Cover - Protecting breastfeeding - Protecting babies fed on formula ...

Issue number 45, May 2013UPDATENestlé and Pepsi’s Crusade in MexicoStrong laws enacted in three countriesIndustry threatens Philippines and KenyaWorld Breastfeeding Trends plots path to successNestlé formula seized for breaking Indian law

Command-shift Who, what, Page why? titleCommand-shift Editorial Page titleBaby Milk ActionBaby Milk Action is a non-profit organisation whichaims to save infant lives and to end the avoidablesuffering caused by inappropriate infant feeding.We work as part of the International Baby FoodAction Network (IBFAN) tostrengthen independent, transparentand effective controls on themarketing of the baby feedingindustry. IBFAN has over 200member organisations in more than100 countries.Baby Feeding Law GroupBaby Milk Action is theSecretariat for the BabyFeeding Law Group whichis working to bring UKlegislation into line with UNResolutions. BFLG members include consumer andmother-support groups and professional bodies suchas the Community Practitioners and Health Visitors’Association, the Royal College of Midwives, theRoyal College of Nursing, the Royal College ofPaediatrics and Child Health, and UNICEF's BabyFriendly Initiative.International CodeWe work for controls implementing the InternationalCode of Marketing of Breast-milk Substitutes (TheInternational Code). This Code was adopted in1981 by the World Health Assembly (WHA), theworld’s highest policy setting body. The InternationalCode bans all promotion of breastmilk substitutesand was adopted as a ‘minimum requirement’ tobe implemented by member states ‘in its entirety’.The International Code and the subsequent relevantWHA Resolutions, which have clarified or extendedcertain provisions of the Code, must be consideredtogether in the interpretation and translation intonational measures.<strong>Cover</strong>: Breastfeeding mother and her child in Chiapas,Mexico, where the Crusade Against Hunger - in partnershipwith Nestlé and Pepsi, will start. Photo: Antonio TurokBaby Milk Action Update 45, May 2013, Page 2<strong>Protecting</strong> <strong>breastfeeding</strong>There is no food more locally produced orsustainable than breastmilk. A breast<strong>fed</strong> child isless likely to suffer from gastroenteritis, respiratoryand ear infections, diabetes, allergies and otherillnesses. In areas with unsafe water a bottle-<strong>fed</strong>child is up to 25 times more likely to die as a resultof diarrhoea. Reversing the decline in <strong>breastfeeding</strong>could save 1.5 million lives around the world everyyear. Breastfeeding helps fulfill the UN MillenniumDevelopment Goals and has the potential to reduceunder-5 mortality by 13%. A further 6% of deathscould be saved through appropriate complementaryfeeding. Breastfeeding also provides health benefitsto the mother, such as reduced risk of some cancers.<strong>Protecting</strong> <strong>babies</strong> <strong>fed</strong> onformulaBreastmilk substitutes are legitimate productsfor when a child is not breast<strong>fed</strong> and does nothave access to expressed or donor breastmilk.Companies should comply with composition andlabelling requirements and other Code requirementsto reduce risks - independently of governmentmeasures. Parents have a right to accurate,independent information. Baby Milk Action is notanti-baby milk. Our work protects all mothers andinfants from irresponsible marketing.Contact details34 Trumpington Street, Cambridge,CB2 1QY, UKTel: (01223) 464420 Fax: (01223) 464417info@babymilkaction.org www.babymilkaction.orgBaby Milk Action is funded by membership (£18waged, £7 unwaged, £25 family, organisation feedependent on turnover), donations and merchandisesales. We are very grateful for grants from the ATeam, S.E Franklin Deceased Charity, Network forSocial Change, OXFAM, Save the Children andSCIAF. Baby Milk Action accepts no commercialfunding.Update 45 was written by Mike Brady and PattiRundall. Update is free to members and affiliates.It is available electronically at:www.babymilkaction.orgPlotting the path to protection for <strong>babies</strong> and familiesMike Brady,CampaignsCoordinatorIBFAN’s World BreastfeedingConference took place inNew Delhi in December2012, organised by ourpartners the BreastfeedingProtection Network of India.It was an inspiring event,done with no commercialsponsorship, yet bringingtogether over 700 peoplefrom more than 80 countries,including many famous names from the<strong>breastfeeding</strong> and campaigning world. (Seepg.4).The latest IBFAN World Breastfeeding Trendsreport was launched, measuring progressin protecting, promoting and supporting<strong>breastfeeding</strong> in 54 countries. Also launchedwas a paper costing how to achieve optimalinfant and young child feeding. This wouldimprove infant survival, quality of life, reducehealth inequalities, and save resources. Surely aworthwhile investment! (See pg 9.)Under existing international agreements, it can beargued that mothers and <strong>babies</strong> have a right tobreastfeed and that governments are duty boundto protect and deliver this right,while others shouldrespect it. (See pg.13.)In the last year Kenya, South Africa andVietnam have introduced new legislationimplementing the International Code of Marketingof Breastmilk Substitutes and subsequent, relevantResolutions of the World Health Assembly. SouthAfrica’s law follows nine years of struggle againstintensive industry pressure and covers productsmarketed for children up to two years of age.There was a struggle too over Kenya’s law thatcovers products up to three years of age includingthe unnecessary formulas for older <strong>babies</strong> - socalled“growing up milks.” These products oftenshare the same branding as formulas for young<strong>babies</strong> but circumvent the restrictions that applythem. Kenya came under particular pressurefrom GAIN, (the Global Alliance for Improved* Global Packaged Food: Market Opportunities for Baby Food to 2012 euromonitor.comNutrition), as it continuedto open up markets for itspartner companies (includingDanone). GAIN is on thelead group of SUN - ScalingUp Nutrition. In NovemberWe published a discussionpaper outlining IBFAN’sconcerns about how SUNand GAIN are encouraginggovernments to partner withbusiness.The idea that foodPatti Rundall, PolicyDirectorCo-Chair IBFANcorporations can be useful partners in hungercampaigns was taken to a bizarre extreme inMexico - with the launch of a Crusade AgainstHunger in partnership with Pepsi (providingformulas for children and nursing mothers) andNestlé teaching 15,000 women how to selldesserts and give nutrition advice! (See pg 6.)In the Philippines companies, led by Nestlé,threatened to cancel a US$400 million ofinvestment if its regulations are not weakened.Which brings us back to India where Nestléproducts were seized for breaking labellinglaws. The Indian formula market fails to grow.Meanwhile in the UK, we won cases againstmisleading advertising and stopped a BabyKnow How roadshow planned by Pfizer Nutriton(since taken over by Nestlé). With the poor UKlaw and Nestlé now entering the market, we areseeing more aggressive practices.Update 45 contentsWorld Breastfeeding Conference 4,5,8Crusade Against Hunger in Mexico 6-7Scaling Up Breastfeeding 8World Breastfeeding Trends 11Breastfeeding as a Human Right 12-13South Africa, Vietnam, Kenya 14-15Nestlé and the Philippines 16-17UK monitoring 17-19Nestle news 20-22Research 23SUN, GAIN and PPPs 25Policy news - Codex and the EU 26Virtual shop and essential reading 27-28Baby Milk Action Update 45, May 2013, Page 3

World Breastfeeding Command-shift ConferencePage titleWorld Breastfeeding ConferenceIndia hosts the world - and leads by exampleBaby Milk Action’s Mike Brady and Patti Rundallwere guest speakers at the World BreastfeedingConference in New Delhi, (6 - 9 Dec. 2012)The event was organised by IBFAN’sBreastfeeding Protection Network of India (BPNI)in partnership with the Indian Ministry of Women& Child Development and Ministry of Health &Family Welfare. Its slogan was “Babies needmom-made not man-made” and called on peopleto “Join the Fight” against promotion of formula overbreastmilk.The Conference was chaired by Dr Arun Guptaof BPNI and Coordinator of IBFAN Asia, andofficially opened by Anwar Fazal, former Presidentof Consumers International and founder of theWorld Alliance for Breastfeeding Action, IBFANstalwart Helen Armstrong, IBFAN CoordinatingCouncil Chair, Joyce Chanetsa, UNICEFrepresentative Nicholas Alipui and representativesof the Indian Government and US Embassy.Among the many memorable moments: TheDirectorate of Health Services, Haryana, Indiaexplaining how they seized Nestlé productsthat broke labelling laws - and were themselveslabelled as “activists” by the company. ElisabetHelsing, who helped create Norway’s supportive<strong>breastfeeding</strong> culture through her writing andfounding of the mother-to-mother support groupAmmehjelpen in 1968. Elisabet reminded theconference that the battle was not over and thateven in <strong>breastfeeding</strong> cultures mothers needsupport, policy makers need educating andformula companies need to be kept at bay.Learning from Dr Homayoun Ludin’s presentationthat Afghanistan has something to teach theworld on protecting mothers and <strong>babies</strong>, as itremoved idealising baby food billboards (right,centre) across the country after introducingmarketing regulations and put up others promoting<strong>breastfeeding</strong>.Right: Mike Brady with campaigners from thePhilippines, Velvet Escarlo-Roxas, AlessandroIellamo, and Ines Fernandez.Baby Milk Action Update 45, May 2013, Page 4Dr Gupta lights the Conference flame with Smt KrishnaTirath, (Minister for Women and Child Development), MrLouis-Georges Arsenault (UNICEF Country Chief for India),Arwan Fazal, Helen Armstrong and Mr Salman Khurshid(Minister of External Affairs). Smt Krishna Tirath toldConference the Government was shortly introducing atrial system of payments for new mothers to enable eventhose in the informal sector to have time off work.Above: Nestlé Cerelac billboard before being removedin Afghanistan. Below: Session on Holding Companies toAccount, Baby Milk Action and Philippines campaigners.Marketing offenders report exposes new trendsA newmonitoringreport waslaunched byBPNI at theConference.It shows thatcompaniescontinue toadvertisebaby formulas when they think they can get awaywith it. For example, in Canada, Mead Johnsonadvertises Enfamil with the headlines: “You wanther to be healthy...Patterned after breastmilk for your baby’snormal, healthydevelopment.”In the Ukraine,Danone advertisesfollow-on milk for usefrom 6 months withthe claim “Immunity isstrengthened” (right).Nestlé’s 146thshareholdermeeting washeld in Lausanne,Switzerland, on11 April 2013 andChairman PeterBrabeck-Letmathélaunched his latestCSV report.This refers to NestléCreating SharedValue Initiative, though critics suggest CreativeStorytelling Venture is more appropriate andreleased an analysis with this title. For example,Nestlé claims it had to act on few baby milkMost companies areinvesting heavily inpromoting so-calledgrowing up milks,unnecessary productsthat are claimed tobenefit health. Healthclaims are increasinglybeing used on babyfoods too. Ghanahas a strong babymilk marketing law, sothere Nestlé claims its Cerelac porridge “HelpsStrengthenBabies’NaturalDefenses”(right).Nestlé’s Creative Storytelling Venture at shareholder AGMmarketing violations, neglecting to say it rejected97% of those reported by IBFAN.The Nestlé Critics call on those wishing toimprove Nestlé behaviour to look at what thecompany actually does, not just what it says itdoes. As the analysis explains, Nestlé PublicRelations (PR) strategy for diverting criticism wasdeveloped in the 1970s by PR guru RaphaelPagan and continues to be followed to this day,with modifications involving sometimes underhandpractices, such as spying on campaigners (aSwiss court ordered Nestlé to pay damages andcosts to Attac Switzerland in January 2013 after itinfiltrated the group).The analysis can be downloaded free of chargeor purchased as a printed copy. (See pg 27.)Baby Milk Action Update 45, May 2013, Page 5

