This is one of a series of posts that features Nestle’s answers to my questions that came out of the Nestle Family event. To access the other questions and answers, go to follow-up questions for Nestle and click on the questions you are interested in. Answers will be posted as they are received and analyzed.

Questions

1. When meeting with bloggers, you characterized your 1-800-4Gerber line as a breastfeeding support line. Is that number just for breastfeeding support? If not, what is the scope of that phone line?

2. What are the qualifications of the staff that work on your 1-800-4Gerber help line? What percentage of them are International Board Certified Lactation Consultants?

3. Do you have any statistics on your 1-800-4Gerber help line? (e.g. how many calls? nature of questions asked? recommendations given?)

Nestle’s Answers

Our trained experts are able to discuss a wide variety of topics with both new and experienced moms that include a wide array of questions ranging from breastfeeding to infant, toddler and preschooler feeding and nutrition questions. We help provide parents and caregivers with answers to the nutritional needs of children aged up to age 4. Parents are able to reach us 24 hours a day 7 days a week and help is always available.

The contact center for Nestle Infant Nutrition has a staff of feeding experts including registered dietitians and breastfeeding educators. All registered Nestlé Infant Nutrition call center dietitians are members of the American Dietetic Association (ADA) and have an average of ten years of experience in Pediatric Nutrition. Our Breastfeeding Educators have completed their certification requirements through UCLA (University of California, Los Angeles UCLA Extension) and The Lactation Institute. The program provides both comprehensive “hands-on” and theoretical training. The length of the time it takes to complete the program varies, as is the case with many educational endeavors, however certification is granted only when all requirements for certification have been met. Our breastfeeding educators are not board certified by IBCLC.

Our trained experts are able to discuss a wide variety of topics with both new and experienced moms that include a wide array of questions ranging from breastfeeding to infant, toddler and preschooler feeding and nutrition questions. We help provide parents and caregivers with answers to the nutritional needs of children aged up to age 4. Parents are able to reach us 24 hours a day 7 days a week. We never close. We are the only infant nutrition company who is always there for mom and her baby 24/7/365. Regarding the specific questions about the exact number of contacts, we treat this and any other sensitive information as confidential.

My Response

When Nestle met with the bloggers at the Nestle Family event, they stated that they are pro-breastfeeding and that they have a 24-hour breastfeeding helpline at 1-800-4Gerber.

My initial thoughts were:

• Who would call a formula company for breastfeeding help? Really. That is like calling a pig farmer for vegetarianism support. Or as one commenter on another post said, calling a tobacco company for help quitting smoking. It just doesn’t make sense. Yet Nestle says it has a 24-hour breastfeeding support line and many other formula companies actively buy keywords like “breastfeeding help” and “breastfeeding support”.

• With “4Gerber” in the phone number, could this really be a breastfeeding support line? Gerber offers a variety of baby products and it didn’t seem logical to me that the same people who would be answering questions about spoons, toddler snack food and bath products would be giving breastfeeding help.

So I wanted to learn more about who was actually tending the phone lines and whether they actually get any breastfeeding questions.

The People Providing Nestle Breastfeeding Support

With regards to the qualifications of their staff, they rattled off a bunch of impressive sounding stuff:

• Call center dietitians are members of the American Dietetic Association (ADA) and have an average of ten years of experience in Pediatric Nutrition.

Good. I hope the ADA members take note of the updated ADA position paper on breastfeeding, in particular the parts about the increased risk of acute and chronic illnesses as a result of not breastfeeding and the fact that real support for breastfeeding is critical. That said, being an ADA member and understanding the importance of breastfeeding does not make one qualified to give breastfeeding advice.

• Our Breastfeeding Educators have completed their certification requirements through UCLA (University of California, Los Angeles UCLA Extension) and The Lactation Institute. The program provides both comprehensive “hands-on” and theoretical training.

The UCLA Lactation Educator Training Program is a one-week (5 day) breastfeeding training course. That is better than nothing, but I would not characterize it as comprehensive. It does not compare with the minimum of 900 hours working directly with breastfeeding mothers and rigorous examination process required to be certified as an International Board Certified Lactation Consultant.

• Our breastfeeding educators are not board certified by IBCLC.

This last point is not as impressive, but somewhat self evident. None of their breastfeeding educators are International Board Certified Lactation Consultants (IBCLC). Do you know why? Because their Code of Ethics would prevent them from working for a formula company. Some of the clauses in their Code that would make it impossible to work for a formula company include:

Remain free of conflict of interest while fulfilling the objectives and maintaining the integrity of the lactation consultant profession.

Disclose any financial or other conflicts of interest in relevant organizations providing goods or services. Ensure that professional judgment is not influenced by any commercial considerations.

