RETAIL SHOPS
Formula makers buy shelf space and flood stores with baby food products, posters and promotional materials. In the Philippines, for example, the supermarkets have been flooded with infant foods and materials to make them seem attractive and make mothers aware of brand names. Next to them on the shelf is Pedialyte for the diarrhea caused by formula when made up with unsanitary water. Now they are selling bottled water for making up the formula but still they don't have the immunological effect of breastmilk. Soy formula is also for sale for infants who developed allergies to the milk-based formula. As always, the hazards associated with use of these products are denied or minimized. In some US supermarkets, the infant formula shelf has a label saying "recommended by WIC," the US government Women, Infants and Children program. The formula industry has used government programs to promote their goods.
In Australia, the retail sector has not been a signatory of the Australian Agreement on the Code and it is being used as a loophole for exploitation. The baby bottle companies never signed, either. Previously, promotion materials were only in some pharmacies but now companies like Mead Johnson have orchestrated many pharmacies to have the same Baby Club inducements. Recently, supermarkets have become baby food centers carrying anti-breastfeeding messages with massive display advertisements in prime store locations. Pharmacies are now in competition with supermarkets to retain their old market share.
AT THE DOCTOR'S
Hospitals, clinics, maternities and doctors' offices have become distribution centers. The sales reps actually come into the wards and clinics with their products, promoting them with misleading information. In a hospital serving mainly south Africans in East London, nurses were told by the Abbott rep that Similac was not formula but a supplement for premature infants. Mothers seeing premature infants fed formula then think it's better than breastmilk. At Tygerberg Hospital in South Africa, Nestlé paid for nurses to teach infant care. They also funded a nutrition department at the University of Capetown. Doctors' offices dispense formula samples and educational materials. They even give out videos on breastfeeding that are produced by the baby food industry!
It has been shown that 93 percent of mothers who receive gift packs use the brand issued. The US government-sponsored WIC program and similar nutrition programs serve as distribution centers for formula. This hooks mothers on a particular brand. (Participants in the WIC program receive only enough formula to feed a nine-pound baby. When the baby needs more, the mothers must buy it themselves. Had they not been persuaded to formula-feed, they could have nursed their babies for free.) Hospitals are paid enormous sums for using and distributing only one company's product. Despite distributors not being allowed on the wards, they do come to nurseries and maternity wards. In South Africa, Abbott uses the forumla product Formance for pregnamt women falsely advertised to produce bigger babies and more milk, to gain access to prenatal and postnatal patients, a practice that is not banned by the Code. Once there, they promote other products.
HEALTH WORKERS
Health workers have a special responsibility for the success or failure of the Code. They are frequently the target for promotional practices and health care facilities are used by companies as the frequent channel for encouraging the use of their products. Health professionals are very naive and often don't realize that they are being used. The baby food industry has used and needs health professionals to endorse, distribute and sell its products. According to an Abbott Labs publication, "As the voice of Abbott, Abbott Topics can be a positive force molding the physicians' opinion of Abbott. In effect we are striving to make the physician a low-pressure salesman of Abbott."
In Pakistan, the reps have cards on doctors that include information on their birthdays, families and practices and this information is passed from rep to rep. The doctors with large pediatric practices and who teach are classified as type A and receive special attention.
Industry representatives attend medical, nutrition, breastfeeding conferences and meetings and also sponsor many of these. It should be noted that the infant food industry meetings never include doctors not in their employ unless the purpose of the meeting is to gain health profession support of their point of view. At a recent Code meeting of health workers in Capetown, ten official company representatives attended in order to undermine what was said about the Code and cause confusion. Additional Nestlé advocates who received funding and gifts from the company were at the meeting.
The formula companies even have the audacity to teach about breastfeeding when promoting formula and in so doing subtly undermine the process and make women and babies dependent on the products.
The Infant Formula Council produces publications to educate health professionals. One of these, a review on infant feeding methods, contains a step-by-step discussion arguing that formula is as good as breastmilk. When the International Group on Breastfeeding Monitoring published their expose "Cracking the Code," Nestlé produced a denial document called "A Missed Opportunity" and distributed it to physicians and health workers everywhere. Scientific studies showing deficiencies in human breast milk are also widely distributed but no one talks about improving the maternal diet. The object is to create fear and sell formula.
The companies do not give money for nothing. The American Association of Pediatrics (AAP) receives $1 million a year from formula companies and they got $8 million for their building fund. (It was after the $8 million grant that the AAP dropped its objection to soy formula.) Companies pay for conferences, special guests, functions, display products in exhibits, sponsor research, journals, publications, institutional premises, scholarships and yearly stipends. Some groups have resisted. The Indian Pediatric Association takes no "milk money" from the formula companies.
IN THE MEDIA
The media portrays women as sexual objects. Nursing women are shown in dressing gowns with fat bosoms like domestic cows. Men are shown bottle feeding and often men portray breasts as their goods. Women need to reclaim their rights and their breasts.
There is no question that the corporations have access to the media and make good use of it to push their case. Nestlé bought the time before and after a television segment on a breastfed baby who died because of stated insufficient milk and not getting formula. Abbott did the same for a report on an infant death due to medical neglect blamed on breastfeeding. The companies effectively use publications like the Wall Street Journal, Time and the New York Times to undermine breastfeeding but recalls of thousands of harmful cans of formula do not get attention.
The internet has become a very important marketing tool and formula makers are very smart in how they use it. Sometimes it's difficult to recognize how it's used to promote bottle feeding. Examples include "Women's Link" by Bristol Meyers and Mead Johnson; Robin Adler's campaign "Bottle Feeding Without Feeling Guilty" "Parents' Choice" by Wyeth (marketed by Walmart); "Bottle Buddy" and "Carnation Baby." Baby food companies are now organizing nutrition education for parent and baby groups with a focus on correct infant feeding. Is there conflict of interest?
CONSUMERS' ACTION
As powerful as these corporations seem to be, they can be compelled by market forces to behave in ways consistent with global and local progress, meeting human needs, doing no harm and building a better future for our children.
We have to take action to protect public health and end inferior feeding practices that interfere with breastfeeding and only benefit corporate profit. We need a system that will make regulations binding on corporations to protect the health of mothers and babies. Evidence-based studies are essential to ensure that all the baby foods are not harmful and that the claims made for them are substantiated. We must value mothers and ensure maternity entitlements. Society has to recognize the value of mothers and support them. But most of all, women need to recognize the unique importance of their ability to breastfeed and stand up for their rights.
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