Adriana AlatorreGuadalupe IrízarItxaro ArtetaNatalia VitelaAdriana AlatorreNatalia VitelaCommand-shift Page titleMexico’s Crusade Against HungerNestle and Pepsi to teach nutrition6 NACIONAL REFORMA - Miércoles 10 de Abril del 2013Ve especialista riesgos en salud de beneficiadosCritican inclusiónde IP en Cruzadad Advierten que comidaindustrializadadisparará obesidady diabetesLa inclusión de empresas privadasa la Cruzada Nacional Contrael Hambre, que pretende atendera 7.4 millones de mexicanosque padecen pobreza extrema ycarencia alimentaria, es un graveerror del Gobierno mexicano,sostuvo la directora de Baby MilkAction, Patti Rundall.“México ya tiene un problemaenorme de obesidad que estáagotando los presupuestos familiaresy al sistema de Salud, por loque, incorporar a esas empresasque han provocado ese estado auna Campaña contra el Hambre,fácilmente podría empeorar estasituación”, alertó la también líderde la Coalición Internacional contrael Conflicto de Interés.que el “negocio del hambre” está dominado por las corporaciones y puede ser usado para expandir mercados.VIsIóN gLObAL. Patti Rundall, líder de la Coalición Internacional contra el Conflicto de Interés, dijoEse organismo demostró enInglaterra que las fórmulas lácteaspara bebés contenían muchaazúcar, y después presionópara que se elevara el control de Avancecalidad de este producto. Por sulabor ha recibido varios reconocimientos,como la Orden delcuestionadoImperio Británico, los premios Especialistas han detectadoCaroline Walker Trust y de la GiraffeAppreciation Society.anomalías a la Cruzada Nacionalcontra el Hambre que atenderática, los materiales y los conocimientospara hacerlo”, aseguróEn entrevista con REFOR-MA, la especialista destacó el riesgoreal de que la Cruzada se con-Aquí algunas:Dentro de la Cruzada Nacional Marcelo Melchior.a 7.4 millones de mexicanos.el presidente de Nestlé México,vierta en un negocio que monopolicenlas grandes corporaciones d Entre los 400 municipios incluidos de Desarrollo Social firmó ayer nio, Melchior y la Secretaria Ro-contra el Hambre, la Secretaría Después de firmar el conve-de la industria de la alimentación, en la primera etapa no están los más un acuerdo de colaboración con sario Rosario posaron para la fototerminando de preparar unaslo cual puede propiciar mayores pobres.Nestlé, a fin de que la empresa déniveles de desnutrición entre los d La mayoría de las localidades cursos para que las mujeres pongannegocios de postres hechos “Necesito conseguirme unostrufas de chocolate.mexicanos.seleccionadas serán disputadasCon el pretexto de mitigar el en las elecciones <strong>fed</strong>erales de julio con sus productos.recursillos. Voy a poner mi negocio”,bromeó Robles.hambre en las poblaciones de mayorpobreza en el país, refirió, las d El Consejo Nacional del programa, dulce negocio” implica que da-Robles aplaudió la iniciativapróximo.El proyecto denominado “Micúpulas de la comida industrializadapretenden que les sea conce-internacionales y académicos, nutrición de medio día, otro día mejor a que sean las madres quie-que incluiría a ONG, organismos rán a 15 mil mujeres un curso de de Nestlé y dijo que no hay nadadida la distribución de productos no se ha integrado.de clases culinarias para prepararpostres, y medio día de capaciciónde sus hijos, y que eso trasnessepan cómo cuidar la nutri-que, por su alto contenido en grasassaturadas y azúcares, además concretas para su implementación. tación sobre gestión de empresas ciende el asistencialismo.d Todavía falta definir accionesde su bajo nivel nutritivo, lejos de d Aunque se dijo que el programa no para que monten su negocio.“Estamos trabajando en unaaliviar el problema representan sería asistencialista, arrancó con la “Ellas podrán convertirse en de las vertientes más importantesun mayor riesgo de problemas entrega de despensas en Chihuahua. microempresarias; podrán venderunos postres (a los) que no-Hambre, que es su vertiente pro-de la Cruzada Nacional Contra elde desnutrición y enfermedadesgraves como la obesidad, diabetes,hipertensión e infartos.ductiva, que es el generar ingreso,sotros le daremos toda la logís- ductiva, que es la inclusión pro-El lunes pasado se dio a conocerque la empresa PepsiCocia monetaria del Gobierno a unano solamente por una transferen-contribuirá a la Cruzada NacionalAlejandro Calvillo:mujer, sino a partir del trabajo deContra el Hambre con la elaboraciónde un producto, con presen-El Poder del Consumidor“A estas mujeres les va a ge-estas mujeres”, afirmó.taciones en atole y galleta, paranerar la posibilidad de un ingresopropio que las ayude a ellas ymejorar la nutrición de menoresy mujeres embarazadas y en lactancia,mientras que Nestlé daráRobles defendió que con es-a sus familias”, indicó.cursos para que las mujeres pongannegocios de postres hechosfortalecen los objetivos de la Cru-Acusan privatizacióntas alianzas público-privadas secon sus productos.zada para beneficiar a la población,y aseguró que entre más“El negocio del hambre estádominado por las corporaciones ypulso nACionAlacuerdos firman, más institucioneslos han buscado para tam-puede ser usado como una forma os convenios para combatirel hambre con empre-Alejandro bién sumarse.de expandir sus mercados”, dijo.Para Rundall, activista inglesaque desde los años 80 defiende generan parte de ese problema afirma:CalvilloL sas transnacionales quePor la mañana, Sedesol signóun convenio marco con la UniversidadNacional para instrumentarla alimentación sana, manifestó con sus productos evidencia la“Van a utilizar lasque estas corporaciones son peligrosasporque, a través de difunteresescorporativos y privados,para distribuir Comunitaria.entrega de la política social a in-25 tiendas Liconsa un modelo de Atención Integraldir una imagen filantrópica, están cuestionó Alejandro Calvillo, directorde organización de El Po-es decir, vamos nes de esta escuela harán servi-estos productos,Robles refirió que los jóve-buscando cambiar los patronestradicionales de alimentación. der del Consumidor.a estar subsidiando nosotros, cio social en municipios del Estadode México y las Delegacio-Aún ahora, detalló la especialista,en el mundo en desarrollo se con REFORMA sobre el acuer-comercialización de productos nes del DF, y la UNAM apoyaráCalvillo alertó en entrevista con nuestros impuestos, lacomen alimentos frescos, sanos do que la Secretaría de DesarrolloSocial firmó ayer con la em-d audiola Secretaría realiza en el Mes deque no son recomendados”. la difusión de las actividades quey más sabrosos, pero las grandescorporaciones tienen interés en presa Nestlé, y que se suma alla Cruzada.captar este segmento de mercado que el lunes estableció con lay hacer que la gente coma esos alimentosultraprocesados.“Es una política privada (empresa Pepsico.Recordó que la mayoría de contra el hambre), no es una políticapúbica porque está favore-los factores de riesgo de las enfermedadescrónico-degenerativastienen que ver con la mala esto es muy grave (...) Ellos sonciendo los intereses privados yalimentación a base de refrescos generadores del problema. O sea,y alimentos procesados, elaboradoscon gran cantidad de conser-de la malnutrición”, indicó.el hambre no se puede separarvadores para durar mucho tiempoen el estante, a diferencia de nidades con problemas de ham-En muchas de estas comu-los alimentos sanos.bre, destacó, hay malos hábitosIncluyen hasta cursospara elaborar postresMéxico debe incorporarse a la listade países que, como Chile, obligaa sus funcionarios a publicar sudeclaración patrimonial, y su de-“Es terrible que las compañías alimenticios ligados también alclaración de intereses, llamaron desconfianza generalizada haciaaprovechen una cruzada para evitarel hambre, como parte su ductos chatarra producidos porEduardo Bohórquez, director de acuerdo con las encuestas quealto consumo de refrescos y pro-ayer organizaciones.el desempeño de gobierno, ya queestrategia de mercadotecnia que estas empresas con intereses ende Transparencia Mexicana, señalóque en democracias avanza-cacionalde Cultura Política, el La-tratan el tema– la Encuesta Na-The penetra en el mercado idea mexicano, esos mercados. that global food businessesdiciendo que son compañías filantrópicasque cuidan a los po-si lo que gastan en comida chapiedadestiene un funcionario, cociode las personas confían real-“Nosotros hemos visto quedas importa tanto saber qué protinobarómetro–menos de un terbres”,criticó.tarra, si tuvieran acceso a alimentossaludables, saldrían de lainterés que, al encabezar una ofi-y los representantes”, refirió.mo los potenciales conflictos de mente en el gobierno, los partidos,Según Patti Rundall, partede la Cruzada Nacional contra el desnutrición”, indicó.cina pública, le podrían surgir. Se percibe, señaló, que la corrupcióny tookel conflicto de interésbe Hambre debe useful lograr que las compañíasdisminuyan en sus produc-que se prevé la capacitación deter simbólico y voluntario de la es un problema que se extiendeEn partners el caso de Nestlé, dijo in hunger campaigns “Es necesario pasar del caráctoslos niveles de azúcar y sal, así 15 mill mujeres de las zonas más PIdEN APOyOsdeclaración patrimonial, a una indiscriminadamente entre loscomo promover a los pequeños marginadas del país para quediscusión de fondo sobre cómo responsables de las funciones públicas.productores que están trayendo tengan su propio negocio. Integrantes de diversas organizaciones campesinas, entre ellas debería ser una versión públicaa los buenos bizarre productos, baratos y “Van turn a utilizar las 25 tien-idas Liconsa para distribuir esles,así como la conveniencia de sable la implementación de me-la CNOC, April el Frente Democrático when Campesino y el Movimiento the de las Mexicandeclaraciones patrimonia-Por ello, añadió, es indispen-de mejor calidad.“México ya tienen tasas de tos productos, es decir, vamos a Agrario Indígena Zapatista marcharon ayer del Monumento actualizar nuestro marco legal parala inclusión de la declaración lar y vigilar los actos de gobiernocanismos que permitan contro-obesidad terribles, tener a Nestlé estar subsidiando nosotros, con a Revolución a Secretaría de Gobernación en demandaes terriblemente negativo. Es una nuestros impuestos, comer-intereses”, indicó.y los factores que influyen en elcopa envenenada lo que ofrecen”, cialización de productos que no de apoyos económicos para la producción agrícola.Guillermo Ávila, investigador desempeño de las y los servidorespúblicos.government puntualizó.son recomendados”, launched alertó. a Crusade Fundar, explicó Againstque el conflic-Hunger. Baby Milk Action’s Policy Director PattiRundall was invited by El Poder del Consumidor(Consumer Power) to a series of meetings withSenators, Parliamentarians and the media to raiseawareness about Conflicts of Interest.We were about to congratulate the Secretaryfor Development, Rosario Robles, for including<strong>breastfeeding</strong> protection in the Crusade whentwo partnerships were announced, before anyacademics or NGOs had been consulted.Among other worrying ideas, Pepsi wouldprovide fortified formulas for pregnant and nursingmothers and Nestle would create a programmecalled Mi Dulce Negocio Nestle (My SweetBusiness). This would involve teaching15,000women how to sell desserts and give nutritionadvice in Mexico’s poorest regions.While Nestle’s plan is the last thing the world’sMarcos Ruizd Mercedes Juan, Secretaria de Salud, dialoga con el Rector José Narrodurante el Primer Foro de Diabetes de la Ciudad de México.Prevé Pactosacar chatarrade escuelasd Alerta titular de Ssasobre repuntede diabetes; hacefalta educar, diceLa diabetes representa una verdaderaemergencia de salud públicaque tiene que enfrentar el sistema,por lo que la Reforma Educativay el Pacto por México están planteandoprohibir la venta de alimentoschatarra en escuelas, informóayer Mercedes Juan, titularde la Secretaría de Salud.Cuestionada sobre la ventade refrescos y alimentos chatarraen las escuelas, la funcionaria señaló:“Como ustedes saben, en laReforma Educativa y en el Pactopor México, una de las cosas importantesque se están planteandoes precisamente la prohibición deestos alimentos, así está establecidaen la Reforma”.Durante el primer Foro deDiabetes de la Ciudad de México,la funcionaria refirió que de 2000a 2012 se ha duplicado el númerode pacientes con esta enfermedad,de acuerdo con las encuestas nacionalesde salud y nutrición.“La Encuesta Nacional deSalud y Nutrición de 2012 indicaque la prevalencia de adultosmayores de 20 años es de 9.2 porciento; esto es dos puntos porcentualespor arriba de lo que habíamosencontrado en 2006, que erade 7.1, y en el 2000, que era de 4.6.Quiere decir que en los últimos 12años hemos duplicado la prevalenciade la diabetes”, detalló.“Lo que tenemos que trabajar,y estamos haciéndolo, es lograreducar a la población, educarfundamentalmente a nuestros niñosy a los padres para disminuirlas porciones de ingesta de los refrescoso de cualquier alimentoque tenga exceso de azúcar, sal ygrasas trans”, indicó.El Presidente Enrique PeñaNieto, dijo, instruyó a la Secretaríade Salud para emprender unaestrategia nacional destinada ala prevención de la obesidad y ladiabetes, la hipertensión y la hiperlipidemia.Para ello, puntualizó, el sistemade Salud se tiene que reorientarpara tener una coordinaciónefectiva entre las instituciones.Hace tres años, la SEP y la Ssaplantearon un proyecto para prohibirla venta de refrescos, fritan-Piden materiasobre saludLa Secretaría de Salud buscaque a los alumnos de educaciónbásica se les impartauna materia en la que se lesprevenga sobre los efectosde la obesidad y la diabetes,indicó la titular de la dependencia,Mercedes Juan.“Estamos trabajandocon la Secretaría de EducaciónPública, espero que lologremos. Estamos en pláticas.Probablemente en relaciónal tema de obesidad,de alimentación y actividadfísica para los niños, puedaser en quinto de primaria”,precisó en un foro dediabetes.Aseguró que, además,están trabajando con la industriade alimentos paraque se disminuyan las porciones.“Por ejemplo, que en loscines las porciones de refrescoy palomitas sean lasadecuadas”, acotó.Some of the 50+media reportson the criticism of the Nestllé/Pepsi deals. From top: Elgas y alimentos industrializadosen escuelas, a fin de combatir elReforma, Marcelo Melchior,sobrepeso.Sin embargo, la Cofemer pidióa la SEP replantear el costobeneficiodel anteproyecto y, trasPresident of Nestlé Mexico, andla polémica que generó el mismo,las dependencias terminaron poraprobar la venta de productos conRosario Robles, Secretary ofsustitutos de azúcar o edulcorantes,así como de alimentos con altonúmero de calorías, pero node grasas.Social Development signing theMercedes Juan reconocióque ni en las instituciones de saludpúbicas y privadas del país, nien ningún sistema de salud deldeal; Cartoon of Robles in Lamundo hay recursos que alcancenpara atender todas las complicacionespor la diabetes.Jornada - showing her dressedEsta enfermedad puede originarcomplicaciones serias e irreversibles,como mal cardiovascular,renal y de los ojos, así comoas Marie Antoinette saying “Aredaño a los nervios, acotó.Ante ello, puntualizó la funcionaria,es fundamental la prevenciónde esta enfermedad, asíyou Hungry? Have a Pepsi.” Patticomo su tratamiento oportuno.En el país hay 6.4 millones dediabéticos.Rundall being interviewed byCarmen Aristagui on CNN. Llaman a transparentarApril 2013 conflictos de interésPaola Urdapilletato de interés se presenta cuandoun servidor público o tomador dedecisión actúa en un asunto conun interés particular, sacrificandoel interés público por el beneficioindividual o de grupo.“No es novedoso decir que hayElizabeth Velázquezlargest junk food company should be doing -Pepsi’s scheme could be even more dangerous.We know formulas for mothers underminewomen’s confidence in <strong>breastfeeding</strong> and havebeen used by other companies such as Fonterrato pave the way for the introduction of formulasfor <strong>babies</strong>. (See ICDC Briefing on Fonterra p25.)About half of Mexico’s 115 million population isclassified as poor, with about 12 million of thoseliving in extreme poverty. But Mexican peoplealso have one of the world’s highest rates ofobesity and diabetes – diseases that are largelydriven by the marketing of ultra-processed foods.Instead of helping small farmers and producers,the Crusade will empower large corporationsand facilitate the penetration of their unhealthyfoods deeper into the Mexican market, underthe perfect philanthropic guise of conqueringmalnutrition. The scheme also threatens Mexico’sunique food culture and ecosystem, which hasbeen declared by UNESCO as an IntangibleCultural Heritage of Humanity.Dr Marcos Arana, of theNational Institute of Nutritionand IBFAN Latin America’sPolicy Council, with youngmothers in Chiapas, wherethe infant mortality rate is,according to some estimates,as high as 27 per 1000.“Nestlé’s plan to train 15,000women to sell desserts anddo education could representone of the biggest violationsof the International Codeand Resolutions. Direct orindirect contact with mothersis forbidden by the Code for very good reasons. In my region of Chiapas, every day I see how badinfant feeding results in malnutrition and infant deaths.” Mexico’s <strong>breastfeeding</strong> rates are appalling.From 2006-2012, exclusive <strong>breastfeeding</strong> under six months decreased from 22.3-14.4%, with a 50%drop in rural areas.* Small wonder when many key aspects of the International Code are voluntary,health claims abound, in some private hospitals less than 4% of births are normal, <strong>babies</strong> are routinelyseparated from their mothers and free/low-cost supplies of formula continue on a rotation system.There is just one Baby Friendly Hospital in Mexico City!Alvaro Urreta Fernandez, President of theUnion of Producers and small merchants,Mexico City, said: “The uncontrolled growth ofthese multinational corporations has a negativeeconomic and social impact, harming smallproducers of fruits and vegetables, encouragingan increase in the consumption of junk foods anddramatically decreasing the consumption of freshfruits and vegetables.”International and national NGOs joinforcesThe media coverage helped raise awarenessamong NGOs. A petition, organised by LLLMexico, quickly attracted 3,000 signatures. LLLalso joined 10 other leading international NGOssuch as the International Obesity Task Force,ILCA, IBFAN and Consumers International inan open letter to President Nieto, placed in 2major newspapers. Meanwhile Mexican NGOsare organising Policy Forums and media events,keeping the issue alive. 27 NGOs met JavierGuerrero, the National Vice Coordinator ofthe Crusade in Chiapas, expressing unanimousopposition to the corporate involvement. Laterthe National Institute of Nutrition met SecretaryRobles and asked her to support three proposals:access to potable water; a healthy market systemwith local products that are not processed andlegislation to protect <strong>breastfeeding</strong>, insisting thatthe proposals are carried out independently of thecompanies.Secretary Robles welcomed the ideas and aswe go to press has also agreed to discuss theinternational concerns with Patti Rundall. Let’ssee....Brazil’s Zero Hunger strategyThe inspiration for the Mexican Crusadewas said to be Brazil’s Zero Hungerstrategy. However several critical points wereignored: namely that it was a fully thoughtoutdevelopment agriculture programme thatfollowed extensive consultation with civilsociety. Public policies were in place toprotect and strengthen <strong>breastfeeding</strong> and foodsystems and only civil society and governmentrepresentatives - not conflicted industries - tookpart in its policy design and implementation. Asa result, the national school feeding programis 100% publicly funded, with at least 30%of the food purchased from local producers atleast 70% unprocessed products. Because ofindustry lobbying some conflicted industries areinvolved, but so far to a limited extent.Photo: CESCBaby Milk Action Update 45, May 2013, Page 6* ENSANUT 2012Baby Milk Action Update 45, May 2013, Page 7

WBC call for actionWBC costs <strong>breastfeeding</strong> initiativesWorld Breastfeeding Conference Declaration (extract)We, the participants from 82 countries comingfrom diverse groups including governments,<strong>breastfeeding</strong> organisations, health providers,people’s organisations and movements,international NGOs and individuals... recognizethat protection, promotion and support of<strong>breastfeeding</strong> and optimal infant and young childfeeding is a human rights issue and should beentrenched in the public policy and programmesas a necessary condition needing resources.We call upon all concerned to take the followingactions:1Adopt a human rightbasedapproachto the protection,promotion and supportof <strong>breastfeeding</strong> andinfant and young childfeeding at international,national, sub-national andcommunity levels.2Establish institutionalmechanisms to avoidand manage conflictsof interest in healthand nutrition decisionmakingand programmeimplementation.3Support all women witha comprehensive systemof maternity protection atwork, including the nonformalsector, with a provision of financing.Baby Milk Action Update 45, May 2013, Page 8The 2012 World BreastfeedingConference Declaration andCall to Action6th-9th December, 2012.New Delhi, IndiaEnsure appropriate and adequate education4 and training of all health care professionalsand allied health and community workers both inpre-service and in-service, and in all sectors, tocounter widespread ignorance.5Establish clear budget lines for <strong>breastfeeding</strong>and infant and young child feeding policy andprogramme interventions to ensure adequatehuman and financial resources in order toenhance optimal practices.6Invest in the Baby Friendly Hospital Initiativeincluding mother friendly practices and linkit to community initiatives. Further this shouldbe rooted in all maternal and neonatal healthprogrammes, and with due attention to low birthweight <strong>babies</strong>.7Publicise widely the multiple risks of artificialfeeding, bottles and teats as well as earlycomplementary feeding through all kinds ofmedia campaigns.Ensure universal access to accurate information8 and counselling on <strong>breastfeeding</strong> and infantand young child feeding to allmothers, and to do that provideskilled counsellors in the healthfacilities and in the communityso that they are available for anysituation.Monitor and track the9 Global Strategy for Infantand Young Child Feeding inevery country using WorldBreastfeeding Trends Initiative(WBTi) and advocate to bridgethe gaps.10Protect <strong>breastfeeding</strong>from commercialsector, by strictly enforcing theInternational Code of Marketingof Breastmilk Substitutes andsubsequent related WorldHealth Assembly Resolutions andprohibit all kinds of promotion ofcommercial foods for children for two years orbeyond.Promote the use of affordable and diverse,11 locally grown, indigenous foods for timelyand appropriate complementary feeding aftersix- months along with continued <strong>breastfeeding</strong>.Enhance and support <strong>breastfeeding</strong>12 related research with public funding.Full declaration available at:www.world<strong>breastfeeding</strong>conference.orgScaling up <strong>breastfeeding</strong> - what will it cost?Breastfeeding saves lives. Millions of people whowould have died during their fist year had theybeen <strong>fed</strong> on formula are alive today becausethey were breast<strong>fed</strong>. Many more lives could besaved if <strong>breastfeeding</strong> rates improved. A paperwas prepared for the World BreastfeedingConference calculating how much it would costgovernments and donors to support all mothers tobreastfeed optimally.It is said that <strong>breastfeeding</strong> is free becausebreastmilk is produced naturally withoutmanufacturing and transport costs and does notrequire bottles or sterilising equipment to deliver.The best food in the best packaging.According to the WHO/Lancet Child SurvivalSeries, improving <strong>breastfeeding</strong> rates couldprevent 13% of under-5 deaths in the 42 countrieswhere most of these occur. That is, improved<strong>breastfeeding</strong> (not even universal <strong>breastfeeding</strong>)could save 1.3 million lives every year as wellas reduce illness and the associated healthcare costs, as well the cost in human suffering.Yet the goal of improving <strong>breastfeeding</strong> ratesseems to lag behind the goals of providingSave the Children’s Report:Superfood for Babies: Howovercoming barriers to<strong>breastfeeding</strong> will save children’slives, found systematic aggressivemarketing by Nestle, Danone andother companies. It made severalrecommendations made includingbringing FTSE4Good criteria intoline with the International Code andResolutions.vaccinations, safe water and adequatesanitation, which even combined would savefewer lives than <strong>breastfeeding</strong>. Is it because<strong>breastfeeding</strong> is “free” that it is undervalued?Or is it the fact that baby milk companies offeremployment and tax income to governmentsthat sees them being subsidised, as in Ireland atpresent? (See pg19.)BPNI presented a discussion paper calledScaling Up Breastfeeding/Infant and YoungChild Feeding Interventions: What will it Cost?This calculated the budget to enable 100% ofmothers and <strong>babies</strong> to breastfeed in the firsthour after birth and then optimally, covering allcountries for all births in a 5-year period. Thetotal cost of protecting, promoting and supporting<strong>breastfeeding</strong> US$ 4 billion, or about 20% of thecost of staging the Olympic Games. If provisionwas made to pay all mothers below the povertyline US$ 2/day for 6 months, this would addnearly US$ 52 billion to the five-year budget.“The cost of not acting is measured in needless sufferingand death, lost workdays caring for children and healthcare costs - while companies count their profits andencourage governments to think of investment and tax.”Farewell totwo gentlegiantsAndy Chetley(right top) andZef Ebrahim(right below)whodied in 2012both playeda huge rolein establishingIBFAN and BabyMilk Action.We miss theirwise adviceenormously.Baby Milk Action Update 45, May 2013, Page 9