So Nestle can take people that it has hired and give them some breastfeeding training, but it cannot hire real breastfeeding professionals because it would be unethical for them to work for a formula company.

Number and Nature of Calls Received

On the second point regarding the number and nature of calls received, they didn’t answer the question. Nestle called it sensitive and confidential. I wasn’t asking for specific names and phone number of the people who called. I was asking for statistics on those calls. Maybe it is sensitive and confidential because the number of breastfeeding questions received were very few to none, which would discredit the phone line’s role as a 24-hour breastfeeding support line. If that is the case, I’m thrilled. It means people are smart enough not to call Nestle with their breastfeeding questions.

My guess, in absence of any data, is that they rightfully probably get a lot more phone calls from people who have formula questions than from people who have breastfeeding questions. Which is good in one way – I don’t think Nestle is the place to get breastfeeding advice. But it is also bad, in that the five day training that their breastfeeding counselors received could get pretty stale pretty quickly if they are not putting it to use regularly. A lactation consultant or breastfeeding counselor who sees people with breastfeeding questions every day is going to have a much fresher memory of breastfeeding knowledge and also be able to learn from the experience of working with so many women.

How is the Breastfeeding Help?

I tried to call the 1-800-4Gerber phone number from here (Canada) and it worked, but got me just to a call centre for information and advice on Gerber products with three options that had nothing to do with breastfeeding. So asked a friend, Danielle Friedland, who also happens to be a Certified Lactation Counselor to give them a call. She ended up calling them twice.

• Call 1: Do I need to supplement? Danielle called them during the day on a weekday about her 4 week old baby. She said that her baby was fussy after nursing on both breasts. She said that her mom said the  baby looked hungry and that she should give a bottle. The woman responded that sometimes it is not hunger, she may want to suck and may need a pacifier if she is a little fussy. She also said that grandmas always think the baby is hungry if she is fussing. She also said that as long as the baby is eating every 2 to 2.5 hours, having wet/poopy diapers, then it is fine. Danielle then asked: “So when should I start giving formula? My mom said to give formula by six months”. The Nestle woman responded that you don’t ever have to give formula and that breastmilk can be the whole source of nutrition for the ifrst year. She said that some moms supplement if they go out, but it can be pumped breastmilk. Then she finished with the soft marketing pitch…if you do want to give formula, Good Start is 100% whey protein, same breakdown in the tummy as breastmilk, etc.

• Call 2: How often to feed baby? Danielle called again on a weekend during the day and asked how many times per day she should be feeding her baby. The woman who answered the phone asked how much she was giving the baby. Danielle said that she didn’t know because she was breastfeeding and said she was nursing her 2 week old baby every 4 hours (**which we know is not often enough**). The woman said she has info for formula fed babies only and put Danielle on hold to get the information. When she came back, she said Danielle should be feeding 8 to 10 times per day but that she didn’t have to wake him if he was sleeping. She asked for Danielle’s contact information and said that a Certified Lactation Educator would call her back. Danielle said “oh, you’re not a lactation person – my friend said she called the number to get breastfeeding help”. The woman said “no, but they are available 24 hours per day”. Danielle said “but not now?”. The woman said they would call her back within an hour. Danielle didn’t want to give her phone number, so she said she had to go.

All in all, the breastfeeding help was not awful. A lot of the information was accurate. But in the first call there were certainly things that you wouldn’t hear from La Leche League (like suggesting a pacifier, or talking about the benefits of formula) and the depth of the breastfeeding advice is certainly also questionable (not probing further for reasons that the baby might be fussy such as oversupply and in the second call not having someone on hand to answer the breastfeeding questions). While these were just two examples, I expect that on the whole, the phone help is probably quite similar to Nestle’s Web help that was documented in my recent guest post by @Artemnesia called Helping Themselves: Breastfeeding Advice Nestle Style, which documented specifically a number of ways that Nestle tries to undermine a mother’s confidence in her ability to breastfeed.

What should Nestle do?

I don’t think Nestle or other formula manufacturers should be providing breastfeeding advice. I think at the most they should refer mothers to reputable organizations or websites that can assist them, like La Leche League or seeing an International Board Certified Lactation Consultant. In an ideal world, perhaps Nestle would contribute financially to breastfeeding promotion through independent organizations, but in reality I think most breastfeeding advocacy organizations would turn down money from Nestle due to the potential conflict of interest (e.g. pressure to downplay the risks of formula, pressure to recommend Nestle as the best alternative when supplementing is necessary, etc.).

