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Advertising Standards Authority finds against Nestlé

BMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7181.417a (Published 13 February 1999) Cite this as: BMJ 1999;318:417

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Un-ethical promotion of breast milk substitutes

Dr. Fasatahullah Husseni (6th March 1999), while defending unethical
promotion of breast milk substitutes, has cited invalid arguments in
favour of his views. Unethical practices for promotion of breast-milk
substitutes by any company ought to be condemned, and this does not
justify sparing any one of them.

Dr. Fasatahullah Husseni states that international organizations and
activists are "waging a war against the use of breast-milk substitutes."
This is quite wrong. The war is not against their use where necessary, but
against their UNETHICAL ADVERTISEMENT TO THE DETRIMENT OF BREAST FEEDING.

Though we all know about nutrition support programs, wether
international organisations are "doing" nothing" to help out the pregnant
and lactating mothers is for these organisations to answer.

I agree that these mothers should be provided much greater
nutritional support but that does not mean that unethical promotion of BMS
is justified.The formula milk costs around Rs 2000/- per month for a 3-4
month old baby in Pakistan , which is one and a half times the monthly
earnings of the majority of families. If only one third of this amount is
spent on lactating mothers , their nutrition will become optimum.

It is scientifically incorrect that the 'quality of malnourished
mother`s milk is very poor.' Numerous scientific studies have proved that
the quality of these mother`s milk is never poor, although quantity may be
diminished only in severely
malnourished mothers. This quantity can be increased by improving their
nutrition , which is more feasible by promoting breast feeding, thus
saving large sums of money required for purchase of formula milk and this
saving will be enough to improve the nutrition of the mother as well as
the whole family.

It is also a wrong argument that the unethical promotion of breast
milk substitutes should be allowed because a minority of mothers are
severely malnourished .The correct approach will be to improve their
nutrition so that exclusive breast feeding done for 4-6 months,
supplemented with semi-solid weaning foods from around 6 months age, and
not by formula milk , becomes possible.

There is a consensus among the pediatricians of the developing
countries, shared also by the Pakistan Paediatric Association, that
feeding breast milk is the key to survival of infants, wether normal or of
low birth weight, and that malnutrition and infant mortality usually
result from bottle feeding of formula milk with associated diarrhoeal
disease.

His statement that 'excessive restriction on milk company has only
caused increased use of raw cow or buffalo`s milk' is completely
unsubstantiated and misleading. There is no advertisement or advocacy for
the use of raw cow or buffalo`s milk and it has never posed any threat to
breastfeeding.

The correct approach will be to strictly enforce the Code of
Marketing of Breast Milk Substitutes in every country alongwith vigorous
campaigns to improve the nutrition of pregnant and lactating mothers.

Competing interests: No competing interests

22 March 1999
M A Arif
General Secretary, Pakistan Pediatric Association and Prof. of Paediatrics
National Institute of Child Health, Karachi PAKISTAN.