Wednesday, October 31, 2007

Breastfeeding reduces cancer risks says expert report

"It's best for mothers to breastfeed exclusively for up to 6 months and then add other liquids and foods. Strong evidence shows that breastfeeding protects mothers against breast cancer and babies from excess weight gain."

That's one of the 10 recommendations in an expert report produced by the World Cancer Research Fund released today. See:

http://www.wcrf-uk.org/research_science/recommendations.lasso

Another cites the link between excess weight gain and cancer: "Be as lean as possible without becoming underweight. Convincing evidence shows that weight gain and obesity increases the risk of a number of cancers, including bowel and breast cancer."

As our poster on infant feeding and obesity notes, an artificially-fed infant consumes 30,000 more calories than a breastfed infant by 8 months - equivalent to 120 chocolate bars.

For a large version, with references to scientific studies, see:
http://www.babymilkaction.org/shop/posters.html#obesity

According to a Government survey, nine in ten mothers who gave up breastfeeding within six weeks said they would have preferred to breastfeed for longer, as did 40% of those who breastfed for at least 6 months. See page 211 Infant Feeding Survey 2005:
http://www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles/infant-feeding/infant-feeding-survey-2005

We have issued a press release on how this report should give added impetus to empowering mothers to breastfeed, and, in particular, heed the advice of health experts as it revises the law on the marketing of infant formula and follow-on formula. See the report we prepared for the Baby Feeding Law Group, Protecting breastfeeding - Protecting babies fed on formula via the press release at:
http://www.babymilkaction.org/press/press31oct07.html

Tuesday, October 30, 2007

Synchronised breastfeeding world record provisional results

You may have seen that 8 November is Guinness World Records Day. It is a promotional event for the famous book, encouraging people to have a go at breaking a record. It reminded me to check what happened with the mass breastfeeding attempt that took place at the end of World Breastfeeding Week on 8 August. See:
http://boycottnestle.blogspot.com/2007/06/world-breastfeeding-record-participate.html

None of the breastfeeding records appear in the search engine on the Guinness site. But they have a text service. Simply text GWR and your question to a number and you receive a reply a few minutes later. There is a charge for this. See:
http://www.guinnessworldrecords.com/

So it seems the figures for the global event are still being scrutinised, but you will be sent provisional figures. The event involved mothers gathering with scrutineers to breastfeed at 10:00, their local time. There were 14 countries involved, with women at 325 sites. The provisional figure is over 10,000.

The organisers said the intention when full figures are available is for each country to try to beat its number for the previous year.

Of course, with 130 million babies born every year, the number being breastfed at any one time will be far greater than those involved in the record attempt. In fact, there are likely to be millions of babies being breastfed right now. An amazing free resource, providing all the nutrition needed, tailored to the child and protecting against infection. Breastfeeding saves many lives, but could save many more.

According to UNICEF: "Improved breastfeeding practices and reduction of artificial feeding could save an estimated 1.5 million children a year."

See the Your Questions Answered section of our website.

A 2003 study in the Lancet examined the question “How many child deaths can we prevent this year?” and concluded that promotion, protection and support of breastfeeding is potentially a more effective health intervention than provision of save water, sanitation and vaccination. Improved breastfeeding rates could prevent 13% of under-5 deaths in the 42 countries where most occur, amounting to 1.3 million. Appropriate introduction of complementary foods could prevent 6% of deaths.
http://www.who.int/child-adolescent-health/publications/CHILD_HEALTH/Lancet_CS.htm

Reducing death rates requires a range of approaches. Protecting breastfeeding is one of them.

Baby food company marketing tactics, ranging from idealizing claims about the benefits of formula, to bribing of health workers to promote their products, to targeting parents directly put profits before the interests of babies and families and contribute to the unnecessary death and suffering of babies around the world. Infant formula is a legitimate product - follow-on formula has been described as 'not necessary' by the World Health Assembly - but it must be marketed appropriately.

The industry attack on breastfeeding (and denial of necessary information to those who use formula) is why the World Health Assembly introduced marketing requirements, why we and our partners monitor companies and hold them to account and why campaigners have to find imaginative ways to promote and celebrate breastfeeding.

Monday, October 29, 2007

Wyeth/SMA television ad still running in the UK as we await action from the ASA

A while ago I wrote about the Wyeth television advertisement in the UK promoting the brand name through a father making promises to his partner about how he would support her, including with 'night feeds'.

Today I received another complaint from a member of the public as it was shown at the weekend.

We have still not received a ruling from the Advertising Standards Authority (ASA) on the advertisement, having called for it to investigate.

My earlier blog includes a link where you can investigate the advertisement for yourself. See:
http://boycottnestle.blogspot.com/2007/09/wyeth-sma-uk-tv.html

The following analysis was posted on that entry by Morgan Gallagher, which I think makes very interesting reading. It makes the point very well that the advertisement is not imparting accurate information about infant feeding, it is promoting a positive emotional reaction to the brand, which is a poor basis for deciding how to feed a child.

---
As you say Mike, the ad is very very clever. The cleverness is multi-layered, not least of which is how it skirts the guidelines on formula advertising to suggest prior formula use whilst pretending to be about follow-on milk.

It's also very British. It's using a film style very reminiscent of British Kitchen Sink dramas, although it has soft focussed it a little to make it modern and accessable to a larger advertising audience. But the iconography of the kitchen sink, the bedroom, the sitting at the old fashioned dressing table, is all quintessential British soap opera territory. A world slightly grimy, slightly ragged and not quite all USA, or Australian, soap opera clean and shiny newness. It's more 'true to life' which is how British TV audiences prefer their drama - with a thin veneer of actuality. Although the aspirational marketing of the product requires it to pitch to the upper end of the spectrum, even this is well done within the framework of it being about everyday families - as it's toys and 'baby sick' that mess up the not quite got there yet feel of the piece. So whilst it's not Perfect Persil Advert Houses, it's just a little short of that advertising ideal. The kitchen isn't quite all matching, the bedroom a bit gloomy in the night, but the living room in the mother in law section, and the garden in the adoration of the madonna without an actual child in her arms, is middle class in its construction. The message is clear here that SMA understands where you're coming from, and where you're hoping to end up, and using SMA is part of that upwardly mobile agenda.

It's also a very clever address to the demographic: first time mothers. Whilst being up front in it's 'new man' appeal, as it's a father speaking, it's all totally about fulfilling the fantasies of the woman. In perfect Mills & Boons cadences, we see the man/husband/father enact a love sonnet to the woman/wife/mother, that treasures her for her domestic skills, still sees her as a vital sexual object as the same time as a mother, defends her against interfering well intentioned mothers in law and gives her emotional space to be 'her own person' whilst he frees her up to be that physically by 'holding the baby' for her.

This part is actually the most disturbing area for me, as it's using the pseudo feminist agenda that's always been used to promote formula, in a subtle and insidious manner. Actually holding the baby in this ad is very problematic for the mother. She's in the night exhausted by her crying baby, she's being criticised by her MiL, she's even covered in baby sick smell when she's fresh and showered and wanting to go out for the evening and doesn't even have the baby with her. Mothering is presented as something that is demeaning and demoralising to her: hence the need for the husband to step in support, encourage and praise her for her efforts. He is rescuing her, by using formula to 'free' her from the constrictions of motherhood. He's being a modern White Knight and needs no pure white steed and shining sword, merely a pure white bottle of formula to slay the dragon that has enslaved her. He can literally take feeding the baby off her hands, and give her a 'break' from overwhelming drudgery.

This message about mothering, and motherhood, is so deeply ingrained in our culture, that most people would look at what I've written and say "So what, all that is true?" Well, it may be true in a formula world, where babies and mothers have to be seperated in order to 'let others have a go at feeding' and to 'give Mum a break' but it doesn't reflect the actuality of my world as a mother, and doesn't reflect that of most mothers I know. Keeping baby beside you in order to breastfeed is easier, less work and far more personally rewarding than handing them over to others whilst you 'escape' to the garden for some 'me time'. Mothering _is_ 'me time' in my world, and I'm heartily sick of the view of it constructed so effortlessly, and so 'naturally' in this ad.

