1	THE VICTIMS

...From Papua New Guinea
The country introduced legislation to protect breastfeeding in 1 977. As the numbers of bottlefed babies decreased, so did the numbers of malnourished babies under years old.

Of the babies in 1976 found to be bottlefeeding, 69% were malnourished. Of the breastfed babies in the same survey, 26% were malnourished. The decrease in bottlefeeding by 1979 brings a corresponding decrease in malnutrition.

Source: J. Bidduiph, Professor Child Health
Advances in International Mother and Child Care 1980

... From Egypt
• Babies breastfed for 15-20 months have a 93% survival probabilility

• For babies fed only on the bottle the figure is 64%

So the difference in the mortality rate of babies breastfed only fori 5-20 months and babies bottlefed only, is a staggering 290 per 1000 live births.

Source: Journal of Biosocial Science 1981

... From Britain
Even in the developed world breastfed babies can be healthier. Of 608 infants treated for gastro-enteritis at The Queen Elizabeth Hospital. London, only 2 were breastfed.

Source: FUi Medical Journal

... From Brazil
A government sponsored study in Sao Paulo, published in April 1 980, measured malnourishment among pre-school children of poor parents.

• Among the children who had been bottlefed, 32% were malnourished. Among the children who had been breastfed for six months only 9% were malnourished

• Of the infant deaths reported in the study, all had been bottlefed in the first month of their life and half had been put on the bottle in the first week

... From the Philippines
A four-year study involving 10,000 infants at Baguio General Hospital was presented to the 1 978 US Senate Hearings. Changes in hospital practice away from routines involving bottlefed and towards routines encouraging breastfeeding brought about dramatic changes.

• Mothers and babies were put together immediately after birth

• No bottle feeding was permitted

• Pro-artificial milk posters were replaced by pro-breastfeeding posters on the clinic walls

In turn there was a marked increase in baby health.

• Baby deaths decreased by 45%

• Diarrhoea in newborns decreased by 78%

2	SO MANY REASONS WHY
A Third World mother who bottle-feeds can face an almost impossible task in preparing a germ-free solution for her baby. She must:

• Fetch firewood or charcoal to make a fire

and then...
• Fetch water, perhaps stored in a dirty pond or a rusty barrel and almost certainly polluted

and then...
• Use up precious fuel by boiling artificial feeding paraphernalia for 10 minutes minimum. A bit much to expect, several times every day

and then...
• Find a clean surface on which to place boiled paraphernalia

and then...
• Figure out instructions on milk tin label — not easy for illiterate parents

and then...
• Resist temptation to over-dilute mixture, although artificial milk is very expensive. If the child is weak or sick, mother often believes mixture ‘too rich’ and dilutes it further

and then...
• Organise more boiled water to mix feed (time-and fuel-consuming again)

and then...
• Cool the mixture — resisting temptation to cool by pouring from one unsterile container to another

and then...
• Ready at last After all this effort the mixture is too precious to discard. Leftovers are kept for a later feed, allowing bacteria to flourish in the milk.

3	THE EVIDENCE

1950-1970
Warning voices of health professionals and nutritionists against the triumphant advance of the bottle largely ignored.

1970
First meeting between health professionals and the babymilk industry held in Colombia, under the auspices of UNICEF and the Pan-American Health Organization.

1972
United Nations Protein-Calorie Group emphasise ‘the critical importance of breast-feeding in developing countries’.

1973
The New Internationalist first exposes unethical artifical babymilk promotion and the connection with malnutrition to the general public. Statements by Drs. Hendricks and Morley.

1974
War on Want follow up with their report The Baby Killer.

‘Nestlé Kills Babies’ is the title of the Swiss Third World Action Group of The Baby Killer. Nestlé sues the Group for defamation.

World Health Assembly adopt a resolution recommending member states to promote breastfeeding and cut publicity for artificial babymilk — including the adoption of marketing codes.

US Consumers Union provides further evidence of the dangers of bottle- feeding.

US church-based groups undertake research nto US artificial babymilk companies and strongly criticise their marketing practices.

The mid 1970s
Criticism within professional medical circles ncreases but the only response from companes is unfulfilled declarations of intent At the same time promotional activity is stepped up.

November 1975
Nestlé case opens in November and arouses great interest around the world. Babymilk companies create International Council of nfant Food Industries (ICIFI) a few days )efore trial and issue a vague ‘Code of Ethics’.

1976
US Court submission by Sisters of the Precious Blood documenting their charge that Bristol Myers babymilk company promote their products where chronic poverty or ignorance could lead to misuse.

1977
Infant Formula Action Coalition (INFACT) formed to change the practices of Nestlé and US babymilk companies. Nestlé Boycott launched

1978
US Senate hearings on babymilk sales in Third World directed by Senator Kennedy prompts the World Health Organization to call an international meeting.

1979
WHO and UNICEF jointly organise an October conference in Geneva on infant feeding attended by representatives from governments, the babyfood industry and. action groups. The babymilk manufacturers publicly accept joint recommendations, including:

• prohibition of promotion to public
• proposal for international marketing code of ethics.

International Baby Food Action Network (IBFAN) created. They document over 1000 violations of the October 1979 agreement.

4	THE VERDICT
FROM THE WORLD HEALTH ASSEMBLY (1981)

The World Health Assembly (the governing body of the World Health Organisation) after listening to the evidence accepts by 118 votes to 1 the International Code for the Marketing of Breastmilk substitutes.

The WHO Code DOES call on governments to:

1. Halt all advertising and promotion of artificial babymilks to the public.

2. Halt the distribution of free milk samples (long-term supplies in specific cases of medical need are permitted).

3.Prohibit ‘mother-craft nurses’ (company personnel acting as health educators). No facility of a health care system to be used to promote breastmilk substitutes.

4.Restrict industry gifts to health workers.

5.Require improved labelling to emphasise the importance of breastfeeding and the hazards of artificial feeding.

The WHO Code DOES NOT:

1 .Ban the use of artificial babymilk, or even its sale, to the public.

2.Prohibit industry from informing the medical profession about their products.

3. Apply only to the Third World, since the benefits of breastfeeding should accrue to all children.

4. Contravene national sovereignty individual countries must enact their own legislation to make the WHO Code law.