So, I think Nestle should focus on the societal barriers to breastfeeding that it can directly do something about. By eliminating any marketing of formula, Nestle can:

• Ensure that mothers are not exposed to formula advertising and formula samples.
• Ensure that medical professionals are not courted and used as an indirect means of marketing to mothers.
• Lobby the government and insurance companies to make access to lactation consultants and breast pumps easy and free.
• Eliminate any Nestle imagery that includes babies using bottles in order to reduce the preponderance of bottle imagery.

But I doubt that will happen. Because in its answer to @MediaMum, Nestle could only name medical reasons for low breastfeeding rates in the United States. The barriers to breastfeeding are not just medical. In fact only a small number of women face true medical issues that prevent them from breastfeeding. Most of them face societal barriers, many of which are facilitated by the actions of formula companies like Nestle.

Thank you to A Mother in Israel and That Danielle for their input into this post. Photo credit: Blogpocket on flickr

This is a guest post by Erin, a breastfeeding counselor who teaches women how to succeed at breastfeeding. This post is a reflection of her opinion on Nestle’s breastfeeding advice. Read what follows and decide for yourself what the company’s true intentions are.

Why would the world’s largest infant formula company want to help mothers breastfeed? Huge spoiler ahead. Ready? They don’t. Yes, Nestle runs a glossy US website called the Start Healthy Stay Healthy Resource Center which claims that it gives expert advice about infant nutrition. Yes, the website’s informational section on breastfeeding is actually larger than the corresponding section on formula feeding. And yes, of course, some of the advice is accurate. It has to be. If they gave nothing but blatantly bogus information that would look pretty bad and a certain level of credibility is essential. Instead, the advice is misleading and manipulative in subtle ways. The “why” part should go without saying; if they can turn a mother who plans to breastfeed (as the majority do these days) into a mother who feeds her baby Good Start, they have just earned thousands of dollars. Switzerland is not in fact neutral.

Confident commitment before initiation is important to breastfeeding success. If a mother’s desire to nurse her baby, her trust in the process, or her confidence in her own abilities can be eroded then that is a win for Big Formula. Take a look at the pages that follow and you will see that those are precisely the types of subliminal messages (breastfeeding is difficult, painful, icky, and unnecessary) in Nestle’s breastfeeding information. I have provided screen captures after the links for readers outside the US who may not be able to access the website. (Clicking the photos again will make them large enough to read, by the way.)

• Breastfeeding accessories (screen capture) This page is bound to get traffic since shopping for a new baby is perennially popular. According to Nestle, a nursing bra is “designed to let you inconspicuously open a cup to expose a breast for your baby.” That’s right– if you want to breastfeed you’re going to have to expose yourself to your child (who incidentally wants “easy access“) while trying to hide the fact. Pervert! Anyway so, oh yeah, you wanted something to put on your gift registry? How about some special (read: weird) nursing clothes. More “oversize shirts with buttons down the front” are going to sound awesome to women who have been stuck in maternity clothes for months.

• Nutritious choices for breastfeeding moms (screen capture) Wait, what, you thought you were going to be able to eat? Make sure that pasta is “lightly sauced” and have some more vegetables with your vegetables. This reinforces the myth that a mother has to be really careful about what she eats while breastfeeding, which in turn makes nursing seem like an ideal that is probably unattainable for the average mother. Sure it’s a great idea for everyone to eat healthier, including nursing mothers, but this page is conspicuously lacking one important fact: what a mother eats usually has zero effect on the quality of her milk.

• Feeding on the road: safe and simple (screen capture) This page is supposed to describe how to feed your baby on the go. Hmmm…something is missing…can’t quite put my finger on it. Hey, wait, aren’t we still in the breastfeeding section?

• Breastfeeding problems and solutions (screen capture, screen capture) There is no mention of colostrum in the section titled “Understanding your lactating breasts.” From reading that someone might think that it could be up to 6 days before there is anything for the baby to eat. And how about the description of the milk coming in? Pain in the mother’s breasts and the baby having a hard time latching are emphasized. Then in case you missed the part about the pain they’ve got “chapped or tender nipples” next in bold. The information given on how to deal with that is flat-out wrong; “lanolin-free moisturizing balms” are not recommended and hydrogel patches are controversial. Next up is “inflamed milk ducts.” Huh? I think they mean “blocked ducts” there. If they were a bigger, richer, more powerful company maybe they could Google the proper term. Or, maybe “inflamed” sounds more painful. To “feed a baby right,” Nestle then tells you, it necessary to make sure your nipple is “covered almost completely by the baby’s mouth, with her tongue on the underside of your nipple.” Poorly written, details and phrasing chosen for creep-factor, and last but not least totally wrong. If your baby doesn’t have the entire nipple far back in her mouth, as well as a good portion of areola, you are going to have some serious pain as well as a baby who cannot get milk from your breasts. In closing, they advise that you should “pay attention to your milk supply” and that fatigue can reduce it. That’s okay though because no new mom is fatigued, right?