In my world, it's not mothering that takes it out of me - it's having to be all things to all people all the time and do it all in the home to boot. And when I'm tired and drained and fed up and exhausted _by life_, I don't need my husband to take my baby off my hands whilst I run off to the garden to be by myself. I need him to bring me hot cups of tea, empty the washing machine into the tumble dryer and cook dinner whilst I put my feet up and snuggle my baby to my breast and flood myself with joy juice: another ingredient missing from formula.

It's no accident, however, that Eulogising Fantasy Husband doesn't do any of this in the advert, as that would undermine his manly status. Houseworking husbands in adverts have to be cheeky chappies taking the mick slightly, and that would not do here. So he has to stay adoring and loving but manly in his everyday Joe Bloggness, hence the shots of a stubble beard, crinkled gray t-shirts and not quite with-it expressions as he shares the 'burden' of a baby. All beautifully counterpointed by those not quite rugged but oh so manly arms lovingly holding and protecting his tiny baby. Softness and strength... bring me the Kleenex, oh no, wait.. bring me the Andrex...

Promoting the seperation of the mother and baby, in order to 'help' the mother out, is such a stalwart of the formula marketing machine, that it is easy to miss how potent that construction is in this advert.

Shock and horror at how comprehensively they're trumpeting formula use can actually mask _why_ this advert is so hideous.

For the hard marketing reality is that adverts don't sell products: they sell lifestyles.

It's the constructed lifestyle in this advert that is so offensive, and so damaging. For it's a lifestyle that requires formula to make good the damage a baby does to a woman's life. It peddles the ultimate formula message in the West - that women _need_ formula to save them from their babies. That formula fulfills some sort of vital support role in the life of the average mother. That breastfeeding is too hard, too difficult, too restricting. Too old fashioned. That modern women _need_ a substitute to enable them to live fulfilled lives as both an individual and as a mother. After all, the entire up front focal point of the advert is that Dad can also do some of the feeding to 'help Mum out'.

This ad does break Code - quite clearly in its construction of Dad giving night feeds - but it is also offensive in the message it sends out about how women cannot manage the simple act of feeding their baby normally. How they need an artificial product to make mothering a success. How they need others to take on 'the load' in order to thrive themselves. That they should, on some level, be grateful that such 'rescue' is available.

Formula feeding is a risk activity. The white powder in the can comes with such delights as salmonella - at no extra cost - and its unsuitability for the newborn stomach puts babies at risk of serious gut inflammation, infection and life long allergies. And that's before you get to the increased health risks from lack of human milk. Formula marketing not only denies these factual truths in its construction of happy healthy babies, thriving on an expensive and inferior artificial product, it suggests that mothers need this intervention to remain true to themselves. In order to sell their product, they have to put themselves between the mother and the baby: they have to create a need for their product. This advert is very clear in its construction of what the problem is: motherhood. In the SMA world, woman simpy aren't up to being mothers without SMA products. They cannot possibly juggle the demands the world makes on them, as woman, wives and mothers, without formula.

'Clever' just doesn't do justice to this ad. Here's hoping the makers manage some sleep... despite all that night feeding.

Friday, October 26, 2007

Little time left to strengthen the UK formula law

We have submitted a report to the UK government consultation on revising the Infant Formula and Follow-on Formula Regulations on behalf of the Baby Feeding Law Group, a coalition of health worker and mother support groups. The report, 'Protecting breastfeeding - Protecting babies fed on formula', has also been endorsed by the Breastfeeding Manifesto coalition. It is available at:
http://www.babymilkaction.org/shop/publications01.html#bflgsubmission

Thank you if you have also written to the Food Standards Agency, which is conducting the consultation.

So what's happening now?

Here's an update from the Public Health Minister, Dawn Primarolo MP, given in a written Parliamentary Answer:

See Hansard 25 October 2007:

---
Harry Cohen: To ask the Secretary of State for Health what process the Government followed in deciding its policy and interpretation of Commission Directive 2006/14/EC on Infant Formula and Follow-on-Formula; and when it expects to announce related decisions. [160484]

Dawn Primarolo: The Food Standards Agency has consulted stakeholders on new draft regulations, which will implement EU directive 2006/141/EC on infant and follow-on formula, and will lay down rules about the composition, labelling and advertising of formulae. Comments received from the stakeholders are now being collated and evaluated by the agency. These will then be published together with the agency responses. The agency also intends to consult in the near future on the accompanying draft guidance notes. The directive requires that regulations come into force on 1 January 2008.
---

We are distributing the report to relevant policy makers. You can help this work by making a donation at:
http://www.babymilkaction.org/shop/publications01.html#bflgsubmission

I'll let you know when the consultation submissions are officially published and if and how the proposed regulations are revised as a result. There will be another campaign action shortly for a final push to convince policy makers to put infant health and mothers' rights before company profits.

Thursday, October 25, 2007

IBFAN Africa awards Gambian community support work

There are over 50 groups in the African region of the International Baby Food Action Network (IBFAN). They monitor the baby food industry and conduct imaginative projects to protect and support breastfeeding.

Baby Milk Action tries to support the network with campaign support and training and has been successful in raising funds for some activities in the past, though most is raised by IBFAN coordinating centres. A few years ago we received a grant from the Hilden Charitable Trust for partners in Ghana to develop materials for use in mother-to-mother support groups. We also received a grant from the Nuffield Foundation to help support the IBFAN Africa coordinating office in Swaziland with a campaigns post.

It is the nature of IBFAN that groups and regions manage their own affairs. It is not a heirarchical system, other than reporting that has to done for specific grants and the control and monitoring of these.

This week the IBFAN Africa coordinating office is in the news after giving an award to community projects in Gambia, run by the National Nutrition Agency (Nana), where the IBFAN Gambia coordinator works. The award is in recognition of Nana's significant achievements in the area of Baby Friendly Community Initiative. The project is serving as a model for other countries.

You can find a report at:
http://allafrica.com/stories/200710221544.html

Wednesday, October 24, 2007

Learning from free lunches in Minnesota

A fascinating news story comes to my attention via the International Baby Food Action Network (IBFAN), which has a working group on industry sponsorship and its impact. By the simple process of limiting the amount of money pharmaceutical companies can spend on food for doctors, the authorities in Minnesota have changed the view doctors have of company representatives and the information they give and changed prescribing habits. The industry is fighting back by tageting nurses and secretaries however.

The story is reported in the New York Times (12 October 2007) and can be seen in its entirety at:
http://www.nytimes.com/2007/10/12/us/12gift.html

Two years ago a state official interpreted powers introduced in 1993 to forbid drug companies from spending more than US$50 per year on food or gifts for a doctor.

Now every health worker knows, or would claim, that they are not influenced by hospitality or gifts of any value, and, so they might say, only meet with company reps for the important product information they impart.

Except with the spending limits in place, drug companies found they could not get appointments with doctors and in some health facilities the doctors actually asked for a ban on the reps visiting.

The companies have suggested this is because doctors are busy people and only have time to meet at lunch time so providing food was to facilitate this. Yet if such meetings were the only way to obtain information then one would think that the health workers would find the time elsewhere or have the meeting anyway while munching on a sandwich. The fact is the information is available by through official channels where it will have been evaluated with competing drugs compared, not on the basis of how good the lunch was, but on their merits.

The New York Times reports that there is interest from legislators elsewhere to impose spending limits and it has conducted is own research on the impact of sponsorship:

---extract begins

The interest in legislation to register or limit the food, gifts and money that drug and device makers lavish on doctors stems from growing concerns that these benefits lead doctors to prescribe more, and more expensive, drugs and devices, raising the costs of health care and changing care to patients.

