Letter to the organizers of the First Annual Canadian Perinatal and Pediatric Conference

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INFACT Quebec 925 Davaar ave. Outremont, QC H2V3B7 infactquebec@videotron.ca

March 19, 2011

Christine Larue SAAC – local 6805 CHU Sainte-Justine 3175 Côte-Sainte-Catherine, Montréal (Québec) H3T 1C5

Dear Madame Larue

As president of INFACT (Infant Feeding Action Coalition) Quebec I am writing to you with respect to the upcoming first Annual Canadian Perinatal and Pediatric Conference http://saac.chu-sainte-justine.org/pages/2010/prog.nutrition-webf.pdf being held in Montreal on April 15 & 16, 2011. INFACT (Infant Feeding Action Coalition) Quebec is a non-governmental organization that works to protect infant and young child health, as well as maternal well being through the promotion and support of breastfeeding and optimal infant feeding practices. INFACT Quebec is surprised and dismayed to learn that Sainte-Justine Hospital has associated itself with a conference that is sponsored by Nestlé Nutrition.

We are aware that Sainte-Justine is actively working towards the “Baby Friendly Initiative™” and has received financial support from the Chagnon Foundation for this process. The “Baby Friendly Initiative™” includes compliance with the International Code of Marketing of Breastmilk Substitutes. World Health Assembly resolution 49.15 expresses “Member states should ensure that the financial support for professionals working in infant and young child health does not create conflicts of interest, especially with regards to the WHO/UNICEF Baby Friendly Hospital Initiative”.

It is important for pediatricians to recognize the influence of companies that market commercially manufactured infant milk direct to the public and to avoid intentionally or inadvertently promoting both the companies and the products they produce. The fact that Nestle is acknowledged in the brochure is a form of publicity. This is a conflict of interest with respect to the aforementioned international code, which was put in place in an attempt to support and protect breastfeeding mother-infant dyads.

The relationship between doctors, patients and society as a whole is termed a “fiduciary” relationship, which implies a particular duty to avoid conflicts of interest. Sponsorship by companies who commercially manufacture infant milk by its nature creates a conflict of interest. Whether it is in the form of gifts, meals, or assistance with conference expenses, such sponsorship creates a sense of obligation and a need to reciprocate in some way. Historically this way has been for recipients to use their influence upon the public to ‘suggest’ sponsor products.

Nestlé has an extensive record of engaging in what many have perceived as irresponsible social and environmental practices which has led to a world-wide boycott of it’s products that is still ongoing. Most concerning is their methods of marketing commercially manufactured infant milk and repeated, systematic violations of the UNICEF/WHO International Code of Marketing of Breastmilk Substitutes and subsequent related resolutions.

Consider the fact that Nestlé is the largest promoter of infant formula in the world, a product that is neither affordable nor safe in many communities and which erodes the food security of infants and young children, the most vulnerable members of society. Nestlé’s participation through the unrestricted education grant, in the upcoming conference, restricts the freedom of participants to analyze the important issues independently. The very presence of this company can very well adversely affect stakeholder decision making.

There has evidently been a lack of communication with other parts of your hospital when the decision was made to hold this event. INFACT Quebec would encourage you to speak to the breastfeeding committee members at Sainte-Justine to understand why this association between Sainte-Justine and Nestlé is professionally, politically and ethically of concern. INFACT Quebec calls upon you to immediately and publicly disengage Sainte-Justine hospital from this and any other affiliation with Nestlé Nutrition and all companies that violate the International Code of Marketing of Breastmilk substitutes.

Working together with the lactation community, it is possible for Sainte-Justine, already an internationally recognized and prestigious institution, to become an internationally recognized and prestigious “Baby Friendly™” Hospital.

Respectfully yours,

Carole Dobrich RN, IBCLC
INFACT Quebec President On behalf of the INFACT Quebec BOD and members.

Cc: Joelle fortier, Isabelle Bayard, Johanne Charron, Louise Lavallée Côté, Dr Fernando Alvarez, Dr Fabrice P. Brunet, Dr Christine Collin, Dr Josée Dubois, Émile Levy, Lise Bouthillier, Dr Valérie Marchand

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