Background to the Nestle boycott

by Mike Aaronson

New Internationalist magazine

This document has been prepared to give information on the reinstating in 1988 of a boycott on Nestle products, due to their alleged continued defiance of World Health Organization (WHO) codes on the advertising and promotion of baby milk substitute and supplements.

The WHO has declared that baby milk substitutes should not be advertised and should not be given away as samples to hospitals and clinics. Nestle has been reported as challenging their need to comply with these rules, defying them, and allegedly putting their own profit before the safety of babies.

Firstly, what are the problems with baby milk substitutes? There is much research and information now that shows a mother's own breast milk is the healthiest for her baby. A few mothers may have problems breast feeding, and so there is a small need for a reliable substitute. But generally breast milk is the way to go, and there are groups who have long been advocating the promotion of "breast is best'' .

Of course, when a company has a good product, it wants to keep its market share, and increase consumer use of it. The problem is that Nestle seems to be redefining its potential customers, not just those who need the milk substitute, but those who may find it more convenient. No problem there, it seems, mothers should have a choice. There are problems though.

Because milk substitute needs to be made up with water, wherever there is water of dubious quality there will be risks of introducing water borne disease to babies, who are otherwise not directly ingesting water. So in places with poor hygiene and poor water supply, which is often the case in the hospitals and living areas of developing countries, there can be major health risks with the use of milk substitutes.

Dr Raj Anand, in New Internationalist states that there is a 14 times higher chance of babies dying from diarrhea when on milk substitutes, over those fed on breast milk.

Another part of the WHO code is that in non-English speaking countries, labels noting the use of the product and whether it is usable as a milk substitute or just a supplement (that breast milk must be given as well), must be in the local language. In India, where the government has legislated that product must display a notice in English and Hindi to the effect that "breast milk is best.", Dr Anand cites an example of a tin of lactogen with no Hindi notice. Where women aren't able to understand the information about the use of the product, they can make a decision that could be disastrous for their child.

WHO and UNESCO recommend that babies be exclusively breast fed for the first four months and up to 6 months if possible. They state that the most common reason for women to stop breast feeding early is because they think they do not produce enough milk, or that it is of poor quality. (2) In most cases neither of these is true. One can imagine that where the mother has been an essential contributor to the family income (the case in many communities in both industrialized and developing countries), the sooner she can get back to work, the better. So to bundle the baby up with one of the younger family members, and a bottle, means she can be at work earlier, and can work longer without interruption.

Women may see the use of these products as a very convenient way of coping with a new child, and the possible loss of a job. The World Alliance for Breast feeding has produced a document on the problems for working women with infants, including comment on the right to breasted in public places. Once the mother uses less breast milk, the breast produces less, and can completely stop production quite quickly, if the milk is not used. So a mother who uses a milk substitute regularly runs the risk of not being able to return to using her own milk.

The WHO International Code on Marketing of Breast Milk Substitutes was introduced because hospitals and health care workers (especially those in developing countries) were receiving free samples, and subsidized product, as well as free gifts and other incentives, which could easily predispose them to advocating breast milk substitutes where breast milk itself would be a much better and healthier choice. Health workers would have a much easier time if they were able to put babies on breast milk substitutes while in hospitals, with little cost to the hospital. Of course, when the mother and child left hospital, they would no longer have access to free or cheap product, and would have to start purchasing it, because the mother's milk would have stopped.

"The concern now strongly felt by many, including Save the Children and UNICEF, is that the baby milk manufacturers are behaving in ways which undermine the consensus and circumvent and violate the Code despite public claims to the contrary. Their interests are clear, however, as the global baby foods market is enormous and growing."

Mike Aaronson, Director-General of Save the Children UK to New Internationalist magazine.

Boycotts page