Few studies have shown that patients are harmed when their doctors accept gifts or money from drug makers, in part because data comparing the prescribing trends of doctors who accept money and gifts with those who do not have for years been available only to drug makers, not to the public.

In one of the few public analyses of the prescription patterns of doctors, The New York Times found that Minnesota psychiatrists who received money from makers of atypical antipsychotics tended to prescribe the drugs to children the most often despite the profound risks from these drugs.

---extract ends

The industry has tried to get around the restriction on promotion to doctors as the New York Times reports: "Food has not entirely disappeared from the marketing efforts of drug makers in Minnesota. The companies still rent out private dining rooms in restaurants and still hire influential doctors to deliver educational talks about drugs during dinner. But instead of doctors, the companies now invite nurses and secretaries to dine, drink and listen."

Doctors are paid to give the presentations and can earn substantial sums for doing so. As one doctor who has earned US$16,000 from such talks said in the article: "Maybe they’re trying to keep me loyal to those drugs."

We have included references to studies showing the impact of promotion to health workers in the report we produced for the Baby Feeding Law Group on the UK formula law consultation: Protecting breastfeeding - Protecting babies fed on formula, available at:

http://www.babymilkaction.org/shop/publications01.html#bflgsubmission

This also includes monitoring evidence of how the industry targets health workers in the UK.

Let us see if the UK authorities look to the experience of Minnesota and accept that a free lunch comes with strings attached.

Tuesday, October 23, 2007

Bringing up Baby

A controversial baby care programme has been showing on Channel 4 in the UK. It is called Bringing up Baby. This is the blurb. See:
http://www.channel4.com/health/microsites/B/bringing_up_baby/

---
Every parent wants the best for their baby but how do you know what that is when childcare advice changes as often as high street fashions? For the past hundred years, parents have been increasingly bombarded with books and manuals giving them the definitive answer on how to bring up a baby – so which era had it right?

To try and make sense of it all, we've taken three of the most influential baby handbooks of the last hundred years and are pitting them against each other with the help of six new families. Each couple has chosen the method they think will best suit their values and lifestyles and has agreed to let cameras observe how they get on for the first three months of their babies' lives.
---

Of particular concern for child health experts have been the methods of Claire Verity, who advocates four-hourly feeds, no eye contact while feeding, early introduction of complementary foods, leaving children to cry in the garden or cot in a separate room from day one. To ensure babies sleep through the night she advocates loading the stomach with feeds at 7 pm and 11 pm - something difficult if not impossible to do if breastfeeding on demand. In discussion with the other mentors on the programme she dismissed the recommendations of the World Health Organisation, disputing that exclusive breastfeeding is sufficient for a child for the first 6 months, ignoring the wide review of research conducted by WHO experts.

As by 3 months one of the couples could boast of their child sleeping from 7 pm to 7 am and already being on solid food, she portrayed this as vindication for her methods.

There have been many complaints about the programme, including a petition on the 10 Downing Street website. Some have pointed out that the National Society for the Prevention of Cruelty to Children (NSPCC) ran an advertising campaign showing a quiet baby in a cot with the message that the baby had learned not to cry because no-one ever came.

Last week the NSPCC and National Childbirth Trust went public on their complaints about this and other programme that subject babies to sometimes extreme situations for entertainment.

The Guardian reported on 19 October, quoting Maggie Fisher of the Community Practitioners' and Health Visitors' Association and the union Unite. See:
http://www.guardian.co.uk/uk_news/story/0,,2194512,00.html

---Extract begins

A spokeswoman, Maggie Fisher, said: "It is clear that voluntary codes of conduct don't work with a television industry obsessed with audience rating figures. Babies can't give their permission to take part in such programmes. They rely on their parents to protect them." She said Ms Verity's parenting methods had left sobbing parents neglecting their baby.

The health visitors' call comes as the NCT, NSPCC and other charities are also drawing up proposals for an ethics panel. The NCT's chief executive, Belinda Phipps, said the watchdog would need jurisdiction not only over regular broadcast channels, but also over non-broadcast productions such as videos made by baby milk manufacturers to promote products.

---extract ends

Curiously the Channel 4 In the news link for the programme didn't include this article when I checked. The article also states: "Both the NSPCC and the National Childbirth Trust called on Channel 4 not to commission the programme, arguing that experimenting with babies in the name of entertainment was unethical."

The programme did include a mentor advocating breastfeeding on demand and exclusive breastfeeding for 6 months, followed by continued breastfeeding into the second year of life and beyond, in line with WHO recommendations.

It may be coincidence, but when I visited the page for the programme it contained two advertisements from L'Oreal, which is part-owned by Nestlé. Whether that is advertising in standard rotation on the site or a programme-specific deal is unclear. The named programme sponsor is Huggies disposable nappies.

We have raised another concern about the programme with the Advertising Standards Authority which is responsible for broadcast and print advertising in UK's voluntary, self-regulatory system. That is the product placement in the programme for infant formula and feeding bottles. While being filmed in a fly-on-the-wall documentary style, the use of branded bottles and shots of formula tins is something that could have been avoided and prompts us to question whether the legislation on advertising of infant formula has been breached. I will let you know what happens.

The programme also contained a plug for formula for 'hungrier babies' as a way to get them to sleep through the night, though the mentor for the mother suggesting this said it was not a good idea. These formulas are casein based which is harder to digest and so remains in the stomach.

If you have concerns about promotion of breastmilk substitutes, feeding bottles, teats or other baby foods, you can report them to us and the authorities via the monitoring project we coordinate for the Baby Feeding Law Group. See the monitoring section of:

http://www.babyfeedinglawgroup.org.uk/

Monday, October 22, 2007

Changing laws to better protect breastfeeding and infants fed on formula is in the news

Several media reports of note over the past few days. A news item in the British Medical Journal on our report on the need to strengthen the UK baby formula marketing regulations. And reports on developments in the Philippines following the Supreme Court lifting the restraining order on the marketing regulations there.

So first welcome coverage for the report we produced for the Baby Feeding Law Group: Protecting breastfeeding - Protecting babies fed on formula. This is available at:
http://www.babymilkaction.org/shop/publications01.html#bflgsubmission

The British Medical Journal ran a news item on this in its 20 October edition available in summary (a fee for downloading) at:
http://www.bmj.com/cgi/content/full/335/7624/794-a

The BMJ highlights our call for improved warnings and instructions on labels to reduce risks of formula feeding as well as ending promotion to protect breastfeeding and to ensure all parents, carers and health workers receive accurate, independent information. Save the Children and UNICEF are quoted - thanks to them for their support for the campaign.

As I wrote a couple of weeks ago, we and our partners in the Philippines welcomed the lifting of the restraining order on regulations there, but I was surprised that parts of the media suggested this was a victory for the industry. An article in the Manila Standard Today also questions why the media put this spin on the Supreme Court's decision. See:
http://www.manilastandardtoday.com/?page=ritaLindaJimeno_oct22_2007

The article, by Attorney Rita Linda V. Jimeno, states:

---extract begins
When the Supreme Court released its decision on the case Philippine Health Care Association of the Philippines vs. Secretary Francisco Duque (GR no. 173034, Oct. 9), 2007), newspaper headlines and stories bandied that the Supreme Court had lifted the ban against advertising of milk. To many, it meant that Supreme Court favored the position of milk companies more than that of the Department of Health. Some women e-mailed or commented to me that it was a pity the cause of the breastfeeding advocates was lost. Some had a mistaken sense that it was all right after all, to feed infants with milk formula rather than breast milk.
---extract ends

I queried when the misleading headlines came out who had been briefing the journalists. It does indeed appear there has been a negative impact. See:
http://boycottnestle.blogspot.com/2007/10/philippines-headlines.html

The Supreme Court did not uphold an ourtight ban on advertising of breastmilk substitutes, but did uphold the powers of an Inter-Agency Committee to vet all marketing materials and to require changes or prohibit any it judges to be inappropriate. The Court ruled that an outright ban over stepped the powers in the primary legislation.