• Solve breastfeeding dilemmas (screen capture, screen capture) You supposedly learned how to solve breastfeeding problems so now you can move on to the dilemmas. Nipple confusion, they say, happens because the bottle is “easier” for the baby and apparently can be avoided by not giving bottles “during the first week.” Then a few sentences later it says to wait three weeks. Oh hell, it sounds like one week is probaby good enough, right? The sooner the better since this breastfeeding stuff is so garbled and confusing. For latch on problems, make sure your baby is taking in “approximately one inch from the tip of your nipple.” Which is unlikely to be a deep enough latch and certainly won’t solve any existing problem.

• When your baby loses interest in breastfeeding (screen capture) Even if your baby is only 3 months old, a nursing strike might mean that “she’s ready to give up nursing.” No, wrong answer, but it plays right into the hope that just a little bit of breastfeeding is enough (surely if baby herself is ready to stop there is no harm) and transforms normal occurences like temporary disinterest into pseudo-self weaning.

• Why breastfeeding is best (screen capture) By this time maybe the resolve to breastfeed is beginning to waver. Why would anyone undertake such a confusing, embarassing, inconvenient sacrifice? Surely reading about why breastfeeding is “best” will affirm that choice. Well, it says here that breastmilk “contains the perfect balance of nutrients including DHA & ARA.” It is also “naturally gentle on baby’s developing digestive system.” Furthermore it “contains antibodies to help protect your baby from illness.” That sounds kind of good. But the language sort of rings a bell. Let’s check the description of Nestle Good Start Protect Plus. (screen capture, screen capture) This stuff has “complete nutrition,” “DHA & ARA for baby’s brain and eye development,” is “easy to digest” and it “supports baby’s healthy immune system.” Wow that’s almost exactly the same! (Except, of course, it isn’t. Not even close.)

Have you come to your senses yet, new mothers? If so, then it’s time to either start supplementing your breastmilk (screen shot) or you might want to just go ahead and transition to formula (screen shot). Nestle treats these two situations as different events even though they usually aren’t. There is no mention of milk supply dropping when supplements are introduced. Any doubts you might have about whether or not this is the right thing to do should be soothed by the assurance that formula could be a “nourishing, nurturing choice for your baby” as well as the helpful transitioning chart, where formula feedings are represented by cute little red hearts that multiply and breastfeedings are the faded blue dots getting nudged off the edge.

You may have noticed that in multiple places these marketing materials (we can stop playing along by calling them breastfeeding information) carry disclaimers. This is one crops up frequently: “Breastmilk is the ideal food for babies. Talk with your doctor about your feeding choices.” For an explanation of why “ideal” is a description of human milk that is ineffective in terms of breastfeeding promotion, check out this classic piece by Diane Weissinger called Watch Your Language. As for the second part about looking to your doctor for guidance, although many health organizations worldwide have very strongly worded recommendations to breastfeed, unfortunately doctors in America don’t necessarily recommend it to their patients. In fact, according to the American Academy of Pediatrics, “Obstacles to initiation and continuation of breastfeeding include…lack of encouragement and guidance from health care professionals.” The disclaimer is probably there at least in part for legal purposes; the company needs to avoid looking as if it is giving out medical advice. But really why wouldn’t Nestle spam this disclaimer all over the place anyway? It makes them look more honest and credible while risking little or nothing. Maybe even gaining.

There is, however, a disclaimer on the site that they probably benefit less from. Not coincidentally it is a little more difficult to find. After trumpeting all over the website that breastmilk has DHA and ARA but so does formula, they quietly admit in the fine print at the bottom of this page that “studies to date have not established brain and eye development like breastmilk based on the levels of DHA and ARA added to infant formula.” Surprisingly, US FDA regulations do not require novel ingredients like these new oils (which are chemically extracted from algae, by the way) to prove their usefulness before being added to an infant formula. If formula companies wanted to, they could throw some blue food coloring into their recipe. Why not. It’s a food product that has “GRAS” (generally recognized as safe) status according to the government. That might be a good idea actually; since human milk often has a slightly blue hue, this new and improved formula could then be marketed as “closer than ever to breastmilk.” If you think that’s way over the top, read this document from the California WIC Association about the lengths that formula manufacturers will go to increase their profits, and also this report from the Cornucopia Institute, a food safety watchdog group.

