About Nestles baby food marketing malpractice PowerPoint Presentation

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What is your milk worth? Mike Brady’s Presentation to La Leche League Ireland – 7 March 2010 Campaigns and Networking Coordinator Baby Milk Action [This title slide must be shown if using this presentation] Baby Milk Action is the UK member of the International Baby Food Action Network (IBFAN) Consisting of over 200 groups in more than 100 countries.

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The short answer

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What’s your milk worth? € 130 / litre Price paid by neonatal units in the UK to cover milk bank processing costs A litre goes a long way.

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Normal new-born stomach sizes 22 – 30 ml 44 – 60 ml Source: LLLI

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Chester milk banking conference 5th May 2010 Conference: Donor Breast Milk in the Care of the Neonate www.chestermilkbank.org.uk

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The International Code The aim of the International Code of Marketing of Breastmilk Substitutes is to: “contribute to the provision of safe and adequate nutrition for infants, by the protection and promotion of breast-feeding and by ensuring the proper use of breastmilk substitutes, when these are necessary, on the basis of adequate information and through appropriate marketing and distribution. “

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Baby Feeding Law Group association of breastfeeding mothers, association for improvements in the maternity services, association of radical midwives, baby milk action, (secretariat) best beginnings, breastfeeding community, breastfeeding network, community practitioners and health visitors association, food commission, lactation consultants of great britain, la leche league (gb), little angels, midwives information and resource service, national childbirth trust, royal college of midwives, royal college of nursing, royal college of paediatrics and child health, the baby café, uk association for milk banking, unicef uk baby friendly initiative, unison, women's environmental network.

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Savings to UK health service from breastfeeding Postnatal care: routine postnatal care of women and their babies. Costing report: Implementing NICE guidance in England. London: National Institute for Health and Clinical Excellence; 2006. pp 36. www.nice.org.uk/page.aspx?o=345136 Implementing the Baby Friendly Initiative cost benefits. National Institute of Clinical Excellence (NICE) analysis: “The evaluation assumes that a 10% improvement in initiation rates is a realistic target. “On the basis of medical literature we assume that an increase in the number of babies that breastfeed will lead to a reduction in healthcare expenditure because of avoided cases of otitis media, gastroenteritis and asthma. On the basis of an annual birth rate of 605,634 a 10% improvement in breastfeeding would mean that 60,563 additional babies would be breastfed.”

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Savings to UK health service from breastfeeding Postnatal care: routine postnatal care of women and their babies. Costing report: Implementing NICE guidance in England. London: National Institute for Health and Clinical Excellence; 2006. pp 36. www.nice.org.uk/page.aspx?o=345136 10% improvement in breastfeeding initiation rates. NICE analysis: • about 17,000 cases of otitis media avoided at a saving of £509,000. • almost 3900 cases of gastroenteritis being avoided, at a saving of £2.6 million • over 1500 cases of asthma being avoided, at a saving of £2.6 million. • a reduction in the cost of teats and formula of £102,000 Total £ 5.8 million per year for 3 illnesses

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Breastfeeding saves the US welfare scheme Montgomery DL, Splett PL. “Economic benefit of breast-feeding infants enrolled in WIC.” J Am Diet Assoc 1997 Apr;97(4):379-85 Compared with formula-feeding, breastfeeding each infant enrolled in WIC saved US$478 (€350) in WIC costs and Medicaid expenditures (the US welfare schemes) during the first 6 months of the infant’s life.

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Savings from reduced illness, including NEC Weimer. The economic benefits of breastfeeding: A review and analysis, Food Assistance & Nutrition Research Report No. 13. Wash.D.C., USDA, 2001. The US study found a minimum of $3.6 billion would be saved if breastfeeding was increased from current levels (64 percent in-hospital, 29 percent at 6 months) to those recommended by the U.S. Surgeon General (75 and 50 percent), for each year at the higher rate. Pro rata to the population of Ireland, this equates to € 40 million per year of improved breastfeeding. Figure based on treatment of only three childhood illnesses: otitis media, gastroenteritis, and necrotizing enterocolitis. This does not count the savings of the cost of formula. It does include the loss of earnings of the 720 babies who were estimated to die each year in the US from Necrotizing Enterocolitis who would not have died if breastfed.

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Environmental impact Radford, A. Breastmilk: A world resource. Baby Milk Action, Cambridge, 1991. We recommended the government commission research on environmental impacts of babies not being breastfed – our figures are out of date. There is no food more locally produced and unprocessed than breastmilk. For formula we need to consider: • Methane from cows is a greenhouse gas. Transport and processing impact. • Resources used for packaging: 86,000 tons of tin plate would be used each year if every US baby was formula fed, with 550 million discarded tins (1991 figures). • In 1987, 4.5 million feeding bottles were sold in Pakistan alone. • A formula-fed 3-month old baby requires a litre of water a day for preparing formula and the equivalent of 73 kg of firewood per year, contributing to deforestation in poor countries.

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Baby Feeding Law Group monitoring project

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Bombard mothers - direct mail

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Company claims about LCPs do not stand up Simmer K, Patole S, Rao SC. Longchain polyunsaturated fatty acid supplementation in infants born at term. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD000376. DOI: 10.1002/14651858.CD000376.pub2. Longchain polyunsaturated fatty acid supplementation in infants born at term 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.