The Daily Inquirer reports that the Department of Health is not going to appeal that decision, but is going to seek changes to the law. See:
http://newsinfo.inquirer.net/inquirerheadlines/nation/view_article.php?article_id=95716

"[Secretary of Health] Duque said the DOH would instead propose changes to the Milk Code and also support the passing of new laws on breastfeeding, now pending in Congress, that will better reflect the government’s intent in seeking to protect the health of mothers and infants."

It is great to see that politicians and policy makers in the Philippines are taking action and the Court has put health before narrow trade interests.

Let us hope the UK's policy makers will do the same.

Friday, October 19, 2007

Who owns Lansinoh and are they Code compliant?

A question that comes up from time to time is who owns Lansinoh, a brand of nipple cream and does it comply with the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant World Health Assembly Resolutions. People are, quite rightly, concerned about conflicts of interest in accepting sponsorship, something which WHA Resolutions draw attention to (see, for example, WHA 58.32).

We and our partners in the International Baby Food Action Network (IBFAN) have a clear funding policy: no sponsorship from companies with an interest in infant feeding choices. That includes breast pump manufacturers and nipple cream companies. Sometimes this prompts a debate on whether such products are necessary or not, which misses the point. We wish to maintain our independence and so do not want to be swayed by, or be seen to be influenced by, a funder. The danger with sponsorship is that you too easily get drawn in to defending a company in trying to justify accepting its money. Baby Milk Action takes a stricter line still and accepts no commercial funding. There are repercussions of course. We have to cut staff hours and do less when funding is tight, but we feel that is better than compromising what we stand for.

The other danger with linking with infant feeding companies - indeed any company - is that you may not be aware of all its business interests and these may change.

So it is with Lansinoh which was taken over by bottle and baby food company, Pigeon, in 2004. In that same year the IBFAN Breaking the Rules monitoring report found Pigeon to be the worst of the bottle and teat companies profiled.

Here is an example of a violation of the marketing requirements I have lifted from the report, which shows how Pigeon draws equivalence between a teat and breastfeeding.

You can download the report at:
http://www.ibfan.org/site2005/Pages/article.php?art_id=302&iui=1

In its 2004 report Pigeon explains about its takeover of Lansinoh and its expansion into the teat market in China - where breastfeeding rates are starting to fall as artificial feeding as viewed or portrayed as a part of industrialisation.

See:
http://www.pigeon.co.jp/english/data/2004_07_e.pdf

---report extracts
2) Expanding our overseas business
In April 2004, we formed an agreement with Lansinoh Laboratories, Inc., a prominent U.S. manufacturer of breast-feeding-related products. Under the agreement, Lansinoh became a wholly owned subsidiary of Pigeon. Our intention here is to secure new sales channels in the North American market, where the birthrate continues to rise, and expand sales through the launch of attractive new breast-feeding-related products.

In the rapidly growing Chinese market, our sales have centered on large cities, such as Beijing, Shanghai, and Guangzhou. Going forward, we will further boost recognition of the Pigeon brand by building a sales network encompassing major regional cities. In April 2004, Pigeon (Shanghai) Co., Ltd., began producing baby bottle nipples as its core product.


[And]

Overseas business: In April 2004, Lansinoh Laboratories, Inc., a prominent U.S. manufacturer of breast-feeding-related products, became a wholly owned subsidiary of Pigeon. Although the acquisition occurred just over two months before the end of the interim term, we are already witnessing favorable results. Going forward, we will work with Lansinoh to expand sales of breast-feeding-related products, not only in North America but in Europe as well.

Other overseas consolidated subsidiaries also performed well during the period. By export market, we reported solid sales in China, South Korea, and the Middle East. By product line, we posted significant year-on-year sales increases of baby bottle nipples and weaning foods in South Korea, and of cleansers and disinfectants for baby bottles and vegetables in Hong Kong and Singapore.
---extracts end

This is the latest information I have available. As is the nature of this business, ownership may change.

From a campaigning point of view, taking a tough stand on links with Lansinoh because of the violations of its parent company is a good way to exert pressure on it to change.

But even if it followed the regulations perfectly, to maintain our independence IBFAN would still keep clear of it as it profits from infant feeding.

Thursday, October 18, 2007

Will the UK Government deliver on its claimed commitment to tackling obesity through breastfeeding?

A new UK report was launched by the Government Office for Science this week. The report is called 'Tackling Obesities: Future Choices' and originates from what is called the 'Foresight programme'. It can be downloaded at:
http://www.foresight.gov.uk/Obesity/Obesity_final/Index.html

The report cites the role of breastfeeding in tackling the obesity epidemic (page 47):

---quote begins
There is evidence that the period soon after birth is a time of metabolic plasticity. Factors in the environment, such as nutrition, can have long-lasting consequences in that they appear to set the baby on a particular developmental trajectory. There is strong evidence, for instance, that low birth weight is associated with increased risks of heart disease and diabetes and, while there is less evidence of a direct link between birth weight and obesity, weight gain in early life appears to be critical. Some low-birth-weight babies may be especially susceptible to catch-up growth (that is, rapid weight gain), while others experience this as a direct consequence of their diet. Breast-fed babies show slower growth rates than formula-fed babies and this may contribute to the reduced risk of obesity later in life shown by breast-fed babies. Weaning practices are also thought to be important, given the association between the characteristic weight gain seen in early childhood at approximately five years of age (early adiposity rebound) and later obesity. Despite the uncertainties surrounding this evidence, and the need for additional research, the work suggests that early life is a critical period for healthy development.
---quote ends

The criteria checklist for an effective obesity strategy includes (page 130)

---quote begins
The intention to increase rates of breast-feeding:

• at an individual level includes support networks to help new mothers to breast-feed

• at a local level means positive breast-feeding policies at local hospitals and initiatives such as Sure Start to inform and educate mothers

• at a national level means regulation to give women the right to breast-feed in public places or to protect employment rights and maternity leave entitlements.
---quote ends

While these are amongst the 7 goals of the Breastfeeding Manifesto campaign we support, a fundamentally important one is missing: the protection of breastfeeding through the implementation of the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions of the World Health Assembly.

As the report we have submitted to a government consultation on revising the UK Infant Formula and Follow-on Formula Regulations shows, promoting breastfeeding has little impact if there is not protection. The UK formula industry advertising spend is already ten times that of breastfeeding promotion and the industry attempts to co-opt health workers to recommend its products through a range of strategies from idealizing claims to giving of gifts.

Companies encourage parents to look to them for information on infant care. You can see examples of the promotion in the submission report: "Protecting breastfeeding - Protecting babies fed on formula" which contains the legislative recommendations of the Baby Feeding Law Group, a broad coalition of UK health worker organisations and mother support groups. It is endorsed by the Breastfeeding Manifesto Coalition, which is an even broader group of organisations. See:
http://www.babymilkaction.org/shop/publications01.html#bflgsubmission

Government efforts to increase breastfeeding duration in the UK is failing - indeed rates have stayed still or even fallen in some regions, according to the latest Infant Feeding Survey. Contrast that with Brazil where median breastfeeding duration has increased from 3 months to 10 months.

The big question is will the Secretary of State for Health have the courage to heed the advice of health experts and implement the International Code and Resolutions? Or is he scared of pressure and a possible legal challenge by the baby food industry? If the Secretary, Mr. Alan Johnson, is feeling nervous he could gain courage from his counter part in the Philippines, Dr. Francisco T. Duque III.

In the Philippines, the Department of Health issued strong regulations last year and when challenged by the baby food industry fought a legal battle at the Supreme Court, which was won last week when the Court lifted the Temporary Restraining Order on the regulations.

