Industry lies and the Code

“Even in the harshest of trade regimes, there is space for public interest laws to meet legitimate health objectives when they are founded on internationally adopted standards and recommendations such as the Code and subsequent relevant WHA resolutions.”– WHO, 2016

All three of my kids sport a similar look when they lie.  As soon as the fabrication tumbles out, their cheeks suck in ever so slightly toward pursed lips. Once they’ve heard themselves, their eyes widen a smidge and their bottom jaw drops just a few degrees. 

Most of us don’t like to be lied to, but usually the dishonesty we encounter can be considered trivial. “I didn’t do it!” when there’s crayon art on the kitchen walls. “Your hair looks great!” when you know it doesn’t. “Of course I remember you!” when you haven’t the slightest clue. 

Just as humans tend to react physiologically when we lie, we have an ability to detect when someone is lying to us. Inundated by the lies told by marketing companies on behalf of major industries though, detecting truth and falsehoods can be majorly challenging. There’s no lip biting, no shifting eyes, no perspiring to give it away. Instead the tactics industries use are cunning, targeted, sometimes irresistible and truly brilliant in many ways. The lies they tell are perpetual, and their claims have completely saturated our culture, influencing just about every facet of our lives, all for commercial gain.

There’s a promotional video featured by a cooking show that showcases a chef professing his allegiance to gas stoves. The video was created by a utilities provider though, and having worked aggressively with state legislatures “to block legislation that would provide cleaner, electric-based building codes,” their marketing got us to believe that cooking on a gas stove is somehow the best while simultaneously waging “war on local electrification initiatives all over the country.” [https://www.thresholdpodcast.org/season-4-episode-6-transcript]  

Here’s another example. Most of the seafood that we purchase and consume in the U.S. is mislabeled as something completely different. This “Seafood Fraud” is detailed in (Mis)labeled Fish

President of the  Center for Science in the Public Interest Peter G. Lurie, MD, MPH calls out unfounded claims of “healthy alcohol” in Peter’s Memo: The Jungle

Fossil fuel companies are greenwashing their efforts, helping to sow doubt about the fossil fuel industry’s role in the climate crisis. 

As explained on How to Save a Planet: “They’ve… done it indirectly, by funding organizations who lobby congress, launching fake grassroots campaigns, and perhaps most importantly, through advertising. These ads, according to Martin Watters at the nonprofit firm ClientEarth, are greenwashing.” 

The tobacco industry pushes “green” public relations too.

Now consider the baby milk substitute (BMS) industry. A recent WHO report examines the scope, techniques and impact of digital marketing strategies for the promotion of breast-milk substitutes which reveals how the $ 55 billion baby formula industry “insidiously and persistently” targets parents online through “tools like apps, virtual support groups or ‘baby-clubs’, paid social media influencers, promotions and competitions and advice forums or services, formula milk companies can buy or collect personal information and send personalized promotions to new pregnant women and mothers.” [https://www.who.int/news/item/28-04-2022-who-reveals-shocking-extent-of-exploitative-formula-milk-marketing

Their efforts have further adapted to target older children with their toddler milks and  formulas. Lurie again calls out false claims like  “Brain & eye development” and “Plant-based protein for toddlers.”

He writes: “The multibillion-dollar infant-formula industry is trying to convince parents that children older than 12 months need formula. They don’t. The beverages—made largely of fortified powdered soy or dairy milk, oil, and corn syrup solids or maltodextrin—typically supply added sugars. They certainly don’t beat a diet of healthy foods.” 

