The Nestle Solution When Sara went to the hospital to have a baby, a nice woman in a nurse’s uniform gave her a free tin of Lactogen, a powdered baby formula. The woman said that Lactogen would be good for her baby if her own breastmilk ‘‘wasn’t enough’’. Sara was worried: she wanted the best food for her baby. She started: feeding her baby Lactogen as soon as she got home. Sara’s own milk dried up before she had even finished the free sample, so when it did run out she ‘had to buy more. It was very expensive. Sara diluted it with more water than the instructrions said, but she didn’t know that — she couldn’t read anyway. Within two weeks her baby was sick. Thinking the mixture too rich, Sara diluted it further with the dirty, rusty water from the pump in her neighborhood. It took a lot of time to mix the formula. It was more convenient to mix a whole of tin of Lactogen and keep it in a pail on the floor. Then she could feed the baby whenever she wanted. Her baby became very sick. He vomited and had diarrhea. He soon weighed even less than he had at birth. By the time Sara took him to the doctor, it was too late. He died of gastroenteritis and malnutrition at the age of six weeks. Lactogen is a product of Nestle, the second-largest food company in the world and the leading seller of baby milk substitutes. The woman in the nurse’s uniform was a Nestle’s employee. Nestle products and practises have been linked to hundreds of thousands of infant deaths in the Third World. According to thne executive director of UNICEF (the United Nations International Children’sFund), a million deaths could be prevented every year if mothers were not discour- aged from breastfeeding their children. - Although not the only company selling baby formula in the Third World, Nestle is by far the largest. It has been the target of the largest non-union boycott in history, started in 1973 when New Inter- nationsalist magazine first made public the com- __ pany’s activities. The publicity associated with the boycott resulted in the World Health Organization’s passing of the International Code for the Marketing of Breastmilk Substitutes. Despite promises to the cont- rary, Nestle has not conformed to the WHO regula- tions in any basic way. The boycott of all Nestle products continues around the world. Cow’s-milk based infant formula was invented in the 1860’s by Henri Nestle, a Swiss laboratory assistant, and Nestle’s products have always dominated the indus- try. When prepared and used properly, Nestle form- ula can be a good substitute for mother’s milk if necessary. But when Nestle began expanding its imarket into the Third World, misuse of its formulas produced serious p obits, partely malnutrition, dis- a million deaths could be prevented each year... ease, — es fo ees 7 eo Proper use of infant formula is complicated and requires a knowledge of proper preparation methods as well germ-free facilities. Both are largely unavail- able in the Third World. To properly prepare a germ-free solution for her baby, a typical Third World mother has to collect firewood or charcoal to make a fire, get water from a dirty, rusty, and almost cer- tainly polluted source, and then boil the feeding paraphernalia for ten minutes minimum. Then, after finding a clean surface on which to set the boiled bottles and nipples, she has to figure out the instruc- tions on the milk tin label - not easy for illiterate parents. After boiling more water to mix the formula and letting it cool, it is ready. - The chance is small that many Third World mothers will go to this much trouble several times a day. Even if a mother goes through the whole process once a day, she has no refrigerator, and leftovers are swarm- ing with bacteria by the time they are used. Also, formula is expensive, often taking up nearly half of the income of a family with a six-month old child, and many mothers cannot resist the temptation to over-dilute. Some, in fact, don’t seem to see the connection between the mixture and their baby’s health. ' The results are not hard to imagine. Since babies receive none of the natural immunizing agents found in breast milk, they are more susceptible to gastric illnesses and chest and ear infections. Germs on bottles, nipples, measuring spoons, and in the water | are likely to cause diarrhea. Diseases like eczema and asthma can also occur. If these alone do not kill the baby, it will still almost certainly be malnourished. “It’s like giving a stick of dynamite a a large match- stick and a barrel of high-grade petrol to your children to play with and saying ‘Please be careful how you handle it.’ This is the way we look at artificial feed- ing,’’ says Dr. E.M. Semba, director of medical services for Gambia. f If a bottle-fed Third World child survives its infancy, its pyhsical and mental development will almost certainly be stunted. cy gifts, conferences, publications, travel - anythi & OW President for the 12th International Congress on Nut} _ What was happening before Nestle came along? Women were breast-feeding} of course. Aside from providing vital immunization against disease, ‘‘breast milk is the original convenience food. No mixing, warming, or sterilising needed; no dirty pots and bottles to wash up afterwards; always on tap from its specially designed unbreakable containers. And it is genuinely the most nutritious wholesome product on the market. A copy-writer’s dream.’’ (Mike Muller, The Baby Killer) ’ Even malnourished women can adequately breast- feed. ‘‘The remarkable ability of poor women to! breastfeed their babies for prolonged periods is the most redeeming feature of an otherwise bleak nutri- tional situation,’’ says Dr. C. Gopolan, Director General of the Indian Council of Medical Research. Although not a reliable method of contraception, breastfeeding can increase the time between babies. The contraceptive effect comes from the release of the fertility-inhibiting hormone prolactin directly after stimulation of the nipples. Despite the lack of a need for baby formula products (even industry estimates say that at most only fiver, estimates say that at most only five per cent of women are unable to breastfeed), Nestle and its counterparts have created a dangerous market in the Third World using aggressive sales and advertising tactics. With a shocking lack of concern for the consequences, Nestle has played on the ignorance of its Third World customers. Formula advertising aims first of all to undermine (however subtly) its ‘‘competition,’’ breastfeeding. Advertisers say that their products are for use ‘‘when breast milk fails’’ or ‘‘if mothers’ breast is insuf- ficient,’ for instance. By introducing the idea that mother’s milk cou/d fail, the likelihood of it happening ' profession. FEBRUARY 23, 1983 increases - ‘‘fear and anxiety can actually stop lactd tion,’’ says New Internationalist magazine. An z ‘saying ‘‘With Nestle you can choose the product bes ited for baby’’ implies that breastmilk is #o¢ bes In Malaysia Nestle “mothercraft nurses” are still at work And formula ads associate bottle-feeding with th ‘‘good life.’’ Other aspects of Nestle’s promotional campaig include free samples, the use of company personng¢ acting as health educators, and industry gifts to heal workers. Free samples have only one purpose - to create physical need for the product. By the time a mothe has used up her free sample she is well on her way being unable to breastfeed. If she buys more (it cost much less to feed a newborn than an older infant), shi is hooked. By donating their products to hospitals Nestle can distribute these samples for next to no Taine, Many Nestle employees have worn uniforms that ar indistinguishable from those of the actual employee of the clinics and hospitals where the babies are bor: Since the Nestle workers never say that they are no health workers unless asked, it is likely that thei words about infant formulas will be taken as absolut fact by intimidated and unquestioning mothers. Nestle spends a lot of money courting the health car¢ _ profession, subsidizing office furnishing, rese, create good will or a feeling of obligation within t ‘In developing countries babies who are not breast fed die,’’ according to Dr. Samuel J. Fomon, Vice tition. ‘‘It’s hard enough for these babies to surviv under the best circumstances; exploitative marketing and merchandising is tantamount to mass infant tcide’’ (emphasis added). After the first expose of infant formula-relatec deaths in The Third World in 1973, research by churc ,consumer, and development groups piled up mor and more evidence against the babymilk companies Nestle and the rest of the industry denied that an thing unethical was happening. In 1977 a grou formed the Infant Formula Action Coalition (IN' FACT), and launched the Nestle Boycott. Prompted by United States’ Senate hearings o: babymilk sales in the Third World, WHO an UNICEF met, in 1979, with government and indust representatives. The industry agreed to stop promot ing its products to the public, but before the end of th year the International Baby Food Action Networ! documented over 1,000 violations of the agreement. The World Health Assembly, governing body a WHO, met again in May, 1981, and after hearing evidence from both sides voted by a 118 to 1 margin t accept the International Code for the Marketin breastmilk substitutes (the United Sates was the dissenter). The WHO code asks governments to: 1. Stop all public advertising and promotion of arti ficial babymilks. 2. Stop the distribution of free milk samples. 3.Prohibit the use of health care systems to promot breastmilk substitutes and to prohibit the use o company employees acting as health educators. 4. Restrict industry gifts to.health workers. 5. Require improved labelling to emphasize thi importance of breastfeeding and hazards of artificia feeding. Nestle’s opposition to the boycott and the code has a course been vigorous. In 1978 a Nestle spokesperso: called the boycott ‘‘an indirect attack on the fre world’s economic system. A worldwide church organ ization, with the stated purpose of undermining th