Dr Duque stated: "By reinforcing the power of the DOH to more strongly regulate milk company sponsorships and advertisements and upholding the independence of the health community in scientific research and policy, the Supreme Court has shown the country’s sovereignty in protecting public health above the narrow trade interests"

See:
http://boycottnestle.blogspot.com/2007/10/philippines-health-trade.html

Mr. Johnson should also learn from the difficulties encountered by the Philippines attempting to address new aggressive marketing tactics through Department of Health Regulations rather than primary legislation. In two areas the Court ruled that the DoH would have to seek changes in primary legislation first.

It concerns us that the UK Food Standard Agency is apparently intending to rely on 'guidelines' published alongside the law to address some practices, rather than legislating. This approach could involve more legal challenges, expense and delay in the future than would showing courage now and introducing strong legislation as everyone whose focus is infant health is advising.

The UK Government claims to be commited to tackling the obesity epidemic. The Public Health Minister, Dawn Primarolo MP, has put her name to the preface of the 'Forsight programme' report, which states:

---extract begins
An unhealthy weight is often seen as a result of individual choice on diet, exercise and lifestyle. However, this report maps the complex web of societal and biological factors that have, in recent decades, exposed our inherent human vulnerability to weight gain. If we fail to tackle this ‘obesogenic environment’ the consequences for individuals, families, communities and society as a whole are grave.

We will therefore jointly be acting on the findings of this project, taking a system-wide approach with Ministers across Government and with professionals and policy makers on a local level. An Expert Panel, drawing on the breadth and depth of expertise that contributed to the report will help us with this. As the report demonstrates, there is no quick and easy solution to tackling obesity. However, we have the long-term commitment – and the learning now – to work together to create a 21st century society better in tune with our biology.
---extract ends

We will soon learn whether this stated commitment is genuine or not. Does the government really want to empower women to breastfeed? Remember 9 out of 10 mothers who stopped breastfeeding by 6 weeks said they wanted to breastfeed for longer, as did 40% who breastfed for at least 6 months. Or will it continue with its current failing approach of promotion without protection?

Will the government listen to expert advice on the Infant Formula and Follow-on Formula Regulations, including that of its own Scientific Advisory Committee on Nutrition, which has called for the legislation to be strengthened in several areas?

If it does not act on this advice it will not only show its commitment to public health is empty words, it will have failed another generation.

Wednesday, October 17, 2007

Nestle Chief, Peter Brabeck, wins another award - for bad practice

News comes from Germany that Nestlé Chairman and out-going Chief Executive, Peter Brabeck-Letmathé, has received an award!

It is one of a growing cabinet of awards his has gained for unethical business practices. In 2005 Nestlé was the overwhelming winner in the public vote for unethical practices, organised by the Public Eye Awards. People also vote with their wallets - Nestlé is 'widely boycotted', according to Nestlé's Global Public Affairs Manager. See:
http://www.babymilkaction.org/press/press6july07.html

The latest prize is the 'Black Planet Award' from ethecon - the Foundation Ethics & Economics. Its companion awared, the 'Blue Planet Award' goes to people who have made a positive contribution to the world's well being.

Mr. Brabeck is awarded along with major Nestlé shareholder Liliane de Bettencourt.

The ethecon press release states: "This years counter-award "The Black Planet Award 2007" goes to Peter Brabeck-Letmathe (chairman of the board of directors) and to Liliane de Bettencourt, (multi-shareholder) of the NESTLÉ Corporation. This award is to pillory the Swiss multi-national for the irresponsible marketing of baby food contaminated by genetically manipulated nutrition, their tolerance of child labour and monopolisation of water resources."

You can find further information on these issues and links to supporting documentation in my blog on what Mr. Brabeck would have told shareholders back in April if he was being honest about the company's impact. See:
http://boycottnestle.blogspot.com/2007/04/got-any-nestl-shares.html

The award will be presented in Berlin on Saturday 1st December at the close of ethecon's conference.

Baby Milk Action will seek to raise awareness, particularly amongst investors, soon after this date. Announcements will be made using our email alert list. But will investors listen? From the way shareholders boo anyone who raises concerns about Nestlé practices at the shareholder meeting and Mr. Brabeck refuses to even respond to the issues, it is not a sympathetic audience. See:
http://boycottnestle.blogspot.com/2007/04/glimpse-of-nestls-soul.html

The ethical award will be presented on ths same date. According to the press release:

---Blue Planet award press release
This year, ethecon, Foundation for Ethics and Economy, will present Vandana Shiva, notable quantum physicist, ecological and civil rights activist with the "Blue Planet Award". This prize is awarded yearly to a person especially dedicated to the preservation of our planet.

Not just recently has Vandana Shiva become more than a symbolic figurehead of those striving for a better and more just world. Originally known for her fight for the rights of indigenous Indians she has achieved world-wide fame for placing the feminist perspective on the ecological agenda. Among other things she is fighting an ardent struggle against the pirate practices of multi-national corporations for the preservation of safe seeds and against genetically manipulated seeds. In addition she has incepted strategies for global sustenance, diversity and fair trading. She is well-know in the peace and democracy movements, as her recent activities in Burma underline.
---quote ends

For a reminder of Nestlé's activities in Burma see:
http://boycottnestle.blogspot.com/2007/10/nestle-burma.html

The news of the shaming award comes as Mr. Brabeck announces above target organic growth in company sales. He states: "The Group's strong organic growth continued over the third quarter, reflecting good performances across most product categories. In spite of increasing input cost pressures, I remain confident that Nestlé will achieve above-target organic growth and a sustainable margin improvement for 2007 as a whole, once again demonstrating the strength of the Nestlé model."

The Nestlé model is, of course, to put profits before infant health, the environment, labour rights and human rights.

Well done, Mr. Brabeck.

Tuesday, October 16, 2007

Philippines Health Secretary says protecting public health came above narrow trade interests in Supreme Court victory

Today the Department of Health, UNICEF and WHO held a joint press conference. There is a report on the Balita website at:
http://news.balita.ph/html/article.php/20071016200230672

The following extract shows how the victory at the Supreme Court is only the beginning. The regulations that came into force with the lifting of a Temporary Restraining Order must now be enforced Health Secretary Francisco T. Duque III said:

---extract begins

”We believe that the most important part of the battle is already won as we now get to screen all the information of milk companies’ future advertisement for misleading and un-scientific claims,” Duque pointed out, stressing they can now regulate manufacturers’ misleading and fake claims on infant formula as well as on those quite known which tend to undermine the superior qualities of breast milk.

The health chief admitted that these fake claims on infant formulas has brought down to less than 16 percent the number of mothers who are into breastfeeding.

According to Duque, the DOH, together with the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF), unanimously hailed the SC ruling as a victory worth celebrating.

He also thanked those who have helped the department to score points in the campaign to save lives of Filipino infants.

”The real battle, however, is only beginning. Hence we continue to ask for their action and advocacy as we now take the fight out of the Court to our communities,” he added.
---extract ends

For my retrospective on the action it took to face down the power and greed of the baby food transnationals see:
http://boycottnestle.blogspot.com/2007/10/philippines-saving-lives.html

As well as enforcing the regulations, the Department of Health is seeking to remove loopholes in the primary legislation so that all promotion of breastmilk substitutes can be banned in line with the provision of the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions of the World Health Assembly.

At the press conference the gains were stressed:

---extract begins
Meantime, Health Undersecretary Alex Padilla said that the SC ruling, among many things, upheld the following: widening the scope of coverage of regulated products to include those for older children (above 12 months), powers relating to the regulation of advertisements; right to specify warnings such as ‘there is no substitute to breast milk’ and that milk formula may contain pathogenic microorganisms; right to delete, reject and prohibit false health and nutrition claims; ban on company involvement in scientific research and policy making, ban on distributing company information through health facilities, and prohibiting donations from companies.
---extract ends

The US Chamber of Commerce threatened the President of the Philippines with disinvestment if the regulations went ahead. Four days after the threat the Supreme Court imposed the Temporary Restraining Order on the regulations. With its lifting last week the Secretary for Health commented that: "By reinforcing the power of the DOH to more strongly regulate milk company sponsorships and advertisements and upholding the independence of the health community in scientific research and policy, the Supreme Court has shown the country’s sovereignty in protecting public health above the narrow trade interests"

This is to be welcomed and here in the UK we hope our authorities will also put infant health above the commercial interests of the baby food industry as our legislation is up for revision.

