nestl© ncompany, marketing its products in almost every country

53IBFAN -- International Baby Food Action Network

estlé claims to be the world's largest and most diversified foodcompany, marketing its products in almost every country in theN

world. It has grown in the Americas and in Europe, mainly by buying upsmaller food companies, by joint ventures and take-overs. In 1985 Nestléacquired Carnation to win a share of the lucrative US baby food market.Later it bought the Wyeth division of baby foods in Canada.

In Asia, there are fewer companies to take over but Nestlé expects to growfaster on its own steam. At a press meeting in 2003, Nestlé pointed to the2.4 billion consumers in China and India combined and said it counted onChina to become the company's biggest market. Indonesia with 220million people is a big third in Nestlé's planning.

In terms of product development, Nestlé was quick to have seen thepotential growth of 'functional' foods compared to ‘normal’ foods.“Functional food”, Nestlé researchers say, “provides a specific health orperformance benefit over that of consuming a normal healthy diet” (sic).Its market grows at about 9% per year, versus 2% for ‘normal’ food.Instead of creating new brands, Nestlé has been adding a claimed healthbenefit to existing products and portrays those benefits through brandedactive ingredients or ‘logos’ such as “Prebio 1” or “Omega Plus”,“Comfort Proteins” and “Bifidus”.

In consumer reports, shareholder publications and in reports to the WHO,Nestlé claims to abide by the International Code. Evidence in this reportonce again shows otherwise. The consumer Boycott of Nestlé productscontinues in some 20 countries aiming to force the company to fulfill itspledge to comply with the Code. As a first step, Boycott organisers haveasked Nestlé to accept that the Code and Resolutions are minimumrequirements for all countries. The company refuses to do so.

In 1999 the UK Advertising Standards Authority ruled against Nestlé'sclaim that it markets infant formula 'ethically and responsibly'. In 2000the company refused to attend a European Parliament hearing into itsmarketing of baby foods. In January 2004, the UK Trading StandardsOffice asked retailers to stop displaying and selling US parentingmagazines containing advertisements for infant formula, includingNestlé brands.

Nestle's interpretation of the Code restricts the scope to infant formulaand follow-on formula by the same brand name. Even under this verylimited interpretation, Nestle ‘breaks the rules’ as demonstrated byevidence in this report. See Section 1.

Where national measures are inadequate or have expired, as is thecase in Armenia and Thailand, Nestle and other companies are quick toreturn to aggressive and competitive marketing tactics, including freeformula supplies to hospitals, samples for mothers, media advertising andseducing health workers with gifts. They only abide by the Codegrudgingly when forced.

In September 2001, Nestlé claimed it supported the WHO recommen-dation of exclusive breastfeeding for six months and would “changelabels of complementary foods, including infant cereals and jarred babyfoods currently marketed between 4 and 6 months” in more than 150“developing countries.”

Nestlé

Peter Brabeck-LetmatheCEONestlé S.A.Avenue Nestlé 55CH-1800 Vevey, SwitzerlandTel: +41 21 9242111Fax: +41 21 924 2813Website: www.nestle.com

FORMULA:Aletemil, Alfaré, AL110, CarnationAlsoy, Carnation Follow-up Soy,Alprem, Aletemil HA, Bear Brand,Beba, Beba HA, Beba Pre, BebaSensitive, Carnation Good Start,Carnation Follow-Up, Lactogen,Guigoz, Nan, Nan AR, Nan HA, NanSoya, Pre Nan, Nestogen, Nidal,Nidina and Pelargon.

COMPLEMENTARY FOODS:Alete, Alete HA Brei, Baby Menu,Cerelac, Nestlé Cereal, Nestlé CHE,Nestlé Legumes, Nestlé Bubur Susu,Nestlé Rice, Nestum, Nestlé PrimaInfanzia.

Products include:

Another new icon, Blue Bear, hasinvaded hospitals and shops aroundthe world. Blue Bear is conspicuouson all promotion for complementaryfoods and has become an instantlyrecognisable mascot even without thecompany name.

Violations by Nestle have been divided into two sections:Formulas and Complementary foods.

Logos & Icons:Nestlé’s trademark family of birdshave been fattened up and have nowbecome an icon on formula labelsand gift items.

Breaking the Rules, Stretching the Rules 2004

54 International Baby Food Action Network -- IBFAN

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Nestle and six months exclusive breastfeedingHealth campaigners have long been concerned about the promotion of products which encourage early weaning. In1994, the World Health Assembly passed a Resolution calling for action on "fostering appropriate complementaryfeeding practices from the age of about six months … emphasizing continued breastfeeding … and frequent feed-ing with safe and adequate amounts of local foods." This means that complementary foods should not be promotedfor use before the age of six months and that local foods can be an adequate complement to sustained breastfeeding.Because there was little action, in 1996 the World Health Assembly repeated its call and urged that "complementaryfoods are not marketed for or used in ways that undermine exclusive and sustained breastfeeding". Finally, in 2001the Assembly issued another recommendation on "six months" and only then Nestlé, as the market leader, an-nounced that it would comply.In April 2003 the company announced that it had "completed label changes on complementary foods to follow thesix-month recommendation". During their general monitoring, IBFAN observers have checked the age recommen-dations of all companies and provide evidence that the change promised by Nestlé finally occurred in many coun-tries but not in all. See Section 2 for continuing violations.It is hoped that Nestlé will abandon its double standard and apply the change in all countries, reflecting the univer-sality of the Code and subsequent Resolutions. Other companies would have to follow suit if Nestlé continues adecisive leadership role.However, at the end of 2003, Nestlé gave a large grant to the American Academy of Pediatrics (AAP) to pay for thecost of sending the AAP 2004 Pediatric Nutrition Handbook for free to over 50,000 doctors. The Handbook re-verses AAP's 2000 endorsement of "six months exclusive breastfeeding" by going back to the old “4 to 6 months.”The Handbook mentions “4 to 6 months” several times but has only one footnote to say that the AAP Section onBreastfeeding favours the 6-month recommendation. Double standards once again?

