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The ethics of marketing baby milk formula in developing nations

Breastmilk is a natural, safe and free human product. As Gabrielle Palmer explains, "Lactation is the very core of our identity…we call ourselves after the mammary gland, 'mammals'—animals that suckle their young." Breastfeeding has been seen by millions of mothers, in all societies throughout history, as a natural extension to the process of pregnancy and birth. A baby is born expecting to suckle, and a labouring mother will naturally produce milk in anticipation of this. Breastfeeding creates a strong maternal bond between mother and child, and it is designed to protect the baby against a number of conditions such as pneumonia and diabetes. Breastfeeding is a skill that needs to be learned, yet no woman is naturally unable to do it. Some have problems producing enough milk, some suffer from feelings of awkwardness or sore breasts. But with a little guidance and encouragement, any child can be nursed naturally.

Even undernourished mothers can breastfeed successfully, and as yet, there is little evidence to suggest that the HIV virus is automatically passed on via breastmilk. Women who breastfeed are themselves given greater protection against breast and ovarian cancers. Breastfeeding also acts as a natural form of birth control. If many more women in developing nations were able to nurse their babies naturally, then maybe some of the problem population and resulting infant mortality rates might fall.

Before the medicalization of childbirth in the Western world—a model that, through globalization, is now being exported to all countries—nursing one's child was universally and socially acceptable. Now, however, various factors of modern society have effected a change in this notion. The sexualization of the female breast into an object of desire has subverted attention from its natural, intended function, and makes many women feel nervous and awkward about nursing, as well as attaching a taboo toward nursing in any public spaces. Medical staff in modern western hospitals do not have the time, the training or the resources to teach new mothers how to breastfeed. If it doesn't quite work at the first attempt, the mother is made to feel that she 'cannot' nurse her baby, and that infant formula is the obvious alternative. However, this product is derived from cow's milk, which is not designed for humans. While it can supplement the diet of a hungry baby, or help a working mother during the day, it should not be marketed as an option that can replace breastmilk entirely. With many mothers returning to work, the formula manufacturers are only to quick to convince them that it is so much easier and more convenient to use formula. The methods of expressing and storing breastmilk are barely mentioned in this era.

In developing nations, the arena of breastfeeding is a very sad, uneducated one. The large, powerful multinationals that control the world's infant formula market take every advantage of the poor and uneducated in order to increase their own profits. Companies such as Nestle, Cow and Gate, and to a lesser extent American Home Products aggressively promote the use of infant formula over breastmilk in the second and third worlds. This increases their own profits—but at the cost of many babies' lives, families' incomes and the natural traditions of suckling which have survived centuries, untouched, until now. The World Health Organization has a marketing code, endorsed by UNICEF and the UNHCR, which bans all promotion of babymilk—both through advertising and indirectly, through healthworkers and midwives, but these powerful companies pay little more than lip service to it. In the developing world, one baby dies every 30 seconds from unsafe bottle-feeding . This is due to the policies of Nestle in particular, which controls about 40% of the worldwide infant formula market and is at present the target of a boycott because of its "unethical and irresponsible marketing of breastmilk substitutes."

Nestle sends its representatives to developing countries, dressed in white so as to appear as 'knowledgeable' medical personnel. They give free samples of formula to hospitals and health workers. As the process of birth is moving from the traditional home and family environment into the increasingly medicalized, western arena, so millions of mothers are at the mercy of the staff they encounter. Nestle gives gifts and incentives to local health officials, as encouragement in promoting their products, and therefore discouraging breastfeeding. Representatives from the charity Baby Milk Action heard Nestle employees telling midwives in Africa that "all Western women use formula to feed their babies, so that they grow up big and strong."

They also found posters advertising Nestle formula on the walls of clinics in South America, and advertisements promoting formula in a national parenting magazine in India. What these companies fail to do, however, is to provide adequate information about formula feeding. The women are in no way given the unbiased and adequate information that the WHO code requires, for them to be able to make informed choices. Nestle and the other companies do not teach these women about sterilizing the bottles they use, and they provide no resources with which to do this. The mothers then use dirty water mixed with formula, which causes severe diarrhoea and dehydration in the babies, which kills them. The formula also does not provide the same natural immunization against other diseases that breastmilk does.

After the newborns have become dependent on formula as their sole source of nutrition, and the mother's milk has dried up through lack of demand, the free samples stop coming. At this point, the mother is told that she will have to pay almost western prices for cans of infant formula to feed her baby. The vast majority of families in the developing world cannot afford this. They either go without food themselves to feed the baby, or mothers will over-dilute the powder to make it last longer. This causes severe malnourishment, and often loss of life, for the baby. The WHO code also requires that labels on formula products are in the appropriate language. Many of Nestle's exported cans carry information written in English, rather than the local language. In addition, many of the mothers that are targeted are illiterate, and so depend on others - their health workers - to tell them about how to best feed their babies.

Nestle's own Infant Formula Charter, which is available on the company website, claims to follow the International Code, but the examples I have given are just a few of the ways in which Nestle's so-called "charter" fails even itself. They are now even using the Internet, a truly global medium, to actively promote the use of infant formula—as opposed to breast milk. True, they are a company trying to make as healthy a profit as possible, they give away many generous donations annually to charities and non-profit organizations, they appear to treat their employees well, and they do have a very comprehensive, and informative website. They are effective at creating, and maintaining jobs—something western society always needs more of—but is this justification for the brainwashing of millions of poor, vulnerable and uneducated mothers who have just as much right to raise their children in a safe and healthy manner as we do, and for the many, many infant deaths which occur as a result of profit-hungry western businesses?

[ Posted by Megan Fisher at June 1, 2001 10:04 AM | More Opinion articles ]

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