BOTTLE BABIES UPDATE
After five years of intensive international campaigning, beginning with the publication in Britain in 1974 of The Baby Killer by War on Want, the issue of aggressive advertising of infant formula and bottle feeding, and infant deaths in Third World countries has come to a head. From 9-11 October this year the WHO (World Health Organization) and UNICEF (United Nations Children's Fund) organized a meeting in Geneva, Switzerland on " Infant and Young Child Feeding". The rather innocent-sounding title camouflages the substance and aim of the meeting which was t o draw up guidelines concerning the commercial marketing of baby foods, and the importance of breastfeeding. For three days representatives from the medical profession, governments, industry, and action groups heatedly debated the issues surrounding breastfeeding, weaning foods, nutrition education, the health and social status of women, and of course appropriate marketing and distribution of infant foods and formula.
The meeting was unusual for the United Nations in that it brought together representatives from such varied groups, all of whom had a vote. Companies which belong to the ICIFI (International Council of Infant Foods Industries) participated as well as representatives f r om many of the organizations which have been actively fighting against the promotion of infant foods in developing countries. Among the latter were INFACT (Infant Formula Action Coalition) and ICCR (Interfaith Center on Corporate Responsibility), two groups behind the campaign to boycott Nestle products in the USA. Also present were the International Organization of Consumers Unions, and the Arbeitsgruppe Dritte Welt ( Third World Action Group), Switzerland, which published the German translation of The Baby Killer in 1975, using a title which landed them in the middle of a libel suit with Nestle. (For details see ISIS Bulletin No.7 and Bottle Babies, published by ISIS, 1976.).
Women's groups participating were not numerous: the International Council of Midwives. Since breastfeeding is clearly something which entirely concerns women, this was a little surprising. Yet WHO could hardly overlook women, and indeed the background paper and the recommendations from the meeting give considerable space to many of the implications of the issue for women. For instance, the general statement from the meeting declares:
"Health for all cannot be attained unless there is a substantial improvement in the socio-economic condition of women, the particular needs of mothers and their infants and young children are recognized and met, and conditions are provided that promote and sustain the well-being of the family. These conditions include the right of women to information and education that will enable them to improve their own health and that of their families and to take an active part in decision-making on matters that affect their own and their children's health. They include also attention to the role of fathers in providing for the needs of their family."
And two important recommendations stress :
"Paid maternity leave of not less than 3 months postnatal, job security and economic support should be provided to all mothers whenever possible, and wherever possible, and the responsibility for economic support during maternity leave should be carried by government, the industry in which the woman is working, and other relevant international and national institutions.
"Creches, paid breastfeeding breaks and other facilities
should be provided wherever appropriate in industry and in other relevant institutions, or close to the place of work to permit mothers to continue breastfeeding and have close contact with their babies. Financing of creches and other mechanisms that allow for this continued contact of breastfeeding should be carried by government and/or the industry in which the mother is working."On the other hand, these resolutions do not deal with women who do not work in industry, but in the domestic sector, as one-day labourers, as prostitutes or as outworkers - a very large percentage..
By far the most difficult and controversial issue, however, was the appropriate marketing and distribution of infant formula . After three days of heated discussion, recommendations which came out of the meeting were clear and uncompromising. Breastfeeding is affirmed as the only natural method of feeding babies, and should be actively protected and encouraged in all countries. Thus, any marketing of breast-milk substitutes and weaning foods should be designed not to discourage breastfeeding. There should be no sales promotion , including promotional advertising (the use of mass media and other forms of advertising directly to the mother or general public) of products to be used as breast-milk substitutes or bottle-fed supplements and feeding bottles. There is a call for an international code of marketing of infant formula, which would be enforced with the help of government, advertising councils, industry and consumer groups. The use of " milk nurses" or company personnel is prohibited inside the health system, and it is stressed that the health care system should never be used for the promotion of artificial feeding. Production and distribution of foods for infants and young children should be governed by strict legal standards
Boycott and action groups say that although this is good, it does not give sufficient grounds to call off the boycott. There is a need, they say, to stop all promotion in health institutions and the medical profession, to do away with milk nurses both inside and outside the health facilities, and to put an end to subtle promotion gimmicks by industry such as paying for pediatric conferences, doctors' air fares, and sponsorship of awards and projects. Although the ICIFI has now pledged adherence to the spirit of the WHO/UNICEF meeting, action groups are skeptical. There have been countless instances in the past four years where industry has violated even its own codes of ethics. "It is evident that responsibility for enforcing promotional guidelines must rest with a non-industry agency. Company promises are no longer sufficient", says INFACT.
The WHO/UNICEF meeting was nonetheless a milestone. It brought together an international group of individuals and organizations who have been protesting for years against the aggressive promotional tactics of the infant food industry. It brought delegates from Third World countries and medical personnel. For the first time these different groups were able to see where their common interests lay, consolidating their position and creating alliances that can effectively pressure transnational corporations.
Further reading
INFACT Update Infant Formula Action Coalition National Clearinghouse 1701 University Avenue SE Minneapolis, MN 55414 USA
A monthly newsletter on development in the boycott and other consumer actions, news on what companies are doing, on studies, and on actions in the Third World.
infant Formula Promotion 1979 A dossier documenting instances of industry violation of marketing codes of ethics in 1979. Available from INFACT.
The Baby Killer Scandal Andy Chetley War on Want 467 Caledonian Road, London N7 9BE England
Published in 1979, this is an update on the original Baby Killer written by Mike Muller in 1974. It gives a good deal of the recent action by boycott and other groups and the responses of companies. Draws on numerous studies in developing countries to demonstrate the extent of the problem, and outlines priorities for action now. An excellent updated resource, t-1.50
Just like mother's milk ? Baby milk action coalition c/o Sadru Kheraj, Trinity College, Cambridge CB2 ITQ England .
A small brochure describing the problems of bottle feeding and the decline of breastfeeding, and outlining what actions can be taken in Britain about this. Published by the newly formed Baby Milk Action Coalition which plans an extensive educational and information campaign throughout Britain.
Publications of the World Health Organization, available from : WHO, Maternal and Child Health Division of Family Health Avenue Appia 1211 Geneva 27
Switzerland.
Meeting on Infant and Young Child Feeding, WHO/UNICEF, Geneva, 9-12 October 1979, Background paper (document FHE/ICF/79.3). A 70-page "state of the art" paper covering : nutritional requirements in infancy, human milk, breastfeeding, supplementation and weaning, and studies in infant morbidity and mortality in relation to infant feeding. Goes on to outline themes for discussion for the meeting, and ends with substantial and forceful suggestions for action by governments and other groups. An excellent paper.
Recommendations and Statement on Infant and Young Child Feeding, WHO/UNICEF, Geneva, October 1979.
Gives the full recommendations resulting from the meeting in October 1979. Breastfeeding, WHO, Geneva, 1979. A handy 40-page illustrated booklet for health workers. Stresses the reasons breastfeeding is so important (appropriate nutrition, protection against infection, affection and stimulation), and the need for active support from family, community and health workers for successful breastfeeding to be established. Gives practical advice on all aspects, including the problems of publicity of artificial baby foods. Also outlines situations that need special attention (undernourished mothers, low-weight babies, mixed feeding, engorgement and abscesses of the breast). A nicely presented practical guide which could be used by lay people too.
THANK YOU
We don't have time to reply individually to all the answers and comments made by our readers in the Third World who sent back our small questionnaire. But we would like to thank you all for taking the time to send them back, and for all the wonderful and most encouraging comments you made. We are sure on the basis of this that we will be able to find sponsors for those of you who have indicated this. Thank you for your support.