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Nestlé is one of the four most boycotted companies on the planet and the most boycotted in the UK because of the way it pushes its baby milk, a problem that continues to this day despite the significant gains achieved by the campaign. The boycott, first launched in 1977, mobilized public outrage at the way the company’s pursuit of profit undermines breastfeeding and helped to bring in international marketing standards. The landmark International Code of Marketing of Breastmilk Substitutes, adopted in 1981, prohibits all promotion of breastmilk substitutes and sets out requirements for their sale. It is intended to both protect breastfeeding and protect babies fed on formula. The standards require ‘breastfeeding is best for babies’ warnings on labels and clear instructions and ban idealising text or images. Health workers are given responsibility for advising parents on infant feeding and companies are limited to providing scientific and factual information to parents. Gifts to health workers are prohibited and companies should not even seek direct or indirect contact with pregnant women and mothers of infants and young children.

Baby Milk Action, based in Cambridge, claims various other victories for the campaign, from forcing Nestlé to agree to translate labels (after exposure on Mark Thomas’s Channel 4 television programme in 2000) to raising global composition standards and helping to bring in legislation implementing the Code and subsequent, relevant World Health Assembly Resolutions in over 60 countries. The 14 Resolutions adopted since the Code respond to changes in scientific knowledge and marketing practices and address questions of interpretation. In countries where these are monitored and enforced, such as Brazil, breastfeeding rates have recovered significantly over the past 30 years. This impacts on company sales and monitoring by the International Baby Food Action Network (IBFAN) shows companies are ever inventive in trying to find new ways to grow their market.

Industry analysts, Euromonitor1, valued the global baby food market in 2008 at US$ 31 billion, projected to grow to US$ 42.7 billion by 2015. Manufacturers are focusing on ‘adding value’ to achieve growth by adding optional ingredients and making health claims about them. According to Euromonitor, “The industry is fighting a rearguard action against regulation on a country-by-country basis.”

Health claims are idealising, undermine promotion of optimal infant and young child feeding and are prohibited by the Code and Resolutions.

The latest World Health Assembly Resolution, passed on 21 May 2010, addresses latest marketing strategies and expresses: “deep concern over persistent reports of violations of the International Code of Marketing of Breast-milk Substitutes by some infant food manufacturers and distributors with regard to promotion targeting mothers and health-care workers”.

Baby Milk Action is currently campaigning against Nestlé and other companies over specific claims used to promote formulas. Nestlé has added logos to labels claiming that its baby milk ‘protects’ babies. The prominent and colourful logos undermine the obligatory warnings and highlight ingredients such as DHA and ARA. These are Long Chain Polyunsaturated Fatty Acids, which the company claims aid brain and eye development. Independent scientists, such as the Cochrane Library, have reviewed the evidence on LCPs and found there is ‘no proven benefit’ from adding them to baby milk.

Ricardo Uauy, chair of the WHO/FAO expert committee on fats has also stated: “The evidence for effectiveness of DHA addition to formula for term babies in terms of improved long term mental development is weak at best. Data from a population based very large study (n=800) per group recently completed in Mexico does not support a benefit from DHA supplementation on measures of mental development at 18 to 24 months. The studies that demonstrate effects are smaller in numbers and few if any show effects beyond 4 years of age. This issue remains open from a research point of view, but until stronger data are available I would opt for a view that the effects of DHA on mental development are not sufficiently documented to establish public health policy. Whether it should be available and used subject to physician and parental choice it is a different story, I would make it available without claims in this regards.”

Because of the lack of evidence of efficacy and the concerns about possible risks these ingredients have not been added to the composition standards developed by Codex Alimentarius and the European Commission.

Nestlé also claims its formula is effective at ‘reducing diarrhoea’, that it ‘stimulates the baby’s immune system’ and is ‘The new “Gold Standard” in infant nutrition’. These claims are made despite the fact that World Health Organisation warns, “infants who are not breastfed in the first month of life may be as much as 25 times more likely to die than infants who are exclusively breastfed” and UNICEF has stated, “Improved breastfeeding practices and reduction of artificial feeding could save an estimated 1.5 million children a year”, a figure repeated in the Assembly’s latest Resolution.