So, should Nestle revise the faux “breastfeeding advice” given on their website? Should they post links to La Leche League International instead? Or should they remove all mention of breastfeeding and just stick to formula? No. None of those options would be the ethically and morally correct course of action for the company to take. They should delete the entire website. All advertising or promotion of infant formula to the general public is forbidden by the International Code for the Marketing of Breastmilk Substitutes (Article 5.1) and furthermore marketing personnel are not permitted to seek contact of any kind with pregnant women or mothers of young children (Article 5.5.) Within the gigantic and blatant violation that is the “Start Healthy Stay Healthy Resource Center” are many more transgressions, such as idealizing artificial feeding (Article 4.2.) Essentially the company breaks every rule that it possibly can ands get away with it because in the United States there are no legal repercussions for doing it.

If any of this makes you angry, and you live in the US, take action. One quick and easy thing you can do is to file a complaint with the FTC online. Companies aren’t supposed to advertise in a way that is false and deceptive. If anyone comes away from that website thinking that any formula is similar to breastmilk then they have been misled. Each time the advertisement is seen it’s a separate violation, so go ahead and bookmark that page. The next thing you can do is to contact Congress. Tell your state Representatives and Senators that you want the Code put into law, in its entirety, so that companies are forced to start honoring it. You may also want to consider joining the Nestle boycott. Speaking to the company in the language they understand, in other words money, is probably the best hope outside legislation for creating change. Finally, perhaps the most important thing we can do is to spread the truth about infant feeding and to reach out and help other mothers whenever possible. Propaganda like we’ve just seen can only be taken seriously enough to do harm in a world where a motley mixture of myth, advertising copy and wishful thinking is routinely allowed to pass as fact.

Note from Annie (PhD in Parenting): If you are in Canada, you may wish to read up on Misleading Representations and Deceptive Marketing Practices and consider filing a complaint with the Competition Bureau.

Erin (@Artemnesia) is a breastfeeding counselor from central Massachusetts.  When she isn’t busy kissing boo-boos and nursing in public, she may be found playing no-limit Texas hold’em online. She isn’t a blogger yet, but is thinking of it…would you all give her some encouragement?

As a blogger on Moms Rising, I feel it is important to raise awareness about issues of importance to women and mothers and to ensure that our voices are heard. Although this one doesn’t affect me specifically as a Canadian, I know many of my readers are Americans. Please watch this video and raise your voice on this issue. We need to be heard.

Today I read a post by@curiousdad on his blog over at the Vancouver Sun. He wrote H1N1 flu vaccine: What the skeptics aren’t telling you. In his post he outlines a case for getting the vaccine and especially for getting your kids vaccinated. His post starts out with:

As the H1N1 vaccine starts to become available across the country, it seems like everywhere I turn there’s someone telling me they’re not going to get it — whether it’s friends on Facebook, people on the street or even a columnist in my own paper.

When this happens, I try to be polite and not say anything. After all, everyone has the right to make their own decision about whether to get the vaccine or not. And, if polls are to be believed, those forgoing the vaccine have plenty of company.

But what I really want to say — what would come out of my mouth if I didn’t always bite my tongue quick enough — is this: Are you an idiot?

The evidence in favour of the flu vaccine (much as with routine childhood vaccinations) is so overwhelming and clear that getting the vaccine — and making sure your children get it — seems about as clear and straightforward as buckling up before you go for a drive.

He goes on to explain a number of reasons for getting the vaccine, to express dismay at the natural parenting community who try to avoid dangerous chemicals in their food and personal use products, but that would be willing to let their children be exposed to H1N1.  He ends with his strong disapproval of parents who refused to get their kids vaccinated:

It’s one thing to decide not to get the vaccine yourself. But with evidence mounting that kids are particularly vulnerable to this flu strain, not getting them vaccinated, in my view, borders on negligence — no different than failing to buckle them up in the car or put a safety gate across your stairs.

Sounds straight forward right? Perhaps, if you are only listening to certain sources.

My reply

My quick response to him turned out to be quite lengthy. It is not as well articulated perhaps as I usually like my posts to be, but since I went to the trouble of writing it I thought I would share it here too:

There are some very well respected doctors and pediatricians that are questioning the safety of the vaccine and the degree of panic around H1N1, including Dr. Jay Gordon and Dr. Bob Sears. Do their opinions count less than your average family doctor in Canada who is pushing the vaccine? Unlike my doctor who shows up at work, does what the Canadian Pediatric Society tells her to do, and maybe does a bit of continuing education here and there, Dr. Gordon and Dr. Sears and others actively analyze and research these issues.