Section 1 – Promotion of formulas

Promotion to the public

Article 5.1 of the Code prohibits advertising and allother forms of promotion of products under the scope ofthe Code.

Article 5.2 and 5.4 of the Code prohibit companiesfrom giving samples and gifts to mothers.

In Argentina, a Nestlédistributor uses the Internet(www.etoledo.com.ar) topromote sales of Nan 1 and2, Nidina and Nestlécereals. The text includesan idealising statementwhich claims Nan 2 is a“maternalised milk”.

Nestlé gives free samples of Nan 1 in Bulgaria.

A magazine ad in Lithuania pro-moting Nan 2 shows an infanthand reaching for support from anadult.

In Switzerland, an advertisementBaby Nutrition from Nestlé in asupermarket magazine promotesBeba 2 and other products andstates that parents can be assured

“…that their child gets, at any step of his development,the nutrition precisely correspondent to his needs.From milk formulas to the delicious little completemenus…”. There is a picture of a happy mother andchild.

A parent’s magazine in Luxembourg advertises BebaSensitive special formula with the claim that “Bebais nearly lactose free and suitable for infants whoare sensitive to lactose” andthe product gives “the safefeeling to make the rightchoice.”

A French magazine ad says“Nidal Bifidus 2 thanksmothers for being themodel” thereby equatingits formula to mother’smilk.

Nestlé maintains a US web site: verybestbaby.comIt promotes Good Start formula with the slogan “It’sthe Good Start that will last a lifetime.”

The baby formulas section claims its Good Start“Comfort Proteins” are gentle on a baby’s tummy andare “patterned after breastmilk” containing the “rec-ommended levels of fat, carbohydrates, vitamins andminerals for baby’s first year.”

Breaking the Rules, Stretching the Rules 2004 NESTLÉ


The section on “Choosing a Formula For Your Baby”idealises bottle feeding by suggesting that “bottlefeeding offers another opportunity for you and otherfamily members to comfort your baby”. The sectionends with a promotional message “When choosing aroutine formula for your newborn, consider iron-for-tified Nestlé Good Start Supreme DHA & ARA”

Nan 2 is promoted asRoyal feeding in aclever ad in Kinderenmagazine, Netherlands.“Royal feeding” inDutch “Vorstvoeding”is only one letter awayfrom Borstvoeding(breastfeeding). The adappeared one monthafter the birth of aprincess in the RoyalDutch family. N.B.–Like in other EU countries,the Dutch law is weaker than theInternational Code and allows for advertising in publications specialisingin babycare. The International Code does NOT permit this. Nestlé’s ownInstructions forbid promotion of follow-up formula when the brand nameis the same as the infant formula name.

In an amazing flyer obtained on a city bus inGaborone, Botswana, Nestle violates every articleof the Code by showing that it does not!

In Thailand, Nestlé gives out samples like Lactogen1 and Nan 1 to mothers at home. Samples of BearBrand follow-up formula are given to mothers in anintroduction scheme where mothers are asked to pro-vide their friends’ contact information to Nestlé.

* Upon complaint, Nestlé claims that these leaflets were used to“educate their distributors and salespeople in South Africa.”

Promotion at point-of-sale

Article 5.3 of the Code bans promotional devices at theretail level.

Nestlé sends sales reps to shops and supermarkets inFuzhou, Nanjing and Wuhan in China to promote Nanand Lactogen.

Fortnightly, Nestlé representatives leave promotionalmaterials on Nan products at a pharmacy in SanCristobal in the Dominican Republic. Employees re-ceive free samples for themselves and to pass on tocustomers.

In Indonesia, Nestlé promotes Lactogen and Nanthrough salespeople in pharmacies in Gowa andSidoardjo. It also offers discounts to customers buy-ing Nan 1 in shops in Surabaya.

In Thailand, Nestlé gives out samples of products likeLactogen 1 and Nan 1 to mothers in shops.

In Armenia, thereare special displaysof Nan. Posters ofthe blue bear logohave the slogan“Start with thebest.”

In Indonesia, a dis-play of Nan productsis prominently set upnear the entrance of ashop in Solo.

Nestle promotesNan HA 1 andNan 1 by organi-sing special salesin Taiwan.

In Malaysia, Nan2 sold out quicklywhen promoted asa special offer.

A supermarket maga-zine in Switzerlandpromotes a range ofNestlé formulas andcomplementary foodssuch as Beba 2 andBeba 2 HA and jarredfoods all recom-mended as suitable from four months.

The ad says “you don’t need to bea successor to the throne to be fedin a princely way.” “Nestle. For alllittle princes and princesses.”



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Gifts to health workers

Article 7.3 provides that there should be no financial ormaterial inducement, to promote products.

In Colombia, Costa Rica and the Dominican Repub-lic, gifts such as mouse pads, diaries, clocks, prescrip-tion pads and stationeries, all with the Nestlé nameand logo, are distributed to health workers.

