International NGOs in Laos have stepped up their criticism of what they describe as Nestlé’s unethical marketing of infant formula.
"Some of the marketing strategy presents formula as better than breastfeeding,” Laurence Gray, World Vision’s Asia-Pacific advocacy director, told IRIN. “It doesn’t take into account the circumstances needed to prepare the formula.”
A month ago, 19 leading Laos-based international NGOs, including Save the Children, Oxfam, CARE International, Plan International and World Vision, announced plans to boycott Nestlé's 2012 competition for a prize of almost half a million US dollars for outstanding innovation in water, nutrition, or rural development projects.
Both the UN Children’s Fund (UNICEF) and the World Health Organization (WHO) advocate exclusive breastfeeding for children up to six months of age - and continued breastfeeding and complementary feeding until age two.
However, infant formula is not considered unsafe in developed countries.
“When mothers cannot breastfeed, infant formula is the only product recognized by the WHO as a safe and nutritious breast-milk substitute,” Ferhat Soygenis, senior corporate affairs manager and a spokesman for Nestlé, told IRIN.
But in developing countries, formula is frequently prepared in unhygienic circumstances with unsafe water and misunderstood instructions.
“In poor nations, formula-fed infants are four to six times more likely to die of infectious disease than breastfed babies," said Gray. "The problem is not with the formula, but with the preparation," he added.
In an open letter to the company on 24 May, the organizations taking part in the boycott outlined how the company had violated the 1981 International Code of Marketing of Breast-Milk Substitutes.
“We won’t be applying for your prize money, Nestlé. Your marketing of formula milk still jeopardizes the health of infants and children in Laos,” begins the letter.
The letter is the latest development in an ongoing battle between Nestlé and child health groups that began in 1977 and is waged across the villages and markets of developing countries such as Pakistan, Bangladesh, and now Laos.
“Nestlé has mastered the art of marketing formula products with many forms of deceptive advertising in Laos and countries throughout the world,” said the letter’s co-author Leila Srour, who works in Laos with Health Frontiers.
Srour accuses Nestlé of making unsubstantiated claims about its infant formula's ability to make babies smarter, stronger and taller, which undermine breastfeeding.
The low-to-medium income groups specifically targeted by Nestlé do not speak English or Thai, and product labels and instructions are not translated into local languages, according to Srour.
Nestlé representatives are also being charged with visiting hospitals and providing incentives, such as gifts and trips, to doctors and nurses, to promote formula usage.
According to Soygenis, Nestlé is “currently investigating each allegation in the letter" and promises immediate corrective action if non-compliance with the codeor national legislation is found.
“There are no incentives offered to health workers for promoting Nestlé products, no pictures of babies on packs; there are product labels which state that breast milk is best for babies, and preparation instructions which are presented graphically,” Soygenis maintained; a response that received a strong rebuke from Srour.
“If Nestlé thinks that paying for flights to Thailand to attend conferences is not a big incentive for health care workers with very low salaries, I don’t know what they’re thinking,” she said.
The issue of perceived deceptive marketing remains the most troublesome, said Srour.
NGOs have strongly protested its anthropomorphized Bear Brand logo, which until recently featured a baby bear held in the breastfeeding position by a mother bear.
"The Bear Brand logo is responsible for the deaths and developmental delay of many Lao children mistakenly fed inappropriate products as breast-milk substitutes,” she said, citing earlier instances in which coffee creamer containing the same bear logo had been fed to children.
Following a wave of negative publicity Nestlé removed the bear from its infant formula, but it remains on its follow-up formulas for young children.
Meanwhile, Nestlé insists they adhere to local and international regulations in product marketing.
“In the 152 countries with high infant mortality and malnutrition rates as described by UNICEF, we apply the respective national laws and/or the WHO Code, whichever is stricter,” Soygenis said.
And because Laos national legislation covers infant products and complementary foods for use until two years of age, Nestlé considers it to be stricter, he added.