World Command-shift Breastfeeding Page Trends titleWorld Command-shift Breastfeeding Page Trends titleWe know how to improve <strong>breastfeeding</strong> rates, but is action beingtaken - or are our <strong>babies</strong> falling through the gaps?Fig. 5: The State of Breastfeeding in 51 Countries measured on a scale of 150Every year close to 136 million <strong>babies</strong> areborn all over the world. Of them as many as 92million are not able to experience the WHO’srecommended optimal feeding practices:beginning <strong>breastfeeding</strong> within one hour, beingexclusively breast<strong>fed</strong> for the first six months, andtimely and appropriate complementary feedingwith continued <strong>breastfeeding</strong> after 6 months,up to 2 years. This is in spite of the risks tochildren’s health, development and survival andto their long-term health and prevention of noncommunicablediseases.In order to increase the rates of optimal feedingpractices, WHO and UNICEF developed theGlobal Strategy for Infant and Young ChildFeeding, which provides a framework for actionto scale up <strong>breastfeeding</strong> and infant and youngchild feeding interventions. They also developeda tool to monitor these inputs. Based on thesetools, the Breastfeeding Promotion Networkof India/ International Baby Food ActionNetwork (IBFAN), Asia, developed the WorldBreastfeeding Trends Initiative (WBTi), whichmeasures inputs and generates national action.The WBTi includes assessment, action, andadvocacy. It is an innovative web tool givinguniversal access to this information, and leads tocolour coding and objective scoring to make iteasily understandable for the policy makers. It isthe central strategy of the global BreastfeedingInitiative for Child Survival (gBICS), jointlylaunched by the IIBFAN and the World Alliancefor Breastfeeding Action (WABA) in 2008.The WBTi was earlier launched in 2004-05 inSouth Asia, and its success led to its introductionin other regions of Asia, Africa, the Arab worldand Latin America in 2008, and in Oceania in2010.Introduced in 82 countries, the WBTi has led to51 countries being assessed, ranked and colourcodedbased on their scores (see right).Five South Asian countries have done their 3rdassessment since 2004-05 and two countries inthe Latin America and Caribbean region havecompleted their 2nd assessment since 2008-09.Many countries in Africa and Asia are in theprocess of conducting trend analysis with their2nd assessment.(Work has also started in the UK.)This shows that the interest is growing to find thegaps and bridge them.Extracted from Are our Babies Falling through the Gaps: TheState of Policies and Programme Implementation of the GlobalStrategy for Infant and Young Child Feeding in 51 Countries:www.world<strong>breastfeeding</strong>conference.orgWBTi indicatorsMEASURING PROGRESSThe indicators for the 10 areas of actioninclude:• National Policy, Programme andCoordination• Baby Friendly Hospital Initiative (Ten Steps toSuccessful Breastfeeding)• Implementation of the International Code• Maternity Protection• Health and Nutrition Care Systems• Mother Support and Community Outreach -Community-based Support for the Pregnantand Breastfeeding Mother• Information Support• Infant Feeding and HIV• Infant Feeding During Emergencies• Monitoring and EvaluationHIGH FIVEThe indicators for five optimal IYCF practicesinclude• Initiation of Breastfeeding (within 1 hour)• Exclusive Breastfeeding (for first 6 months)• Median Duration of Breastfeeding• Bottle-feeding (

