Nestlé Alimentana of Vevey, Switzerland, one of the world’s
largest food-processing companies with worldwide sales of over
$100 billion, has been the subject of an international boycott. For
over 20 years, beginning with a Pan American Health Organi-
zation allegation, Nestlé has been directly or indirectly charged
with involvement in the death of Third World infants. The charges
evolve around the sale of infant feeding formula, which allegedly
is the cause for mass deaths of babies in the Third World.
In 1974 a British journalist published a report that suggested
that powdered-formula manufacturers contributed to the death
of Third World infants by hard-selling their products to people
incapable of using them properly. The 28-page report accused
the industry of encouraging mothers to give up
east feeding and
use powdered milk formulas. The report was later published by the
Third World Working Group, a lo
y in support of less developed
countries. The pamphlet was entitled “Nestlé Kills Babies,” and
accused Nestlé of unethical and immoral behavior.
Although there are several companies that market infant baby
formula internationally, Nestlé received most of the attention. This
incident raises several issues important to all multinational compa-
nies. Before addressing these issues, let’s look more closely at the
charges by the Infant Formula Action Coalition and others and the
defense by Nestlé.
THE CHARGES
Most of the charges against infant formulas focus on the issue of
whether advertising and marketing of such products have discour-
aged
east feeding among Third World mothers and have led to
misuse of the products, thus contributing to infant malnutrition
and death. Following are some of the charges made:
• A Peruvian nurse reported that formula had found its way to
Amazon tribes deep in the jungles of northern Peru. There,
where the only water comes from a highly contaminated
iver—which also serves as the local laundry and toilet—
formula-fed babies came down with recu
ing attacks of
dia
hea and vomiting.
• Throughout the Third World, many parents dilute the
formula to stretch their supply. Some even believe the bottle
itself has nutrient qualities and merely fill it with water. The
esult is extreme malnutrition.
• One doctor reported that in a rural area, one newborn male
weighed 7 pounds. At four months of age, he weighed
5 pounds. His sister, aged 18 months, weighed 12 pounds,
what one would expect a four-month-old baby to weigh. She
later weighed only 8 pounds. The children had never been
east fed, and since birth their diets were basically bottle
feeding. For a four-month-old baby, one can of formula
should have lasted just under three days. The mother said
that one can lasted two weeks to feed both children.
• In rural Mexico, the Philippines, Central America, and
the whole of Africa, there has been a dramatic decrease in
the incidence of
east feeding. Critics blame the decline
largely on the intensive advertising and promotion of
infant formula. Clever radio jingles extol the wonders of
the “white man’s powder that will make baby grow and
glow.” “Milk nurses” visit nursing mothers in hospitals
and their homes and provide samples of formula. These
activities encourage mothers to give up
east feeding and
esort to bottle feeding because it is “the fashionable thing
to do or because people are putting it to them that this is
the thing to do.”
THE DEFENSE
The following points are made in defense of the marketing of baby
formula in Third World countries:
• Nestlé argues that the company has never advocated bottle
feeding instead of
east feeding. All its products ca
y a
statement that
east feeding is best. The company states
that it “believes that
east milk is the best food for infants
and encourages
east feeding around the world as it has
done for decades.” The company offers as support of this
statement one of Nestlé’s oldest educational booklets on
“Infant Feeding and Hygiene,” which dates from 1913 and
encourages
east feeding.
• However, the company does believe that infant formula
has a vital role in proper infant nutrition as a supplement,
when the infant needs nutritionally adequate and appropri-
ate foods in addition to
east milk, and as a substitute for
east milk when a mother cannot or chooses not to
east
feed. One doctor reports, “Economically deprived and
thus dietarily deprived mothers who give their children
only
east milk are raising infants whose growth rates
egin to slow noticeably at about the age of three months.
These mothers then turn to supplemental feedings that are
often harmful to children. These include he
al teas and
concoctions of rice water or corn water and sweetened,
condensed milk. These feedings can also be prepared
with contaminated water and are served in unsanitary
conditions.”
• Mothers in developing nations often have dietary deficien-
cies. In the Philippines, a mother in a poor family who is
nursing a child produces about a pint of milk daily. Mothers
in the United States usually produce about a quart of milk
each day. For both the Filipino and U.S. mothers, the milk
produced is equally nutritious. The problem is that there is
less of it for the Filipino baby. If the Filipino mother doesn’t
augment the child’s diet, malnutrition develops.