In Germany, Nestlé provides health workers with in-formation records used for the transfer of newbornsduring emergencies. The Alete brand logo appearsat the bottom of the sheet with the slogan “All thebest for your child”.

Promotion in health facilities:samples and supplies

WHA Resolution 47.5 (1994) urges an end to free orsubsidised donations of products to all parts of the healthcare system.

In Thailand,

Nestle provides health facilities with free supplies ofLactogen 1, Nan 1, Nan HA and Bear Brand fol-low-up milk.

it recommends the use of its products by distributingpromotional materials and samples, offers services andgifts such as special classes on infant feeding andvideo tapes on pre-natal care such as “Guide for ex-pectant mother” to promote company loyalty amongwomen at a time when they are making infant feedingdecisions.

it persuades pregnant women and mothers to fill informs with their contact information and expected de-livery date so that specific product promotion can bemailed out at appropriate stages. Health facilities areasked to distribute samples and sign-up sheets tomothers.

In the Chinese provinces Fujian, Nanjing and Jiangsu,Nestlé donates unsolicited infant formula Nan 1 tohospitals including Baby Friendly ones.

In Argentina, mothers receive free samples of NanSoya in health facilities.

In Armenia, two 450 g tins ofAlfaré hypo-allergenic for-mula marked “sample for profes-sional evaluation” are routinelygiven to each patient in a resusci-tation unit. Doctors fill up requestforms but no evaluation is con-ducted.

In the Dominican Republic, Nestlé representativesprovide free infant formula for display in clinics whichthe paediatricians will then prescribe to mothers. Inone clinic, mothers received Nan 1 infant formulafrom nursing staff in the perinatal room and also Lac-togen, Nestogen and Nestlé Cereals elsewhere.

In Peru, Nestlé offers supplies of Nan.

In Indonesia, Nestlé is reported to have donated sup-plies of Nan 1 and Lactogen 1, either:

unsolicitedor upon request of health workersor as a sale without collecting paymentor at a hefty discount.

New mother with Lactogen 1 sample inIndonesia

The company alsodistributes samplesof Nan 1 andLactogen 1 tomothers throughIndonesian mid-wives. Nestlé repsthen call on newmothers at home toenquire whetherthey are still givingtheir babies Nestléproducts.

it actively promotes Nan 1 and Lactogen 1 to preg-nant women and mothers in health facilities; mothersare given samples purportedly to ‘help them savemoney.’

it distributesLactogen 1and Nan 1and gift packsthroughobstetricians,paediatricians,nurses andgeneralhealthworkers who passthem on to mothers.



In Armenia,

Nestlédistributes“Love my mom”baby suits to poly-clinics andmaternities.

Promotional leaf-lets on Nan aredistributed to poly-clinics and then passedon to mothers.

Nestlé distributes prescriptionforms to doctors in clinics inArmenia. The prescriptionsare given to mothers to taketo pharmacies where they pur-chase whatever Nestlé prod-uct is prescribed. Doctorsthen get a commission, report-edly about 10% of the sale.

A similar scheme is said to beoperating in Bulgaria wherethe commission is said to be 7%.

The NestléBlue Bearmascot ispositioned insuch a waythat theslogan reads“I love myNestlé mom”

Doctors fill in their name,

their clinic and the brand

to get a commission

Nestlé desk calendar implying medicalendorsement

In Serbia and Montenegro, Nestlé distributes table cal-endars as gifts to health workers.

Nestlé wall clocks are displayed in a South Africanhealth facility.

Nestlé in Nigeria givesout notepads to healthworkers. Each pagereminds them of theNestlé name and logowith a caption promotingthe company as “...theexperts in nutrition.”

In Indonesia,Nestlé distrib-utes posters,diaries, calen-dars, stationeryand materialson infant careand nutrition tohealth facilitieswhich are displayed in waiting rooms, nurseries anddoctors’ offices. Many of these materials contain pro-motional pictures and text for products such as Nanand Lactogen. Nestlé also provides gifts for distri-bution to mothers. Gifts vary depending on which classmothers are warded in.

Nestlé distributes many gifts to health workers in Thai-land which feature the company name with and with-out the logo of the ‘fattened birds’ – organisers, book-lets and growth charts, pregnancy cycle cards, candles,paper holders, toys, bags and pens.

Gifts tohealthworkers inThailand

In the UAE, Nestlé distributes every year expensivedesk and pocket diaries to health workers.

The inside pages of the 2004 diaries promote Nan 1, Nan 2,Cerelac and Neslac in the UAE

Nestlé apron worn by a health worker in Venezuela

In Venezuela, Nestlé distributes aprons with the com-pany name and logo to nurses and other workers inpaediatric wards.



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Labelling

Article 9 of the Code requires labels to NOT discouragebreastfeeding and to inform about the correct use of theproduct and the risk of misuse.

In most developing countries, Nestlé’s formula labelscomply with the Code to a large extent although theyuse small print for the required warnings. Several, how-ever, do violate Article 9 by comparing the product tobreastmilk and by using idealising statements such as:

In China, Nan 1 labels say“Choose quality food, chooseNestlé” and claim that theproduct is close to breastmilk.Nan 1 is idealised by the claimthat its low phosphorous contenthelps calcium absorption andpromotes the growth of Bifidusbacteria.

