifesto campaign

Footballer Theo Walcott joins Breastfeeding Manifesto launch

The 16th May was the official launch of the Breastfeeding Manifesto, a seven-point plan to improve support and protection of a mother’s right to breastfeed and to remove obstacles to breastfeeding.

The launch was attended by members of the manifesto coalition, the Minister for Public Health and two of the celebrities supporting the campaign: Jemima Khan and Theo Walcott, the Arsenal and England footballer.

The picture shows Theo and his mother, Lynn, at the launch, with Mike Brady, Campaigns and Networking Coordinator at Baby Milk Action, holding our Hard Sell Formula exposé of the baby food industry.

Implementing the baby food marketing requirements in law is point 7 of the manifesto.

Theo said in a statement to the press:

“I have grown up knowing how important breastfeeding is as my mum was a La Leche League breastfeeding leader. Healthy eating is a very important part of my life as a professional footballer. I support the Breastfeeding Manifesto as it would help to ensure the first step to a healthy lifestyle for all children.”

See Mike Brady's blog for more news from the day:
http://boycottnestle.blogspot.com/2007/05/
launch-of-breastfeeding-manifesto.html

Single equality bill offers hope on the right to breastfeed in public

The Government opened a consultation on a consolidated law on discrimination in June. According to the press release:

“The law would make clear that expectant and new mothers are protected from discrimination in relation to goods, facilities and services generally. For example, a mother with a baby under one-year-old could no longer be made to leave a cafe when they are discreetly breast feeding their baby.”

The protection of the right to breastfeed is an interpretation of the proposed legislation, which is due to pass through Parliament in the 2007/08 session, rather than an explicit provision and only applies with regard to commercial services. Protection of this right is point 5 of the Breastfeeding Manifesto. Campaigners have called for better measures, going at least as far as The Breastfeeding etc. (Scotland) Act 2005.

The Scottish Act states it is:

“An Act of the Scottish Parliament to make it an offence to prevent or stop a person in charge of a child who is otherwise permitted to be in a public place or licensed premises from feeding milk to that child in that place or on those premises.”

Legislation sends an important message, but there is more to changing cultures. Consider the situation in Herkimer County in New York State. Figures in a survey found that 54% of men and 35% of women were comfortable with having their child breastfed in public. The Healthy Start partnership for the County launched an advertising campaign with billboards and films. The campaign had an effect. Three months later the numbers were up to almost 69% of men and 46% of women saying they would be comfortable with having their child breastfed in public. See Chronicle Online, 1 June at: http://www.news.cornell.edu/stories/June07/breastfeeding.sl.html

Brazilian celebrities supporting breastfeeding

In Brazil aggressive marketing of baby foods has been stopped by increasingly strong legislation implementing World Health Assembly marketing requirements over the past 20 years.

This is coupled with support and promotion for breastfeeding, such as having TV stars promoting early initiation as in the cutting shown here (from the newspaper Viva Mais), which states:

“Little Gael is not yet one month old, but he is already promoting a noble cause: son of the actors Thiago Lacerda and Vanessa Lóes, the baby launches World Breastfeeding Week in Brazil, together with his parents. In more than 120 countries from 1 to 7 August, specialists will be calling attention to the advantages of putting the baby to the breast soon after birth.”

This is helping breastfeeding rates to recover. In 1975, one out of two Brazilian women only breastfed until the second or third month; in a survey from 1999, one out of two breastfed for 10 months.

Ref: Dr. Marina Rea. A review of breastfeeding in Brazil and how the country has reached ten months’ breastfeeding duration. Cad. Saúde Pública v.19 supl.1 Rio de Janeiro 2003. Click here.

UK News

SMA marketing strategies

There was much controversy in August when a Wyeth/SMA advertisement appeared in OK! magazine on the page following a picture of model Jordan/Katie Price feeding her new-born child with an SMA ready-to-feed bottle. Both Wyeth and Katie denied any collusion, though the juxtaposition was, at the very least, a deliberate act. The Advertising Standards Authority refused to investigate.

