Milk War:
Shifting of the Target.
If we look at the conflict rather war against the evil forces jeopardising the health of be babies globally, we all have chosen only one group of people—the baby-food manufacturing companies. All our activities apart from promotion of breastfeeding through meetings, conferences, training, awareness programs etc., one of our main activity is directed to the fight against a few unscrupulous company. But for last few years, I am seriously thinking about our mistakes.
Scientists often so intensely absorbed in inventing things that sometimes they forget the long term harmful effects of the inventions. The feeding bottle is one such invention, that for years after years, centuries after centuries, babies throughout the globe are paying the cost of this invention by sacrificing their health and even lives. The great invention of feeding bottles is now being kicked out as “baby killer”.
The famous microbiologist Louis Pasteur worked on heat treatment of milk for its self like extension and invented the process of pasteurization and made artificial feeding popular and viable. Invention of rubber nipple made feeding bottle a convenient feeding article.
The famous Louis Pasteur through his outstanding work on milk hygiene made artificial feeding popular and viable. Invention rubber nipple made feeding bottle a convenient feeding article.
The milk companies sneak into the scenario of infant feeding in a baby-friendly way. They made an ambience that even the doctor community becomes convinced that artificial feeding is the most modern and best scientific approach to infant feeding and started discarding breastfeeding a primitive and uncultured method of feeding. The profits by baby food industry compounded with the effects of Industrial Revolution made artificial feeding to progress by leaps and bounds. The whole health care system gradually forgot the art of breastfeeding.
The aggressive marketing and misleading information about the tin-milk went to such an extent that nobody could even imagine having a baby without baby-food and feeding bottle. I still remember while was a teen that there was a huge hue and cry for the scarcity of baby-food in the market. The issue became such strong that it became a regular news item backed by criticism about the government’s role. People were mad to get baby-food at any cost. The situation became so worse that the shopkeepers were scared and force to put up board mentioning that “BABYFOODS ARE NOT AVAILABLE HERE”!
While idea of baby-foods and feeding bottles became totally integrated in our social living, a very concerned and aware people started thinking in other way round. Defying the best and natural food’s benefits to the babies forced Dr. Cecily Williams had to deliver a lecture entitled milk and murder to the Rotary Club in 1939 where she said,
“If you are a legal purist you may wish me to change the title of this address to Milk and Manslaughter. But if your lives were embittered as mine is, by seeing day after day this massacre of the innocents by unsuitable feeding, then I believe you would feel as I do that misguided propaganda on infant feeding should be punished as the most miserable form of sedation, and that these deaths should be regarded as murder… Anyone who, ignorantly or lightly, causes a baby to be fed on unsuitable milk, may be guilty of the child’s death.”
This was the first open declaration of Milk War. Though we cannot pin point the birth date of the conflicts against the baby-food manufacturing companies, but it can be divided into Pre-60 era and Post-60 era.
Marketing and promotion of infant formula increased steadily in the industrial countries in 1930s through heavy marketing strategies. By the end of industrial revolution, bottle feeding became a standard practice in USA and to a lesser degree in Europe. In between 1950 to 1960, the market began to saturate in the developed countries as the birth rate declined. The greedy multinational companies were attracted to the maiden vast area of developing countries. They get access too - as people of developing countries started to pursue the 'Western' style. But there were series of 'protests' by the health workers and physicians of developing countries during the period in between 1950 to 1960.
The 1960s was the period of a few voices of several committed doctors and health workers of the developing countries denouncing the upsurge of infant formulae and their deadly effects. In 1980s, breastfeeding movements and advocacy were taken up to the United Nations and some national governments.
Host movements with call for boycotting Nestle, formation of La Leche League International (LLLI), WABA, IFBAN, and many other organizations aiming at promoting, supporting and protecting breastfeeding. Now almost every nation has one or more such organizations. In India, Breastfeeding Promotion Network of India (BPNI) was formed in December, 1991 with he aims of promoting, supporting and protecting breastfeeding along with the monitoring and controlling the violation of baby-food manufacturing company’s’ unethical activities. In our neighboring Bangladesh, Bangladesh Breastfeeding Foundation (BBF) formally began to function in 1989 for the protection, promotion and support of breastfeeding in the country.
The formation of IBFAN in 1979 led an era of brave new activities. Formulation of International Code of Marketing of Breastmilk Substitutes was a bold step for fighting against the baby-food companies. Innocenti Declaration was adopted on 1 August 1990 in Florence, Italy by 32 governments and 10 international agencies. It stands as the second most important landmark in the history of the breastfeeding movements, the first being adoption of the International Code of Marketing of Breastmilk Substitutes. In India, the Government enacted a strong law, named, the Infant Milk Substitutes, Feeding Bottles and Infant Foods (Regulation of Production, Supply and Distribution) Act, 1992, amended in 2003.
This write-up is meant for narrating the details of the breastfeeding movements. All persons involved in breastfeeding activities, know more details of the breastfeeding movements. The WABA’s “THE BREASTFEEDING MOVEMEMENT: A SOURCEBOOK” gives great and excellent details of these movements. My intention of writing this has a bit different motive.
