Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1694819427188.pdf (Australia)
(b) Evaluate the impact of marketing of breastmilk substitutes on breastfeeding rates and, in particular, in disadvantaged, Indigenous and remote communities A PICTURE PAINTS A THOUSAND WORDS…..

This is a mother of twins (boy & girl) in Pakistan – a tragic victim of aggressive marketing and cultural beliefs that give priority to males.
When asked for permission to take this photo, the mother replied “If it will help.” 29 Cicely Delphine Williams: Doctor of the World’s Children Naomi Baumslag, MD, MPH, Journal of Human Lactation, 2005: 21(1) Cicely Williams was a pioneer who revolutionized the approach to mother and infant care.

Born in Jamaica in 1883, she had a rare respect for her patients, believed in commonsense measures.
She recognized the importance of breastfeeding for the health and general welfare of infants, mothers, and society.

In addition, she identified how the marketing of breast milk substitutes caused malnutrition and high infant mortality.

Cicely Williams became a doctor at Oxford University, England in 1928.

She was sent that same year to serve in Ghana, West Africa.

It was here that Williams became impressed with breastfeeding and realized how important it was for child survival.
She found in Ghana that the weanling who was taken off the breast early and displaced by a newborn developed malnutrition, called kwashiorkor.

The Ghanian term in the Gha language means “disease of the deposed” or premature weaning.

In 1939, Williams was transferred to Singapore, where she discovered that bottle-feeding with Nestle’s condensed milk was widespread.

Her hospital was full of children with malnutrition and rickets; the mortality in these infants was high.
This was in sharp contrast to universal breastfeeding in Africa.

Williams was appalled by the dreadful conditions in which poor women lived and worked and by how they were feeding their infants.
Invited to speak at the Singapore Rotary Club in 1939, she gave her famous speech titled “Milk and Murder.” Despite the fact that the chairman of the meeting was the president of Nestle, Williams told the audience, If you are a legal purist, you may wish to change the title of this talk to “Milk and Manslaughter.” But if your lives were as embittered as mine, seeing day after day this massacre of innocents by unsuitable feeding, then I believe you would feel, as I do, that misguided propaganda on infant feeding should be punished as the most criminal form of sedition, and that these deaths should be regarded as murder.
Williams recommended to the audience that to correct this unfortunate state, they should insist that their wives and daughters breastfeed their own babies.

She stressed that hygiene lessons should be presented as part of a life to be lived, not as a lesson to be memorized.

She urged the audience to advocate for maternity benefits so that women could have adequate time after delivery to feed their own babies.

Cicely Williams died in 1992 at the age of 98.


In her life, she received many honours and was a wonderful teacher whose approach always stressed common sense.

She was both a provider of care and a researcher.

Many remember her as the Florence Nightingale of the 20th century.

The following quote sums up William’s feelings about breastfeeding: The whole subject of infant feeding is .

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of great importance to the welfare of society and a subject of which a large section of the population shows abysmal ignorance and irrational prejudice.

There is no doubt that every sentient being in the world agrees the best food for the baby is mothers’ milk.

There is no invented satisfactory substitute.

30 Does your marketing kill little babies for profit?

From: Marketing Magazine – Editorial – December 198?
RECENTLY a former creative director with a multinational advertising agency operating in Africa and Asia admitted on radio that he had been instrumental in a marketing campaign that resulted in the deaths of thousands, possibly hundreds of thousands of babies.

On Andrew Olle's Sydney program on 2BL, Harry Grebert recalled the shock he felt when seeing an ABC Four Corners program that revealed the results of his strategy and the devastating impact of infant milk formula in the Third World.
Harry Grebert and his family sat down to watch Four Corners, unaware of what was to be screened.

HG: I was quite staggered when this expose of multinational attitudes towards marketing products in the Third World came on.

I sat there appalled.

A mother who had lost a child said she used the particular product because she believed it to be the 'next best thing'.

At that stage I felt as if I'd been hit by a large truck because I was the person who coined that phrase.
It was designed specifically to appeal to that portion of the market that would be most responsive.

Apparently it was incredibly successful, and here we were witnessing the disaster it had caused, not just the slogan bus the whole marketing strategy behind these products.
The deep ethical and moral issues this public "confession" raises for those of us in marketing, justify printing here much of what went to air on Mr Olle's program: Andrew Olle: In normal circumstances the infant formula in question can be a valuable food supplement for babies.

But the multinational manufacturers have aggressively marketed the milk product powder in some under-developed countries where hygienic preparation of the formula - which is so essential - is often impossible.
As a result children already deprived of the natural immunity of mother's milk are being exposed to often fatal infections and disease.

The fact that the corporations continue to pitch their products to the Third World, despite overwhelming evidence going back 15 years new of the dangers, has caused considerable outrage.

Harry Grebert helped formulate the marketing push for some of the infant milk powder in the Third World.
HG: I was part of a team based in South East Asia working for multinational advertising agency that had (multinational food company) as a major client internationally.

I don't think (the company) set out to have the effect that it did.

The product, when used in a modern environment in an industrialised society, causes no problems.
In round table discussion with executives from India, Kenya, and Europe discussing which products would be most penetrative in these areas, it was decided that the markets would be most receptive to infant baby formulas.

Mothers are very emotional about their children.

But we didn't discuss the availability of hygienic water and no attempt was made to introduce training programs along with programs for use of the product.
AO: Did you discuss the fact that you were trying to supplant perfectly good mother's milk?