• Many poor women in the Third World bottle feed because
their work schedules in fields or factories will not permit
east feeding. The infant feeding controversy has largely to
do with the gradual introduction of weaning foods during
the period between three months and two years. The average
well-nourished Western woman, weighing 20 to 30 pounds
more than most women in less developed countries, cannot
Nestlé: The Infant Formula ControversyCASE 1-2
cat42162_case1_01-016.indd 5 21/10/15 2:49 pm
Part 6 Supplementary Material
feed only
east milk beyond five or six months. The claim
that Third World women can
east feed exclusively for one
or two years and have healthy, well-developed children is
outrageous. Thus, all children beyond the ages of five to
six months require supplemental feeding.
• Weaning foods can be classified as either native cereal
gruels of millet or rice, or commercial manufactured milk
formula. Traditional native weaning foods are usually made
y mixing maize, rice, or millet flour with water and then
cooking the mixture. Other weaning foods found in use are
crushed crackers, sugar and water, and mashed bananas.
• There are two basic dangers to the use of native weaning
foods. First, the nutritional quality of the native gruels is
low. Second, microbiological contamination of the tradi-
tional weaning foods is a certainty in many Third World
settings. The millet or the flour is likely to be contami-
nated, the water used in cooking will most certainly be
contaminated, and the cooking containers will be contami-
nated; therefore, the native gruel, even after it is cooked,
is frequently contaminated with colon bacilli, staph, and
other dangerous bacteria. Moreover, large batches of
gruel are often made and allowed to sit, inviting further
contamination.
• Scientists recently compared the microbiological contamina-
tion of a local native gruel with ordinary reconstituted milk
formula prepared under primitive conditions. They found
oth were contaminated to similar dangerous levels.
• The real nutritional problem in the Third World is not
whether to give infants
east milk or formula but how to
supplement mothers’ milk with nutritionally adequate foods
when they are needed. Finding adequate locally produced,
nutritionally sound supplements to mothers’ milk and teach-
ing people how to prepare and use them safely are the issues.
Only effective nutrition education along with improved
sanitation and good food that people can afford will win the
fight against dietary deficiencies in the Third World.
THE RESOLUTION
In 1974, Nestlé, aware of changing social patterns in the develop-
ing world and the increased access to radio and television there,
eviewed its marketing practices on a region-by-region basis.
As a result, mass media advertising of infant formula began to
e phased out immediately in certain markets and, by 1978, was
anned worldwide by the company. Nestlé then undertook to ca
y
out more comprehensive health education programs to ensure that
an understanding of the proper use of their products reached moth-
ers, particularly in rural areas.
“Nestlé fully supports the WHO [World Health Organization]
Code. Nestlé will continue to promote
east feeding and ensure
that its marketing practices do not discourage
east feeding any-
where. Our company intends to maintain a constructive dialogue
with governments and health professionals in all the countries it
serves with the sole purpose of servicing mothers and the health of
abies.” This quote is from “Nestlé Discusses the Recommended
WHO Infant Formula Code.”
In 1977, the Interfaith Center on Corporate Responsibility in
New York compiled a case against formula feeding in developing
nations, and the Third World Institute launched a boycott against
many Nestlé products. Its aim was to halt promotion of infant
formulas in the Third World. The Infant Formula Action Coalition
(INFACT, successor to the Third World Institute), along with
several other world organizations, successfully lo
ied the World
Health Organization to draft a code to regulate the advertising and
marketing of infant formula in the Third World. In 1981, by a vote
of 114 to 1 (three countries abstained, and the United States was
the only dissenting vote), 118 member nations of WHO endorsed
a voluntary code. The eight-page code urged a worldwide ban on
promotion and advertising of baby formula and called for a halt
to distribution of free product samples or gifts to physicians who
promoted the use of the formula as a substitute for
east milk.
In May 1981, Nestlé announced it would support the code and
waited for individual countries to pass national codes that would then
e put into effect. Unfortunately, very few such codes were forthcom-
ing. By the end of 1983, only 25 of the 157 member nations of the
WHO had established national codes. Accordingly, Nestlé manage-
ment determined it would have to apply the code in the absence of
national legislation, and in Fe
uary 1982, it issued instructions to
marketing personnel that delineated the company’s best understand-
ing of the code and what would have to be done to follow it.
In addition, in May 1982 Nestlé formed