The Nan label in Finland claims that it “can be usedfrom birth as an addition to breastmilk or to substi-tute it” and that the “amino acid composition of theproduct has been renewed…able to reduce the amountof protein which is now closer to the protein level ofbreastmilk”.

In Mexico, Nestlé’s Nan 2 label and in Peru Nan 1claim the product have “new improved protein effi-ciency from start.”

In South Africa, the Lactogen 1 label suggests theproduct has the same benefits as breastmilk with theclaim that it "has all vitamins and minerals requiredby an infant for growth and development."

The Pelargon label in Tanzania promotes its higheracidic content as being able to aid digestion.

Nestlé occasionally fails to comply with the local lan-guage requirement on infant formula labels. In somecases, there is inaccurate translation. For example:

In Armenia,

the Alfaré label has instructions in 13 languages andtranslation is inconsistent. For example the statement:“Semi-elemental formula with low osmotic activity”in Russian reads as “semi-elemental formula with lowasthmatic activity” in Armenian.

Translation is also inconsistent on the Nestogen la-bel. In Russian, there is a statement that breastmilk isthe ideal nutrition for a“newborn”, meaning a babybelow one month, while in Armenian breastmilk issaid to be ideal for a “baby”.

Labels on Pre Nan, Nan Hypoallergenic 1, andPelargon in South Africa are only in English with-out the local languages as required by the Code.

Nan and Nestogenproducts in Armeniaand Georgia carry im-ages of a large feedingbottle on the label, thuspromoting the culture ofbottle-feeding. (bottleson labels are only al-lowed for illustrating themethod of preparation).

Nestle’s Nan 1 label in Zimbabwe which originatesfrom South Africa is not in the two main local lan-guages which are chiShona and isiNdebele.

Booklets and brochures for doctors proclaim thatbreastmilk is best for babies and the warnings aboutthe hazards of bottle feeding are there– in tiny print! – so legally, Nestlécomplies with the Code. In practice,promotion dominates by far.

Article 4.2 requires all information material to advocatefor breastfeeding and not contain pictures or text whichidealises the use of breastmilk substitutes.

For health professionals, Article 7.2 of the Code only allowsproduct information which is factual and scientific.

Misleading text and pictureswhich violate the Code

Most Nestlé materials are marked “for the medical pro-fession” but they fail to meet the criteria set down underArticles 4.2 and & 7.2 The following are examples ofmaterials which fail to meet the mark and are often sup-plied in bulk and thus made freely available to mothers.

Argentina

Advertisements in professionaljournals and leaflets promoteNan as “the most complete,balanced and safe range of in-fant formulas” and “… clos-est to mother’s milk, at lowestprice”, “nutritive and naturalas your love” and “the mosteconomic starter formula”.

A Nan 2 promotion “Nutritionallysuperior to cow’s milk” whileNan HA says “Infant formulawhich prevents allergy”.



Armenia

A leaflet found in a paediatric hospital claims Nan isa fully adapted infant formula and is close to humanmilk in content and digestibility.

Nan leaflets – Nan: New with improved quality ofproteins and Nestlé Nan Acidophilic - distributed tohealth workers at a Nestlé conference make broadclaims comparing the product with breastmilk andcompare the growth of the breastfed child with onewho is fed new Nan. There are statements whichclaim that Nan promotes formation of bones, braindevelopment and visual acuity.

At a paediatric congress, a Nestlé poster and an ad-vertisement in a scientific journal both claim (liquid)Nan is “The most intelligent choice when it is neces-sary to replace breastmilk; so intelligent that it evenprepares itself.”

Promotion for health workers in Armenia

“My first CD” with songs from TheBeatles and sounds of laughter of littlebabies. This CD was distributed at theArgentinean Paediatrics Congress.Inside the case is a coupon to requestinfo about Nestle’s products forbabies.

Huge packshots dominatethe congress.

A Nestlé Nutrition booklet in Russian promotes thefull range of Nestlé infant formula, Nestogen, Nan,Alsoy, Alprem and Alfaré with a summary of microand macronutrients added to the products making themcloser to breastmilk, closer to nature and fully replac-ing breastmilk.

Warnings on back page in small print

Botswana

An 8-page book-let found in aBotswanan hos-pital proclaimsthat “Growingup is ThirstyWork” and pro-motes Lactogen1 “for the hungryfull term infant”and Lactogen 2 as “specifically adapted to the needsof infants on complementary food” and “high inbioavailable iron.”

A leaflet 37ºC in the shade claims that by usingPelargon “diarrhoea and its side effects are coun-teracted” but fails to explain the risks involved inartificial feeding where water is unsafe.

Another Chinese leaflet with a similar picture asks“Why the Nan baby’s bottom is not red?” Two of thebabies suffer red bottoms but the one fed on Nan doesnot, implying that Nan 2 with Bifidus can preventsore bottoms.

An advertisement in a professional journal promotesLactogen 1 and Lactogen 2by showing a colourfulsketch of children playingaccompanied by the slogan“Look! More and MoreLactogen Babies GrowHealthily and Happily”. Theadvertisement claims thatLactogen is the leadingbrand in China and usesadvanced technology in itsmanufacture. (see page 60)

China

A leaflet in a Chinese mater-nity ward, Nan healthy baby,the future will be evenbrighter claims that Nan 1 isthe only formula that is lowin phosphorus and closest tobreastmilk. The background issimilar to a Nan label.



