Infant formula marketing

Breastfeeding is best for babies. Henri Nestlé stated this in his Memorial of the Nutrition of Infants soon after founding our company in 1867, and it is still true today.

We are committed to ensuring that the best interests of mothers and babies are served by our employees around the world. The following is the Nestlé Infant Formula Policy in developing countries (1):

DOES comply with both the letter and the spirit of the World Health Organisation's International Code of Marketing of Breast-Milk Substitutes as well as with national regulations giving effect to the WHO Code when these are stricter
DOES support WHO's global public health recommendation calling for exclusive breastfeeding for six months and introduction of safe and appropriate complementary foods thereafter
DOES encourage continued breast-feeding up to two years or beyond after introduction, after six months of age, of safe and appropriate complementary foods
DOES warn mothers of the consequences of incorrect or inappropriate use of infant formula (2)
DOES believe that there is a legitimate market of infant formula (3) when a safe alternative to breast milk is needed
DOES believe that parents have the right to choose how their babies are to be fed on the basis of adequate and objective information
DOES support efforts by governments to implement the International Code through legislation, regulation, or other appropriate measures
DOES NOT advertise or promote infant formula to the public
DOES NOT permit staff whose responsibilities include the marketing of infant formula to make direct contact with mothers, except in response to consumer complaints
DOES NOT use pictures of babies on its infant formula packs
DOES NOT distribute free infant formula samples to mothers
DOES NOT allow educational material relating to the use of infant formula to be displayed publicly in hospitals and clinics
DOES NOT give financial or material incentives to health professionals for the purpose of promoting infant formula
DOES NOT donate free infant formula to health care facilities for use by healthy new born babies. Free infant formula may exceptionally be given to bona fide social welfare institutions upon their request to serve social or humanitarian purposes (e.g. where the government policy allows manufacturers to respond to a specific social request, for example if the mother dies in child birth)
DOES NOT give incentives to its staff based on infant formula sales
WILL

take disciplinary measures against any Nestlé personnel who deliberately violate this policy.

Nestlé invites government officials, health professionals, and consumers, to draw to its attention any Nestlé infant formula marketing practices in developing countries which they consider are not in conformity with the above commitment.

(1) All countries in Eastern Europe that are not members of the European Union, and all countries or territories of Africa, Middle East, Asia, Latin America, the Caribbean nations and the Pacific Nations except Japan, Australia, New Zealand, Republic of Korea, Singapore, Taiwan and Hong-Kong.

(2) See information printed on all Nestlé infant formula labels, educational materials intended for mothers, and on documentation for health professionals.

(3) Breast-milk substitutes manufactured in accordance with strict international quality standards to be suitable as the sole source of nutrition for a baby during the first 6 months of life, and all follow-on formula that do not have brand/label design distinctly different from infant formula (the International Code does not apply to Weaning Foods, see Code Articles 2, 10.2 and Annex 3).

Printed on all Infant Formula Labels and
Educational Materials Intended for Mothers

Labels:
Important notice: Breast milk is best for babies.
Before you decide to use an infant formula consult your doctor or clinic for advice.
Warning: Unboiled water, unboiled bottles or incorrect dilution can make your baby ill. Only prepare one bottle at a time. Feed immediately. Do not keep unfinished bottle. Follow instructions exactly.

Educational Materials:
Important Advice for Mothers
Breast-feeding
Breast-feeding provides the best nutrition and protection from illness, for your baby. For most infants, breast milk is all that is needed for the first 6 months of life. Many mothers continue to breast-feed after 6 months and then give other foods as well. For advice on breast-feeding, consult your doctor or any other health professional, or a friend or relative who has successfully breast-fed. Frequent feeding is the best way to establish and maintain a good milk supply. A well balanced diet, both during pregnancy and after delivery, also helps sustain an adequate supply of breast milk.
Advice especially for the working mothers
Your baby can still receive the benefits of breast milk even if you go out to work. Partial breast-feeding is better than bottle-feeding completely, so continue to breast-feed even if you have been advised to give other foods. If you sleep with your baby, he will breast-feed during the night without disturbing you. Before you leave home in the morning and again when you return, breast-feed your baby. When mixed feeding, always offer the breast before giving other foods.
Remember: Breast milk is the best and most economical food for your baby.
Seek advice
The use of foods which are not intended for young babies can be harmful. Unnecessary introduction of partial bottle-feeding or other foods and drinks, will have a negative effect on breast-feeding. Therefore always consult a health professional before introducing anything other than breast milk.
Using a breast-milk substitute
If a doctor or another health professional recommends an addition to breast-feeding, or its replacement, during the first 6 months of life, it is preferable to use an infant formula meeting recognized quality standards. When used correctly this supplies the nutritional needs of your baby in an easily digestible form. You will need more than one can (450g) per week if your baby is only bottle-fed, so keep your family circumstances and costs in mind before deciding whether to use infant formula.
As soon as your baby is old enough, feed infant formula with a cup and spoon.

Information for Health Workers
Printed on all Materials Intended for
The Medical and Paramedical Professions
IMPORTANT NOTICE The World Health Organization (WHO*) has recommended that pregnant women and new mothers be informed of the benefits and superiority of breast-feeding – in particular the fact that it provides the best nutrition and protection from illness for babies.
Mothers should be given guidance on the preparation for, and maintenance of, lactation, with special emphasis on the importance of a well-balanced diet both during pregnancy and after delivery. Unnecessary introduction of partial bottle-feeding or other foods and drinks should be discouraged since it will have a negative effect on breast-feeding. Similarly, mothers should be warned of the difficulty of reversing a decision not to breast-feed.
Before advising a mother to use an infant formula, she should be advised of the social and financial implications of her decision: for example, if a baby is exclusively bottle-fed, more than one can (450g) per week will be needed, so the family circumstances and costs should be kept in mind. Mothers should be reminded that breast milk is not only the best, but also the most economical food for babies.
If a decision to use an infant formula is taken, it is important to give instruction on correct preparation methods, emphasizing that unboiled water, unboiled bottles or incorrect dilution can all lead to illness.
* See: International Code of Marketing of Breast-milk Substitutes, adopted by the World Health Assembly in Resolution WHA 34.22, May 1981.