Monday, October 15, 2007

Football star Theo Walcott in The Times supporting breastfeeding

The Times on Saturday ran a story about the young footballer Theo Walcott and his support for breastfeeding. You can read the article at:
http://women.timesonline.co.uk/tol/life_and_style/women/body_and_soul/article2645153.ece

Here's an extract:

---extract begins
He seems unconcerned (or perhaps unaware) about the potentially lethal dressing-room combination of being baby-faced and advocating mother’s milk. “I know I’ll get the mickey taken out of me, but that’s always happening anyway. What can I say? It’s the right thing to do. It’s about healthy eating, getting healthy bones, right from the start of life, and men need to support their wives in that. That’s what I’ll be doing with my kids.” He adds hurriedly: “I’m not saying I’ll have them now!” He and Mel, 18, a mayor’s daughter from Southampton, who is about to train as a physiotherapist, have been an item for two years.

The breastfeeding manifesto that Walcott is promoting has been produced by a coalition of 39 organisations, including the Royal Society of Paediatrics and Child Health and the Royal College of Midwives. It not only calls for health-care professionals to be fully trained to support mothers with breastfeeding but also for government support for breastfeeding in public. Walcott says he’s amazed when people give dirty looks to his sister when she’s breastfeeding in restaurants.

---extract ends


I met Theo and his mother Lynn at the launch of the Breastfeeding Manifesto, which Baby Milk Action is also promoting. See:
http://boycottnestle.blogspot.com/2007/05/launch-of-breastfeeding-manifesto.html

We are with our pamphlet Hard Sell Formula, which exposes the strategies baby food companies use to undermine breastfeeding.

To help raise funds for the Breastfeeding Manifesto coalition we have put some great tops for adults and babies into our on-line Virtual Shop. See:
http://www.babymilkaction.org/shop/manifesto.html

They are shown here with Alison Baum, the coordinator of the Coalition.


All proceeds after costs go to the Coalition.

Don't forget to check out our merchandise at the same time, such as our 2008 breastfeeding calendar. Our popular fridge magnets are back in the shop as well:


This are very popular. They are hand made in Brazil, so clothing and hair styles vary. A real collector's item. I had taken them out the shop as we tried to build up supplies, but have now initiated a new stock system, so you can see immediately how many are available. Go to:
http://www.babymilkaction.org/shop/magsanddolls.html

This is a critically important time for us and the wider coalition as we work to strengthen the UK law on formula marketing. The coalition has endorsed the report we produced on behalf of the Baby Feeding Law Group for the government's consultation on the law. It is called: Protecting breastfeeding. Protecting babies fed on formula.

It's great to have the support of Theo Walcott and his family for the campaign and generating publicity. Thank you for your support too.

Friday, October 12, 2007

How was protection for infant health in the Philippines achieved?

This is a story with pictures about the ruling by the Philippines Supreme Court on the Department of Health's marketing regulations, as reported in our press release at:
http://www.babymilkaction.org/press/press10oct07.html

In lifting the Temporary Restraining Order on the regulations the Supreme Court said in its ruling:

"The Court and all parties are in agreement that the best nourishment for infant is mother's milk. There is nothing greater than for a mother to nurture her beloved child straight from her bosom. The ideal is, of course, for each and every Filipino child to enjoy the unequaled benefits of breastmilk. But how should this end be attained?"

So let us remember what it took to face down the greed and power of the baby food transnational who wanted the regulations to die for ever and called in the power of the US Chamber of Commerce to threaten the very economy of the Philippines if the President didn't join their cause.

The International Code of Marketing of Breastmilk Substitutes was adopted by the World Health Assembly in 1981 as a minimum requirement for all countries. Article 11.3 states that independently of any other measures to enforce the Code's provisions, companies should "ensure that their conduct at every level conforms to them."

People from the Philippines were campaigning to protect their babies and mothers from aggressive marketing even before the Code was introduced. Indeed, they were instrumental in achieving the Code. Dr. Navidad Clavano, then head of pediatrics at Bagaio Hospital in Luzon, Philippines, gave evidence to Senator Edward Kennedy's Senate Hearing into the baby food industry in 1978, which gave impetus to the calls for a marketing code. Dr. Clavano, who died this month, said: "Most of the health workers are aware of the havoc that bottle feeding creates.... In the Philippines it is common knowledge that we have a very high malnutrition and high infant death, and we have a lot of economic problems. You see mothers diluting their formula, because the basic salary of a Filipino father is only around - less than two dollars, and how much would a tin of feed cost? It costs more than what he earns."

Dr. Clavano encouraged mothers to breastfeed and those that did saw marked reduction in sickness and death in their children. You can find extracts from the presentations to the Senate Hearing and much more about the history of the campaign in our response to a shamefully inaccurate article by Chris Sidgewick et al published by the pseudo-scientific journal, the British Journal of Midwifery (whose peer reviewers do not even appear to have read the primary reference used by the authors who misquoted and misrepresented its data). See:
http://www.babymilkaction.org/resources/yqsanswered/yqanestle09.html

The introduction of the Code should have been enough. There should have been no Nestlé gifts to community health workers (photo from 2006):

No Wyeth events targeting parents (photo from 2007):

No Mead Johnson formula labels claiming IQ and eye development (current label):


But the industry had opposed the Code. Nestlé's Vice President, Ernest Saunders, saying prior to its adoption it was 'irrelevant' and 'unworkable'.

So it took campaigning to achieve the Milk Code implementing some of the Code's provisions in 1986 and to expose on-going aggressive marketing, an assault on the breastfeeding culture, including in 1989 the launch of a boycott against Nestlé and the other companies in the Philippines, coinciding with the re-launch of the Nestlé boycott in other countries.

The launch took place as members of the International Baby Food Action Network (IBFAN) from around the world gathered in Manila to celebrate the 10th anniversary of IBFAN’s formation and to discus progress and plan future strategy.


In 1996 IBFAN helped Dr. Imelda Ben travel from the Philippines to the Nestlé shareholder meeting in Switzerland to raise directly with the board of directors at the shareholder meeting the aggressive marketing taking place in the Philippines. The board did not want to know and dismissed the complaints. Having attended the shareholder meeting this year I can imagine how unpleasant shareholders made it for her as they boo anyone who criticises their beloved money-making machine. See:
http://boycottnestle.blogspot.com/2007/04/glimpse-of-nestls-soul.html

One of the tireless campaigners then and now is Ines Fernandez of the Philippines IBFAN group, ARUGAAN. I think I first worked with Ines soon after joining Baby Milk Action after she had appeared on television in the Philippines and spoken of the boycott. Nestlé then threatened the television with loss of advertising if it ran any more critical programmes. See:
http://www.babymilkaction.org/CEM/compsept97.html#2

On our March 1998, we exposed on our Campaign for Ethical Marketing action sheet Nestlé's strategy of promoting formula direct to mothers in the community with so-called 'Health Educators'. See:
http://www.babymilkaction.org/CEM/compmar98.html#1

Nestlé objected to our exposing this practice, which ended up causing a PR disaster for the company. It claimed in its 'Code Action Report' that our allegation was untrue, which gave us the opportunity to demand a right to reply in this publication which was distributed to policy makers around the world. Nestlé took legal advice and published my letter in its entirety - dressing it up as welcoming 'dialogue'. This is typical of Nestlé's mismanagement of the controversy - it's strategy of denials and deception results in greater attention being brought to our campaign and its malpractice.