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Dominican Republic

A Nan leaflet in the waiting room of a paediatric clinicsays that “the best infant formulas have a composi-tion qualitatively and quantitatively adapted to hu-man milk”; “New Nan – optimum calcium phospho-rus ratio … in quantities closer to human milk”

A booklet “Nucleotides in infant nutrition” given tomothers in clinics states that “Nan 1 starter formulahas added nutrients to cover the needs of the new-born, among them nucleotides”. The booklet promotesNan 1 as equivalent to breastmilk.

Nan 1 booklet Importance of adequate protein inges-tion found in clinics bears the message - “Breastmilk:high quality protein; Nan 1: the appropriate alterna-tive”. There are tables comparing Nan 1 composi-tion to that of breastmilk. It claims that the stool pat-terns of babies fed on Nan 1 are similar to those fedon breastmilk.

A magazine advertisement for Nidina follow-up for-mula says “Give him all the protection he needs” anduses a baby picture to promote the use of Nidina asof four months.

Too little, too late – pursuant to complaints made to Nestlé China on thematerials marked on this page and on page 59, the company agreed toeither withdraw or amend the materials.

A Lactogen leafletstarts with the slo-gan “the naturalsmell of milk andDHA content makesyour baby healthyand smarter.” Thesame slogan alsoappears on a Nanleaflet. Nestlé denies it portrays bottle feeding asequivalent to breastfeeding and explains instead thatDHA oxidises easily and can develop a fish off-tasteand that Nestlé’s manufacturingprocess ensures the natural taste ofmilk is preserved.

Georgia

A Nan leaflet found in a doctor’s office claims thatits protein, carbohydrate, amino acid and mineral com-ponents are close to mother’s milk.

Germany

Booklets distributed to health workers at a perinatalconference in Berlin have many phrases discourag-ing breastfeeding or equating Nestlé products tobreastmilk. For example –

- a booklet titled Allergen-Low Infant Nutritionwith Alete displays a healthy infant on the frontpage with the motto “All the best for your child”.

- booklet for parents has advertisements forAletemil HA 1 & 2 and has the Alete slogan“All the best for your child”. There is a state-ment claiming that “Babies need allergen-lownutrition to prevent allergies. If there is notenough breastmilk, Aletemil HA is … the provenalternative from birth.”

- A booklet for parents – “Intensive care unit forinfants – advice for parents” advertises AleteHA Brei and features the Alete slogan “All thebest for your child”. Complementary feeding issuggested to start as early as four months.

- A daily nutrition booklet meant for parents rec-ommends the use of Alete complementary foodsfrom the fifth month and baby teas from the sec-ond week of life.

- A Beba booklet claims that it can solve infantcolic with its low lactose content.

Leaflets promoting Nestogen infant formula featur-ing a packshot of the product and a huge bottle andteat are found in health facilities,shops and pharmacies.

In Finland, a brochure aimed athealth care professionals comparesNan baby formula to breastmilk.

- A Beba Pre booklet uses phrases like “… his-tory of life-saving Nestlé products” to catch theattention and confidence of the reader. Text like“Beba Pre contains nucleotides modelled onbreastmilk” attempts to equate bottle feedingwith breastfeeding.

- A Beba Pre leaflet titled“Nestlé Beba Pre evennearer to the natural model”equates Beba to breastmilk.It also claims to containproteins “even closer now tomother’s milk.”

In Ghana, Nestlé reps persuade health workers of ababy-friendly hospital to accept Lactogen 1 and 2promotional leaflets on the grounds that HIV+ moth-ers, orphans, mentally sick or caesarean mothers

A Nan leaflet proclaims that“raising an intelligent child is nolonger an impossible dream”with Nan 1 and Nan 2 and thatthe Bifidus in Nan makes “ex-cellent baby”.



A leaflet found in a super-market in Arkhangelsk, Rus-sia promotes Nestogen andidealises the use of formulawith a large bottle printed onthe front and back of the leaf-let. Packshots of five otherproducts are shown – Nan,Alprem, AL110, Alsoy andAlfaré.

A six-page brochure–Nan 1 – The New Standard:Closer to the reference – inGhana is portrayed as sci-entific and factual informa-tion for health profession-als. It promotes Nan as hav-ing “a protein contentequivalent to the mean den-sity of mature breastmilkand an increased proteinquality closer to the nutrient composition of humanmilk.”

A booklet titled I amBreastfeeding my Baby is en-dorsed with the statementthat it is “Educational mate-rials for mothers for distri-bution by health profession-als only. Presented with com-pliments of Nestlé.” It con-tains misleading informationon breastfeeding and wasstopped from circulation by Ghanaian authorities inJune 2003 after complaints by health workers. InMarch 2004, the booklet, purportedly revised, is backin circulation but still has misleading information par-ticularly on positioning and attachment.

would need it. Thefront of the leafletshows packshots ofLactogen 1 and 2,while under Lacto-gen 1 it says “theright choice” andunder Lactogen 2,“Two feeds of Lactogen 2 a day provides the dailyprotection needs of the infant”.

A poster displayed in a pharmacy in South Africa –“The Lactogen range, the specialty range and intro-ducing the range of Nan” – shows a row of Lactogenand Nan products.

When closed, leaflet seems topromote breastfeeding ...

When opened, a differentstory unfolds!

Thailand

A Nan 1 brochure claims to have “new improved pro-tein efficiency” and starts with the statement that“breastmilk is best” with a page showing the face of ababy next to another page showing the mother’s breast.The leaflet opens up to symbolically separate the babyfrom the breast with a picture of Nan 1 and the state-ment that “Nan 1 is closer now than ever ...”

