Intended for healthcare professionals

Rapid response to:


Misperceptions and misuse of Bear Brand coffee creamer as infant food: national cross sectional survey of consumers and paediatricians in Laos

BMJ 2008; 337 doi: (Published 09 September 2008) Cite this as: BMJ 2008;337:a1379

Rapid Response:

The latest step in a series of extraordinary labelling measures

We are concerned about inaccurate allegations that Nestlé is
violating the WHO Code as contained in a letter by Barennes et. al. in the
recent BMJ on-line Rapid Responses.

In the past Nestlé has taken extraordinary labelling measures on
products that are not intended for infants; especially on the sweetened
condensed milk based "coffee creamers", but also on other products such as
milk powders for children over the age of 1 year. Nestlé has gone even
further than the requirements of the Code with printed statements in
different languages to the effect that the product should not be used to
feed infants, along with an additional warning pictogram which had been
agreed with the Ministry of Health.

We now have gone one step further in labelling changes and are
removing the baby in the adult bear’s arms on all products not intended
for use in feeding infants, and have replaced it with a glass. This new
logo will be rolled out during the second quarter of 2009, although old
products will still be on the shelves until retail outlets of older
supplies are exhausted.

Our communication with health professionals does not encourage the
use of infant formula over breastfeeding, but rather educate about the use
of legitimate breast milk substitutes instead of dangerous alternatives.
We do not provide financial incentives to promote alternatives to breast
milk. Small items of professional utility provided (with no infant formula
brand) as well as institution-approved support of attendance at scientific
and medical meetings are in no way in violation of the WHO Code.

We reiterate our concern that infants are currently fed a wide
variety of inappropriate and dangerous breast milk substitutes,
particularly raw whole cow’s milk, sugar water, and rice water – or
sweetened condensed milk based products. We will continue to do our part
to reduce and eliminate the use of inappropriate substitutes.

This also means that if babies are fed breast milk substitutes, it is
vital that they are fed the only substitute approved by WHO/FAO Codex
Alimentarius: infant formula. We are committed to babies having the best
start in life, which means breast-feeding if at all possible, legitimate
breast milk substitutes where they are needed, and nutritious
complementary foods after 6 months of age.

Competing interests:
The author of this response is the Business Executive Manager for Dairy at Nestlé (Thai) Ltd.

Competing interests: No competing interests

27 January 2009
Roland Stieger
Business Executive Manager Dairy, Nestlé (Thai) Ltd.
Bangkok 10330