The WHO report confirms these concerns: “Science is a dominant theme in the marketing of formula milk across all eight countries, including scientific imagery, language and pseudo-scientific claims. Formula milks are positioned as close to, equivalent and sometimes superior to breast milk, presenting incomplete scientific evidence and inferring unsupported health outcomes. Ingredients, such as human milk oligosaccharides (HMOs) and docosahexaenoic acid (DHA), are advertised as ‘informed’ or ‘derived’ from breast milk and linked to child developmental outcomes. Examination of the scientific evidence cited does not support the validity of these claims.” (p. 9)

In response to the absurdity of BMS industry claims during Protecting Breastfeeding in the United States: Time for Action on The Code, David Clark, International Public Health and Human Rights Lawyer and Legal Advisor for the UNICEF Nutrition Programme (1995 to 2020), laughed “I don’t think I’ve seen anything so outrageous in my life.”

The marketing of formula products is different from other commodities because it impacts the survival, health and development of children and mothers; disrupts truthful information– an essential human right as noted by the Convention on the Rights of the Child; disregards the International Code of Marketing of Breast-milk Substitutes; and exploits the aspirations, vulnerabilities and fears at the birth and early years of our children solely for commercial gain. (WHO/UNICEF, 2022, p. x) 

Considering the current state of affairs– the industry’s guileful tactics, the permeation of their influence in every sphere of life, our nation’s lack of adoption of the International Code of Marketing of Breast-milk Substitutes/ subsequent WHA resolutions and any monitoring or enforcement systems– it’s easy to feel crushed as a maternal child health advocate, like the way forward is straight into the Apocalypse. 

Fear not. Researcher Britt Wray has suggestions on how to keep ourselves within our windows of tolerance in order to continue to mobilize. While Wray’s work focuses on the climate crisis, her findings are easily applied to maternal child health advocacy. Learn about these techniques here

There are also simple actions (and some bigger ones too) that we can employ to continue to move the needle.

Françoise Coudray of ADJ+ Allaitement Des Jumeaux et Plus offered this to health advocates attending the launch of WHO’s latest report : “The mosquito: small, small, but have one in your bedroom and you will have a very bad night; so do the mosquito, let us all do the mosquito.” 

  • On Facebook, find the three little dots in the upper right hand corner of the ad to locate the “Report ad” prompt.

    When marketed formula products on social media platforms, report them directly to the platform.

  • Make a presence at the Codex Committee on Contaminants in Foods Public Meetings. In April, individuals like Consumer Reports Senior Staff Scientist Mike Hansen, Ph.D, Environmental Defense Fund’s chemicals policy director Tom Neltner and Center for Science in the Public Interest’s Thomas Galligan, PhD made clear in brief comments that we need to rethink how toxin levels are approached at CCCF. Hansen pointed out that the current permitted levels are not sufficient to protect infants and young children. Echo these demands for safer products. [While we wait for more stringent requirements, consumers can check out the Clean Label Project to find information about food and products not available on their labels.]  
  • Join forces with other advocacy groups to put pressure on the enforcement agencies responsible for food safety. 
  • Check out this Indonesian model of a platform for reporting violations of the Code
  • Support relactation efforts. Artificial feeding does not have to be the default.  Ines Fernandez in the Philippines has a model for this work.  There is also information about this included in the Global Breastfeeding Collective’s recordings of Building Better Breastfeeding Counselling Programs
  • Get people fired up. Increase public interest participation using NACCHO’s flyer on advocacy and lobbying to drum up attention about how the Code benefits all babies, no matter their feeding method. This has been grossly overlooked and cannot be overstated as formula companies often attempt to pit breastfeeding advocates against those who do not breastfeed.
  • Support the Baby-Friendly Hospital Initiative (BFHI). In the U.S., this is the only “federal” program that is enforcing the Code, albeit voluntary participation.  
  • Encourage divestment. Check out Norwegian Secretary-General of Save the Children Tove Wang’s push for the Norwegian Government Petroleum Fund’s withdrawal from investments in companies aggressively pushing infant formula in developing countries. According to Save the Children’s Don’t Push It, “The largest global fund management firms have more than $110 billion invested in companies that market milk formula. As we have documented in this report, the profits these companies generate are fuelled in part by marketing practices that directly – and profoundly – harm children….Active investment funds have the power to wield huge influence over the boards of the companies they have a stake in.” (p44-45)  
  • Support the work of Baby Milk Action. Patti Rundall, Mike Brady and colleagues work tirelessly to uphold the Code and its resolutions including speaking at shareholder meetings.
  • Stay tuned for an engaging opportunity with the newly formed INFACT USA to uphold the Code here in the U.S.