A Nan 1 brochure found in a Thai hospital claims theproduct “gives valuable nutrients which have com-plete benefits for baby from birth to one year.” It alsoequates the product with breastmilk by claiming that“the amino acid profile of Nan 1 is close to breastmilkand is suitable for the best growth”. The brochureuses the picture of a lovely healthy baby with the cap-tion “add value with quality protein…”.

A brochure Protect your baby from allergy shows apicture of a healthy looking baby with a happy fam-ily. The brochure states that if a mother is not able tobreastfeed, the risk of allergy in the baby will increaseand the alternative would be to use Nan HA formulawhich is similar to breastmilk.

Another Serbian brochure entitledNan 2 Follow-Up for Older Infantsshows a beautiful picture of a baby’shand clutching an adult’s finger to-gether with the Blue Bear mascoton a label of Nan 2. It couldsymbolise bonding. It also equatesbottle feeding to breastfeeding bystating that “Nan is the first choiceat the right moment”.

A Nan booklet found in a doctor’soffice in Serbia promotes its lac-tose-free formula by implying medi-cal endorsement of the product witha nurse’s cap and a stethoscope‘worn’ by a Nan tin.



NESTLÉ

Other brochures found in a hospital promote Nan HAunder different slogans such as “Protect your belovedbaby from allergy”, “Nan HA: for baby…there’s norisk involved.” All claim to decrease the risk of aller-gies in a child because of small molecules of proteinswhich ease digestion and absorption like breastmilk.A statement boldly equates Nan HA to breastmilk bystating that “If mother cannot breastfeed, risk of al-lergy will be increased. The other choice ishypoallergenic formula (HA) which is similar tobreastmilk.”

A leaflet given out at a perinatal conference offersfree membership of Nestlé’s Dear Mom Club whichcomes with the promise of programmes for motherand child and free gifts.

A selection of the many information materials for health professionalsinThailand – they are not restricted to scientific and factual matters.

A leaflet on Nan HA, Nan 1 and Nan 2 with a healthybaby picture idealises the use of the products with thecaption “Complete nutrition for healthy growth anddevelopment”.

A Nan 2 brochure, part of a set called Full of Lovefrom Mother’s Breast claims that it contains BifidusBL which promotes body resistance and prevents in-fection the same way as in breastfed children. An-other brochure in this set promotes Nan HA as simi-lar to breastmilk with a statement “Breastfed babyand/or Nan HA fed baby can reduce the incidence ofskin allergy”. It idealises Nan HA with a picture of ahealthy baby.

A leaflet on Nestlé Carnation Follow-up formula inTrinidad and Tobago claims that the product is a “nu-tritionally complete baby formula specially formu-lated for babies 4 months of age and older to ensureactive babies’ needs for calcium” and although“starter formulas are adequate for the first year,…Follow-up provides extra nutrition insurance”.“Priced to save parents up to 20% compared toEnfamil (Mead Johnson) and Similac (Abbott-Ross)”,it “helps promote the continued use of an iron-forti-fied formula throughout the first year of life”.

Nestlé promotes Lactogen 1by distributing a four-pagecard leaflet in health facilitiesin Vietnam. This leaflet haspackshots of Lactogen 1 with

Numerous copies of a leaflet found in a waiting roomof a community health centre in Trinidad andTobago describe the “unique characteristics” ofNestlé’s soy-based Carnation Alsoy - “nutritionallycomplete”and Carnation Follow-up Soy - “slightlysweeter taste than soy starter which increases com-pliance in infants”. Carnation Good Start is “de-signed to keep the osmolality similar to breastmilk”producing “stool consistency similar to breastfedinfants”and Carnation Follow-up is “ enriched withvitamins and minerals for healthy growth and devel-opment.”

Contrary to what the pictureshows, women in the Middle Eastdo not sleep in their head-dress.Guigoz claims credit for thepeaceful scene of both mother andbaby sound asleep (and far apart).

In the UAE, a brochurefor Guigoz 1 and Guigoz2 for the medical profes-sion specifically targetsmothers in the MiddleEast with claims that theimproved formula ad-dresses mother’s worriesregarding a list of com-mon ailments including“fever, coughs and colds,colic” and “baby not de-veloping normally:weight, walking and talk-ing, etc., baby not sleeping well”.

‘rays’ emanatingfrom a can andarching towardsthe baby’s brain,bones and bodyimplying theproduct is bene-ficial to the baby’sgrowth and deve-lopment.

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IBFAN -- International Baby Food Action Network

In September 2001, Nestlé announced its support forResolution WHA 54.2 (2001) which recommendsexclusive breastfeeding for six months. The companypromised to change its labels in more than 150developing countries although the Code andsubsequent resolutions apply universally. Nestlé’sinitiative, however was welcomed as it showedgoodwill and leadership over other companies whichso far have ignored the need for label change.This section shows, unfortunately, that Nestlé was slowto fulfill its promises. Monitors in a dozen countriesstill found many labels and ads with the four-monthrecommendations which undermine exclusivebreastfeeding. The evidence recorded here is basedonly on reports after Nestlé’s April 2003 announcementthat it had “completed the change.”For reasons of space, we are not reporting on thegreat number of pre-April 2003 violations ofcomplementary foods promoted as breastmilksubstitutes.