I’m still on the fence about whether to get the vaccine or not. Also, it isn’t available yet in my area. Not for priority groups, not for the general population. From that perspective we have both (a) the risk of getting H1N1 because we don’t have access to the vaccine and (b) the opportunity to watch and see a bit with regards to any adverse reactions to the vaccine in the areas that have been first to receive the vaccine. The PHAC has promised weekly reports on adverse reactions to the vaccine on fightflu.ca and I am checking each day to see if the first one has been released.

In the meantime, we are taking precautions to try to limit our chances of getting H1N1 and spreading it to others. If we are sick, we stay home. We wash our hands frequently, cough into our sleeves, etc. We are taking significant amounts of Vitamin D. I am taking 5000 IU myself and giving between 1000 IU and 2000 IU per day to the kids. Personally, I feel like taking these types of precautions is likely to be better protection from H1N1 than being put in a crammed enclosed space for 7 hours with a bunch of potentially infected people waiting to get the vaccine. I hope that by the time the vaccine is available in my area they will be taking appointments by phone (like they are in Sault Ste Marie, Ontario) so that people are not exposed to those ridiculous conditions (because the vaccine isn’t immediately effective after getting it, so you can get sick waiting in that stupid line).

Finally, there are vaccines out there that have been approved and later removed from the market when it was discovered that they were causing serious adverse effects that went undetected in testing. That is in vaccines that were thoroughly tested, unlike the H1N1 vaccine which has not been properly tested on children, pregnant women, etc. Don’t believe me? Look up rota virus, which in the United States annually sickens about 2.7 million children younger than five, sends up to 70,000 to the hospital and causes 20 to 70 deaths.  One vaccine was pulled from the market in 1999 and another one later introduced has significant concerns/adverse effects. My son was hospitalized for rota virus. It sucked. It was scary. But I’m glad he didn’t have the vaccine.

I am on the fence, but leaning towards getting the H1N1 vaccine for my kids and for myself. However, I think it is smart to:

• ask questions about vaccine safety
• to insist on seeing the weekly reports on adverse affects that the Canadian government promised but that have not materialized yet (especially in the absence of real safety tests )
• to do more to protect yourself than getting into a panicked frenzy about vaccine availability

Sticks and stones may break my bones, but being called an idiot won’t bully me into not questioning things.

This is one of a series of posts that features Nestle’s answers to my questions that came out of the Nestle Family event. To access the other questions and answers, go to follow-up questions for Nestle and click on the questions you are interested in. Answers will be posted as they are received and analyzed.

Question

You say that you comply with the WHO International Code of Marketing of Breast-Milk Substitutes in all countries that have adopted the code. Canada is a signatory to the Code and the Canadian government actively encourages companies to comply with it. However, despite Canada being a signatory to the Code, you do not comply with the code in Canada. When you say “adopted” is it fair to assume then that you mean “legislated” and that you will not comply with a developed country’s will unless it puts regulations in place to force you to?

Nestle’s Answer

The WHO Code was adopted by the WHO Member States as a recommendation to governments, which are required to implement the Code as appropriate to their social end legislative framework. Nestlé universally follows all countries’ implementation of the WHO Code. [emphasis mine]

In addition, Nestlé decided over two decades ago to voluntarily and unilaterally apply the WHO Code in all developing countries, whether or not they have implemented it in their own legislative framework. If the local legislation is stricter than the Code, we apply local legislation.

My Response

On September 30, in response to a tweet by @momslant from The Mom Slant, Nestle Family said:

There is some hair splitting going on here. Canada is a signatory to the WHO International Code of Marketing of Breast-Milk Substitutes. In my mind, becoming a signatory means the same thing as adopting. The Canadian government put its signature on the dotted line and said this is something we support. Nestle on the other hand obviously has a different definition of adopt. In its answer above Nestle is essentially saying being a signatory to the WHO International Code of Marketing of Breast-Milk Substitutes means nothing. Nestle will do whatever they want unless a country uses legal means to force them to comply with the code. Let me explain…

The responsibility of governments

As Nestle states in its answer, the WHO code does put some responsibility on governments.Article 11.1 of the WHO International Code of Marketing of Breast-Milk Substitutes states that:

Governments should take action to give effect to the principles and aim of this Code, as appropriate to their social and legislative framework, including the adoption of national legislation, regulations or other suitable measures. For this purpose, governments should seek, when necessary, the cooperation of WHO, UNICEF and other agencies of the United Nations system. National policies and measures, including laws and regulations, which are adopted to give effect to the principles and aim of this Code should be publicly stated, and should apply on the same basis to all those involved in the manufacture and marketing of products within the scope of this Code. [emphasis mine]