Many of these immediate and long term actions are outlined in Constance Ching and colleague’s piece Old Tricks, New Opportunities: How Companies Violate the International Code of Marketing of Breast-Milk Substitutes and Undermine Maternal and Child Health during the COVID-19 Pandemic.

 

Add your name to #EndExploitativeMarketing here. Tell us about your efforts engaging with the Code. Email us at info@ourmilkyway.org.

A call to reinvigorate the International Code Of Marketing Of Breastmilk Substitutes

Last month marked the 39th anniversary of the World Health Organization (WHO) International Code Of Marketing Of Breastmilk Substitutes. As the World Alliance for Breastfeeding Action (WABA) reminds us,  “Following the adoption of the Code in 1981, governments have been called upon by the World Health Assembly to give effect to the provisions in the Code through national legislation. So far, UNICEF/ World Health Organization (WHO)/ #IBFAN have identified 136 countries as having Code regulations in place.”

Photo by Andre Adjahoe on Unsplash

You might know that the U.S. is not one of these nations. 

In a timely offering– when formula companies use the crises of the pandemic to prey on mothers and babies– The Network for Global Monitoring and Support for Implementation of the International Code of Marketing of Breastmilk Substitutes and subsequent relevant World Health Assembly Resolutions (#NetCode) has developed a toolkit to reinvigorate and reinforce ongoing monitoring and periodic assessment of the Code and national laws. The toolkit offers health advocates an opportunity to connect with governments to establish a sustainable system that will monitor, detect and report violations of national laws. Find it here: https://waba.org.my/netcode-toolkit-for-ongoing-monitoring-and-periodic-assessment-of-the-code/?fbclid=IwAR2PzeROMctrsCJ3ZiG8gah07IXQMhI-3eSn6EqLDhV3-TdGhhmk-IxDzt4

“Formula manufacturers are exploiting the panic and fears of contagion to intensify their aggressive marketing practices,” Patti Rundall writes in the Baby Milk Action policy blog. “In this context, government action to regulate the marketing of breast-milk substitutes has never been greater.”

On May 28, the World Health Organization (WHO), UNICEF, and the International Baby Food Action Network (IBFAN) launched the virtual 2020 Status Report which highlights which countries have implemented measures required by the Code. [The official launch event can be viewed here.]

Photo by Kelly Sikkema on Unsplash

“Given the important role of health workers in protecting pregnant women, mothers and their infants from inappropriate promotion of breast-milk substitutes, the 2020 report provides an extensive analysis of legal measures taken to prohibit promotion to health workers and in health facilities,” Thahira Shireen Mustafa, Department of Nutrition and Food Safety, writes. 

In the U.S. in late March, Baby-Friendly USA released a statement detailing access to adequate nutrition for babies born during the Covid-19 crisis with an announcement explaining that BFUSA  would relax one standard regarding the provision of small quantities of formula upon discharge to formula feeding families in communities experiencing shortages in retail outlets. 

“We did so to ensure that formula feeding families receive essential support during this global emergency,” BFUSA CEO Trish MacEnroe writes. “We did NOT loosen restrictions on interactions with formula companies.”

MacEnroe goes on to write, “Regrettably, some formula companies have interpreted our statement as a window of opportunity to reengage their aggressive marketing tactics with Baby-Friendly designated hospitals… 

“We at BFUSA are appalled that these companies would use the pandemic as an ‘opportunity’ to advance their business interests under the guise of an intent to support facilities during this difficult time.

So, please let us be perfectly clear: Our standards are still our standards. We have not ‘loosened’ our guidelines and we still expect Baby-Friendly designated facilities to shield health care workers, mothers and families from commercial influence, as outlined in the International Code of Marketing Breast-Milk Substitutes.”