Baby Milk Action raised Nestlé’s ‘protect’ marketing strategy before the company’s shareholders in April 2010 and has spent the past year trying to convince the United National Global Compact Office to act. This voluntary initiative posts on its website Nestlé’s “Creating Shared Value” reports asserting the company complies with marketing standards. The Global Compact Office responded: “Of course, abuses of the 10 Principles do occur; however we believe that such abuses only indicate that it is important for the company to remain in the Compact and learn from its mistakes.” While refusing to investigate egregious violations of the Global Compact Principles and the misleading claims in reports posted on its site, the UN Global Compact Office accepted Nestlé as a patron sponsor for its recent Leaders’ Summit in New York (24-25 June 2010).

Baby Milk Action also asked the Swiss Government for help under the terms of the OECD Guidelines for Multinational Enterprises, but this only offered to facilitate ‘dialogue’. Baby Milk Action suggested it request from Nestlé copies of its baby milk labels - according to executives the ‘protect’ logos have been launched in 120 countries. The Swiss Government refused and said it was closing the case. In Brazil the ‘protect’ logos are illegal and do not appear, but for providing protection where legislation does not exist or does not work, the existing international regulatory framework - the voluntary Global Compact and OECD Guidelines - has shown itself to be worse than useless, as it takes campaigners time to no end and diverts attention from meaningful regulations. Failed by those who should hold corporations to account, campaigners fall back on the tried and trusted resort of consumer action.

Baby Milk Action has produced a youtube clip of Mr. Heny Nastie, spoof marketing guru, explaining Nestlé’s strategy and is encouraging members of the public to email the company.

There has already been some movement. Baby Milk Action found Nestlé formula prominently displayed in a rural area of Malawi, one of the poorest countries in the world where breastfeeding saves lives. Nestle internal instructions prohibit such displays and it has promised to investigate why its systems are failing and stop a repeat. But the ‘protect’ logos remain - at least until the Nestlé boycott forces another climb down.

In May 2010 the World Health Assembly adopted two new landmark Resolutions on the promotion of junk foods and baby foods – resolutions which should have a long-lasting impact on child health.

A Resolution proposed by Norway called for Member States to implement a set of recommendations which aim to reduce the impact on children of the marketing of ‘junk’ foods. They call on Governments to restrict marketing, including in ‘settings where children gather’ such as schools and to avoid conflicts of interest.2

The resolution on Infant and young child nutrition gave a strong call to Member States to toughen up controls on marketing and not rely on voluntary approaches.

Some key excerpts:

“Recognizing that the promotion of breast-milk substitutes and some commercial foods for infants and young children undermines progress in optimal infant and young child feeding;”

“Expressing deep concern over persistent reports of violations of the International Code of Marketing of Breast-milk Substitutes by some infant food manufacturers and distributors with regard to promotion targeting mothers and health-care workers;”

“Aware that inappropriate feeding practices and their consequences are major obstacles to attaining sustainable socioeconomic development and poverty reduction;

“calls for governments to act collectively: to develop and/or strengthen legislative, regulatory and/or other effective measures to control the marketing of breastmilk substitutes in order to give effect to the International Code of Marketing of Breastmilk Substitutes and relevant resolution adopted by the World Health Assembly;

“to end inappropriate promotion of food for infants and young children and to ensure that nutrition and health claims shall not be permitted for foods for infants and young children, except where specifically provided for, in relevant Codex Alimentarius standards or national legislation;”

The Resolution specifically: “CALLS UPON infant food manufacturers and distributors to comply fully with their responsibilities under the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant World Health Assembly resolutions;”

Despite this, in its response refusing to remove the ‘protect’ logos and other claims, Nestlé has stated to people emailing it:”For your information, the World Health Assembly does not formulate marketing standards – rather it makes health policy recommendations to Member States.”

Further details and full analysis of Nestlé’s response to the email campaign can be found on the Baby Milk Action website, www.babymilkaction.org

1 Global Packaged Food: Market Opportunities for Baby Food to 2013 is available at: www.euromonitor.com

2 WHA Resolution 63.14 Marketing of food and non-alcoholic beverages to children. http://apps.who.int/gb/ebwha/pdf_files/WHA63/A63_R14-en.pdf