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Mothers are misled ‘Myths stop women giving babies the best start in life’ Department of Health survey, May 2004: “Myth: Over a third (34%) of women believe that modern infant formula milks are very similar or the same as breast milk “Fact: Infant formula milk does not contain the antibodies, living cells, enzymes or hormones present in breastmilk. Breastmilk is designed for each individual baby and changes over time whereas infant formula milk is designed for every baby.”

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1.3 million deaths in 42 countries Use my picture if it will help," said this mother at the Children's Hospital, Islamabad, Pakistan. Photo: UNICEF.

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What’s milk worth in a developing country? (How many child deaths can we prevent this year? Lancet, Vol 362, July 5, 2003) Improving breastfeeding rates in the 42 countries where most under-5 deaths occur, could save 1.3 million under-5s every year.

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What’s milk worth in a developing country? (How many child deaths can we prevent this year? Lancet, Vol 362, July 5, 2003) Improving breastfeeding rates in the 42 countries where most under-5 deaths occur, could prevent 13% of those under-5 deaths. That’s more than would be saved by: • universal provision of safe water and sanitation (3%) • universal provision of HIB, Tetanus and Measles vaccines (4%, 2%, 1%). (Combined total 10%) Appropriate introduction of complementary foods could save a further 6%.

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What’s milk worth in a developing country? The Costs of Attaining the Millennium Development Goals, World Bank, accessed March 2010, www.worldbank.org/html/extdr/mdgassessment.pdf The World Bank has estimated that meeting the health Millenium Development Goals of providing universal access to safe water and sanitation by 2015 at € 22 billion per year. Improved breastfeeding could prevent over 4 times as many deaths. Where is the money and support for breastfeeding?

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What’s your milk worth? Global Packaged Food: Market Opportunities for Baby Food to 2013, Euromonitor, 2009, euromonitor.com The retail value of the global baby food market in 2008 according to analysts Euromonitor was € 23 billion. Two-thirds of this is formula, € 15.3 billion. We could reduce this by the formula that is needed for medical reasons, to say € 15 billion for feeding babies who could have been breastfed.

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What’s your milk worth to baby food companies? Global Packaged Food: Market Opportunities for Baby Food to 2013, Euromonitor, 2009, euromonitor.com “The industry is fighting a rearguard action against regulation on a country-by-country basis,”  “Government Regulation a Growing Constraint”. “There are significant international variations in the regulations governing the marketing of milk formula, which are reflected in sales differences across countries.”

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Defending breastfeeding in the Philippines

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Defending breastfeeding in the Philippines “Breastmilk is best” – but Nestogen contains “Brain Building Blocks” These are the LCPs – remember, there is no evidence that adding them to formula benefits babies.

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Defending breastfeeding in the Philippines August 2006: ICDC at ‘What next forum’ organises a letter of support after finding the US Chamber of Commerce is lobbying the President of the Philippines to strike down the milk code regulations (known as the RIRR). September 2006: Philippines groups Arugaan and Piglas ng Kababaihan called for mothers to attend a mass demonstration on 1 September 2006. Over a thousand turned out with decorated umbrellas. Then the rest of the world got involved….

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Defending breastfeeding in the Philippines

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Defending breastfeeding in the Philippines

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Defending breastfeeding in the Philippines

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Defending breastfeeding in the Philippines

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Defending breastfeeding in the Philippines

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Defending breastfeeding in the Philippines

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Defending breastfeeding in the Philippines

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Defending breastfeeding in the Philippines

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Defending breastfeeding in the Philippines

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Defending breastfeeding in the Philippines

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Victory in the Philippines Supreme Court rejects the petition against the Regulations on 9 October 2007. “We are delighted that amidst the many challenges in the past two years to find resolve on this matter, the DOH, along with local and international breastfeeding advocates, like UNICEF Philippines, Save the Babies Coalition led by Arugaan (a Filipino NGO), the World Alliance for Breastfeeding Action (WABA), IBFAN Network, Baby Milk Action UK, La Leche League, and many others remained faithful in their role to protect Philippine children’s health and welfare.” WHO Philippines (Nestlé tried to have the heads of UNICEF and WHO Philippines removed for supporting the campaign)

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What’s your milk worth? Is it worth: • Sending a complaint to the ASA? • Contacting you elected representatives? • Sending advertisements and other promotions to La Leche League Ireland? • Re-starting a Baby Milk Action group in Ireland (contact Baby Milk Action if you are interested info@babymilkaction.org)?

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What’s breastmilk worth? Is it worth: • Supporting the boycott of Nestlé, the worst of the companies? • Writing to Nestlé calling on it to end its latest marketing practice – telling mothers its formula ‘protects’ babies? (Campaigning works – Nestlé refused to translate this label in Malawi, Africa, till our campaign shamed them on UK television).

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The challenge “Ireland is in the unenviable position of having the lowest breastfeeding rates in Europe and this has been the situation for at least two generations. “Currently only about 40% of new mothers in Ireland initiate breastfeeding and many of these cease doing do so before their infants are four months old.” Fallon M, Breastfeeding in Ireland, Department of Health and Children, Accessed March 2010, www.equality.ie/index.asp?docID=586

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The hope La Leche League Ireland exists. You have come to the Conference. You know what your milk is worth!!

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We can help www.babymilkaction.org Coming soon, online training on monitoring the International Code and Resolutions