Photo by Luiza Braun on Unsplash

In other parts of the world too, companies exploit the Covid-19 crisis. Baby Milk Action documents how one company violates Indian Law with their YouTube channel. Keep scrolling and scrolling and scrolling on Baby Milk Action’s page and you’ll find offense after offense after offense documented in multiple countries. 

In response, there are several documents cited offering guidance on how to navigate avoiding partnerships with these corporations.  Find them here

On an individual level, this is a great time to remind Certified Lactation Counselors (CLCs) of our Code of Ethics which states we must “Abide by the International Code of Marketing of Breast-Milk Substitutes and subsequent resolutions which pertain to health workers.”

How to support world’s coordinating authority in setting global health norms

I have a friend who describes her experience wading through the pandemic as paralyzing. 

Photo by The New York Public Library on Unsplash

In the first few weeks of the social distancing orders, she says she found herself just standing there at times, staring off into the distance with an utter sense of loss. 

It’s a familiar feeling. Even with so much to be grateful for, there’s static that surrounds us– a heaviness that lingers around the edges, as my friend puts it. 

“It’s a pretty big presence to try to push away with positivity right now,” she counseled me. 

Amidst the stillness, what sometimes feels like paralyzation, there are actions taken, decisions made– like President Trump’s decision to halt funding to the World Health Organization (WHO) during a global pandemic— with sweeping consequences. 

Trump’s plan to defund WHO has been met with mobilization by the International Baby Food Action Network (IBFAN) and partner civil society organizations who are  joining forces to support WHO. You can read IBFAN’s full statement of support to WHO from April 11 here

Patti Rundall is the Policy Director Baby Milk Action, Global Advocacy IBFAN.  

“We have been one of the most outspoken NGOs, calling for WHO to adopt a sound conflict of interest policy to safeguard its independence and resist the unjustified influence of powerful interests, be they commercial or political,” she writes in an email to Our Milky Way.  “…All our criticisms are focused on supporting WHO in its unique role as the world’s coordinating authority in setting global health norms.” 

Specifically, WHO “is absolutely critical to the world’s efforts to win the war against COVID-19,” as U.N. Secretary-General António Guterres declares in a UN News story

Guterres goes on to say in that piece that it is “not the time to reduce the resources for the operations of the World Health Organization or any other humanitarian organization in the fight against the virus.”

Bill Gates on Twitter writes: “Halting funding for the World Health Organization during a world health crisis is as dangerous as it sounds. Their work is slowing the spread of COVID-19 and if that work is stopped no other organization can replace them. The world needs @WHO now more than ever.” The Bill & Melinda Gates Foundation’s voluntary contribution to WHO is second to the U.S.’s assessed and voluntary contributions. [More here.] 

Rundall adds: “WHO is needed to guide not only country responses to COVID-19 but also the host of other global threats that we face – not least global heating, new viruses, antimicrobial resistance and non-communicable diseases.” 

Rundall explains that “the U.S. is not the only nation to lobby against the much needed increases of Member States assessed contributions, but it is one of the most powerful.”

“For goodness sake, WHO’s total annual budget of $2.5bn is about the same as the budget of a large US hospital,” she puts the money into perspective.  

Even without defunding, WHO is already underfunded

Even as many of us are feeling debilitated to some degree, Rundall offers suggestions on how to take action for good. 

“We hope that US citizens– and especially anyone working in infant and young child health– will remember the critically important role that WHO has had in child survival,” she begins. “and do everything they can: write to politicians, media, social media, friends  and distance themselves from President Trump’s statements about health.”  [Link added.] 

Rundall directs us to the Society for International Development’s stance on Trump’s move which reiterates the G2H2 statement as well as an open letter of support to WHO and Dr. Tedros Adhanom Gebrheyesus in BMJ

Visit Rundall’s frequently updated policy blog here