On the cover of this issue is a photograph of grave no. 19232. It is the grave of a Zambian baby. On it, the mother has placed a feeding bottle and an empty tin of milk-powder. They are symbols of infant death and of the mother’s attempt to do her best for her child during its short life. What the mother does not know is that the way in which she used that same milk-powder and feeding bottle was also the main cause of her baby’s death.
This mother is not to blame. The baby milk and feeding bottle were perhaps recommended or even given to her by a nurse in the maternity hospital. She was not to know that the nurse was employed by a baby food company. Or she may have seen one of the many large hoarding boards in the town showing a healthy robust baby sitting next to a tin of powdered baby milk and she may have gone out and spent a large fraction of her family’s small income on buying this product in the belief that it would make her baby like the one in the advertisement. She was not to know that her own breast milk was better, cheaper and safer than anything she could buy in a tin. She may have mixed the milk powder with too much water to make it go further because she could not afford another tin that week. But she could not read the instructions on the back of the tin, nor work out the correct proportions. Or she may not have boiled the milk or sterilized the feeding bottle. But she did not fully understand that these processes are essential. And she probably did not have cold running water to cool the bottle even if she had been able to boil it.
She did what she thought best and could little afford. But her baby drank over-dilute feed and so became malnourished. Malnourishment lowered the baby’s resistance to disease – which was always threatening from the unsterile bottle. Disease prevented the baby from benefiting even from the dilute milk powder. And so a vicious circle set in. Gradually the baby lost weight, shrivelled up like a little old man, and died.
Had that dead child survived, he or she would now be one of two hundred million children growing up physically and mentally stunted by malnutrition. For the wrong food in the wrong quantities in the vital early months of life can and does inflict irreparable damage on both body and brain.
Anything which can lead to further malnutrition in young babies is a tragedy – for the children themselves, for their families, for their nation, and for the whole process of development which they can neither fully benefit from nor contribute to.
In this issue, two leading child nutrition experts give evidence that the inappropriate promotion and consequent misuse of artificial baby milk in poor and often illiterate communities is leading directly to an increase in infant malnutrition. They tell of techniques of baby milk selling, including the use of irresponsible advertising and the employment of nurses as salesgirls, which in the context of poverty are disastrous and dishonest.
We must accept that research into the effects of artificial feeding in the poor world is recent and incomplete. We must accept that it takes time for companies to respond to new findings with new policies. We must accept that in many situations baby milk companies can and do play a vital humanitarian role. But we must not accept the creation of more malnutrition for the sake of commercial gain by the selling of artificial baby milk to mothers who do not need it, cannot afford it, and are not able to safely use it.
The International Organization of Consumer Unions has prepared a draft code of practice for the promotion of infant foods in developing countries. It stipulates that no food should be advertised as suitable for a baby of three months or less; that no claim should be made which will in any way encourage the mother not to breast-feed her baby; that instructions for the use of artificial milk should be both clear and feasible in the context of the community in which it is sold; that photographs of babies must not be used in advertisements in a way which might mislead a mother as to the likely benefits of the food; and that all persons selling baby food direct to mothers should be licensed to do so by the national health authorities.
There is no time for fiddling while children starve. There is urgent need for:
- The ratification of such a code of practice by a consensus of expert opinion.
- The strict observation of the new code by all baby food companies and its strict enforcement by all governments of developing countries.
- A stepping up of research into the effects of artificial baby foods in poor communities.
- A new international campaign to encourage mothers to breast-feed their babies wherever possible.
The initiative for such action could come from a number of different sources. As it concerns food it is the responsibility of the Food and Agriculture Organization; as it concerns health it is the responsibility of the World Health Organization; as it concerns children it is the responsibility of UNICEF; as it concerns their products and exports it is the responsibility of the baby food companies and their governments; as it concerns their future generations it is the responsibility of Third World governments.
But neither is there time for buck-passing. The New Internationalist will therefore be submitting evidence to all these bodies and reporting back on their reactions.