Breastfeeding advocate battles formula companies, protects mothers and babies

unnamed-4The Breastfeeding Promotion Network of India (BPNI) is celebrating 25 years of activism.

Arun Gupta MD, FIAP formally founded BPNI in 1991 in an effort to resist formula companies’ “massive propaganda” and protect mothers and babies from predatory marketing. Specifically, Dr. Gupta was concerned by companies’ fear-mongering tactics which made women believe they could not produce enough milk to feed their babies.

Dr. Gupta became interested in maternal child health while interning at a district hospital in Jalandhar, Punjab in 1973.

“I witnessed lot of illness and deaths among children,” he says. He was especially drawn to working with children when he realized the “rampant practice of bottle feeding was causing great harm and it was being neglected.”

In 1989 he attended the first International Baby Food Action Network (IBFAN) meeting. (BPNI now serves as IBFAN’s Regional Coordinating Office of Asia (IBFAN Asia.)) Dr. Gupta’s advocacy proliferated; he attended the launch of the first human milk bank at a hospital in Mumbai, he completed trainings in lactation management, and established BPNI.

“Being a clinician it was hard, but slowly over the years I learnt and gave way to this job of an activist,” says Dr. Gupta.

The work BPNI does to protect mothers and babies is epic. The organization offers services free of charge at their Infant and Young Child Feeding (IYCF) Counseling Center.

Perhaps most monumental is the enactment of The Infant Milk Substitutes, Feeding Bottles and Infant Foods (Regulation of Production, Supply and Distribution) Act (IMS) in 1992. The IMS Act includes several clauses regarding the promotion of milk substitutes, sponsorship, labeling, etc. Non-compliance is a criminal offense.

Early in his career, Dr. Gupta recalls all maternity hospitals in Punjab giving formula to newborns.

“These hospitals were undermining breastfeeding in a big way, without realizing what harm they [were] doing,” he says.

Today, the evidence is clear that the marketing of artificial baby milk undermines breastfeeding.

Dr. Gupta says he quickly realized that doing “the right thing” wasn’t influential enough for hospitals or physicians themselves to eradicate formula companies’ influence in health systems. Before the law was enacted, academic journals were littered with Nestlé advertisements for instance.

“They would not relent until the law came,” he says. “Once the law came, everyone was in line. They were scared of the legal implications.”

The law did its job to influence physician’s behavior, but formula companies continue to violate the law and the health of mothers and babies.

BPNI documents violations of the IMS Act. Just this year, the organization documented a formula advertisement in the Indian Journal of Pediatrics among others like discounted e-marketing of milk substitutes and Nestlé’s sponsorship of an Indian Society of Clinical Nutrition conference.

Formula companies continue to violate the law because of weak implementation of the law.

“It can take up to 20 years to get into court,” Dr. Gupta explains.

So companies continue to find loopholes, and activists like Dr. Gupta and his team continue to expose their exploitation.

The U.S. does not have a law enforcing the Code, but the National Alliance for Breastfeeding Advocacy (NABA)– the IBFAN organization responsible for monitoring the Code in the U.S– encourages you to become a Code Monitor.

Dr. Gupta will present about International Baby Food Action Network(IBFAN) Asia’s /BPNI’s flagship program, World Breastfeeding Trends Initiative (WBTi): Success Story So Far and Study of Trends in South Asia: 2004-2014, at the 23rd Annual International Breastfeeding Conference.

unnamed-5He also recently co-hosted the 2nd World Breastfeeding Conference in Johannesburg, South Africa where Healthy Children Project’s Cindy Turner-Maffei and Anna Blair presented the findings of the U.S. expert panel for WBTi.  

WBTi was developed in order to provide a platform for the assessment of achievement and progress toward the goals of the WHO/UNICEF Global Strategy for Infant and Young Child Feeding (“Global Strategy.”)

The initiative has been introduced to 113 of the world’s nations, 84 of which have completed country reports, Dr. Gupta announced at the World Breastfeeding Conference.   

“However, there is much progress to be made in improving practices,” Turner-Maffei quotes Dr. Gupta during a presentation at the World Breastfeeding Conference.

Dr. Gupta reports that ten years ago, only 70 countries had data on breastfeeding. The data from the 84 countries that have completed their WBTi reports indicate about 55 percent of mothers start breastfeeding within one hour after birth.

“That’s a huge gap,” Dr. Gupta comments.  “Women go unsupported in the health systems. That’s a fact.”

The WBTi process has three phases executed by a core group at country level usually a volunteer one:

  1. A National Assessment of the implementation of the Global Strategy. In this phase, multiple partners analyze and document the situation in their country and identify gaps according to ten indicators of policy and programs and five of practices.
  2. The scoring, and color coding of each indicator or a country or region according to the findings of the national assessment is then done by the tool.
  3. The repetition of the assessment after 3-5 years to analyze trends.

As WBTi assessment coordinator Turner-Maffei puts it, “A simple ‘traffic light’ coding system like (red/yellow/green) indicates level of achievement of each aspect of the Global Strategy.” You can read more about the U.S. team’s process here.

“The beauty of the WBTi is bringing multiple partners together to do their own investigation, debate, discuss and design individual strategies for improvement,” Dr. Gupta said at the World Breastfeeding Conference.

Moreover, WBTi shows “that changes can be brought slowly but surely if such a tool is institutionalized,” he adds. “Patience does pay.”

BPNI is raising money to Help Create 2000 Breastfeeding Counselors in India. Learn more about this fundraising project here.
To register for the upcoming International Breastfeeding Conference and learn more from Dr. Gupta, click here.

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