Nestle Answers: Don't mind the small print about breast being best
Saturday, October 17, 2009 Question
Does any Nestle formula packaging in any nation make claims that the formula offers protection or protects the baby against diarrhea or any other ailment?
This question was submitted by Candace from Mamanista.
Nestle's Answer
Nestlé makes significant investments in R&D and technology to deliver innovative products with scientifically proven nutritional benefits. While our infant nutrition products meet the needs of non-breastfed babies during the first critical months of life, the functional benefits that are referred to on our products are scientifically substantiated – the result of many years of intensive research on how best to improve the formula composition. However, we never claim in any manner that infant formula is superior to breast milk. All our infant formula labels contain the following text: “Important notice: Breast milk is best for babies. Before you decide to use an infant formula, consult your doctor or clinic for advice.”
My Response
Take a look at the labelling on this product. What do you see?
According to Mike Brady from Baby Milk Action, this label is from Malawi, one of the world's poorest countries. In 2007, Malawi had an under-5 mortality rate of 111 children per 1,000 live births. For comparison purposes, the United States has an under-5 mortality rate of 8 children per 1,000 live births. (Source for infant mortality data: UNICEF Info by Country). Cuba, a poorer country than the United States but with substantially higher breastfeeding rates and much better breastfeeding support, has an under-5 mortality rate of 7 children per 1,000 live births (better than the United States).
In Malawi, the majority of babies are breastfed, but there is still lots of room for improvement in the breastfeeding rate overall and in ensuring exclusive breastfeeding for 6 months (57% manage exclusive breastfeeding for 6 months according the same UN report quoted above). Given the high infant mortality rate, the poverty, and ongoing challenges with clean water, Malawi is not a good place to be promoting formula as "protecting" infants.
Nestle is right that this label contains a clause saying that "breastmilk provides the best food for your baby and reduces the risk of diarrhea and illnesses" (see the small print at the bottom of the can), but it is significantly less prominent than the big PROTECT stamp telling you all the wonderful ways that Nestle formula will protect your baby. The thing is, all of those protections and more exist in breastmilk.
Where I live, we have language laws designed to protect the French language. On signs, labels, etc. the French has to be more prominent than the English. Perhaps we need a similar law for breastfeeding protection. A law that says that the information on breastmilk being best must be bigger than any claim about the formula and it must be clear that the claim about the formula is compared with other formulas, not compared with breastmilk. This is similar to the issue that I had with the Avent ad that was claiming its bottles protected against colic, but only in the very small print a few pages down did they tell you that it was compared with other bottles.
How often do you read the fine print?
Really?
Are you sure?
If we want to be sure that the right messages are getting to parents and if we cannot get companies to voluntarily comply with the International Code of Marketing of Breast-milk Substitutes, then I don't see any way other than to specifically legislate something similar to what is required on tobacco labels in Canada - i.e plain packaging, big warnings, graphic images of the dangers, only available behind the counter. To be clear, I'm not comparing the dangers of formula with the dangers of tobacco (although given the conditions in developing countries they could perhaps be compared there). However, the tactics of tobacco companies and the tactics of formula companies are similar. They will be sneaky and devious about their marketing until they are completely cut off.
Please also read the comment from Mike Brady below for additional context and information on the labelling issue.
Reader Comments (20)
[...] 7. Does any Nestle formula packaging in any nation make claims that the formula offers protection or protects the baby against diarrhea or any other ailment? ANSWER HERE [...]
Notice thay they didn't directly answer the question either...
Although I agree the breastmilk is best (I am still bfing my 1 year old). But why would a company that manufactures and sells formula promote breastfeeding on their product? I understand that its better, but a negative (against their product) campaign like "If you milk doesn't flow, get a Good Start with Nestle!" isn't exactly what they teach in marketing/advertising school.
Do you think formula companies like Nestle should market that way? What do you think their canisters should say? In what arena should they advertise/provide samples?
Noticed the price tag on the canister you have shown. Did a little calculating. Wanted to share.
In May 2005, Malawi is reported as one of the ten poorest countries in the world with an income per
capita of around $160 per year. The formula you have depicted has a price tag on it of 1550 MKW which was $14 in May 2005. That is MORE than 1 month's salary for the average person in Malawi for 1 can of formula, which might last a WEEK!
I live in South Carolina. In 2005, the average per capita income for SC was around $40,000. To compare with Malawi, that canister of formula would cost have to cost me $3333!! That is ridiculous.
