For A Complete Stop of Dangerous Infant Feeding Practices
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For A Complete Stop of Dangerous
Infant Feeding Practices - extracted text
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For A Complete Stop of Dangerous
Infant Feeding Practices
Call for a National Campaign
Battle of the Bottle
K. P. Sunil
On March 27, 1990, replying to unstarred question no
1721 raised by Pramod Mahajan in the Rajya Sabha,
Professor M.G.K. Menon, then minister of state in the
ministry of science and technology said: “ The information
and broadcasting ministry has decided that advertisements
for baby foods can be accepted by All India Radio and
Doordarshan, so long as the manufacturers and distributors
of these products do not promote them as being suitable
for use as partial or total substitutes for breast milk."
This announcement, which formally lifted the ban on TV
and Radio advertisements of infant formulas, renewed the
debate on breast - feeding.
Breast-feeding has been universally acknowledged
as the best means of feeding the new - born child. While
breast milk alone cannot give 100 percent protection, its
anti - infection
properties provide natural protection
against many potentially fatal infant diseases.
Needless to say, millions of infants succumb each
year to diseases like chronic diarrhoea, pneumonia,
meningitis and malnutrition simply because they are not
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breast - fed.
The reasons, especially in developing
countries where the devastation is at its worst, are not
hard to find. Contaminated water supply, inadequate
fuel for boiling, poor storage facilities, poor sterilisation
of bottle and teat, all contribute to work against the
health of the baby, already deprived of his mother's milk.
One of the biggest advantages of breast-feeding is that
the mammary glands react to the microbes brought to
it by the infant and respond by producing specific
antibodies which fight the invading microbes before they
take control of the infant's systems. In contrast, formula
milk lacks the immunological properties of breast milk.
Combine this factor with contaminated water, an infinite
dilution of the formula milk out of sheer ignorance or
acute poverty, and one has a situation which is truly
alarming.
By the late 1970s, it had been brought home to the
world that the bottle was fast replacing the breast in
urban and semi-urban conglomerations worldwide, with
disastrous consequences to the baby. Realising the need
to check this tendency, the World Health Organisation
drafted the international code of marketing of breast-milk
substitutes to ensure safe and adequate nutrition for
infants by the protection and promotion of breast-feeding
and by ensuring that breast - milk substitutes like formula
infant foods were used only when deemed absolutely
necessary and then only on the basis of adequate infor
mation and through appropriate marketing and distribution.
The WHO hoped that the code would be adopted by all
member countries in deference to the right of every child
and every pregnant and lactating women to be adequately
nourished.
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Shortly after the passage of the WHO code, the
ministry of social welfare announced that a legislation
was on the way to prevent aggressive marketing practices
of infant food. What finally took place was not the
enactment of any legislation but the adoption of an
indigenous version of the WHO code.
In December 19, 1983, the ministry of social welfare.
Government of India, passed the Indian National Code
for Protection and Promotion of Breast-feeding under
resolution 18-11/83-NT. The code constituted a virtual
adoption of the WHO draft with minor variations. It formed
the first firm commitment from the Government of India
that it recognised the evil effects of the bottle, and that
it was prepared to launch a crusade against formula infant
food.
The code was comprehensive, in Article 4, it placed
the onus of ensuring that consistent information was
provided on infant feeding, squarely on the government.
In article 5, advertisement and other forms of promotion
of infant food and breast milk substitutes was totally
banned. Under Article 9, it was envisaged that labels
on infant formula containers should have necessary
information about the appropriate use of the product in
a conspicuous and easily readable format and in an
appropriate language and should also incorporate a
message on the superiority of breast - tending. Article II
sought to internalise these principles in a legislation
empowering the government to act on the provisions of
the code.
Unfortunately, however, all the above provisions are
today observed only in the breach.
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On November 18, 1988, cutting across party affilia
tions, the Oppsition and the treasury benches joined
hands in the Rajya Sabha to unanimously pass the infant
Milk Foods and Feeding Bottles (regulation, supply and
distribution) Bill presented before the house by the thenminister of human resources development (Bill no XLI-C
of 1986). The bill was poorly worded and full of
loopholes. Its formulation had clearly been influenced
by infant food manufacturers, most of whom are large
multinationals, to suit their purpose.
In the first place, by calling the bill the Infant Milk
Foods and Feeding Bottles Bill (infant milk food is
defined under section Z-F as food marketed .as a partial
or total replacement for mother's milk), it leaves out of its
purview the vast market of cereal foods, complementary
foods and weaning foods. These are equally harmful
and had also been considered by the WHO code and the
1983 Indian code. The bill also leftout of its purview
products commonly referred to as pacifiers or soothers
which are recognised as amongst the largest source of
diarrhoeal infection in infants. Offenders under the bill
were considered bail-able and punishment were nominal
considering that the offenders, if at all, would be large
multinationals for whom a fine of a few thousand rupees
would mean next to nothing.
In spite of these obvious drawbacks, it was a
positive step in the right direction. However, despite the
assurances of the minister who piloted the bill in the
Rajya Sabha, it was never placed before the Lok Sabha
and never became a law though five years have elapsed
since then. And, all the while, advertising of infant foods
has continued unabated. Advertisements that violate every
provision of both the WHO and Indian codes on the
subject:
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"Is ths best baby in the world getting the best baby
food?" asks the advertisement for Amulspray. "Baby's
nutritionally complete cereal food - complete with milk,
sugar and love " goes the jingle for Cerelac. Doctors
recommend Farex" says an agency - spun untruth ; while
Nestum promises 'to add variety to your baby's foods"...
And as if this were as not enough, in 1990, the
Government of India decided to allow advertisement
of baby foods on AIR and- Doordarshan as long as
manufacturers did not promote them as being suitable
for use as partial or total substitutes for breast milk.
This question of allowing advertisements that adher
ed to certain guidelines has been discussed
in
several forums.
Manufacturers, the medical frater
nity, consumers, women's organisation, the Govern
ment of India, WHO ' and UNICEF had all gone into
the question and conculded that advertisements of
baby foods in
any form would suit manufacturers
and would
also go
against the interest of babiesand consequently ought not to be allowed. Consi
dering that India is a signatory to the international baby
food code which prohibits all advertising of baby foods,
the decision of the Janata Dal government can
only be termed a retrograde step clearly influenced by
a powerful, unscrupulous manfacturers' lobby which
markets over Rs. 200 crore worth of baby foods - a full
50, 000 tonnes of it - annually, all over India.
In this context, the decision of the Chandra Shekhar
government to introduce before Parliament (Bill no 5 of
1991 )a revised version is very welcome. The bill, in its title,
takes into consideration not only infant milk foods but
also infant foods, thereby rectifying a serious defect
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of the earlier bill. However, the bill is flawed in the sense
that in crucial sections pertaining to advertising or the
use of incentives for sale promotion, infant foods have
conveniently been left out. Obviously, the manufacturers
have had a say in things.
The bill, as it now stands, has, as some one wise
cracked, so many loopholes that an unscruplous manu
facturer could drive a herd of milch cows through it I Yet
the law, if passed, would prove a small step in the right
direction. Given the precarious state of the Indian govern
ment and the question mark dangling over the future
course of political events, the question of the health and
well-being of a few million children in the country is
hardly likely to exercise the minds of our parliamentarians.
In all probability, the current bill is likely to die a
natural death without becoming law just like its pre
decessor. And multinationals will continue to dump infant
food onthe unsuspecting millions and rake in the profits.
(Taken from The Illustrated Weekly of India, Weekend
March 2-3, 1991)
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Baby Food Bill in Limbo
Max Martin
The bill on the banning of baby food advertisement
is still pending in Parliament. The bill, which was intro
duced on January 10, 1991 by the Minister of State for
Labour and Welfare Ramji Lal Suman, seeks to ban all
advertisements of infant milk food and feeding bottles,
gifts of same and any kind of promotion of infant milk
foods or weaning foods in hospitals and other health
centres.