I strongly believe that all the anti-baby-food movements so far have not achieved much success because our strategy of “Milk War” were wrongly targeted. The unscrupulous companies are so monetarily powerful and cunning in policies that our attempts to stop their baby-killing intentions cannot be overpowered. It seems to attack a giant octopus possessing lethal tentacles. Whenever we try to target the body of it, the tentacles prevent us. The octopus use tentacles to attack and defend. The baby-food companies also work through their networks. And these networks are none other than the members of our own health care systems – the hospitals, doctors, nurses and others. Unfortunately there is no law on code of conduct for these.
For last few years, I am compelled to think that we are wasting our time and energy fighting against the companies, it high time that we shift our target. We should target those whom we call as ‘our men’. We have to rethink seriously about those so called saviors are really saviours oare not!. There are concrete examples of their mischiefs, as for examples,
Allmost all hospitals, especially the private ones, ask the guardians to bye baby-foods and feeding bottles even before delivery.
There are some hospitals, big or small, do not ask for procuring formulae or bottles, but they themselves provide those at a higher price while the family members even do not know the nature of feeding provided by the hospitals.
All most all babies are kept separated from the mothers for a day or more and give pre-lacteal feeds to babies.
Many doctors try to find excuses for prescribing baby-foods, like: ······· · If you do not stop breastfeeding, never dare to come to me”. ······· · “Your baby is allergic to breast milk”. ······· · “Your baby is not gaining weight, give him …” ······· · “As you are taking these medicines, stop giving your milk”. All doctors who prescribe baby-foods never give it written. They always tell verbally the names of the brand they prefer.
Many doctors prescribe baby foods only because they really do not know what to do when faced with simple or complicated problems during breastfeeding.
There are lack of basic knowledge on breastfeeding and infant feeding and basics of medicine of the pediatrician. The most common example is stopping breast milk because of frequent loose stools of baby. This is completely physiological condition. Yet the doctor's advice or rather forces the mothers to stop breastfeeding and go for special antidiarrheal (?) baby foods. Some paediatricians go for test for Reducing Substance in stool. This is a bigger mistake. Any baby on milk will have excess of Reducing Substance and are not cases of Lactose Intolerance.
There are plenty of examples where the doctors ask to stop breastfeeding and insist on feeding baby foods out of ignorance and carelessness. But there another big reason for prescribing baby foods and that is purely greediness. They get plenty from the companies in cash or kinds.
The baby-food manufacturing companies also continue to play the dirty game of three Cs, i.e. Convince, Confuse and corrupt.
They send fresh and ignorant representatives to doctors to promote the products. They present unscientific documents for this purpose. Usually doctors do not cross question them. When confronted with questions, the ignorant representatives surrenders and never come again to the same doctors.
They spend huge amount of money as sponsorship to big events like seminars, meetings, conferences etc. Though prohibited by law or code, the medical communities do not feel guilt about those.
The companies themselves approach different medical institutions to arrange programs. Recently, they even celebrate WORLD BREASTFEEDING WEEKS in some hospitals and nursing homes! The health care staff, strangely, do not ask for the ethical questions for such activities.
Often the companies invite staff of lower strata to join seminars etc. to big hotels and along with foods and drinks, offer costly gifts.
To summarize all of the company’s in single statements we can say that whatever company does, it does through the members of health care systems. All these facts clearly point to one thing that companies can run their business of money-making and baby-killing through - the professionals. So, I strongly feel that it is high time, if not too late, to look at ourselves and do something urgently and earnestly.
The suggestions: I dare not say the followings as recommendations. But I feel all benevolent organizations to look into the matter and act. These are:
No matter the qualifications or experiences one doctor or a nurse dealing with newborns or infants, must have proper breastfeeding training.
There must be a department or body (governmental or autonomous) with the power of monitoring the nature of advice given by an individual doctor or nurse. If he/she advice baby-food, he must provide written prescription. And keep a record for it.
The retail sellers must keep a record of the person’s name, address and phone number, who wants to buy baby-food (against a proper prescription).
The doctors must submit the monthly statements of prescriptions of baby-foods with reasons for such prescriptions.
The authorized body must have the power to ask for the detail explanation of using baby-food from the concerned doctor.
If the body finds the reasons and explanations unsatisfactory it may take or recommend suitable action against the doctor. If necessary, the body may recommend proper training on breastfeeding and infant feeding.
The Conclusions: For long many years I have personally felt that unless the profession rectifies itself, we have to force it. To achieve the bigger goal of saving the mankind from grasp of the giant octopus (the baby-food company), the milk war must targeted our own profession – SHIFTING OF TARGET.
Mothers held a protest in 2006 over breastfeeding at Thurgood Marshall Airport, between Baltimore and Washington.
During International Nestle-Free Week 2012 (29 October - 4 November) people have been sending messages to Nestle about its systematic violations of baby milk marketing rules and signing a petition of solidarity with the people of the Philippines.
(Dr Kamalendu Chakrabarti is an internationally acclaimed Kolkata-based Pediatrician, a known crusader for breastfeeding promotion in India, is an eminent writer and Health Editor at Bengal Newz.)