Exactly right on the need for new requirements for labels. Formula has risks. Moms are being duped into thinking it does not. In addition to labels, there has to be an enforced restriction on advertising and marketing, esp. The horrible marketing to doctors and hospitals.
Those communications guys at Nestle can really make up some great twisty doublespeak all dressed up to go down smooth!
Baby Milk Action wrote to Nestlé about this label and also an end-of-aisle display found in a rural area in Malawi. Nestlé replied, but simply stating that it respects the marketing requirements. You can see the other pictures here:
http://www.babymilkaction.org/CEM/cemjuly09.html
You have posted Nestlé's response to us on our website. Since receiving it, we have found that Nestlé has posted a different response on its website. We have also analysed that. Full details at:
http://www.babymilkaction.org/CEMresponses/CEMRjuly09.html
Two points to note. Firstly, Nestlé refused to translate the breast is best warning into Chichewa, the national language of Malawi, in the past, citing 'cost restraints'. It took a 3-year campaign from Baby Milk Action which put the issue on national television in the UK before Nestlé agreed to translate the warnings and instructions.
Secondly, this is what Nestlé states on its website about the 'protect' logos (following the link above for links to supporting documents):
"Nestlé makes significant investments in R&D and technology to deliver innovative products with scientifically proven nutritional benefits. While our infant nutrition products meet the needs of non-breastfed babies during the first critical months of life, the functional benefits that are encapsulated in the ‘Protect’ logo are scientifically substantiated - the result of many years of intensive research on how best to improve the formula composition to stimulate the infant’s immune system."
[****Baby Milk Action comment: Nestlé's justification for them is simply untrue. They promote the addition of Long-Chain Polyunsaturated Fatty Acids (LCPUFAs) - DHA, ARA and one Nestlé refers to as Opti-pro to give the impression it aids eye development, a claim sometimes made about them. However, the respected Cochrane Library has investigated the impact of adding LCPUFAs to infant formula and concluded: "It has been suggested that low levels of long chain polyunsaturated fatty acids (LCPUFA) found in formula milk may contribute to lower IQ levels and vision skills in term infants. Some milk formulas with added LCPUFA are commercially available. This review found that feeding term infants with milk formula enriched with LCPUFA had no proven benefit regarding vision, cognition or physical growth."****]
Here's the link to the Cochrane Library review:
http://www.cochrane.org/reviews/en/ab000376.html
Nestlé continues: "The logo helps distinguish this particular formula from other less advanced products but does not claim in any manner that infant formula is superior to breast milk."
[****Baby Milk Action comment: A comparison comment, with no scientific basis for it, would be misleading, but this is not a comparison comment. The logo simply says 'Protect Start' on the infant formula and 'Protect Plus' on the follow-on formula, an absolute claim that the formula will protect. This undermines the legally-required warning that breastmilk is best for babies. In the Philippines, Nestlé has used logos promoting 'brain building blocks' and claimed 'Experts recognize DHA as essential for brain development and good vision.'. UNICEF Philippines has produced a film examining the impact of such claims: they lead some parents to believe their children will be more intelligent and have better eyesight if fed on formula. You can watch the film online.****]
So Nestlé is defending its 'protect' logos - for now. With more people exposing Nestlé's bogus claims and sending messages to Nestlé the sooner we will succeed in persuading it to remove the logos. You can send a message via the Campaign for Ethical Marketing action sheet (top link).
@smoaksmom:
I think that the product should be available for those that need it, but should not be promoted in any way (as per the International Code of Marketing of Breast-Milk Substitutes). Nestle has enough other businesses where they can engage in heavy marketing. In this instance, where there is a specific public health concern, they should back off the marketing. If they don't do it themselves, they should be required by law to point out the risks of formula and that breastfeeding is best. But that message should not be small print only. It should be more prominent. They also shouldn't be allowed to claim that their formula "protects".
Hospitals make more money when a woman has a c-section than when she has a natural birth, but you don't see them advertising the benefits of a c-section ("no vaginal tearing!!!" or "choose your baby's birth date!!!")and then putting a small print warning at the bottom that natural birth is the best option. C-sections are there when necessarily and even without advertising are used more often than they should be. I think the same would be true with formula. Even if we got rid of all promotion, it would still be used more often than it should be. But hopefully at least less than it is now.
@smoaksmom: Exactly. This is why giving free samples to moms in those countries is sabotage and completely irresponsible. The moms use that bit of free formula, their milk dries up, and then they can't afford the formula to feed their babies.
