Breaking the rules:
promoting artificial feeding in Canada
The normalizing of artificial feeding, the creation of trust in formula
feeding and the belief in its equivalency to breastmilk all come through as
key messages to pregnant women and new mothers. Through the multitude of
free samples, mailings, booklets, baby clubs, magazines, TV promotions,
internet pages, shelf talkers and yes even physicians' offices, mothers have
become inescapable targets of the industry. Admittedly the artificial
feeding industry has an uphill battle as it works hard to defend and promote
a product that is nutritionally and immunologically inferior, for which
scientific evidence has overwhelmingly demonstrated numerous risks to infant
health, and which costs a lot of money as well. Clearly the industry has to
work hard to seem convincing, as INFACT Canada's monitors noted.
The World Health Organization recognized two decades ago that
unscrupulous marketing of formula put breastfeeding -- and babies -- at
risk. In Canada, however, violations of the WHO Code are everyday
occurrences. To quantify this problem, INFACT Canada trained ten monitors
who looked for violations in Vancouver, B.C.; Toronto, Ont.; Saskatoon,
Sask.; St. John's, Nfld.; and Granby, Que. From January to September, 2000,
the monitors checked community clinics, doctors' offices, paediatric and
general hospitals (including maternity units), stores, pharmacies and
supermarkets. Local newspapers, Internet sites, and magazines were also
Join the Club. Shelf talkers picked up at
supermarkets and drug stores throughout Canada offer free and low-cost baby
supplies. The baby club membership information provides company access to
families for the promotion of formula and 'nutritional information'.
INFACT Canada's monitoring report noted a decreased reliance on the
health care system as a means to promote artificial feeding and an
intensification of efforts to influence infant and young child feeding
practices by targeting mothers and parents directly by all communication
means at their disposal. Most striking is the increased use of data bases,
collected through marketing surveys, the internet, product information
telephone lines, maternity and department store coupons and promotions and
baby club brochures, which then become the basis for age-targeted mailings
of free samples and glossy subtle and not-so-subtle messages encased in
related infant and young child development infomercials.
Isomil shelf talker -- collected from an IDA
Pharmacy in Ontario, claims the
endorsement of the medical profession.
INFACT Canada's full report will be available by the end of August. Here
follows some examples from our report:
In a Newfoundland maternity
facility, the booklet 40 Weeks to Motherhood was funded by Similac. Aimed at
pregnant women -- it includes information on fetal development -- it is also
filled with product ads and invites women to join the Similac Welcome
At a clinic in Ontario, a package
called The Baby Comes First prepared by Similac and including a booklet,
video and sample of formula was in the waiting room for parents.
A new strategy used by Carnation
Good Start in advertisements announces that their formula is "specially
designed to offer complete nutrition plus an extra measure of comfort." The
whey proteins are re-named 'Comfort Proteins' and comfort is trade marked.
Becoming a parent has its rewards pamphlet
includes coupons from participating stores which offer discounted
baby products -- including
infant formula. [Right & below]
Code Article 4: Information and education
"...intended to reach pregnant women and mothers of infants and young
children, should contain clear information on all of the following points:
- the benefits and superiority of breastfeeding;
- maternal nutrition, the preparation for and maintenance of
- the negative effect on breastfeeding of introducing partial bottle
- the difficulty of reversing the decision not to breastfeed; and
- where needed, the proper use of infant formula, the social and
financial implications of its use, the health hazards of unnecessary and
A Mead Johnson baby club -- Baby Steps,
containing feeding information and a sample of Enfalac formula was sent to
new mothers around the estimated time of delivery.
Sobey's supermarket in St.
John's, Newfoundland, hosted extensive formula displays and gave free
samples of formula to mothers.
Sampling companies such as
Samplex include formula, bottles and pacifiers in packages designed to be
bought inexpensively as gift packs for expectant or new mothers. These are
sold at IDA, Zeller's and many others.
Samples of formula are mailed
directly to the homes of pregnant women, with follow-up mailings every two
months or so -- often because mothers have signed up for "Baby Clubs" such
as the Good Start program (Nestlé), Baby Steps (Mead Johnson) or Welcome
Baby (Abbott Ross). Some of these clubs are sponsored by stores such as
Sears. Mothers may also sign up through ads in magazines like Today's
Good Start -- a Nestlé gift pack sent to a
first-time mother in Ontario, containing Alsoy formula (without a warning of
the potential risks of soy) and product information.
"Linked sales" are a new strategy
where products such as Pampers disposable diapers and baby toys come with
information about formula. In another example, Pedialyte rehydration
solution comes with a sample of Isomil formula and recommendation that
babies with diarrhea be given a non-dairy milk.
Direct advertising and financial inducements
in the form of Bonus Air Miles and discounts on products are common
Code Article 5: The general public and mothers
There should be no advertising or other form of promotion to the
general public of products within the scope of this code.
Manufacturers and distributors should not provide to pregnant women,
mothers or members of their families, samples of products within the scope
of this code.
There should be no point-of-sale advertising, giving of samples, or
any device to induce sales -- special displays, discount coupons, premiums,
special sales, loss-leaders and tie-in sales.
Marketing personnel should not seek direct or indirect contact with
pregnant women or with mothers of infants and young children.
Feeding your Baby -- A hospital in Canada
gave this gift pack to a new mother on discharge from maternity; it
contained product information and three cans of Similac formula.
At the Albany Medical Clinic in
Ontario, a table in the waiting room displayed formula samples and a booklet
promoting Similac Advance formula. The baby change table in the same office
had a similar display box with Isomil Soy Formula and included sample cans.
Hospitals continue to give "gift
packs" with formula samples to new mothers when they are discharged with
Financial and other supports are
given to health care professionals and institutions -- for example, Nestlé's
Good Start program contributes to the Hospital for Sick Children, and
conferences for health professionals are co-sponsored by Health Canada and
Nestlé's Baby Days -- a television series
aired across Canada uses images and
language to promote formula feeding.
Code Article 6: The health care systems
No facility of a health care system should be used for the purpose of
promoting infant formula or other products in the scope of this code.
For parents wanting advice on
infant feeding, all formula companies offer toll-free access to the nurses
and nutritionists employed for this purpose.
Nestlé employees at the Pickering
Baby Expo in Ontario gave advice and free samples of formula to pregnant
women and mothers of babies.
Nestlé Baby Cereal depicting a young baby.
Code Article 8: Persons employed by manufacturers and distributors
Personnel employed in marketing products covered by the Code should
not perform educational functions in relationship to pregnant women or
mothers of infants and young children.
Playtex bottles are advertised on
the package as "better for baby ... most like mother."
Milupa cereals are marketed as
being suitable for babies in four stages: #1 First solid feedings, #2 From
first fruit feeding, #3 From about six months, #4 From about 12 months.
Heinz juices are sold in bottles
with a picture of a baby on the front and a threaded neck so that feeding
bottle tops and teats can be attached.
While Nestlé does not have a
picture of a baby on the can, the full-page ads in parenting magazines show
a large photo of a baby.
Heinz rice cereal labelled "Phase One" has a
picture of a very young baby on the box. This implies the age of
introduction at less than the recommended six months.
Code Article 9. Labelling
Labels should not have pictures of infants, nor pictures or text which
may idealize the use of infant formula. The terms "humanized" or "maternalized"
or similar terms should not be used. WHA Resolution 54.2 specifically
mentions that health claims should not be used to idealize infant formulas.
Enfalac AR is a formula with
added rice cereal, and promoted as a remedy for babies who spit up
frequently. Such health claims are clearly misleading and violate article 9
of the Code.