The Code Action Report, which was launched as a monthly publication, became less and less frequent as Nestlé had to report other embarrassing news and run apologies. There hasn't been an issue for four years. See:
http://boycottnestle.blogspot.com/2006/10/searching-for-action.html

Monitoring conducted by IBFAN in the Philippines showed continued violations of the Code and subsequent, relevant Resolutions of the World Health Assembly, some of which were exposed in IBFAN's global Breaking the Rules monitoring reports.

This exposure and dedicated work by campaigners and health advocates 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, a challenge which was almost completely rejected by the Supreme Court this week.

It would be nice to believe that the Supreme Court is independent and not subject to political pressure. We have to note, however, that the Court first rejected the industry's request for a Temporary Restraining Order on the RIRR. It was only after 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” that the Restraining Order was imposed - four days after Mr. Donohue's letter.

The industry has a history of not only opposing marketing regulations at the World Health Assembly, but country by country. There was a very real concern that pressure could influence the outcome of the hearing if it was not exposed.

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 letter calling for restraint from the business community and an independent decision from the judiciary. See:
http://www.ibfan.org/site2005/Pages/article.php?art_id=434&iui=1

As sections of the media in the Philippines seemed reluctant to report on the case, perhaps fearing losing advertising revenues and recalling past threats from Nestlé, national and international events were organised. To remind us of some of them and other significant developments, here are some pictures and links.

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. See the UNICEF press release and my earlier blog entry (which has more pictures).


Campaigners launched a national petition calling for the regulations to be implemented in October 2006.

My colleague Patti Rundall OBE (below, middle) and Elisabeth Sterken (left), Director of INFACT Canada, were able to visit the Philippines in November, travelling on from an international meeting on international baby food standards in Thailand. They gave many television, radio and newspaper interviews and spoke at a hearing in Congress. The story was now gaining increasing media coverage.


Back in the UK I launched our petition of solidarity with the Philippines. Hundreds of people and many organisations and networks around the world signed. We sent this to partners in the Philippines who passed it to the Secretary of State for Health and we presented it to the Embassy in London. See:
http://www.babymilkaction.org/press/press8dec06.html

From r-l: Right Rev. Simon Barrington-Ward (former Bishop of Coventry), Minister Leo Herrera-Lim, Patti Rundall OBE, Peter Greaves (retired Senior Nutritionist, UNICEF) and Embassy official.


Rather bizarrely, Nestlé Philippines wrote to us objecting to being included in the campaign as it was not party to the legal action by the pharmaceutical companies in the Philippines, and alleged the violations we reported were years out of date. This was untrue. For example, it's labels claiming 'brain building blocks' as ingredients were still on the market and it had been told by the authorities in the Philippines too that its gifts to community health workers were not permitted.

It later emerged that Nestlé also tried to have the UNICEF and WHO representatives in the Philippines removed from their posts for criticising aggressive marketing. See:
http://boycottnestle.blogspot.com/2007/07/nestle-war-philippines.html

Nestlé head office became involved in the correspondence, in the course of which the Global Public Affairs Manager admitted that Nestlé is 'widely boycotted', something the Chief Executive had tried to play down previously. See:
http://www.babymilkaction.org/press/press6july07.html

In December there was the shocking news of the assassination of Assistant Solicitor General Nestor J. Ballocillo who had been defending the Department of Health in the Supreme Court. He had worked on other high profile cases and no-one jumped to conclusions, but it understandably made our colleagues fearful. The Solicitor General said publicly the murder may have had something to do with the case. See:
http://boycottnestle.blogspot.com/2006/12/lawyer-defending-philippines-baby-food.html

And so the campaigning went on. With demonstrations outside the Supreme Court. See:
http://boycottnestle.blogspot.com/2007/02/misled-mothers-in-philippines-protest.html


Record-breaking mass breastfeeding events. See:
http://boycottnestle.blogspot.com/2007/05/philippines-mothers-go-for-mass.html


I took some of Nestlé's promotional materials along to our annual demonstration at Nestlé (UK) HQ in May 2007 to show how Nestlé targets health workers. See:
http://boycottnestle.blogspot.com/2007/05/exposing-nestl-malpractice-on-its.html


The case gained coverage in the UK media. See:
http://boycottnestle.blogspot.com/2007/06/wyeths-assault-on-law-and-logic-in.html
Even on Chinese television. See:
http://boycottnestle.blogspot.com/2007/07/china-tv.html

UNICEF Philippines produced its film Formula for Disaster, which can be ordered or viewed on line via:
http://www.babymilkaction.org/shop/videos.html#philippines

The crack down in the UK on health claims may have had an impact. The Supreme Court upheld the ban on these in the Philippines. This was a report of the UK action in the Manila Times:
http://boycottnestle.blogspot.com/2007/04/uk-sets-example-as-companies-remove.html

And, of course, the bare breasts demonstration outside the Supreme Court on the final day of hearings caught the interest of the tabloids in the Philippines. See:
http://boycottnestle.blogspot.com/2007/06/brave-breasts-protest-in-philippines.html

And now we have our victory. All points won bar an outright ban on advertising - advertisements have to go before a committee, which has the power to ban them - and the schedule of proposed fines.

Let's remember what was won. The Court found for the Department of Health on virtually all points:

* 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

For more details see:
http://www.babymilkaction.org/press/press10oct07.html

In its statement welcoming the ruling, WHO Philippines said:

"We congratulate the DOH for its commitment to the revised Implementing Rules and Regulations of the Milk Code. 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, the World Breastfeeding Action Group (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."

The actions set out above were just a part of efforts of many people around the world.

There are two messages to take away from this.

If you have come to this campaign new and think that lives can be protected simply by sitting down with the companies and asking them nicely to change, then you are mistaken. Enforceable legislation is necessary. The malpractice should have stopped with the introduction of the International Code 26 years ago. As the experience of the Philippines shows, it takes concerted action by campaigners over years to hold these corporations to account. At any time they could have agreed to meet their obligations under Article 11.3 of the Code, but instead they continued to push their products, contributing to the unnecessary deaths and suffering in the Philippines. Remeber 16,000 infants die every year there because of inappropriate feeding. Efforts to promote breastfeeding are undermined by the companies.

They are still being undermined as I type this, because the companies do not stop just because the regulations are now in force. The regulations will need to be monitored and enforced. And the Philippines is just one of many countries where the same story is playing out.

The more positive message is that if you have supported this campaign in any way, in the Philippines, internationally or supporting our actions, then you share in this victory.

While there is still work to be done to enforce the regulations and achieve the outright ban on promotion, the situation in the Philippines is perhaps now more hopeful than at any point in the past 26 years or longer. We hope to see aggressive marketing stopped and breastfeeding rates to increase. Lives that would have ended with pitiful deaths from diarrhoea, dehydration and malnutrition will not be lost.

The Supreme Court said: "The ideal is, of course, for each and every Filipino child to enjoy the unequaled benefits of breastmilk. But how should this end be attained?"


In the pictures on this page you see part of the answer to that question.

Thursday, October 11, 2007

Philippines court ruling: who is behind the headlines?

Something peculiar happened with the media reporting of the Supreme Court ruling on baby milk marketing regulations in the Philippines. The message I received from campaigners as the ruling came out on Tuesday was an excited: "We won almost everything!" But the Associated Press story that went out around the world, as reported in the International Herald Tribune for example, was that : "Philippine court lifts ban on infant formula ads in blow to breast-feeding advocates". This described a supposed lifting of a ban on advertising on formula advertising as: "a victory for multinational milk companies".

What the Supreme Court actually lifted was the Temporary Restraining Order on the Ministry of Health marketing regulations, meaning they come into force. Certainly, the Court didn't approve an outright ban on advertising of these products on the technical grounds that this exceeded the Department of Health's power in the primary legislation, known as the Milk Code. The ruling recognises the power of an Inter-Agency Committee to vet all advertising and other marketing materials before they become public and its right to block any advertisements or other marketing materials that are not scientific or factual or which idealize formula feeding.

