Since the introduction of Baby Milk formulas to the market, there has been a constant debate concerning the benefits of breast-feeding compared to the use of baby milk formula as a substitute. Health professionals have since reached a universal concurrence that breast milk is the ideal food for infants' healthy growth and development. The World Health Organisation (WHO) and the United Nations Children Fund (UNICEF) have for many years emphasized the importance of maintaining the practice of breast-feeding – and of reviving the practice where it is in decline – as a way to improve the health and nutrition of infants and young children. Efforts to promote breast feeding and to overcome problems that might discourage it are part of the overall nutrition and maternal and child health programmes of both organizations. Adopted in 1981, the WHO's International Code of Marketing Breast-milk Substitutes calls for exclusive breast-feeding for the first 6 months of a baby's life and contains provisions laying down clear boundaries on marketing substitutes for breast milk. The code applies to the marketing and practices related of the following products: breast-milk substitutes, including infant formula, other milk products, foods and beverages, including bottle-fed complementary foods, when marketed or otherwise represented to be suitable, with or without modification, for use as a partial or total replacement of breast-milk. It also applies to their quality and availability, and to information concerning their use.
The conundrum for the baby milk industry lies in product marketing. How far are companies willing to go in order to win market share? Are there limits to profit-making at the expense of the consumer?
Marketing and advertising are one of the most powerful socializing forces in our societies' cultural life. They create consumer need by selling images, values, concepts of who we are and who we should be…they create cultural change by shaping our attitudes and our attitudes shape our behaviour. “When a company successfully introduces a new idea into a culture, the culture changes and those changes can be functional or dysfunctional to established patterns of behaviour.”
The Nestle Baby Milk Formula Controversy
Nestle's marketing activities have received much attention in the area of international marketing ethics since the early 1970s. Nestle came under fire then for the way it marketed baby milk formula in the developing world to poor, illiterate women. It continues to be the subject of media each year for its involvement in the death of Third World infants. Health professionals at the time found bottle-fed babies sometimes became undernourished and suffered from chronic illnesses because their mothers were misusing it by watering down costly formula to make it go further. Because milk substitutes need to be made up with water, wherever there is water of dubious quality there will be risks of introducing water borne diseases to babies, who would otherwise not directly ingest water. In conditions with poor hygiene and water supply, as is often the case in developing countries, there can be major health risks associated with the use of milk substitutes. Some medical experts have estimated that there is a 14 times higher chance of babies dying from diarrhea when on milk substitutes compared to those breastfed. Nestle was careless about educating mothers with regards to the use of infant formula, neglecting to take local economic and environmental conditions into consideration.
It has been agreed that breast-feeding is the single most effective way to reduce infant mortality and morbidity rate and promote child health, especially in developing countries. Lack of breast-feeding will result in more cases of diseases such as diabetes, hypertension, thyroid disorders, allergies, etc. While there are women who genuinely have problems lactating, the problem is that Nestle seems to be redefining its potential customers as not just those who need a milk substitute, but those who might find it more convenient. An angle for baby milk formula companies is to use every opportunity to market formula as breast milk substitute, for example suggesting that a mother has to use expensive supplements to breastfeed successfully. This is one of the strategies that the industry uses to undermine breast-feeding.
Parents want the best for their infants and are anxious to secure their healthy growth and development. This sentiment is often preyed upon by the baby milk industry who take advantage of this vulnerability to create an artificial need. As well, for many women from deprived backgrounds, bottle-feeding has an aura of acculturation and prosperity. Successful marketing has led to baby milk formula becoming aspirational consumption as a status good.
Article 5.5 of the International Code of Marketing Breast-milk Substitutes explicitly prohibits companies from targeting pregnant women and mothers of infants and young children. (Young children are defined as up to 3 years of age) But the industry has long enjoyed an inside track in promoting their products because of their ties to the medical establishment. Many hospitals distribute free samples of Baby Milk formula to mothers of newborns when they check out. Research shows that many mothers end up using the formula that they received for free at the hospital. While other companies producing baby milk formula also do some advertising, Nestle alone markets with radio spots and promotions at baby fairs.
The Situation in China
In February 2004 Baby Milk Action supported a campaign to stop Nutricia (Dutch company-NUMICO) pushing its ‘Kissing My Baby' range of formulas in China with a free gift CD of children's songs. Nutircia responded by attempting to justify the promotion, but following bad publicity in its home country of Holland, the company said that it intended to adjust its marketing program to be ‘entirely in line with the Chinese regulations'. The Chinese Rules Governing the Administration and Marketing of Breast milk Substitutes (1 October 1995) state that giving gifts to promote sales of breast milk substitutes is prohibited, however monitoring has found that Nutricia did not remove the packshot of Kissing My Baby formula and a mother reported receiving a copy of the CD when she bought the formula in the range ‘For use from birth'.
The promotion first came to light when the Director of Nutricia China, Marc de Reouw, boasted to a television program that the company had ‘gold in its hands' with its entry into the market. While Nutricia looks forward to profit, health experts are already counting the cost. When the International Baby Food Action Network (IBFAN) launched a report in China in May 2004 exposing violations, an official with the Ministry of Health told the media: “The health of following generations of the Chinese nation might be threatened if breast-feeding is replaced by milk powder.”
However, while Chinese authorities are concerned about the emergence of a bottle-feeding culture, worries do not only involve inappropriate marketing, but the presence of counterfeit baby milk formulas.
In April 2004, State media reported the deaths of 50 to 60 infants, mostly from poor families, who died of malnutrition after being fed counterfeit baby milk formula which contained almost no nutrients. Following investigations brought to light 45 types of substandard baby milk formula in retail outlets across Fuyang city, Anhui. Further 10 brands of counterfeit formula were found in Shandong province. It has been estimated that as many as 200 babies have died as a result of being fed the formula – the worst case of malnutrition in the country in 20 years.
After being put on the fake formulas by their unwitting parents, the affected babies lost weight rapidly with one of the side effects being a bloated face. The symptoms are like those of edema, a buildup of fluid that is a feature of starvation. Called ‘Big-Head Disease', this often masked the fact that the infants were being malnourished. An analysis of one particular formula found that it contained one sixth of the required amount of protein to sustain the average baby's dietary requirements for development.
The deaths prompted a national crackdown on safety violations in China's food and drug industries, where phony medicines and other products regularly cause deaths and injuries. Police have raided scores of markets, allegedly confiscating thousands of bags of counterfeit baby milk formula made under 45 different brand names by 141 factories scattered across China. The government has also promised the family of each dead infant 10,000 yuan and ordered local authorities to help pay the medical bills of hospitalized children. The problem in China exists on dual fronts – combating a counterfeit manufacturing culture on one hand, and the marketing aggressiveness of baby milk companies on the other, to protect the welfare of its most silent citizens.
Resources:
http://www.msnbc.msn.com/id/4785942
http://www.cbsnews.com/stories/2004/06/09/health/main622021.shtml
http://www.nutraingredients-usa.com/news/ng.asp?id=60501
http://www.foodnavigator.com/news/printNewsBis.asp?id=51597
http://online.wsj.com/article/0,,SB107835935754646000,00.html
www.babymilkaction.org/CEM/compdec04.html#2
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