Thanks for providing this additional context Mike.
I see your point. Thank you for clarifying. :)
It makes me think of how one mama was telling me at the Dept of Social Services there were two posters next to each other. One advocating the benefits of breastfeeding and the other advocating how great formula is. Kinda confusing to mothers (especially young mothers) getting on the WIC program, which provides formula whether they need it or not!
Out of curiosity I went to the store tonight to look, since I've never been close and personal with a can of formula. The GoodStart by Nestle had teeny tiny print in the very top on the side, I had to spin it several times to find the breastmilk wording. Then I found something called Nido Kinder, that is some sort of formula/milk replacer for toddlers. It says kids over 1 year. No where on it have anything about breastfeeding. I'm assuming it's Nestle because it was among the other Nestle items, though it was the local Hispanic store so it may not be.
[...] of poverty, more likely to die. There is a good analysis of Nestlé’s response on the PhD in Parenting blog, showing the ‘protect’ logo on the Malawi tin we have been highlighting (click on the [...]
Truly legistlation is the best way to go on this issue (just like legistlation is the best way to go with environmental issues). Formula companies are simply not going to voluntarily comply with "suggestions" as they see it. What can we do so that our contries pass and enforce some new laws on this? That is what we should be thinking about.
[...] of poverty, more likely to die. There is a good analysis of Nestlé’s response on the PhD in Parenting blog, showing the ‘protect’ logo on the Malawi tin we have been highlighting (click on the [...]
I totally agree Kathy. Last week the International Baby Food Action Network (IBFAN) launched its latest chart assessing the state of the International Code around the world. There are 63 countries that have legislation implementing most or many of the Code's provisions.
Groups around the world are campaigning to introduce or strengthen national measures. We produced a report looking at the lessons learned from experiences in 7 countries - some where campaigning had succeeded and others where the industry lobby had derailed these efforts. You can download the report at:
http://www.babymilkaction.org/shop/publications01.html#checks
We run campaigns as necessary to support governments that are facing opposition from the formula industry. A recent success was in support of the Philippines. You can see what it took on this blog:
http://boycottnestle.blogspot.com/2007/10/philippines-saving-lives.html
At the IBFAN meeting, reference was made to an industry report produced by Euromonitor International in 2008. This warned companies: "Government Regulation a Growing Constraint". It stated: "The industry is fighting a rearguard action against regulation on a country-by-country basis." And: "There are significant international variations in the regulations governing the marketing of milk formula, which are reflected in sales differences across countries."
This is what we are up against. Implementing the Code protects breastfeeding, which is bad news for formula companies interested only in profits. In Brazil, regulations and efforts to promote breastfeeding have seen median duration of breastfeeding increase from 3 months in the 1980s to 10 months today. That means lost sales to the formula industry. We have had to repeatedly defend the Brazilian regulations from efforts to weaken them in the congress.
While there is much that still needs to be done, we can take some comfort from the fact that the industry is feeling constrained, at least in some countries.
Sheeesh, that IS small print!
;(
@Bettina:
Don't give the communications guys at Nestle all the credit. Look up Marcus Thomas LLC and Fishburn Hedges. I suspect they are getting a bit of professional help with their spin from reputation management and crisis communication experts.
[...] fact, Nestle packaging has big letters telling moms how the formula “PROTECTS” with only very .... Perhaps the product should have a plain label with no nutritional claims that very clearly warns [...]
[...] wrote about this issue previously when I asked Nestlé about the wording on its labels. Here is a brief excerpt of my key point from that post: Nestle is right that this label contains a [...]
I am very thankful for efforts to keep women breast feeding. I appreciate your efforts to improve transperancy and make corporations accountable for their actionso or ommisions
BUT don't forget, there are people in Malawi that desperately need formula. Why is the infant mortality rate so high? Part of the reason is because this tin of formula you show a photo of is SOOOOO expensive.
Women die in childbirth. Just after her family has suffered the loss of a daughter, aunt, mother, they have to watch helplessly as her baby dies of starvation because they can only feed it cow or goat's milk.
Women suffer post-partum psychosis, become ill, have psychiatric issues or otherwise cannot breast feed their infants properly.
Infants DIE because formula is too expensive and unvailable!!! Nestle needs to make formula MORE available, MORE affordable and for the people that need it most.
Don't impose your western breastfeeding priorities on people you know little about. Ask a woman in Malawi, most of whom won't even be able to read the label, what questions they have for Nestle!