A rights-based approachA rights-based approachBreastfeeding is a human rightMike Brady reflects on what it means to say<strong>breastfeeding</strong> is a human right. Human rights applyuniversally and it is the responsibility of governmentsto deliver and protect these rights.The right to breastfeed is an interpretation ofexisting rights, such as the right to adequate foodin the Universal Declaration of Human Rights, theInternational Covenant on Economic, Social andCultural Rights, and the Convention on the Rights ofthe Child, amongst others.Professor George Kent of the University of Hawaiiwrote in a paper on Human Rights and InfantNutrition prepared for the World Alliance forBreastfeeding Action Global Forum in 2002:“The principles are based on the concept thatmothers should not be legally obligated tobreastfeed, but rather they should be supported inmaking their own informed choices as to how tofeed their infants.”<strong>Protecting</strong> the right to breastfeed does not forcemothers to continue <strong>breastfeeding</strong> if they want tostop. We have the right to free speech, but thatdoes not mean we are forced to give an opinion onevery subject under the sun; if we want to speak,that right is protected.In the UK, 90% of women who stop <strong>breastfeeding</strong>before six weeks do so before they wish to (Bollinget al, 2007 cited in UNICEF, 2012 - full InfantFeeding Survey details available at http://www.ic.nhs.uk/pubs/ifs2005). If the Government hadprotected the right to breastfeed, might the situationhave been different?To protect <strong>breastfeeding</strong> and empower mothers,we need to provide an environment that makes<strong>breastfeeding</strong> possible. Many societies presentobstacles to <strong>breastfeeding</strong>, rather than remove them.Maternity leave for working women needs to besufficient, at least for the recommended period of 6months exclusive <strong>breastfeeding</strong> (so those who wishto do so, can do so), and working conditions mustbe conducive to continued <strong>breastfeeding</strong> into thesecond year of life and beyond. Convention 183(2000) of the International Labour Organisationstates:“A woman shall be provided with the right to oneBaby Milk Action Update 45, May 2013, Page 12or more daily breaks or a daily reduction of hoursof work to breastfeed her child... These breaksor the reduction of daily hours of work shallbe counted as working time and remuneratedaccordingly.”Not all countries have ratified the Convention. TheUK has not yet done so.Mothers also need protection from aggressivemarketing of breastmilk substitutes. Ensuring parentshave the required information and support on<strong>breastfeeding</strong> as called for by the Convention ofthe Rights of the Child entails implementing theInternational Code of Marketing of BreastmilkSubstitutes and subsequent, relevant Resolutionsof the World Health Assembly, which also aimsto protect mothers who use breastmilk substitutes,who also have a right to accurate, independentinformation.The Committee on the Rights of the Childnow routinely looks at how governments haveimplemented the International Code and Resolutionswhen assessing their progress in complying with theConvention. The Committee commented in 2008on the UK: “it is concerned that implementation ofthe International Code of Marketing of BreastmilkSubstitutes continues to be inadequate and thataggressive promotion of breastmilk substitutesremains common”.To promote <strong>breastfeeding</strong> and inspire mothersand their families may require investment in socialmarketing.In the UK, the coalition government scrapped theInfant Feeding Coordinator posts at the Departmentof Health, even though these posts are called forin the Global Strategy on Infant and Young ChildFeeding.It is also short sighted if the intention is to savemoney. UNICEF UK issued a report this year onthe unnecessary illness that could be prevented andcosts saved if <strong>breastfeeding</strong> rates increased, if themothers who stopped <strong>breastfeeding</strong> earlier than theywanted were able to continue for longer.The theme of the World Breastfeeding Conferencewas “Mom-made, not man-made”. Perhaps “Mummade,not manufactured” works better in ourculture and helps us to highlight that the EuropeanUnion prioritises trade and growth over health.So we see the Irish Government’s EnterpriseIreland and Danone announcing investment ofEuro 50 million in a baby milk factory to boostthe economy by exportingformula around the world.According to EnterpriseIreland “98% of the outputfrom [the] Macroom[facility] will be exportedand commercialized inmore than 60 countriesworldwide”. This willinevitably displace<strong>breastfeeding</strong> in othercountries as well as itsown. To benefit its economy, the Irish Governmentcould instead invest in mothers, the “real milk”producers, in a country where less than half (47%)of mothers are <strong>breastfeeding</strong> on discharge frommaternity services (NPRS, 2008 cited by theHealth Service Executive).To support <strong>breastfeeding</strong> requires provision ofhealth care services, a supportive environmentand counselling services, particularly in countrieswhere <strong>breastfeeding</strong> is not entrenched and visible.As Prof. George Kent comments with regard to theright to adequate food :“There is increasing recognition at theinternational level that good nutritional statusis an outcome that depends not only on goodfood but also on good health services andgood care. Health services consist of a broadrange of measures for the prevention andcontrol of disease, including the maintenance ofa healthy environment.”In the UK we have the National Health Service,free at the point of use, and an increasing numberof hospitals are entering the UNICEF BabyFriendly Initiative, which aims to ensure supportis provided to pregnant women and mothers in<strong>Protecting</strong> the right to breastfeeddoes not force mothers to continue<strong>breastfeeding</strong> if they want to stop.We have the right to free speech, butthat does not mean we are forcedto give an opinion on every subjectunder the sun; if we want to speak,that right is protected.hospital and in the community. However, there aregrowing concerns about the way health workersare being targeted in the UK and other countriesby baby milk companies, including throughfunding training and other events. (See pg 17.)Mother support groups provide counsellingservices in the UK and the Department of Healthdoes provide a grant towards the NationalBreastfeeding Helplineoperated by a coalition ofthem. This is one exampleof the Government actingon its human rightsobligations. However,a coherent approach isneeded as the failure toadequately regulate thebaby food industry meanscompanies encouragepregnant women andmothers to contact company-branded telephone“carelines” for support on infant feeding andto sign up to their mother and baby clubs forinformation. There is an intrinsic conflict of interestin baby milk companies with products to sellmaking direct and indirect contact with pregnantwomen and mothers, and this is prohibited bythe Code. The fact this is a marketing strategywas demonstrated in Nov 2012 when BabyMilk Action won a case against Pfizer/Wyethbefore the Advertising Standards Authority (ASA)over its illegal advertising of infant formula whenostensibly providing <strong>breastfeeding</strong> support. (Seepg 18.)A human rights approach requires action on manyfronts. It helps us to think coherently and logicallyabout what is required to protect and deliver therights in question.Further readingBreastfeeding: A Human Rights Issue? Development, Vol.44, No. 2 (June 2001), pp. 93-98. http://www2.hawaii.edu/~kent/<strong>breastfeeding</strong>rights.pdfGlobal Obligations for the Right to Food, edited byProfessor George Kent, with a chapter on HoldingCorporations Accountable by Mike Brady.Baby Milk Action Update 45, May 2013, Page 13

Struggles for Regulations wonStruggles for Regulations wonSouth Africa - scope to three years of ageSouth African health campaigners are celebrating the adoption of the Regulations Relating toFoodstuffs for Infants and Young Children. This covers the marketing of products for children up tothree years of age and was gazetted on 6 December 2012, a great way to mark the start of theWorld Breastfeeding Conference in India. (See pg 4.)Implementation of the International Code of Marketing of Breastmilk Substitutes, adopted by theWorld Health Assembly in 1981, was diverted in South Africa when in 1986 the industry agreeda voluntary code of conduct with the Department of Health. This was ineffective and the industryresponded to calls for regulations by forming the Freedom of Commercial Speech Trust in 1997 toargue that it was against their constitutional rights to prohibit advertising of products (Update 21).The first draft of the new regulations was produced in 2003 and it took nine years to bring theminto force in the face of constant pressure from the industry. In 2003, Nestlé attempted to buy aphoto-opportunity with Nelson Mandela by offering to present a £500,000 cheque to him for hisChildren’s Fund via film director and actor Richard Attenborough (Update 33). The Fund turned itdown, telling the media (iAfrica) that it was not the first time, “given the Nestle debacle in relationto HIV/Aids infected mothers and their campaign on promoting formula milk as opposed to breastmilk and the disadvantages they put out publicly regarding breast feeding, the Nelson MandelaChildren’s Fund declined the donation.” Nestlé took British MPs on an free trip to visit South Africain 2008 and one, Tom Levitt from Buxton, where Nestlé bottles water, (who also accepted gifts ofsports tickets from the company) took to defending the company publicly (Update 41, 43).IBFAN has gathered evidence of agressive marketing practices throughout this time and more thanonce Baby Milk Action supporters have sent messages of support to the South African Governmentto counter industry lobbying. In the final consultation on the regulations just adopted, the industryagain claimed they were unconstitutional, tried to limit them to products up to one year of age andopposed the ban on baby food company sponsorship. In parallel with this, the industry tried torecruit health workers to their cause, saying they would gain Continuing Professional Developmentpoints from company-sponsored events if the law allowed them. Now the Regulations are in force,the harm caused by aggressive marketing can start to be reversed.Vietnam - scope to two years of agePhoto: Martien van Asseldonk, VietnamIn June 2012 the Vietnamese National Assemblyvoted overwhelmingly (90% in favour) for the newAdvertising Law which prohibits the advertising ofbaby milks for children up to two years of age andcomplementary foods up to 6 months of age.• The US Embassy in Hanoi wrote to the Presidentof the Assembly and Government Ministers urgingagainst a ban on advertising formula milk productsfor <strong>babies</strong> above the age of 12 months.Kenya - scope to three years of ageKenya’s new Law, the Breastmilk Substitutes (Regulation and control) Act 2012, finally came intoforce on 26 October 2012. As in many other countries, this is a story of concerted action bycivil society and UN bodies to encourage policy makers to take action, and delays as they werediverted towards voluntary codes by the industry. In the final stages, as the Law awaited thePresident’s signature, Kenya came under pressure to weaken the proposals from GAIN, the GlobalAlliance for Improved Nutrition, who in a lobby paper suggested that proceeding with the lawwould threaten “Kenya’s ability to meet its commitments as a Scaling Up Nutrition (SUN) country.”(See pg 25.)The following chronology is based on a presentation at the World Breastfeeding Conference (pg 4).1981: Kenya supports the adoption of the International Code of Marketing of Breastmilk Substitutesat the World Health Assembly.1983: Civil society through the Breastfeeding Information Group (BIG) supports the Ministy ofHealth (MoH) to draft first Breastmilk Substitutes Bill. However, this becomes a voluntary standardunder the Kenya Bureau of Standards1984 - 2001: Attempts to translate the marketing requirements into law are unsuccessful.2002: MoH is supported by UNICEF to train an Attorney General lawyer on the Code.2003-2007: Several more unsuccessful attempts to progress with legislation.2008: Small core team formed of MoH UNICEF, WHO, IBFAN (Kenya), University of Nairobi.Attorney General provides a new lawyer to redraft with new WHA recommendations2010: Draft Bill submitted to cabinet by Minister for Public Health• 10th August 2012: Draft Bill gazetted for public review (10 days)• 29th August: First reading in Parliament• 12th September: Second reading – debate• 20th September: Committee of the full house, motion was passed with few amendments• 26th October: His Excellency President Mwai Kibaki assented and published the law asThe Breast milk Substitutes (Regulation and Control) Act 2012.The law prohibits the promotion of designated products, which includes infant formula and followonformula (defined as milk for use up to two years of age, including milks for special medicalpurposes) and complementary food products (defined as products for infants from 6 - 36 months ofage).A National Committee on Infant and Young Child Feeding is established to oversee the law,which shall not include “a person who has a direct or indirect interest in the manufacturing,distribution, marketing, advertisement or promotion of a designated product or complementary foodproduct”. It also prohibits all forms of company samples, gifts, sponsorship, grants, conferences andcourses to health workers. Sanctions include up to three years in prison.Baby Milk Action Update 45, May 2013, Page 14Baby Milk Action Update 45, May 2013, Page 15

