Milking the Innocent

Marketing infant formula at the cost of young lives.
by Sharon Craig

In the Philippines, as in much of the global South, infant formula powder is a booming industry. Television ads for formula feature prodigy violinists and boast of “brain building blocks” and “IQ nutrition systems.” False advertising also leads mothers to believe that breast milk is inferior, and that their bodies will not produce enough milk to nourish a child.

Last September, more than a thousand breastfeeding mothers rallied in Quezon City. The Catholic Bishops Conference of the Philippines has been distributing booklets emphasizing that “breast milk is important because it is a unique gift from God which no one can replace.” Dr. Shigeru Omi, World Health Organization Director for the Western Pacific Region, said, “The church has a major role in advocacy to promote breastfeeding and will greatly influence society.”

Breastfeeding benefits infants with balanced age-specific nutrition and immunities that prevent infections. UNICEF estimates that 1.3 million children die per year because they are not exclusively breastfed for the first six months. Medi­cal research shows that formula-fed babies can suffer poor nutrition and growth and decreased IQ, along with numerous life-long risks. Formula, which comes in a powder that must be mixed with water, is especially dangerous in areas with poor access to clean drinking water; infants’ weak immune systems are exposed to treacherous bacteria and viruses, starting a cycle of diarrhea and malnutrition.

A long with the industry’s misleading promotions, health professionals in the Philippines often agree to promote formula to patients in return for incentives and commissions, as UNICEF’s documentary Formula for Disaster highlights. Representatives from formula makers distribute brand-name merchandise and samples to healthcare facilities in an effort to entice new mothers into formula consumerism. If families start bottle-feeding with the free powder, milk production decreases; when the free samples run out, families are faced with the artificial need to bottlefeed. Impoverished families then struggle to buy substitute formula, often lessening the powder-to-water ratio to make the can last longer.

As a result of all these tactics, an astounding 84 percent of Filipino babies are formula-fed, even though bottle-feeding costs at least $43 a month—in a country where income averages $118 per month. This contributes to the fact that nearly one out of every three babies in the Philippines is underweight at age 1.

Formula companies have long been notorious for unethical marketing practices. In response to Nestle’s behavior in the developing world, the Infant Formula Action Coalition started a boycott of Nestle products (from 1977 to 1984 and from 1989 to the present), which was supported by many U.S. churches. In 1981, in response to corporate tactics that endanger the lives of millions of children, the World Health Organization ratified an international code on the marketing of breast-milk substitutes.

Many of WHO’s key recommendations were incorporated—in theory—in the 1986 Philippine Milk Code. But harmful and unethical formula marketing continued in the Philippines, so, in the summer of 2006, the nation’s Department of Health (DOH) announced plans to enforce the Milk Code with concrete regulations, including prohibitions on free samples and on advertising food for infants less than a year old.

U.S.-based infant formula companies Wyeth, Novartis, Mead Johnson, Glaxo­SmithKline, and others—which each year spend $100 million, more than half the DOH’s total annual budget, advertising their lucrative breast-milk substitutes in the Philippines—got the Supreme Court to issue a temporary restraining order against the DOH marketing regulations. In the name of international investing, multinational formula companies also lobbied against the marketing regulations through the U.S. Em­bassy and the U.S. Chamber of Com­merce.

Last October, the Supreme Court of the Philippines finally ruled that some of the DOH regulations could go into effect. Breast-milk substitute labels will have to state risks of inappropriate formula feeding, and there will be limitations on advertising with “pictures or texts that idealize infant and milk formula.” While the Supreme Court did not ratify all of the proposed regulations, UNICEF and breastfeeding activists see the ruling as a minor victory for Filipino babies.

“Women are being brainwashed about infant formula,” says Dr. Marsden Wagner, former WHO Director of Women’s and Children’s Health. “Breastfeeding will increase only when there is control of this industry by the government through laws and regulations which ensure women get the right, scientific information [and when] doctors and hospitals are all ‘baby friendly.’” Governments, citizens, and businesses must not allow the baby-feeding industry to continue its harmful and unethical formula marketing at the cost of innocent lives.

Sharon Craig is a midwife and freelance writer who has worked in Russia, the Philippines, and Afghanistan and is currently based in California.