Moreover, the bill makes it mandatory to label all
these tins with "Mother's milk is best for your baby" and
"use the tin food only on advice of a health worker".
A bill, on the same lines, was introduced in 1986.
But despite the then govenrment's repeated promises the
bill was not passed in the Lok Sabha.
But why this hue and cry against baby food ?
Because it is bad for babies.
A study by UNICEF reveals that in the first six
months, the risk of illness or death from diarrhoea is 25
times higher for children who are bottlefed, compared to
those who are exclusively breastfed. Child specialists
and health activities endorse the same.
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Says Dr. S. Ramji, assistant professor of pediatrics
at the Maulana Azad Medical College, New Delhi, "More
than 80 percent of infants brought here with diarrhoea
are bottlefed. On the contrary, you can just see the occ
asional mirth of an exclusively breastfed child."
"The disease occurs because of unhygenic feeding
habits and malnutrition,"
says Dr. Mira Shiva of
Voluntary Health Association of India. "It is not always
possible for mothers to keep the feeding bottle clean and
sterile. And mothers tend to dilute the milk to cut down
costs (around Rs. 30 for a tin of half kg)."
But as the belief goes that everything that comes
nicely packed is good, more and more mothers go for
tin food.
Moreover, there is the problem of urban
working mothers who cannot spend the daytime with
their babies. Others imitatethem. "Only less than 10 per
cent of mothers have problems in lactating. For that
prescription will do, not ads, " says a doctor from the
Capital's Lady Irwin Medical College.
In short, mothers who can stay with the infant at
least for the first three months don't have to go in for
milk substitutes and spend atleast six times extra money
in the process.
"If at all they cannot breastfeed, cattle milk is
economical, though it is not as nutritious as breastmilk:
but it can be easily complemented," says Dr. Ramji.
The marketing of baby food worldwide by multi
nationals is aggressive indeed. It is a six-billion - dollar
industry. Apart from advertisements, they provide free
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supplies to hospitals. According to a report published
by Action for Corporate Accountability, Minneapolis,
USA, the companies still give free or cost-reduced supplies
to hospitals in Mexico, Mauritius and Malaysia. Nestle,
the leading multinational with more than one third of the
world market, provides free supplies to atleast 20 coun
tries, according to the report.
Bottlefeeding in hospitals interfers with breast
feeding at the most crucial time. With a lack of suckling
stimulus it will be difficult for mothers to lactate. Apart
from that, says a pediatrician, the infants get used to
passive feeding habits with bottle milk, leaving out nutri
tious breast milk. The latter has proteins and antibodies
vital for the baby's health.
Manufacturers promote baby food by sponsoring
international scholarships and seminars for doctors and
providing research facilities for hospitals.
It is against this aggressive promotion that protests
mounted worldwide, giving birth to a baby food code.
Baby food Action Network an international body based
in the U. K. even called for boycott of Nestle products.
Nearer home, organisations like Voluntary Health
Association of India, Delhi Consumers' Forum, and various
doctors'associations have been demanding control on the
activities of manufacturers.
The government adopted the National Code for
Protection and Promotion of Breastfeeding in 1983, on
the lines of the WHO / UNICEF code. This is applicable
to infant milk foods, ie, breast-milk substitutes and any
formula that partially or totally replaces breast-milk.
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The major provisions of the code include :
□
No direct promotion of such products to the public.
□
No promotion of them in health-care facilities
□
No free samples or gifts to mothers
□
No contact with mothers by company sales personnel
□
No promotional samples or gifts to health workers
□
The provison of clear and consistent information to
health professionals.
□
No Picture of infants on labels plus clear and con
sistent information on labels. ■
□
No promotion of sweetend condensed milk for
infants.
To give teeth to the code, professional and con
sumer group put pressure on the government. The '86
bill was a result of that, but was however scuttled.
Reportedly, the producers of Amul, the Gujarat Co-opera
tive Milk Marketing Federation, were behind the blocking
of the bill, because the ban on ads of breast milk
substitutes would have deprived them of the cutting edge
over multinationals like Nestle.