Regulations under attackMarketing in the UKNestlé and co’s US$400 million threat against the PhilippinesCampaigners in the Philippines are exposinga threat levelled at the economy by Nestléand other transnational companies if baby milkmarketing regulations successfully defended in2007 are not replaced.Nestlé and its partners are pushing for a new,weak law to be introduced, which will allowthem to advertise milks for use from 6 months ofage (with the same branding as milks for use frombirth) and target mothers directly.The Department of Trade and Industry hasbeen lobbying legislators on the industry’s behalf,writing to Members of Congress: “The proposedban on advertising for milk products jeopardizesmultinationals’ plan to invest $400 million.”Meanwhile the Department of Health, WHOand UNICEF have said in joint statement thatthe draft bill: “aims to support multinationalcompanies while damaging the Filipino society:families, the mothers and children.”Campaigners have organised events such asprotests outside congress (above right). Theypoint out that elections for congress take placein 2013 and they have been hearing politicianswarned that investment in their constituencies willbe cancelled ifthey do not backthe bill.Nestlé has formedthe Infant &Pediatric NutritionAssociation ofthe Philippineswith formulacompanies AbbottLaboratories,Fonterra Brands,Mead JohnsonNutrition andWyeth (whichit now owns) tolobby againstthe existingBaby Milk Action Update 45, May 2013, Page 16marketing requirements - yet Nestlé and othercompanies cite anti-trust regulations when calledon to mutually agree to stop violations of theinternational minimum standards adopted by theWorld Health Assembly.If Nestlé’s law is passed it will no longer have toput clear notices on labels about the benefits or<strong>breastfeeding</strong>, as shown left.The Department of Trade and Industry toldCongress: “The benefits derived from theperformance of the infant formula industry interms of government revenues and employmentopportunities cannot be overemphasized.”• In the Philippines the industry is arguing that nocountry regulates the marketing of products forchildren over 6 months of age, falsely claimingthis goes beyond the Code and Resolutions. Infact many countries have laws covering productsfor children to two or three years of age. (See pgs14 and 15 for recent additions to the list.)Fiji’s Marketing Controls - Foods for Infantsand Young Children which was gazetted inMay 2010 and was presented at the WorldBreastfeeding Conference by Ateca Kama, aSenior Nutritionist at the National Food andNutrition Centre, Ministry of Health, coversproducts for children up to five years of age.Latest trends: baby clubs, social media and health workersBaby Milk Action’s Look What They’re Doing2013 monitoring report exposes latest strategiesfor targeting mothers in the UK. Danone’sFacebook strategy to promote its Cow & Gatebrand of formula, for example, invites mothersto “Ask, chat,share & laugh!”It has contentspecificadvertisingplaced onsites andwebsearches relating to infant formula andchildcare and attempts to supplant health workersand mother support groupsas the source of informationon childcare by offering“expert advice andsupport”.Leaflets on pregnancyare placed in health facilities and displayedalongside NHS leaflets on diabetes and givingup smoking. Outside there is the subtle Cow &Gate heart logo. Inside, pregnant women areencouraged to contact Danone’s Cow & Gatebranded“Careline”, visit its websites and sign upfor information - including on formula.In May 2012, following a Baby Milk Actioncampaign, Danone promised to stop distributingmaterials intended to reach the public throughhealth care facilities, not justin the UK, but around theworld. This is an importantvictory, but perhaps showshow the other strategies aretaking over. Danone’s mainaim is to get mothers to useits own website, offeringinformation, film clips,advice, free gifts and more. Itclaims 3,000 mothers aresigning up every week.Mother support groups haveto compete if they want toreach mothers with unbiased information.Once on the list, the emails come. One forpregnant women nearing their delivery datespromotes the Cow & Gate starter kit: “Competepeace of mind for the first 48 hours”. Motherswho opt out of receiving information on milks aresent a weaning mailing when their children are3 months old, encouraging spoonfeeding pureés- undermining the recommendation to begincomplementary foods at about 6 months.Perhaps most worrying of all, health workersare actively working withDanone. For example,Community Practitionermagazine distributes the Cow& Gate-branded Feedingfor Life supplement, whichpromotes a website linking toinformation on formulas. TheInfant and Toddler forumfor health workers and parents is a partner inthe government’s Public Health ResponsibilityDeal - the website is owned by Danone, whichsponsors events. Of course, all of this is paidfor by premiums on the formula price. (See Nopromotion - Cheaper formula campaign pg18.)Danone free booklet undermineshome-grown organic foods.This booklet boasts about Cow&Gate’s qualityassurance. Someone asks if it is safe for children toeat home-grown organic vegetables. Stephan (fromCow&Gate) answers: “Do you know if the soil onyour vegetable patch contains heavy metals, or whatpesticides may have been used in the past?”“No I don’t....there’s a thought....”Baby Milk Action Update 45, May 2013, Page 17

UK campaignUK and Ireland campaignsHolding Wyeth/Pfizer to account: SMA advertising ruledmisleading, email marketing condemned and...In a nationalbillboard, print andonline advertisingcampaign inMarch 2012,Wyeth (part ofPfizer) promoted itsformula in a seriesof advertisementsshowing motherswith youngchildren underheadlines: “What’s the best milk after Kate’s?”,“What’s the best milk after Lisa’s?”etc.Following complaints by Baby Milk Action andother groups and individuals, the AdvertisingStandards Authority (ASA) has ruled the answer isNOT SMA formula.In a ruling published on 19 September it warnsPfizer not to repeat the advertisements afterfinding: “the ads misleadingly implied thatfollow-on milk was the best alternative to breastmilk” and “the ads misleading implied that SMAFollow-on milk was superior to other follow-onmilks”.However, there is no requirement under the UKAdvertising Code for companies to run correctionswhen they have misled the public and no fines.On 28 November, the ASA upheld anothercomplaint brought by Baby Milk Action, this timeagainst an email campaign. The email headed“How is feeding going?” was aimed at motherswith four-week-old <strong>babies</strong> and played on fearsabout milk intake and possible problems with<strong>breastfeeding</strong> before asking “Thinking of bottlefeeding?” and promoting SMA infant formulawith a claim it contains a fat blend closer tobreastmilk. The ASA ruling states:“The ad must not appear again in its currentform. We told SMA [sic] not to producemarketing communications for infant formulaexcept in a scientific publication or, for theBaby Milk Action Update 45, May 2013, Page 18purposes of trade before the retail stage, apublication of which the intended readers werenot the general public.”[SMA is the brand, the company was Pfizer].This is a significant ruling and we are calling onNestlé, which has now completed its purchase ofPfizer Nutrition/Wyeth to stop all infant formulamarketing communications. (See pg 20.)These rulings are welcome, but Wyeth continuesto promote its formula to health workers with theclaim “Drop for drop, no other formula comesclose” safe in the knowledge that the ASA refusesto investigate advertising in health journals.• See Baby Milk Action’s briefing How theAdvertising Standards Authority fails to protect<strong>babies</strong> and their families in the UK.No promotion - cheaper formulaThe millions companies spend on advertising,gifts, courting health workers etc. is addedto the price of formula, which is alreadyoverpriced - see the calculation on BabyMilk Action’s website and the No Promotion- Cheaper Formula petition, a campaignsupported by Mumsnet and others....the SMA Baby Know How roadshow stoppedPfizer/Wyeth cancelled its much promoted SMABaby Know How roadshow in June 2012 aftershopping centres pulled out of the event. Theroadshow was to have run through June and July,including during National Breastfeeding Week.The stated purpose was to launch new packagingfor SMA formula, while enticing mothers withthe offer of advice, free mother-and-babyphotographs and other inducements.Members of the public sent messages of protestto the shopping centres in support of a Baby MilkAction ‘Stop Wyeth’ campaign.The first event at Lakeside shopping centre on14 June was cancelled the day before, meaninga planned demonstration did not have to goahead.The second event at Bluewater scheduled for 21June was cancelled on 16 June, though Wyethcontinued to advertise it until announcing theroadshow as a whole was ‘postponed’ on 20June after other shopping centres also pulled out.Baby Milk Action is calling on the shoppingcentres to put in place policies to respect babymilk marketing requirements to prevent a repeat.Irish Midwife of the Year refuses to be branded with SMABaby Milk Action was pleased to support a campaign in Ireland in November against baby foodcompanies sponsoring awards to health workers organised by Maternity and Infant magazine. Themain sponsor of the event for the past five years is Pfizer/Wyeth, which uses the awards to promoteits SMA brand of formula.Last year Pfizer/Wyeth received a Maternity and Infant Award itself for SMA, which it then used inits advertising without mentioning it sponsored the awards. The Irish Advertising Standards Authorityupheld a complaint from rival Danone. In 2012 Danone, manufacturer of Aptamil and Cow & Gateproducts, was allowed to be a sponsor to promote its own formula brands.The SMA Baby Know How roadshow began inIreland in April 2012, before the attempt to launchit in the UK. The website yourroadshow.comexplains how the specially adapted bus containsa mini cinema and bottle preparation and nutritionadvice areas and more units are planned.Philomena Canning from Dublin, refused her award when shelearned that it would brand her the SMA Midwife of the Year andinstead organised a demonstration (left).In December a letter signed by over 100 members of TheNurses and Midwives Board of Ireland called on the Board toremind members that the Code of Professional Conduct states,“The nurse should avoid the use of professional qualifications inthe promotion of commercial products...” CEO Maura Pidgeonreplied announcing a review of the Code was underway,including aconsultation ofprofessionalsand the public.Baby Milk Action Update 45, May 2013, Page 19

Eye on NestléEye on NestléNestlé loses spying case - ordered to pay damages to victimsA Swiss court has ordered Nestlé and Securitasto pay damages and legal costs to members ofATTAC Switzerland for violating their privacy.Nestlé contracted Securitas to recruit spies whoinfiltrated the group when it was producing abook on Nestlé’s harmful business practices in2003 (Baby Milk Action spoke at the launch inNestlé’s home town of Vevey, Switzerland in June2004, Update 35).In typical media management style, Nestléresponded publicly to the court ruling saying itwould study the Judge’s ruling and, “If it shouldturn out that a Nestlé employee had actednegligently, we shall take appropriate measures.”Fortunately Le Courier newspaper was not sonaive as to fall for the “over-enthusiastic rogueemployee breaking the rules” spin, commenting(26 January 2013):One may recall that the [Nestlé] defenseattorneys had worked diligently to present theATTAC members as potential criminals in orderto better justify “the preventive observation” ofNestlé centre monitorsdigital communicationsReuters reported in October 2012 that Nestléhas been running a Digital Acceleration Teamfor the past year from its Vevey Headquarters:“It looks like mission control: in a Swissmarket town, an array of screens in Nestle’sheadquarters tracks online sentiment. Executiveswatch intently as California wakes up, smellsthe coffee - and says whether it likes it.”“If there is a negative issue emerging, itturns red,” says Blackshaw [who managesthe centre], indicating a screen powered bysoftware from Salesforce.com Inc., which is alsoused by such brands as Dell computers anddelivery company UPS. It captures millions ofposts each day on topics of interest to Nestle.”Insight - At Nestle, interacting with the online enemy:Reuters 26 October 2012.Baby Milk Action Update 45, May 2013, Page 20their activities. They had also declared thatowing to their militant commitment, they couldnot “claim such an extended protection of theprivate sphere” as an ordinary citizen.In other words, Nestlé’s defense wascampaigners are fair game to be spied on.The operation reported to Nestlé’s head ofsecurity - a former employee of the British SecretService MI6 (made famous by the James Bondstories). Nestlé and Securitas claim the operationended in 2005. Yet ATTAC Switzerland claimthey detected another Securitas employeeattending meetings as late as 2008 and aregoing to pursue the case. (See pg 28 for thebook, Secret Manoevres in the Dark.)Nestlé completes takeover ofPfizer Nutrition/WyethNestlé announced it was purchasing Pfizer’snutrition business in April 2012, having won afierce battle with Danone, the world’s secondlargest baby milk company.It paid US$11.9 billion for the company and hadobtained regulatory approval in 85% of marketsat the time it announced the deal was completeon 1 December. Mexico blocked the takeover,fearing price hikes, and anti-trust authorities inSouth Africa, Kenya and five Latin Americancountries had not yet approved the deal,according to Dairyreport (3 December)Pfizer Nutrition was formerly known as Wyeth insome countries and markets formula brands S-26,SMA and Promil. The purchase brings Nestléinto the UK market, where it previously had onlyspecialist formulas after trying unsuccessfully toenter the general infant nutrition market three timesin recent years (see past Updates).However, Nestlé says its interest in the businessis because “85% of its sales are in emergingmarkets”. It is in countries where <strong>breastfeeding</strong>rates are currently high, but formula marketingregulatiions are not yet in place where theindustry sees maximum potential for growth.WHO speaks out against PAHO - Nestlé linkA Reuters Report (19 October 2012) revealed that the Pan American Health Organisation (PAHO)had accepted funding from various companies, including Coca Cola and Nestlé, prompting WHOto issue a clarifying statement: “The World Health Organization (WHO) recognizes the importanceof working with the private sector. However since part of our work involves setting norms, standardsand guidelines for public health, we have very strict guidelines for accepting money from the privatesector. WHO does not accept funds from the food and beverage industry for its noncommunicablediseases work. It is unfortunate that the Pan American Health Organization (PAHO-WHO) hasaccepted money from the food and beverage industry. PAHO - while it is a WHO regional officefor the Americas – is, unlike the other regional offices, also the health agency of the Organization ofAmerican States. Therefore in some areas, PAHO has its own operating guidelines. Not all PAHOguidelines are aligned with WHO. One such area is collaboration with the private sector.”Nestlé weakens its formulamarketing policyNestlé’s policy and instructions fail to respect theCode and subsequent, relevant Resolutions of theWorld Health Assembly.Although monitoring evidence shows that Nestlébreaks its own weaker instructions, previouslythese claimed that Nestlé would not promote(in countries of its own choosing): “a) all infantformula and b) all follow-up formula productsexcept in the rare instances where they havebrand/label design which is distinctly differentfrom infant formula.”In the version of the Instructions introduced in July2010, Nestlé has weakened this by limiting thescope of its instructions to products up to 1 yearof age: “They also apply to follow-up formulaproducts which are marketed for consumption byinfants up to 1 year of age.”This came to light as Nestlé is increasinglypromoting its formula brand names through milksfor older <strong>babies</strong>, as in this example reportedCampaigners in the region launched a petition on the Care2 site andthe logo shown left - http://bit.ly/QWyp1kSeven distinguished nutrition scientists, members of the World PublicHealth Nutrition Association, sent an open letter to Carissa Etienne,PAHOs new director calling for No more deals with Nestlé please.http://www.wphna.org/2013_mar_hp1_paho.htmin Armenia. This is one of Nestlé “high risk”countries and so would not have been permittedunder its old Instructions.Change prompted by FTSE4Good?Nestlé made the change shortly before FTSEintroduced weakened criteria for its FTSE4Goodethical investment index in September 2010.Nestlé was added to the Index in March 2011even while violating the World Health Assemblymarketing requirements. FTSE assesses companiesagainst their own policies rather than theInternational Code and Resolutions.Baby Milk Action Update 45, May 2013, Page 21