Comments

These statements are not true:

"DOES NOT advertise or promote infant formula to the public" - I can't find a "parenting" or "mother" magazine that does not have your infant formula ads in them. I also see the commercials on TV.

"DOES NOT allow educational material relating to the use of infant formula to be displayed publicly in hospitals and clinics" - I have seen educational material related to your infant formulas on display in hospitals and clinics. I have also seen the delivery of such.

"DOES NOT give financial or material incentives to health professionals for the purpose of promoting infant formula" - I have read that you routinely buy cars for foreign dignitaries whose vote to allow your advertising and sales of your infant product in their countries.

"DOES NOT donate free infant formula to health care facilities for use by healthy new born babies. Free infant formula may exceptionally be given to bona fide social welfare institutions upon their request to serve social or humanitarian purposes (e.g. where the government policy allows manufacturers to respond to a specific social request, for example if the mother dies in child birth)" - I have had two healthy births and was not in any need for your infant formula, yet I was given your products in a "baby welcoming package".

I specifically refused any and all types of infant formula related products, samples, and anything with an image of the products at the 2nd hospital where I gave birth to my 2nd child. (This included a well baby immunization booklet to take with me to pediatric appointments).

I chose a different hospital to give birth at for my 2nd child since the first hospital apparently had no ability to support breastfeeding mothers. Fortunately, the 2nd hospital was much more supportive of breastfeeding moms and actually had nursing gowns available, whereas the 1st hospital had no such thing and we had to make ourselves indecent to feed our children.

My family and I have been boycotting any and all products related to your company (including products shipped and distributed by your company) since the birth of my first child in 1997 when I became aware of your companies policies. I do not find that your company has been following WHO or WHA's statements.
Posted by Kita from TX - February 28, 2008

Nestlé replies: It is a fact that Nestlé follows all of the principles that are stated on our website in developing countries. However, in developed countries, governments have taken decisions about how public health measures of all sorts should best be applied to their own people. This includes measures related to infant formula.

Thus in the developed world, Nestlé follows these governmental decisions, as all other infant formula companies do. More specifically, neither the United States Government, nor the Canadian government believe that the articles of the WHO Code apply to their country, and have not implemented them. In fact, the US never even voted to adopt the Code as a recommendation back in 1981.

Consequently, the US government donates free formula to over half the babies born in the US every year through the Women’s, Infant’s, and Children’s (WIC) nutrition program. The US government does this because they have found that for every dollar spent on infant formula, more is saved in healthcare costs. Formula is far superior to what the low income, non-breastfed child would otherwise receive (many of these infants are cared for by people other than the mothers, particularly other family members).

The governments of the European Union have not implemented the Code in its entirety, but applied only parts of it, based on their assessment of public health needs in the European Union.

This is natural, as the Code was passed as a public health measure in response to the problem of formula being mixed with unclean water in the developing world, for women who did not have the money to buy sufficient quantities, nor the education nor literacy to understand it.

In summary, the WHO Code applies universally as a recommendation to countries, but not as regulation, and the member states of the World Health Organization have treated it as such. In the developed world, Nestlé follows what the different governments mandate. In the developing world, Nestlé applies the WHO Code as a minimum.
Posted by Nestlé Public Affairs from Switzerland - March 5, 2008

I live in Indonesia, where marketing of infant formula are both very common and often quite “aggressive”. Every day you will see advertisement for various international and national brands on TV and on large billboards around town. Advertisement is also publicly displayed in health centers, and starter-packages of infant formula usually form part of the delivery packages you pay for when giving birth in a clinic.

As a consumer, I think it is excellent that Nestlé take your CSR seriously, but at the same time the reality here in Indonesia makes me wonder how your policies are implemented and monitored in practice? As an example, today’s newspaper quotes the Nestlé corporate affairs director in Indonesia saying that Nestlé “provides milk formula free of charge” to malnourished children. How can Nestlé guarantee that this free milk formula is handed out under circumstances that also make the preparation and consumption safe, considering e.g. that safe drinking water is a luxury that millions of poor people cannot afford and only 2% of all Indonesians have access to proper sanitation?

Posted by Johanna from Jakarta, Indonesia - April 3, 2008
Nestlé Indonesia responds:
Our policy in marketing of breast milk substitutes strictly follows WHO Code as well as National Regulations. Our donation policy is also very strict; please be assured that Nestlé Indonesia never donates Infant Milk Formula to malnourished infants. On the other hand, for older children who are malnourished, Nestlé will donate nutrient fortified milk powder which is specially adapted to the nutritional needs of older children This is called 'Growing Up Milk' and provides essential protein, energy, vitamins and minerals for health, but it is not an infant formula.
It seems from your comment that there is a confusion between Infant Milk Formula vs. Growing up milk. Infant Milk Formula producers don't advertise their products on general media like TV, newspapers, etc.. If you think you have found something and would like to report a specific instance to us (via www.nestle.com 'contact us' at the top of this page) we will investigate.

Posted by Nestlé Public Affairs from Indonesia - April 4, 2008
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