Even now Nestle India Ltd. claims that they support
the legislation on the code. Nestle and other multi
nationals can always advertise products like Nestum,
Cerelac and Farex, which are not exactly infant milk foods,
but prop up the company name besides fetching good
profits.
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The bill, if passed, will put some control on adver
tising of baby food products.
As Ramji Lal Suman puts it. "It is for the good of
all children of our country. The multinational lobby will
be there to stall it but we will not budge."
(Taken from Sunday Mail March 3, 1991)
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Let Us Know,
They may Be Breaking The Rules
Are you aware of the promotional activity of the
baby food industry ? Use this questionnaire to inform,
us about promotion of artificial infant milk and commercial
weaning food in your community.
Please feel free to
write on additional sheets. Read and pass on copies.
IBFAN aims to stop the unnecessary promotion of
bottle feeding worldwide. Concern about the decline in
breastfeeding and the consequent illness and death of
babies led to the adoption of the WHO/UNICEF Inter
national Code on the marketing of baby milk. The pro
motional activities of the baby food industry, together
with misguided hospital practises have destroyed breast
feeding for millions of mothers and babies.
In order to ensure that companies abid? by the
Code we need your help.
All we ask is that you become aware of the pro
motional activities of the baby food industry, in India.
Use this questionnaire to inform us. The questions will
help you to identify some of the important violations that
often occur.
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..........
Name
Address
• •••■•••■••ft. •
• ■.•••••tan i a. ia, •
Date
Confidential
Yes 1
j
No
1. Are mothers still getting free milk or weaning food
samples
If yes, state brand
Name and address of hospital I clinic
Confidential
No
Yes
2. Are hospitals, maternity wards or health clinics recei
ving free or low - cost supplies of baby milk / weaning
foods ?
Are they receiving free gifts ?
Please give as much details as possible, addresses etc.
Confidential
No
Yes
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3. Do baby milk products or weaning complementary
food labels show pictures of babies ?
Yes
No
If Yes, state brand / company name,
Do they have adequate warnings ?
IF NO give examples
5.
Yes
No
Is breastfeeding actively supported in your region ?
Facilities for working mothers, nursing rooms
Good literature etc.
Anything else?
6.
Do hospital practices discourage breastfeeding? eg.
Conflicting / Unhelpful advice
Strict feeding routines
Unnecessary separation of mother and baby [_
between Company reps and mothers
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Contact
Promotion of formula milk
Anything else ?
7. Do hospital practices encourage commercial weaning
foods ?
(Send your responses to the Centre for Development
and Women's Studies, we will communicate them to
IBFAN)
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For A Complete Stop Of
Dangerous Infant Feeding Practices
Ten years after India signed the International Code
of Marketing Breast Milk Substitutes, prohibiting the
advertising of commercial infant formula to the public,
no laws exist in India to deter the baby food companies
from continuing to promote inappropriate and dangerous
infant feeding practices.
Why not
foods ?
commercial infant formula or weaning
It is universally accepted that breast - feeding is
the best food for babies. Its anti-infective properties
provide natural protection against many potentially fatal
illnesses, whereas routine bottle feeding causes mothers'
milk to dry up due to the lack of suckling. The bottle fed baby becomes hooked on to a infant formula which
many mothers can neither afford nor safely prepare.
However, aggressive, high pressure advertising and
promotion technologies coupled with contaminated water
supply, inadequate fuel for boiling, poor storage facilities,
illiteracy and low buying power - all work against the
health of babies. The situation takes an alarming turn
when formula milk is very diluted out of sheer ignorance
or acute poverty.
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Where weaning ■ foods . are concerned, locally,.
available, traditionally accepted weaning foods like dal,
rava (sooji), bananas etc., provide enough nutrition at
a much lesser cost. It is clear that there is no justification
at all for the current spate of advertising of weaning
foods.
Towards an International Code of Marketing :
By the late 1970s it was brought home to the world
that the bottles of commercial preparations of infant
milks was fast replacing the breast in urban and semi-.
urban conglomerates world - wide, with disastrous con
sequences on babies. At the World Health Assembly in
1981, the late Prime Minister, Mrs. Indira Gandhi, cited
the use of baby foods as an example of ''how publicity
has made us the victims of habits which are economically
wasteful and wholly
contrary to good health".
Realising the need to check this tendency, the World
Health Organisation and UNICEF, with support from the
International Baby Food
Action Network (IBFAN)
formulated an International Code of Marketing of Breast
- milk Substitutes, to ensure safe and adequate nutrition
for infants.
India voted in favour of the WHO code in baby food
marketing and immediately appointed a committee to
recommend its implementation.
The code was to protect and promote breast feeding
by ensuring that breast - milk substitutes, like formula
infant foods, were used only when absolutely necessary for example, in orphanages.
After the passage of the WHO / UNICEF code in
1981, the Ministry of Social Welfare announced their
intention to introduce legislation to prevent aggressive
marketing of infant foods in India.
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Towards a national code - a bill introduced
In November 1986, cutting across party lines, there was
a discussion in the Rajya Sabha, on the Infant Milk Foods
and Feeding Bottles ( Regulation of production. Supply
and Distribution ) Bill. Despite the professed good intentions
of the government, the manufacturers of baby foods had
influenced the drafters of this Bill, since it only covered
"Infant Milk Food
Infant foods such as complementary
weaning and cereal foods and pacifiers were convenienty
left out of the scope of the Bill.
Article 5 of the Bill banned advertisements and other
f ormsof promotion of infant food and breast milk substitutes.
Morever the Bill lapsed as it was never placed before
the Lok Sabha.
The situation created by the indifference of the
powers-that-be which allowed the Bill to gather dust and
pass into oblivion was a golden opportunity used to the
hilt by baby food manufacturers.
A revised version of the old bill, Infant Milk Foods
Feeding Bottles and Infant Foods (Regulation, Supply
and Distribution) Bill, 1991 is now on the cards. Whi|e
seeming to cover " Infant Foods " it is silent about
"Infant Foods" especially in the clause on adverstising I
Advertisements Galore
Advertisements on infant foods that violate every
provision of the WHO and Indian Codes still appear in
newspapers and magazines. In 1990, the Government
of India allowed advertisement of baby foods on AIR and
Doordarshan even (so long as manufacturers did not
promote them as being partial or total substitutes for
mother's milk).
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It is clear that if the manufacturers do not promote
them as being partial or total replacement of mother's
milk, they will in fact do precisely that to protect their
advertising interests !
The spate of advertisements on "Infant Foods"
point to the general awareness among manufacturers
that there would be no deterrent to their continued
advertising. The millions once spent on direct advertise
ments is now being spent to push artificial baby food
into hospitals, and health centres. The baby food manu
facturers use the print media, doctors, conferences, exhi
bitions and even shops for advertising baby food. These
continued unethical, aggressive and totally inappropriate
marketing practices of baby food companies is an issue
that concerns all people who care about justice in health
care.
This trend needs to be stopped - it is clear that
manufacturers are making use of the loop holes in the
Code and in the proposed Bill, which anyway, does
not prohibit advertising of infant and weaning foods:
Even in the interest of the economic crunch that
India currently faces, the promotion of formula milk and
weaning foods is a waste of money. That it is dangerous
to the health of babies, has already been stressed.
Call for support - and action
That something must be done to check the conduct
of baby food promoters cannot be contested. A more
inclusive Bill, with strong measures to control a adver
tising and sales of baby foods, is the need of the hour.
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We communicate this information to you, because
we feel that it is time to generate a national debate and
a national campaign to demand strong legal action against
companies which defy the Code.
How can you support such a campaign ?
Can you suggest things that can be done ?
Will you be willing to participate in any action planned ?
Please reply to the following organisation which is
facilitating such a process at the initial stages.
Centre tor Development
April 1991
Madras.
and Women’s Studies
1829, 18th Main Road,
Annanagar (West,)
MADRAS - 600 040.
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