Nestlé boycottResearch newsTaming the Nestlé monster at the last Croydon demoCampaigners gathered for the annual boycottdemonstration at Nestlé (UK) HQ in Croydon, prior tothe company’s relocation to Gatwick and faced theNestlé monster - a costume dinosaur representing thecompany, which tramples on the rights of mothers and<strong>babies</strong> - unless we take action to stop it. Look out forthe film clip online.Campaigners distributed “Fight the Nestlé monster”leaflets with ten facts executives do not want people toknow. The leaflet included an QR code for smartphonesto access further detailsNestle tries to undermine InternationalNestle-Free Week with KitKat pledgeIn an attempt to divert attention from InternationalNestlé-Free Week (29 October - 4 November 2012),Nestlé announced that its two-finger KitKat chocolatebars will bear the Fairtrade logo from January 2013.International Nestlé-Free Week is a time for peoplewho boycott Nestlé over the way it pushes baby milkto do more to promote the boycott - and for those whodon’t boycott to give it a go.According to statements from Nestlé and the FairtradeFoundation a total of 7,000 farmers will provide cocoafor KitKat under Fairtrade terms, up from the 6,000announced in 2009 when only the four-finger KitKathad the Fairtrade mark (though, curiously, the lateststatements claim the initial number of farmers was2,500).The 9,600 tonnes of cocoa Nestlé says it will buythrough the Fairtrade scheme amounts to 2.6% of itsannual cocoa purchase (about 364,000 tonnes). Ithas been criticised for failing to deliver on its 2001commitment to end child slavery and child labour in thesupply chain as a whole within five years. Baby MilkAction has produced a leaflet explaining “Why boycottNestlé Fairtrade KitKat” with key facts on the baby milkissue, as well as concerns about Nestlé’s sourcing ofcocoa and other business practices.The next Nestlé-Free Week will be 28October - 3 November 2013. For resourcessee: info.babymilkaction.org/nestlefreeweekBaby Milk Action Update 45, May 2013, Page 22Rachel’s Dairy added toNestlé boycott listRachel’s Dairy has been added to the Nestléboycott list for the UK as it is now owned byLactalis Nestlé Chilled Dairy (LNCD). Lactalispurchased Rachel’s Dairy in August 2010.In May 2012 the organic yoghurt and dairyproduct company was moved into LNCD,which is a joint venture with Nestlé. Lactalisowns 60% of LNCD and Nestlé 40%.US Girl Scouts shamed byassociation with NestleUS Girl Scouts put its name to a Nestlécandy bar marketing campaign that ran inAugust 2012 to boost sales in September.Campaigners called on Girl Scouts to ditchNestlé and send a message of solidarity towomen in the Philippines instead. (See pg16.) Nestlé was also criticised for breakinga commitment in the US not to target childrenwith junk food advertising, but claimed thatalthough the adverts featured a Girl Scoutthey were aimed at adults.Inconvenient truth? Everyone agrees thatmalnutrition is a shameful world problem thatmust be tackled. However, the idea that theanswer is giving micronutrient supplements toall children, regardless of whether they areneeded, is risky. Marketing them freely to alleven more so. The study from Pakistan belowshows some of the problems and urges caution.Like all studies this needs to be evaluated andcorroborated - but such evidence should not beoverlooked just because it’s ‘inconvenient.’ Thefilm from Cambodia* shows the importance ofEffect of provision of daily zinc andiron with several micronutrientson growth and morbidity amongyoung children in Pakistan: a clusterrandomisedtrial.This Gates-funded trial in Pakistan shows thatInfants and young children given micronutrientpowders (containing iron; folic acid; andvitamins A, C, and D, with or without additionalzinc) had more bloody diarrhoea and morerespiratory symptoms than controls. The authorshave called for a closer look at safety beforedistribution is scaled up. “Use of micronutrientpowders reduces iron-deficiency anaemia inyoung children. However, the excess burden ofdiarrhoea and respiratory morbidities associatedwith micronutrient powder use and the very smalleffect on growth recorded suggest that a carefulassessment of risks and benefits must be done inpopulations with malnourished children and highdiarrhoea burdens.” Soofi, Bhutta et al The Lancet - 18 April2013: 10.1016/S0140-6736(13)60437-7WHO Guideline:Use of multiple micronutrientpowders for home fortification of foods consumedby infants and children 6–23 months of agedoes recommend the use of these powders - butwith provisos: “Programmes involving the use ofmultiple micronutrient powders for home fortificationof foods should be preceded by an evaluation ofthe nutritional status among children under 5 yearsof age ...to ensure that the daily micronutrientneeds are met and not exceeded.” whqlibdoc.who.int/publications/2011/9789241502047_eng.pdf“Improve the food security of farming families affected by volatile food prices”by the Food and Agriculture Organisation (FAO) and the EU See pg 26nutritious foods from local ingredients.A bit of history on ‘Sprinkles’ Dr.Stanley Zlotkin did the research to developa micronutrient powder called ‘Sprinkles’ in1996 and owns its patent. He went on tocommercialise them globally in conjunctionwith the H.J. Heinz Company and Foundationin 2001. He has been an infant feedingconsultant for Nestlé and Mead Johnson and inCanada has pushed iron supplementation for allbreast<strong>fed</strong> <strong>babies</strong>.Profits and pandemics: prevention ofharmful effects of tobacco, alcohol,and ultra-processed food and drinkindustries.This study assesses the effectiveness of selfregulation,Public Private Partnerships (PPPs), andpublic regulation and concludes that unhealthycommodity industries should have no role in theformation of Non-Communicable Disease (NCD)policy. On our request this was discussed at theEuropean Platform Plenary meeting in February.Discussing the merits of product reformulation “inlow-income countries, benefits are less obvious,and the dangers are very apparent. In suchcountries, consumption of ultra-processed productsis low. These countries are therefore the primetargets of transnational corporations.” An increasein the overall consumption of ultra-processedproducts would “undermine long-establisheddietary patterns based on fresh or minimallyprocessed foods.”The Lancet, Volume 381, Issue 9867, Pages 670 - 679, 23 February2013 www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2962089-3/abstractCall to end early cord cuttingUK Medical bodies, senior doctors and theNational Childbirth Trust (NCT) are calling foran end to clamping of a baby’s umbilical cord assoon as it is born. Newborn <strong>babies</strong> deprived ofvital blood from the placenta are more at risk ofiron deficiency - all the better for the companiesselling fortified formulas and supplements!Baby Milk Action Update 45, May 2013, Page 23