• Another magazine advertisement shows a toddler anda whole range of eight Nestlé foods: three are rec-ommended from four months and a partially hiddenone is labelled from three months. (June 2003)

• In China, label changestook effect mid-2003. Evenso, in August 2003, anadvertisement in a scien-tific journal shows 15 veryyoung babies (below sixmonths) competing in aglobal baby competitionand with the winner beinga baby fed on cereals underthe Nestlé Nutrition Plan.

In Hong Kong

• Blue Bearstickers withpackshots of“Infant CerealRice” and“Infant CerealMilk” bothlabelled foruse from fourmonthsonwards aredistributed at the HongKong Baby Products Expo (Aug. 2003).

• In shops in Botswana, Nestum cereals labelled fromfour months are sold at a discount and advertised inweekly special sales flyers as newspaper inserts, hand-outs in stores, to homes and on the streets. (Aug 2003).By Jan. 2004, Nestlé cereals in Botswana were stilllabelled at four months.

• In Argentina, Nestlé promotessales of formula and comple-mentary food through(www.etoledo.com.ar). Nestlépurees are promoted as suitablefor use as of four months andNestlé cereals do not have anyage recommendation. (30 Oct 2003)

• Coupons with an attached application form to jointhe Nestlé Caring BB World are found in Hong Kong.Upon submission of the form, a free bib bearing thename of the baby is given as a gift. Cereals in HongKong are marketed for use at four months (Aug.2003).

Section 2 – Complementary foods promotedas breastmilk substitutes

In Bulgaria• An advertisement in a

magazine shows a happycouple with their baby on abeach with a pack shot ofBaby Menu recommendedfor use from four months(April 2003).

Promotion to the public

Article 5.1 of the Code prohibits advertising and all otherforms of promotion of products under the scope of the Code.

Article 5.2 and 5.4 of the Code prohibit companies fromgiving samples and gifts to mothers.

Upon complaint, Nestlé China argues that it is allowed to ad-vertise to health professionals (companies are only allowed toprovide factual and scientific information) but agrees neverthe-less not to continue with the ad.



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contains a discount booklet with eight couponsworth a total of €4. (April 2003)

• In pharmacies in Milan, Italy, Nestlé aggressively pro-motes their Nestlé Prima Infanzia products throughthe use of special displays, piles of promotional ma-terials which encourage the use of the products as offour months, special occasion leaflets, special sales,discounts and shelf-talkers. (June 2003)

• A Lithuanian magazine adoffers a free pair of NestléBlue Bear socks in ex-change for a Blue Bear cutout from Nestlé cerealboxes. Some of the prod-ucts are recommendedfrom four months onwards.(April 2003)

In Malaysia,

• Free sample of Nestlé Rice Cereal recommends theproducts as suitable for use as of four months of age.(Nov. 2003)

• Shelf talkers promote NestléRice Cereal in supermarketswith the slogan “Nestlé BabyCereal, weaning babies forgenerations.” Label indicatesfour months. (April 2003)

In Serbia,

• An advertisement in a Serbian magazine recommendsweaning with Nestlé Rice Cereals from four months.(July 2003)

• A 24-page booklet deliv-ered to Italian homes presentsNestlé ready-to-use comple-mentary foods many of whichare recommended from fourmonths (April 2003).

• A community service bill-board in Indonesia remindsmothers to send their babiesto the community healthcentre and at the same time,advertises Nestlé milk por-ridge at four months withthe slogan “Growing Mo-ments, Nestlé Moments”.(April 2003)

• Nestlé set up a stall at a Baby/Children Products Expoin Hong Kong to give out coupons which indicate thatproducts are sold at special prices at the exhibition.When mothers fill in forms attached to the couponsthey may select to receive samples of Nestlé Cerealrecommended for use from four months or Neslacgrowing up milk. (Aug. 2003)

• A leaflet in Hong Kong entitled The Nestlé NutritionPlan promotes “The New Improved Formulation ofNestlé Infant Cereals” from “Stage 1” (from fourmonths) “so that your baby always gets the rightnutrition at the right moment of development”. TheBlue Bear mascot is featured with a bowl of cereal.(July 2003)

• In Italy, Nestlé sends outgift boxes of Nestlé Cerealsor Nestlé Prima Infanziapurees by mail to mothers.

“Dear Mom” letter emphasisingthe need to start baby oncomplementary foods, either

cereals or purees,as of four months.The letter fails tomention theimportance andbenefits of exclu-sive and sustainedbreastfeeding.The gift pack also

These gift boxes contain a

• A magazine advertisement for cereals with the sameslogan induces mothers to submit their particularson coupons which entitle them to receive free bibsfrom Nestlé. (July 2003)

• A leaflet headed“Nestlé: Why com-promise whenit’s the question ofbaby’s growth?”found in a Serbianshop advertisescomplementary foodsfrom four monthswith packshots of jarredfoods and a picture ofthe Blue Bear carrying asign with a big ‘4’ onred background.(July 2003)

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IBFAN -- International Baby Food Action Network

• A Nestum Blue Bear leaflet fromTrinidad and Tobago talks aboutintroducing cereals from sixmonths but one of the packshotlabels has a four-month recom-mendation. (Nov. 2003)

• Nestlé CHEcereals in Chinaare recom-mended for fourmonths andshow a largebaby picture onlabel. (May2003)

• Nestlé’s infant juice labels in Switzerland recommendthe product for babies from four months. There is aspecial coupon on the label for collection of “bearpoints” in exchange for special offers. (July 2003)

• In Malawi, the Nestum label carries the age recom-mendation of four months. (July 2003)

• In Serbia where cereals arelabelled for four months, apharmacy gives out BlueBear car stickers to mothers.

before complementary foods are necessary. Nestlé’sBlue Bear features on different types of puree. Nestlénon-milk cereal label advises that “milk feeding,preferably with breastmilk should continue as longas possible” but recommends the product for babiesfrom four months. (April 2003)

Promotion in health facilities

WHA Resolution 47.5 (1994) urges an end to free orsubsidised donations of products to all parts of the healthcare system.