HG: Yes, I have to say yes, that is true.

When we were thinking around the ideas of visual imagery, we wanted to use a nursing mother with the youngest possible baby.

31 The strategy was formed around the idea that mothers had better things to do than to nurse their babies.
There was also a cosmetic proposition that was appealing to the idea that if you nursed your baby you might suffer from what was referred to as ‘bosom sag’.

AO: Did this cause any dissention around the table, Harry?

HG: No.

At that stage, in the innocence in which we were operating, it seemed to be a legitimate point to put .

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The thing that is most horrific is that we were operating in medical ignorance and we didn't realise the essential ingredients in mother's milk which are critically necessary to infant's survival, such as immune properties and so on .

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.The thing that distresses me most is that when information carne on line that there were terrible dangers inherent here.

The multinationals did nothing about it.

I think this is a reprehensible situation, and it is the reason I am speaking to you now.
AO: It's obviously playing on your conscience, Harry.

HG: Well yes.

Not only myself, but members of the team that were involved at that stage.

AO: Perhaps we could ask you to devise an advertising campaign to get people back to natural mother's milk.

HG: It can be done, and I'd like to be involved in something like that.

It's the sort of thing that the responsible elements of the world, such as the United Nations .

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or even a co-operative effort by the multinationals funding a program like that could undo some of the damage that they've done.

They can't of course return the babies that have died, but they could educate people in how to handle their products properly so they would be of benefit.
AO: It's hard to imagine, them taking such an altruistic approach when they've known for so long the damage that has been caused since it was first exposed 15 years ago and nothing's changed except the market's got bigger.

(The population of Pakistan is expected to double in the next 20 years from 110 million to 220 million.)

HG: Multinationals are a bit like that.

They tend to think of themselves as being a government and an entity on their own and encourage their employees to feel the same way.
You don't have any loyalty to anyone else except the corporation.

Mr Grebert's distress confronts us with fundamental questions that marketing professionals rarely ask themselves: Should you be concerned about the possible effects of what you are promoting?
If you work for a multinational corporation, can you simply appeal to the Nuremberg Defence issued by the SS guards who operated the gas chambers (‘We were only following orders’) if a future documentary exposed your market success as destroying the lives of innocents?

How far beyond simple success in the marketplace should you look when judging the quality of your actions?

These questions are not only critical for graduating students and young professionals.
It could be said, for instance, that some prominent people in the marketing fraternity have become very wealthy flogging tobacco and alcohol to kids, and easy credit to the financially incompetent.

Or is it truly a case of caveat emptor – let the buyer beware?

In the final analysis, where does marketing fit into the moral fabric of our society?

There can be no general rule.

Each must decide for themselves.


32 Remedia execs, health officials face charges By Yuval Yoaz Retrieved 18/01/07 from: www.waba.org.my/remedia_manslaughter.htm Three former executives of baby food maker Remedia will face involuntary manslaughter charges for the 2003 sale of soy-based infant formula that lacked the vitamin B1.

Five Health Ministry employees will also face charges in the affair, the state prosecution announced yesterday.
The former Remedia executives who will be tried are former CEO Gideon Landsberger, former chair Moshe Miller and Frederick Black, head of research and development for the firm.

The three will be charged with involuntary manslaughter, as well as negligent sabotage, misleading the public, obstruction of justice, actions that may spread disease, fraud and conspiracy.
The draft indictment charges that the essential B1 vitamin (thiamin) was not included in the mixture of vitamins added to the formula, however, Remedia did not inform the public of the error, and printed labels that stated that the formula included more vitamins than it actually did.

According to the charges, several babies who were fed the formula were hospitalized with severe central nervous system damage.
After being given B1 supplements, some of the infants showed improvement, but others sustained irreparable damage and two of the infants died.

Seventeen families have sued the German company Humana that manufactured the formula for compensation in the affair.

Five Health Ministry officials will also be charged as part of the indictment for actions that may spread disease, the sentence for which is up to three years in prison.
Among those charged is the head of the ministry's national food service, Dr. Dorit Nitzan-Closkey.

According to the charge sheet, the ministry officials did not verify that the formula sent from Germany contained the ingredients listed on the labels.
Senior Health Ministry officials yesterday expressed "rage and disappointment" at the prosecution's decision to try Nitzan-Closkey and four other officials, calling it a "knife in the back of first-rate Health Ministry professionals who work day and night to protect public health."

A senior prosecutor said yesterday, "we discovered a fundamental deficiency in the ministry's regulatory mechanism."
He said Health Ministry inspectors at the ports did not examine the documents accompanying the shipments and therefore did not evidence the absence of any chemical analysis of the formula's components, relying solely on Remedia to do so.

33 PAEDIATRICIANS AND INFANT MILK FORMULA COMPANIES Howard Bauchner, Editor in Chief, Archives of Disease in Childhood 2006: 91:e377 The influence of infant formula manufacturers on paediatricians has been debated for decades.
I remember attending my first College spring meeting a few years back and the heated discussion about the appropriate "place" for sponsors.

Given the myriad benefits of breast feeding, and concerns about the influence of infant formula manufacturers, it would seem that support of the Baby-Friendly Initiative and breast feeding through six months of age, should be emphasised by all participants in the healthcare system.

Breast feeding rates in England remain low compared with many other European countries.
If rates were to rise to 75%, I believe that the debate about infant formula would be much more muted.

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