Public Private PartnershipsGAIN’s Trojan Horse failsIBFAN Concerns about Public Private PartnershipsRight: USSecretary ofState, HilaryClinton, and thesinger ChristinaAguliera (?)watching apresentation ofthe World FoodProgramme inpartnership withthe ‘YUM’ (KFC,Pizza Hut, TacoBell) brand.Far right: IBFAN’sdiscussion paper.Update readers will know thatwe have been worried for sometime about the rise of PublicPrivate Partnerships (PPPs) andalliances such as the GlobalAlliance for Improved Nutritionand the Scaling Up NutritionInitiative called SUN. SUNemerged from a World Bankinitiative in 2009 and calls itselfa global ‘movement’ that unitesgovernments, civil society andbusinesses in an effort to endundernutrition.While IBFAN supports SUN’scall for multi-sectoral actionon nutrition and support andprotection for <strong>breastfeeding</strong>,we have many concerns aboutone of SUN’s aims,which isthat governments set up multistakeholder‘platforms at countrylevel. A Sun Business Networkwas set up in December toincrease business involvement onthese platforms.We have long experienceon the EU Platform on Diet andPhysical Activity and know therisks well. In November, aftermuch consultation, including withSUN members and leadership,we published a DiscussionPaper outlining our concerns and“Because of the move to‘product-based’ solutions,funding is already dryingup for most infant andyoung child feedingsupport programs andfor community-basedapproaches that teachand promote skills to makenutritious family foodsfrom local indigenousingredients. I fear thatonce this runaway trainleaves the station therewill be no stopping it.”Malang Fofana, thehead of the Gambiandelegation, CodexNutrition.2011The Special Rapporteuron the Right to Food,Olivier de Schutter callson SUN and otherinitiatives to “begin byregulating the marketingof commercial infantformula and otherbreastmilk substitutesand not to“overlookthe entitlements thathave been establishedunder international lawfor women, children,minorities, refugees andinternally displacedpersons..” *2011SUN’s lack of adequate safeguardson conflicts of interest, without whichconflicted corporations can gainunprecedented opportunities toinfluence health policies. We believethe SUN approach conflicts withWorld Health Assembly Resolutions.WHA Res.65.6 specifically callsfor safeguards against conflict ofinterest in policy development andimplementation of nutrition programs.Surely businesses should only beinvolved once policies are decided?In response to these concernsSUN leaders are now stressing<strong>breastfeeding</strong> and the need forinitiatives to be ‘government-led’more. We hope this will signal theneed for proceeding with cautionrather than confidence. For sure,if children are to be protected theyneed more than words and they needSUN to pay attention to what GAINand others do at Codex and atgovernment level.(See pg 25.)l The Global Social Observatorywill do a Consultation Processon Conflict of Interest in the SUNMovement, to be funded by the GatesFoundation, which is also a funder ofSUN. Let’s see...The Global Alliance forImproved Nutrition is anespecially worriesome entity.On the Lead Group of SUN itis in a key position to influenceSUN policy development.GAIN often presents abenign image as a non-profitNGO that is only interestedin reducing malnutritionthrough local foods and smallcompanies. However, thoseof us who are involved inadvocating stricter marketingcontrols see a different side.For example:l Lobbying at CodexFor the last 3 years wehave witnessed GAIN’slobby against World HealthAssembly Resolutions at CodexAlimentarius meetings whereglobal food standards are set.GAIN is clearly trying to open upmarkets for fortified foods and supplements forits Business Alliance members such as Danone,Pepsico, Coca Cola, Brittania. (See above andpg 26.)Some of GAIN’s BusinessAlliance membersl Lobbying Kenya In October, GAINchallenged the Kenya’s draft law that proposedstrict controls on baby formulas and foods. Inits lobby paper GAIN implied that proceedingwith the law would threaten “Kenya’s ability tomeet its commitments as a Scaling Up Nutrition(SUN) country.” We have asked how SUN canclaim to be government-led when a member of itsLead Group is doing such lobbying. Kenya wentahead with the Law. (See pg15.)l World Health Assembly GAIN hasbeen involved in WHO’s work on micronutrientsand in 2012 applied for official NGO relationsstatus. This would allow it to make interventions atAssembly meetings. The WHO Executive Boardin January 2013 did not approve the application,pending answers to questions about GAIN’srelations with global corporations andallegations about its lobbying againstWHA Resolutions on baby foods. (SeeEB Res.132.R9. Jan 13)l Monitoring The first report of theGAIN sponsored Access to NutritionIndex (ATNI) was published in March2012. The report scored 25 of theworld’s largest food and beveragemanufacturers on the basis of theirwritten policies and statements, ratherthan on independent monitoring oftheir actions on the ground.The highest scores went to thecompanies that have invested mostin using Public Relations strategiesto counter criticisms. Danone,Unilever, Nestle, PepsiCo, and Kraftreaped the reward as media reportsdescribed them as the “best largefirms worldwide when it comes tooffering products that address both theproblems of obesity and poor nutrition…”(USA Today) ATNI criteria are the perfectwhitewash because they reward companies forall the wrong things: the promotion of fortifiedfoods, consumer ‘education’ about healthy dietsand active lifestyle, and engagement with‘stakeholders’ in public private partnerships.l Lack of transparency The BritishMedical Journal wrote to Veena Rao abouther opinion piece entitled, “Law on infant foodsinhibits the marketing of complementary foodsfor infants, furthering undernutrition in India”“In this online Personal View ..Veena Rao, didnot declare any competing interests. She hasnow told us that she has been “a member ofthe Advisory Board on the Britannia NutritionFoundation (a non-profit trust) since 2009.”...Brittania Industries is represented on the LeadGroup of SUN and the Board of GAIN. Its statedpurpose is to `’Help people enjoy life –throughhealthy snacking.” Encouraging all day snackingon ‘slightly better for you’ junk foods seems to beone of the food industry’s Top Strategic Priorities.Baby Milk Action Update 45, May 2013, Page 24* www2.ohchr.org/english/bodies/hrcouncil/docs/19session/A.HRC.19.59_English.pdfBaby Milk Action Update 45, May 2013, Page 25

“The UN Committee on the Rightsof the Child recommends that theState party implement fully theInternational Code of Marketingof Breast-milk Substitutes.... TheCommittee is concerned thatimplementation continues to beinadequate and that aggressivepromotion of breastmilk substitutesremains common.”Companies spend a fortune on promotion, undermining <strong>breastfeeding</strong>, inflatingproduct prices and forging links with health workers and parents.• Requires information materials to advocate for <strong>breastfeeding</strong>, warnagainst bottle feeding and NOT to contain pictures of <strong>babies</strong> orThe International Code of Marketing of Breastmilk Substitutes aims to text that idealise the use of breastmilk substitutes.promote safe and adequate nutrition for infants and young children, • Bans the use of the health care system to promote products.by protecting <strong>breastfeeding</strong> and ensuring appropriate marketing ofproducts under its scope.• Bans free or low-cost supplies.The Code applies to all products marketed as partial or total • Demands that product information be factual and scientific.replacement for breastmilk, such as infant formula, follow-up formula,• Bans sales incentives and contact with mothers.special formula, growing-up milk, cereals, juices, vegetable mixes andbaby teas. It also applies to feeding bottles and teats.• Requires labels NOT to discourage <strong>breastfeeding</strong> and to informfully about the correct use of infant formula and the risks of misuse.The Code:• Bans all advertising and promotion of products to the general The Baby Feeding Law Group (BFLG) consists of the leading UK healthpublic.worker and mother support groups. Baby Milk Action coordinates theBFLG monitoring project. Examples shown date from 2012 and 2013 unless• Bans samples and gifts to mothers and health workers.otherwise stated.Policy newsCommand-shift essential reading Page titleNo claims at CodexWe joined the IBFAN team, representingIACFO (the International Association ofConsumer Food Organisations) at theCodex Alimentarius Nutrition meetingin Germany in December. GAIN and thebaby food industry failed in an attempt tolegitimise health claims in the Guidelines onFormulated Supplementary Foods for olderinfants and young children. At the request ofthe Botswana delegate the FAO/EU film (seeright) was shown to everyone. It was alsoshown at the Save the Children workshopon Infant and Young Child Feeding inEmergencies in June. There was much debateabout when supplements are needed and howthey might undermine local family foods.Whether the Codex Follow-on FormulaStandard should be revised was also a hot topic,with the baby food industry keen to open up themarket - not just for formulas for 6-12months, butfor the potentially huge market for older <strong>babies</strong>and young children. WHO, supported by manygovernments, including the US, called for areview on whether there was any need for theseproducts or indeed a separate standard.European Union The EU has beendiscussing much the same questions during thereform of PARNUTS, the Framework Directive thatdetermines how baby formula and food legislationis formed. MEPs called for much stricter ruleson marketing and the use of the precautionaryprinciple. The Greens called for no advertisingof foods for infants and young children. MEPs,like most health professionals are worried aboutformulas for older <strong>babies</strong> and young children,not just because of the cross-branding but theexcess sugar levels. The European Food SafetyAuthority (EFSA), which has revised its rules onConflicts of Interest, will review these productsand the nutritional needs of infants and youngchildren. Among other changes, baby pictures andidealised images and text on follow-on formulalabels will end and promotion of specialisedformulas will be reviewed and possibly curtailed.See Policy Blog: http://info.babymilkaction.org/EUFOODLAWBaby Milk Action Update 45, May 2013, Page 26WHO Reform, Non-communicableImprove the food security of farming families affected byvolatile food prices. This short but important film by theFood and Agriculture Organisation (FAO) and the EU givesa different message to those suggesting that all <strong>babies</strong>need micronutrient supplements. The film shows children inCambodia getting healthier as parents learn how to providenutritious meals from readily available local ingredients alone.www.youtube.com/watch?v=0rUX6F7ieVYThe IBFAN group in Indonesia, AIMi, made another usefulfilm(cartoon with english subtitles), with the support of Savethe Children. AIMi also managed to stop an unethical industryfunded formula trial going ahead in January.http://aimi-asi.org/benar-awalnya-lancar-menyusuinya/Diseases, Conflicts of Interest andWHO’s interactions with “Non StateActors” have been key cross-cutting issuesthat we have followed at WHO’s meetings andconsultations throughout the year as members ofIBFAN, the Conflict of Interest Coalition andDemocratising Global Health.WHO’s Director General, Dr Margaret Chan,is now repeatedly stressing the need to protectWHO’s ‘norms and standards’ setting process.A WHA Resolution (65.6) passed in May 2012called for safeguards against conflict of interestin policy development and implementationof nutrition programmes. Whether WHO willadopt a coherent and effective policy to protectitself and its policy making process from undueinfluence remains to be seen. Resolution 65.6also addressed <strong>breastfeeding</strong> and the marketingof complementary foods. (See stories on PAHOpg 21 and GAIN pg 25.)Free downloads and hard copies of these papers can be accessed through theonline version of UPDATE or from www.babymilkaction.org/shop/UKCode Violations • 2 0 1 3How companies violate the International Code of Marketing of BreastmilkSubstitutes and subsequent WHA Resolutions and UK measuresCode overviewAdvertising, mum and baby clubs, sponsorship, direct mailPromotion is funded by formula sales: No promotion = Cheaper FormulaThree above from www.firststepsnutrition.orgLook What t hey’re Doing!Monitoring Code Compliance in Arme-Baby Milk Action Update 45, May 2013, Page 27

In Command-shift the online Virtual Page Shop title2013 Calendars now reduced.Also available packs of past years.Complementary Feeding: Nutrition, Culture and Politicsby Gabrielle Palmer, author of The Politics of Breastfeeding (and one of the expertsappearing in the Infant Formula Explained DVD). This thought-provoking book providesan important perspective to the debate about the role of forti<strong>fed</strong> processed foods.NestléMonsterT ShirtsThanks toRebeccaClark for thisimage,also availableona reusableshoppingNew Maternityprotection kitan invaluable resourcethat has taken years toproduce - a joint effortby the InternationalLabour Organisation,IBFAN and many others.Women.What liesbehindNestlé’sGreen PRStrategy?New campaignleaflet.SecretManoevresin the Darkby EvelineLubbers.Thisdisturbing bookis aboutundercoveroperations bycompanies - ithas a chapteron Nestlé. - ithas a chapteron Nestlé.Infant Formula Explained DVDand iPhone appThe DVD has a 25-minute film for healthworkers, where experts explain aboutformula and answer typical questions fromparents and carers, a 7-minute film for usewith parents and carers who have decidedto formula feed (and health workers withless time available) and a 10-minute filmshowing how to make up powderedformula in line with WHO guidance. Thelast two films are included in the IFE iPhoneapp.MyMeter iPhone appThanks to Nigel Harrison fordeveloping the. The dial and toneindicate when you are getting closerto the item/person you are detecting.Set it to display “Nestlé Product!”and see what happens when thealarm goes off. Give your target anupdated Nestlé boycott product listcards as compensation.Diary dates: 201328th October - 4th November:International Nestlé-Free WeekMembership OfferBaby Milk Action is an independent voice to protect<strong>babies</strong> and their families because we take no fundingfrom companies. Members are essential for us to carryout the work described in this newsletter. Please join usvia the Virtual Shop or one of our reply formsBaby Milk Action Update 45, May 2013, Page 28