The United States has, for the most part, completely missed the boat on this one. Canada, however, is in a different position.  Canada is a signatory to the Code. The Canadian government also made amendments to the Food and Drug Regulations pertaining to nutritional labelling, nutrient content claims and diet related health claims, which came into force on December 12, 2005.  In 2007, the Canadian Food Inspection Agency outlined, in a letter to industry, its Requirements Related to Nutrition Information and Health Claims for Infant Formula.  Among other things, the letter clearly states that:

It is the responsibility of all manufacturers, importers and distributors of infant formula to ensure that their products comply with Canadian legislation.  The CFIA and Health Canada also strongly urge the infant formula industry to support and implement the principles of The International Code of Marketing of Breastmilk Substitutes. [emphasis mine]

This last bit in bold is not a law. However, Canada is a signatory to the Code and via these guidelines to industry is using a social framework/other suitable measure to seek the industry’s cooperation in implementing the Code. However, Nestle and other formula manufacturers are doing a good job of proving that this is in fact not a suitable measure since the industry refuses to go along with the strong urging of the government.

In Canada, Nestle and other formula manufacturers aggressively promote their infant formula using traditional and online advertising, samples, sponsoring conferences for health professionals, wining and dining health professionals, coupons, promotions, and so on. Quoting again from the Canadian government’s letter to industry:

Comparing infant formula to breast milk, including comparisons of the levels of a nutrient in infant formula to the levels of the same nutrient in breast milk, is contrary to the message embodied in the Code. While the Code has not been incorporated into Canadian domestic legislation, the infant formula industry is encouraged not to make a reference to breast milk on a label or advertising of infant formula, other than a statement regarding the superiority of breastfeeding or that breast milk is the optimal method of feeding infants.

Also, highlighting an ingredient in infant formula as a key component of breast milk is considered misleading and is contrary to section 5(1) of the Food and Drugs Act as many components in breast milk are equally important.

…

The International Code of Marketing of Breastmilk Substitutes also recommends that labels do not carry pictures of infants on the container or label of infant formula. The infant formula industry is encouraged to support the Code and refrain from displaying pictures of infants or young children on labels or advertisements for infant formula. All other pictorial representations should meet the guidelines set out in the 2003 Guide to Food Labelling and Advertising.

…

All advertising for infant formula should comply with all the above provisions. This includes advertisements in magazines, websites, advertising flyers, shelf talkers, and advertisements and pamphlets displayed in physicians’ offices and hospitals.

That is what the Canadian government has set out as a social framework that it perceived as a suitable measure for obtaining the cooperation of industry. But then Nestle has ads like this splattered across its own Canadian website and magazines (like Today’s Parent, Canadian Family) and who knows where else:

Anyone want to count how many of the above provisions this ad violates? Comparing to breastmilk. Insinuating that they have copied the ingredients of breastmilk. Includes images of infants in formula ad. Is advertised in a variety of different media.

Nestle is not the only company that does this. For example, Enfamil has ads with smiling babies splattered all over websites right now. But that shouldn’t be an excuse. Even my five year old understands that saying “but Johnny did it too” doesn’t hold any water.

The responsibility of manufacturers and distributors

It is ironic that Nestle chooses to pick at Article 11.1 of the Code, while at the same time ignoring Article 11.3, which states that:

Independently of any other measures taken for implementation of this Code, manufacturers and distributors of products within the scope of this Code should regard themselves as responsible for monitoring their marketing practices according to the principles and aim of this Code, and for taking steps to ensure that their conduct at every level conforms to them.

The Code clearly states that manufacturers and distributors are responsible for complying with the Code even if countries have not taken any measures to implement it. So Nestle’s statement that it “voluntarily and unilaterally” applied the Code in developing countries, essentially means that it chose to only partially comply with Article 11.1. This is not an altruistic step by Nestle. It is a half-assed job.

Conclusion

In conclusion, let me reiterate in simple terms. Nestle does aggresively promote formula in countries that are signatories to the Code and that have explicity requested that formula manufacturers comply with the Code. Nestle has also chosen not to live up to its responsibilities under Article 11.1 of the Code.

I just finished writing a couple of product reviews and posting a giveaway.

Go check it out here:

Toys from KidBean: Funny Face Game and Honeysuckle Dreams Doll

Good luck!

As I continue to work on my responses to Nestle’s answers to my questions that came out of the Nestle Family blogger event, I thought I’d put in a quick reminder that this week (October 26 to November 1) is Nestle-Free Week. Even if you do not or feel you can not fully support the boycott all of the time, this one week protest gives a wider range of people the opportunity to make a difference, raise an objection, and perhaps make a tiny dent in Nestle’s profits.

• RSVP to show your support on the facebook page.
• Read more about Nestle Free Week or about the Nestle Boycott in general.
• Read about how Nestle USA thinks the boycott ended 25 years ago.