So advertisements can be blocked as they are presented, but there cannot be a blanket ban.

A blanket ban would be clearer for all involved, but scrutiny, if carried out properly, will stop the type of propaganda the industry spews out in the Philippines at present, as shown in the UNICEF Philippines film, Formula for Disaster.

Why did sections of the media immediately declare a victory for the industry? Was it that they didn't read the 53-page ruling as I have done and made available on our website with my analysis? See:
http://www.babymilkaction.org/press/press10oct07.html

Or was there something else going on? Were journalists, or those briefing them, wanting to convince people advertising is now legal and unregulated? It would serve the industry well if people believed they have no means to complain about advertising and campaigners became demoralised. Who was behind these headlines?

Sections of the media are now catching up with what is actually in the ruling.

The Daily Inquirer in the Philippines today has run a story: DoH: Formula milk ads will still pass through tight checks. That is based on statements from the Department of Health. There is also an article based on statements from UNICEF (included below): SC ruling on milk ads still a victory for breastfeeding.

Losing the outright ban on advertising was a blow, however. The Department of Health is reportedly appealing the judgement that its right to 'control' advertising does not give it the power to issue an outright ban. See the Manila Standards Today. As that article reports, there is also a move in Congress to amend the primary legislation to make it clear a ban is permitted.

The headlines are not what really matter of course. The real test will be whether the Inter-Agency Committee stops the aggressive marketing and forces companies to remove health claims and to add warnings to labels. Action is urgently needed. Remember 16,000 children die in the Philippines every year due to inappropriate feeding.

Here is UNICEF's statement on the ruling:

---quote begins

UNICEF Philippines applauds Supreme Court’s removal of the temporary restraining order on the national milk code

Manila, October 10, 2007 – After its initial reading, the United Nations Children’s Fund (UNICEF) Philippines is delighted with yesterday’s Supreme Court decision to lift the temporary restraining order on the Revised Implementing Rules and Regulations (RIRR) of the National Milk Code (EO51). UNICEF believes the ruling is a significant victory for infant, young child and maternal health in the Philippines.

With this ruling, infant formula manufacturers will be prevented from making false or exaggerated health claims about their products, and all advertising and marketing practices will be strictly regulated by a vastly strengthened Inter Agency Committee that monitors the Milk Code. The ruling also upholds the Department of Health’s authority to regulate advertising of all products covered by the International Code on the Marketing of Breastmilk Substitutes.

Notably, the Supreme Court upheld Section 16 of the RIRR which states that “All health and nutrition claims for products within the scope of this Code are absolutely prohibited.” This signals an end to the un-ethical advertising claims that infant formulas increase intelligence – a strategy that has been particularly successful in undermining efforts to promote breastfeeding.

In addition, promotional tactics such as donation of products, marketing in the guise of seminars for health workers, giving of gifts to health workers, use of health care facilities for promotions, etc., will be banned. All infant formula labeling will have to comply with stringent new guidelines intended to help parents to understand that powdered milk substitutes for breastmilk are not sterile and can contain “pathogenic micro-organisms.”

Now the crucial work of educating families and communities about the vastly superior benefits of breastfeeding can proceed without having to compete with billion peso marketing schemes based on false health claims about infant formula brands.

UNICEF wishes to acknowledge the unwavering efforts of a broad alliance of actors in the Philippines and abroad – including the Department of Health, the Philippines Congress, the World Health Organization, Arugaan, Children for Breastfeeding and other breastfeeding advocates – who have helped inform the public about this vital public health issue.
---quote ends

Wednesday, October 10, 2007

Philippines court ruling: formula health claims banned, warnings on labels required

I have now gone through the ruling from the Supreme Court in the Philippines and posted a press release about this on our website at:
http://www.babymilkaction.org/press/press10oct07.html

As I wrote yesterday, there is disappointing news that the outright ban on advertising of milks for young children has not been upheld. The schedule of fines proposed by the Department of Health has also been rejected.

But everything else in the Revised Implementing Rules and Regulations (RIRR) stands!

The press release and a document analysing the ruling gives full details.

Here I want to flag up some of the protection that has been won regarding labelling. On Friday I wrote about the court case in Belgium where a couple lost their legal action agasint Nestlé over contaminated formula. Nestlé does not warn on its labels that powdered infant formula is not sterile and may contain harmful bacteria and how to reduce the risks. But the Judge found for Nestlé as it complied with the legislation.

Well, the regulations that now come into force in the Philippines with the lifting of the Temporary Restraining Order do require warnings on labels. The industry was trying to strike this down. It doesn't want to warn people of the risks, no doubt fearing it may effect sales.

The Supreme Court threw the objections out. The ruling states:

---Extract begins
The label of a product contains information about said product intended for the buyers thereof. The buyers of breastmilk substitutes are mothers of infants, and Section 26 of the RIRR merely adds a fair warning about the likelihood of pathogenic microorganisms being present in infant formula and other related products when these are prepared and used inappropriately.

[The industry’s] Petitioner’s counsel has admitted during the hearing on June 19, 2007 that formula milk is prone to contaminations and there is as yet no technology that allows production of powdered infant formula that eliminates all forms of contamination.

Ineluctably, the requirement under Section 26(f) of the RIRR for the label to contain the message regarding health hazards including the possibility of contamination with pathogenic micororganisms is in accordance with Section 5(b) of the Milk Code.

---extract ends

So there you have it. The industry admitted formula is prone to contamination, but challenged the requirement that warn people!

Now they will have to. At least in the Philippines. We, and our partners in the Baby Feeding Law Group, are calling for the UK Government to take similar action as set out in the report Protecting breastfeeding. Protecting infants fed on formula.

The Supreme Court also rejected the industry challenge to the rules on health claims. The ruling states:

---Extract begins
[Another section] of the RIRR prohibits all health and nutrition claims for products within the scope of the Milk code, such as claims of increased emotional and intellectual abilities of the infant and young child.

These requirements and limitations are consistent with the provisions of Section 8 of the Milk Code.
---extract ends

If you have visited this blog before you may well be familiar with Nestlé's claim in the Philippines that its formula contains 'brain building blocks' which, as well as being idealzing, is not substantiated by the science. See, for example:
http://boycottnestle.blogspot.com/2007/07/nestle-war-philippines.html

The UK authorities embarked on a crackdown on illegal claims here at the turn of the year, which was picked up in the media in the Philippines and, who knows, may have helped set an example for the authorities there. We need to maximise the protection for infant health and parents by learning from each other.

While the Supreme Court rejected the outright ban on advertising in the Philippines, this was on the technical grounds that the Department of Health had over stretched its right to 'control' advertising. As the press release explains, an Inter-Agency Committee will have the power to pre-approve all advertising and marketing materials and require changes or disapprove anything that is not scientific and factual or implies formula feeding is equivalent or superior to breastfeeding. Properly exercised this will stop the type of promotion exposed in the UNICEF film, Formula for Disaster.

However, we know from experience in the UK that regulatory authorities are not always effective and we advocate an outright ban on company promotion in the UK as well as in the Philippines. In both places we call on legislators to strengthen laws.

Given the power of the baby food industry it is a tough job and it is not always possible to achieve all goals in one go. As the examples of the gains set out above show, the authorities now have strengthened tools, even if not as sharp as we might like. The campaigning must continue, including monitoring to see what does and does not change in the coming weeks and months.

As Senator Pia S. Cayetano, Chair of the Health Committee said today: "From the judiciary, the battlefront has just shifted to the legislature. Admittedly, the process may take time and could be drawn-out. But this would be the proper course of action, as the Supreme Court itself had recommended in its decision." See:
Battle over infant formula ad ban now shifts to Congress

Many thanks once again for your support in the phase of the campaign for the Philippines that has just ended.

We hope you are as tireless as we and our partners try to be.