Labelling

WHA Resolution 54.2 (2001) advises exclusivebreastfeeding for 6 months which means that the recommendedage for use of complementary foods cannot be under 6 months.

• In the Dominican Republic, mothers receive freesamples of Nestlé Cereals in health facilities(July 2003).

• In Indonesia, Nestlé put upa signboard for a maternityin Indonesia which fea-tures the names of Nestléand the Cerelac brand atthe entrance of a health fa-cility (April 2003).

• A prescription pad in a UnitedArab Emirates hospital showspack shots with check boxes andrecommends cereals and othercomplementary foods from fourmonths (Nov. 2003).

• Nestlé Prima Infanzia puree label in Italy recom-mends it for babies from the age of four months,

• Similarly, Nestléfruit puréelabel inIndonesia ispacked in acardboardcarton withmainlyFrench andEnglish texts. Worse, thecardboard packaging recommends use from sixmonths but the bottles inside the packaging havelabels which recommend four months. (Aug. 2003)

• In Vietnam,Nestlé fruitpurées arelabelled assuitable foruse fromfour months.Text on thecarton is inFrench buta sticker inVietnamese pasted over the bottle’s label showsonly the composition of the product.(Oct. 2003)

“four months” on its way out ...

The Blue Bear mascot for Nestlé’s complementary foods is quickly finding its way into neonatal,maternity and paediatric wards to promote brand recognition and tempt parents to introduce

complementary foods early. Several ads address new mothers.

Blue Bear comes in

Promotion in healthcare facilities

International Baby Food Action Network -- IBFAN

• Free 15gm sachets of infant cereals rec-ommended for use from four months areat the reception of a clinic in Malaysia.There is no limit to the amount that canbe taken by patients. Nestlé representa-tives also visit antenatal classes and dis-tribute door gifts comprising samplesand pamphlets of Nestlé Cereals.

• Nestlé distributes large Cerelac calendars to health facilitiesin the UAE and Russia where Blue Bear features as acommon denominator. Various packshots promote products.Cerelac is described as "a spoonful of love.”

• In Malaysia, Nestlé distrib-utes stacks of notepads tohealth facilities withcompany name and BlueBear mascot in variousposes.

UAE hospitalsreceive three-dimensionalembossed BlueBear calendars.

• Nestlé gives out ball-point pens with theNestlé name and the Blue Bear mascot tohealth workers in Armenia. The BlueBear icon promotes Nestlé’scereal products.

The ubiquitous Blue Bear in a variety of posesadorn boards like this in Chinese hospitals

• Many maternityand paediatrichospitals inChina havenotice boards oninfant care andfeeding. Thosesponsored byNestlé sportconspicuousBlue Bears.

Breaking the Rules, Stretching the Rules 2004NESTLÉ

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• Unsuspecting healthprofessionals in Chinawere glad to use sheetafter sheet of BlueBear stickers onpaediatric doors andneonatal walls totallyunaware that thesedecorations wereclever advertise-ments for comple-mentary foodswhich their littlepatients would notneed for at least sixmonths or never.(WHO recommendshome-made comple-mentary foods out oflocal ingredients).

Blue Bear stickers coverthe entire glass door to aneonatal ward.

• A leaflet WhenLife’s Appetite isOn the Rise, foundin a doctor’s officein Serbia, featuresa child’s impres-sion of BlueBear. An ‘actual’Blue Bear ispictured on thefront while onthe back page isa feeding table advisingcomplementary feeding from four months.

• A leaflet in a Macedonian doctor’s office showsa range of Nestlé cereals recommended for useat four months. Other products on the leaflet in-cludes fruit juices and purées.

• A leaflet distributed at a paediatric confer-ence in Lithuania promotes the use of allNestlé products except for infant formula.Many Blue Bear cereals, purées and juicesare recommended from four months.

• Found in a doctors cabi-net in Georgia, a guidefor mothers shows pic-tures of an infant beingspoon-fed and a motherbottle-feeding her baby.Blue Bear wearing a bibreminds her of Nestlé ce-reals. The text discour-ages breastfeeding

“If you can’t breastfeedyour baby, use specialisedinfant feeding products,which are very close tobreastmilk.”

• A card “An Invitation to all New Mothers” found in aSingaporean clinic offers mothers to enrol in Nestlé’s InfantNutrition Plan; it requires contact information of mother andbaby’s birth details.

It promises a free sample upon enrolment andpromotes Nestlé products including fourcereals recommended forfour months.

• Nestlé gives mothers anintroductory copy ofNestlé Baby Newsmagazine in maternitiesin Switzerland and sendsupdates and promotionsby mail. The magazineadvertises its websitewhich shows a banner ofNestlé baby services andBlue Bear links toNestlé’s website.Nestlé Baby News website (top)


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nestl© ncompany, marketing its products in almost every country

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