If you’ve been wanting to learn more about me, this is your chance. This morning I sat down and asked Julian some questions about mothering and about his mother (that’s me!).  I saw these questions in the mumsy meme post on blue milk and she got them from Out of the mouths of… on Wallaby. I modified some of the questions because the references to God would have made no sense to Julian.

Q1. Why did God make mothers? (modified question: What are mothers for?)

For love.

Q2. How did God make mothers? (modified question: How were mothers made?)

You were in somebody’s tummy and then you came out.

Q3. What ingredients are mothers made of ?

Cement and bones and blood. Your head is made out of cement. It is very hard.

Q4. Why did God give you your mother and not some other Mum? (modified question: Why am I your mommy your mommy instead of another woman being your mommy?)

Because you love me and you like to hug me.

Q5. What kind of little girl was your mommy?

I think you were funny. I’m a little bit nervous because I don’t understand what you are saying.

Q6. What did Mommy need to know about Daddy before she married him?

You had to remind him you were going to marry him.

Q7. Why did your Mommy marry (choose) your Daddy?

Because you love him.

Q8. Who’s the boss at your house?

Mommy and Daddy.

Q9. What’s the difference between mommies and daddies?

Daddies are bigger than mommies.

Q10. What does your mommy do in her spare time?

You sit on the chair upstairs or downstairs.

Q11. What would it take to make your mommy perfect?

You’re perfect right now because you are cuddling me.

Q12. If you could change one thing about your mommy, what would it be?

I would change your eyes from blue to green.

I also tried to ask Emma these questions, but she has a bit of a potty mouth at the moment. The answer to each question was pee pee, poo poo, or some combination thereof.

I’d like to learn more about you too…would you ask your kids these questions, post the answers on your blog and link back here? Drop your post URL in the comments below too if you do.

Since I started my blog, I’ve been calling my kids “our daughter” and “our son”. While I don’t want to use their real names on the blog, I wanted them to have online names to help make the descriptions of them less impersonal. They have also expressed interest in being able to post here from time to time to share stories or ideas or thoughts. So this morning we sat down together and they each got to choose a name to use online.

Julian

Julian is my oldest and turned five years old this year. He is the one who taught me how to be a parent and I learned all about attachment parenting by being his mom and trying to find the best way to relate to him and meet his needs. He had a very strong tongue tie at birth and we had a really rough start with breastfeeding. He is a very spirited and bright kid and does everything with a passion. He loves to learn and loves to play. His favourite food is french toast (at the moment!). He is getting a new room in a few weeks and chose bright orange paint for the walls.  Julian is going to be the Cat in the Hat for Halloween.

Emma

Emma is my baby and she is two years old. There was much less experimenting in my parenting with her. I was prepared for and had a natural birth. She was breastfeeding a few minutes after being born and was in a sling within an hour of being born. She spent most of her first six months firmly attached to my body either in a sling, on the breast, or sleeping with me in bed. She loves to dance and read stories and likes to talk, talk, talk. She says her favourite food is french fries, but unlike Julian she loves just about any fruit or vegetable you can imagine. She chose purple walls and big flowers for her room. Emma is dressing up as a Lady Bug for Halloween.

Please join me in welcoming them formally to the blog. Julian already has a few posts in progress…

I’m really pleased to see more and more organizations stepping up to provide positive messages and support for breastfeeding. I’ve been thrilled to be working with Best for Babes for a while now to try to spread their message about beating the booby traps (and can’t wait to tell you all about some exciting upcoming initiatives!), I’m always happy to recommend kellymom.com as a great resource for research-based breastfeeding information and support on their message boards, and I’m a card carrying member of La Leche League.

Personally, I think the more good information there is out there to support breastfeeding women and to promote breastfeeding, the better (and I dream of the ways we could all work together to do an even better job with our advocacy). So when I heard about the efforts of the women behind Bravado Designs nursing bras  to educate the public at large about breastfeeding and support a positive breastfeeding experience for women in North America via their Bravado Breastfeeding Information Council, I was happy to honour their request to tell my readers about a survey they are conducting to better understand the breastfeeding experiences of women.

Go Take the Survey!

I should note that when I took the survey, I was not comfortable giving out my baby’s birth date (as requested), so I just put her month and year of birth instead. I followed up with Bravado afterwards and although they are not able to change the question at this point, they said it is fine to give the birth month instead of date if you prefer.

The survey is open until next Wednesday at midnight and you can win a prize by participating (see the survey for details).

Image credit: Couldn’t resist using a pic of my bloggy friend Christina from Ami Expat nursing her little tiger when I came across it on flickr!