Some of the media coverage missed the point of campaigners calling for enforcement of baby food marketing standards, instead claiming that Jordan and mothers who use formula were being attacked for their decision. See the blog entry: We need to learn from the controversy over SMA and the Jordan feature in OK! Magazine.

Wyeth issued a statement highlighting the shops where the ready-to-feed bottles are available and is apparently preparing for a wider launch in the new year.

We registered complaints about an SMA television advertising campaign promoting the brand with the mother’s partner making promises to help with ‘night feeds’.

Update 19 December 2007: ASA ruling on SMA formula advertisement reveals how UK regulations are failing mothers and babies.

Product placement in the controversial Channel 4 programme Bringing up Baby for SMA and other formulas, bottles and teats, also prompted us to complain.

Let us and the authorities know if you encounter baby food marketing strategies which concern you via the Baby Feeding Law Group monitoring project at: www.babyfeedinglawgroup.org.uk

Lisa Northover short listed for Sheila McKechnie awards

Baby Milk Action Director and current co-Chair, Lisa Northover, was shortlisted for a ‘Consumer Action’ award and attended the ceremony, hosted by Chancellor Gordon Brown at 11 Downing Street in April.

Here she is pictured with Adam Sampson of award sponsor, Shelter, and the category winner Debbie Crew of the Crosby, Formby and District Citizens Advice Bureau.

Award organisers explain:

“The Sheila McKechnie Foundation is dedicated to equipping campaigners with the skills they need to change the world. Campaigners are setting the agenda for decision makers in new and diverse ways - passion, creativity and vision are powerful forces for change. The Foundation invests in campaigners through an awards scheme and campaigning workshops to help them develop new tactics and plan high impact campaigns.”

Alison Baum of Best Beginnings and the Breastfeeding Manifesto Coalition won the Health & Social Care category.

To apply to the 2008 awards see: www.sheilamckechnie.org.uk

Bin it! campaign

The binit campaign launched by Baby Milk Action Director Lisa Northover asks health workers to bin company-branded materials from health facilities. But before you do, send a picture to www.binit.org.uk

Home Office breaks own rules on imprisoning breastfeeding mothers

Last year Baby Milk Action and Lord Avebury complained to the Home Office Minister, Liam Byrne MP, about two cases where breastfeeding mothers seeking asylum in the UK had been detained and separated from their babies (see Update 38) prompting a change in Home Office Guidelines which now say:

“Breastfeeding children should not be separated from their mother purely for Immigration purposes. The only exception would be if there are compelling and exceptional circumstances which indicate that this may be appropriate to keep the child safe... Authority to separate a breastfeeding mother and child must be obtained from an officer of Ass. Dir. Level or above in all cases. There must be full written record of the authorisation, the reason for the split and who was informed e.g. police, social services, detention services etc as well as any proposed future actions required.”

The Minister told the media that the cases were isolated incidents and wrote that immigration officials had failed to follow the correct procedures on the treatment of families.

In May however, Janipher Maseko, an 18-year-old Ugandan mother of a one-year-old and three-week-old breastfed baby was detained in Yarl’s Wood Immigration Removal Centre and forcibly separated from her children. The Black Women’s Rape Action Project and Crossroads Women’s Centre alerted us to this case and Morgan Gallagher of Nursing Matters, Helen Butler of LLL, Phyll Buchanan of ABN and others provided support to Ms Maseko. We contacted the Minister and officials at the detention centre. Lord Avebury raised questions about the case. It took over a week to reunite Janipher with her children in family accommodation and they were released in July.

• In October Sheila Kitzinger contacted us about the procedures in Holloway Prison where five prisoners have been separated from exclusively breastfed babies. Birth Companions provide mother-to-mother support to pregnant and new mothers in Holloway.

See section 58.7
www.ind.homeoffice.gov.uk/documents/oemsectione/

Update 40 - continued