I learned about the Nestle Family blogger event with dismay when a friend e-mailed me about it. I was happy to hear that she had declined their invitation and hoped that many of the other mommy bloggers that I hold in high regard would follow suit. When I later saw the list of people who were attending, I was distressed to see women who I respect and women who are breastfeeding advocates had accepted the invitation. I wanted to believe that they must just not be aware of Nestle's unethical business practices and that once they found out that they would, of course, decline the invitation and boycott the event. That was not the case. Some of you heard the concerns and said that you didn't care. Some of you heard the concerns and said you would go anyways because you felt a dialogue with Nestle would be more productive. You are all skilled communicators. But having followed the Nestle fiasco for a long time, I know how ineffective dialogue has been in the past and I know that their public relations people will tell you a good story and try to take you for a ride.
That said, you are going. I can't change that now. Many of you were tweeting this morning about packing your bags and heading off to the airport. So, in a last ditch effort to help you make a difference, I am writing you a letter outlining the things I would like you to know.
How formula marketing kills
Let me be clear. This is not about what you chose to feed your babies. If you formula fed, whether by choice or by necessity, that is none of my business. That said, the marketing and advertising of formula has been linked to the deaths of millions of babies every year. According to the World Health Organization:
The protection, promotion and support of breastfeeding rank among the most effective interventions to improve child survival. It is estimated that high coverage of optimal breastfeeding practices could avert 13% of the 10.6 million deaths of children under five years occurring globally every year. Exclusive breastfeeding in the first six months of life is particularly beneficial, and infants who are not breastfed in the first month of life may be as much as 25 times more likely to die than infants who are exclusively breastfed.
In developing countries, the difference between being breastfed and being bottle fed truly is life or death. When women choose to formula feed in developing countries, their babies are at significant risk. They do not have the financial means to keep buying formula, so they water it down and give their babies less than they really need. There is often a lack of clean water, so formula gets mixed with dirty water, which can lead to infections, disease and death. In the developed world, formula feeding isn’t as likely to kill a child, but not breastfeeding does come with a whole host of health risks for both the baby and the mother. It can lead to deaths as well as increased health problems and increased health costs (whether you have a public system or a private insurance system, you do pay for other people’s health care to some extent). Around 1.4 million lives could be saved every year with improved breastfeeding.
Advertising formula and providing free samples to women in developing countries could be likened to advertising free c-sections with a dirty knife and untrained medical staff. Infant formula and c-sections can both be life saving under specific circumstances. But marketing them to the general public as an equal, better, or even close to as good alternative is dangerous, especially in countries where they do not have the means to use it safely.
The International Code of Marketing of Breast Milk Substitutes
In order to reduce the negative effect of formula marketing and save lives, the World Health Organization developed the International Code of Marketing of Breast-milk Substitutes (World Health Organization), which restricts marketing and related practices of the following products:
- breast-milk substitutes, including infant formula, other milk products, foods and beverages, including bottle-fed complementary foods
- feeding bottles
- teats, like bottle nipples and pacifiers
Governments in more than 60 countries have adopted the Code and made it law. Some countries have gone a step further by making formula available only by prescription or requiring warnings on labels. In the absence of legislation, the Code encourages manufacturers and distributors to comply with its provisions. Some do so voluntarily. Some pretend that they do, but instead blatantly lie (Nestle), do not fully disclose ownership (Lanisoh), or make other choices that compromise their compliance. Others just don’t care at all about compliance and care only about profits.
How Nestle lies, cheats and deceives
What is Nestle's role in this problem? According to INFACT Canada, Nestle controls 40% of the worldwide market for baby food and is active in 80 countries. It is the biggest player in this market. Other companies are unethical too, but the size and reach of Nestle makes its violations of the Code especially problematic and especially risky for moms and babies. Nestle has been characterized by experts in the field as the worst of the baby food companies in terms of its breaches of international standards.
Some illustrations of Nestle's unethical practices include:
- Nestle has an Infant Formula Marketing Policy that it says complies with the International Code of Marketing of Breast Milk Substitutes, but its scope is much narrower, covering only infant formula (instead of all breast milk substitutes) and covering only developing countries (instead of all countries). Read more here and check out a detailed chart comparing the two here.
- Nestle invests in public relations initiatives to divert criticism, instead of making changes to bring its practices in line. Read more.
- Monitoring of the baby food industry by NGOs has found many areas where Nestle's advertising and promotion practices violate the Code. Look here for 13 pages of illustrated and annotated examples of violations.
- Nestle systematically violates its own policies as brought to light by a senior Nestle employee in Pakistan who resigned and then wrote a scathing, detailed and well-documented whistleblower report on all of the violations that were both allowed, encouraged and ordered by his superiors. He is pursuing legal action against the company. His family has been threatened.
It is important to note that Nestle will try to tell you that all of this is in the past. That has been their approach all along. According to Baby Milk Action's report on Nestle's PR machine, "Nestle's strategy is to admit to malpractice only years in the past, even though it denied it at the time".
Beyond the marketing issue, there are other business practices related to its infant formula that have come into question. For example, apparently Nestle is purchasing 1 million litres of milk per year from Grace Mugabe, the wife of the President Robert Mugabe, despite sanctions due to human rights violations by his government and despite the fact that these farms were seized from farmers by Grace Mugabe. As per its usual practice, Nestle came up with some weak excuses for why this was not a problem.
There is so much to say. I feel like there is no way I can do it justice in a few short paragraphs.
What I would like Nestle to do
I think there is an opportunity for Nestle, as a leader in the food industry, to take a leadership role on this issue. At a minimum it should start abiding by the law in all countries where it operates and not just the letter of the law, but the spirit of the law. But ideally, in order to rectify some of the damage that its past practices have caused, it should go above and beyond what the law requires. Nestle should:
- Commit to abiding by the International Code of Marketing of Breast Milk Substitutes in all countries worldwide for all products covered by the Code
- Ensure that all of its packaging includes information on:
- The risks of formula
- Where people can go for breastfeeding help from trained lactation professionals (not Nestle staff)
- Provide funding for lactation programs in developing countries and in low income neighbourhoods in the United States as part of its corporate social responsibility program
I think a complete about face is required here. Nestle should shift from trying to circumvent the law and the Code to proactively trying to encourage the safest nutrition for infants.
What I would like you to do
At a minimum, while you are there, I hope you'll listen with a critical ear and not take everything at face value. Nestle's public relations machine is well oiled and they will find a way to "address" your concerns without really doing so. I would like you to tell Nestle in no uncertain terms that you do not support its unethical business practices. I would like you to tell them that you will not be using your blog, your twitter presence, or any other platform you are on to help market their products. I would like you to tell Nestle that you are going to boycott its products and ask your friends and family to do so too. Above all, I would like you to ask yourself how you feel about supporting a company that puts profits ahead of the lives and health of babies.
I'll be watching your blogs with interest and a critical eye following this event.
Following the event, I posed a number of follow-up questions to Nestle via e-mail. As they respond to them, I am posting their responses and posting a reply to their responses in separate blog posts. You can access an index of the questions, and the blog posts with the responses here: