THE lives of hundreds of thousands of infants could be saved each year in the 1980’s by the promotion of breastfeeding, said James Grant, Executive Director of UNICEF. The World Health Organization indicts the infant formula industry: ‘The promotion, marketing and distribution of breastmilk substitutes can. . . contribute to the overall discouragement of breastfeeding and contribute to underfeeding, malnutrition, and vulnerability to infection.’ The current corporate drive to replace breastmilk with a profitable artificial product is convincing women perfectly capable of producing wholesome, plentiful breastmilk to become consumers of expensive, imperfect and sometimes lethal infant formula.
The infant formula industry’s attack on the basic human function of breastfeeding has been the rallying point for the largest-ever international campaign to expose and reverse exploitative corporate practices. But the scandal is not a unique case. The formula company executives now trying desperately to crush this growing international movement are no different from their counterparts in many other multinational enterprises. To ave the way for sales, they implant values and aspirations that make their products as desirable to a slum-dwelling Kenyan ama as to a housewife in London or Tokyo. Local cultural traditions and tastes are systematically undermined to create the corporate vision of a united world — one big happy marketplace.
The four billion dollar a year infant formula market and its estimated 15-20 per cent annual growth are small beer for the big corporations. The real issue is the corporations’ ability to sell their products to consumers everywhere, using every possible marketing techniques no matter what the human cost and regardless of the usefulness, safety or quality of the product Also at stake is the ability of concerned citizens groups and individuals to organize and educate people to protect themselves against the global marketing onslaught.
The result of each sales success story reach— like ripples in a pond— far beyond the sphere of any single product. Each time a free sample tin of artificial baby milk is foisted on a vulnerable new mother in the Third World, she is forced into the consumption community and it is that much easier for the next marketeer to reach the same customer. In the transformation of more traditional communities, human needs for community, meaningful work, freedom from hunger and misery, and basic liberties are subsumed by a dazzling array of purchasable ‘happiness’ that increase corporate profits. The infant formula controversy focuses on a very particular need and a group of especially vulnerable consumers. But it is part of a larger picture that encompasses Coca Cola, Ritz crackers, Chevrolet, and Marlboro.
How does an industry go about creating consumers? There are clear rules:
How does this strategy work for infant formula? Formula marketing has systematically undermined its ‘competition’, breast-feeding, at both psychological and physiological levels. Promotional campaigns have encouraged the view that breastfeeding is complicated and prone to failure. Breast-feeding is thought of negatively on the basis of beauty(breast sag); work (you have to stay home); snob appeal (only the peasants do it); racism (white women don’t breastfeed); and fear (it won’t work, your baby will starve).
Knowing that fear and anxiety can actually stop lactation, companies consciously design marketing strategies that aggravate in-built worries and interfere with the pyschophysiology of the human body in order to sell more of their products. In Africa, Nestle’s Lactogen was advertised for use ‘when breast milk fails’. And in the 1950’s a radio jingle for Borden KLIM in the Belgian Congo went like this:
What does make the infant formula case unique is that there are few other products where the marketing can actually undermine a normal bodily function in order to create the physical need for the commercial product. Unlike soap or toothpaste samples, which may create a psychological need for the product, formula samples literally hook the mother on formula For once bottlefeeding starts, breastmilk begins to dry up. When the free sample is finished, there is a physical need to buy more formula.
Formula samples used to be delivered to new mothers by ‘milk nurses’, women hired by milk companies and dressed in semiofficial uniforms to promote artificial feeding to mothers and health professionals. Banned from entering maternity wards directly in Singapore for example, Dumex milk nurses would wait just outside the hospital gates to catch new mothers with free samples on their way home. In Jamaica, Bristol Myers milk nurses evaded government bans to enter public maternity hospitals and copy down names and addresses of new mothers to visit at home and leave free samples. In the Philippines milk nurses worked the public housing projects of the poor, calling at dwellings where diapers on the clothesline signalled a newborn at home.
Now the baby formula firms have convinced many hospitals to act as their sales agents in handing out samples to new mothers. The effect is even more powerful. The hospital is essentially saying to each mother, ‘Here, use this formula It’s good stuff.’ Naturally baby formula companies compete viciously with each other for the hospital business as the stakes are so high. ‘When one considers that for every 100 infants discharged on a particular formula brand, approximately 93 infants remain on that brand,’ Abbot Laboratories sales training manual states, ‘the importance of hospital selling becomes obvious.’ So the hospital has become a platform from which commercial products are promoted for private gain.
In exchange for giving ‘discharge packs’ of formula to new mothers, hospitals get free formula for in-house use together with equipment, literature, and a package of other services. The most insidious of these is a free architectural service to hospitals which are building or renovating facilities for newborn care. Abbot Laboratories helps design at least 200 maternity departments a year in the US alone. The layout of these centres, whether by accident or design, makes breast-feeding difficult Mothers are physically separated from their newborns. Nurses can swiftly and conveniently administer donated formula in ready-to-mix bottles. But establishing breastfeeding is more troublesome because, instead of rooming-in mothers and babies together, babies must be carried long distances to their mothers for feeding, a task that nurses resent The investment in architectural plans thus yields dividends in the form of new bottlefeeding customers for the entire life span of the building.
Convincing doctors of the virtues of artificial milks — or at least neutralizing their resistance — is the key to establishing bottlefeeding. Babymilk companies spend untold millions of dollars subsidizing office furnishings, research projects, gifts, conferences, publications and travel junkets of the medical profession. The American Academy of Pediatrics received a renewable $1 million grant from Abbot Laboratories. The purpose is to generate physician good will toward the company and its products. An Abbott Laboratories trade publication states, ‘In effect, we are striving to make the physician a low-pressure salesman for Abbott’ And of course it is the ordinary purchaser of artificial babymilk who must pay a portion of the cost of every cocktail that a doctor sips at conventions like the recent ‘Ski-and-Study’ symposium at a California mountain resort which Abbott Laboratories helped finance.
The tactics work.. Physicians continue to allow free infant formula samples to be distributed despite the evidence that this discourages breastfeeding.
The objective of the baby formula industry, as the Economist magazine recently wrote, is ‘weaning its customers on to higher-value added, more elaborate foods’. In ways similar to infant formula, other industries use startlingly effective tactics to change cultural habits and sell particular products. Mass media advertising and blanket distribution have never been so successfully used as by Coca Cola How else could a company persuade an entire generation around the world to spurn cheaper, more nutritious local fruit juices in favour of the heavily sugared, expensive import from the West? Tragically, West African pediatricians now report cases of’Fanta Syndrome’, infant malnutrition and dehydration caused by ingestion ofFanta rather than milk. Fanta is Coke’s orange soda.
The tobacco industry takes the ‘big lie’ theory of propaganda and pushes it to the absurd. To overcome the medical facts that link smoking with cancer, Newport cigarette advertisements promise to make you ‘alive with pleasure’. Like infant formula, cigarette adverts promise health, but can cause death. And the tobacco industry’s massive investment in scientific research to dispute the irrefutable link between smoking and cancer recalls the formula industry’s current drive to flood medical literature with ambiguous findings to mislead doctors and policy-makers.
Corporate marketing means using whatever works to sell, until public pressure forces reforms in their tactics. The baby formula industry is putting up an extravagant fight to protect its marketing practices since they are still generating new sales and high profits. Current estimates indicate about a 2Opercentprofitability rate on baby milks, well above the average in the food sector. Understandably the industry will not change such practices except under tremendous pressure.
The history of the ‘baby killer scandal’ shows that a broad international campaign can wake the world up to some of the horrors of modern multinational marketing, People all around the globe are more aware of the value of breastfeeding, while health professionals have learned to be a bit more skeptical of formula company giveaways. For example, the Indian Academy of Pediatrics recently turned down a cash offer from Nestle because they were anxious to avoid the inevitable ‘conflict of interest’.
Above all, the international infant formula campaign, spearheaded by the Nestle Boycott, keeps pressure on formula products. The growing movement links consumers, health workers, women’s organizations, trade unionists and social justice activists.
The infant formula case is unique only in that the industry’s ability to create a need for its products depends in part on the ability to undermine a normal physiological process, and in that consumers are so vulnerable that misuse can lead almost immediately to malnutrition, dehydration and death. A tremendous amount has been learned about how to stop an industry’s exploitative practices for marketing over-priced, often unneeded and dangerous products. The infant formula campaign has created a coalition of groups in both developing and developed countries and brought the issue to the attention of health officials and government authorities in national and international forums. As people around the world understand how multinational corporations operate and how pervasive their influence is, and draw lessons from the successes and failures of the infant formula campaign, then the full promise of the campaign’s work will be fulfilled.
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