breaking the law - bpni (breastfeeding promotion … · aggressive promotion of ... breastfeeding...

and undermining Breastfeeding

Breaking the LawSeries 5 (2013)

Baby Food Companies Continue to

Mislead Mothers

Series 5 (2013)

A plethora on benefits of breastfeeding have been

documented beyond doubt and so are the dangers of

inappropriate feeding practices/artificial feeding in the form

of increased risk of diseases (diarrhoea, pneumonia,

newborn infections etc.) and death. More recently long term

benefits of breastfeeding that include prevention of non

communicable diseases (NCDs) like obesity, diabetes and

heart diseases makes this more important as a public health

intervention.

At the same time breastfeeding

practices are threatened by

aggressive promotion of baby

foods. Keeping such practices in

v i e w a n d t h e d e c l i n i n g

breastfeeding rates across the

globe, World Health Assembly

adopted the International Code of

Marketing of Breast Milk Substitutes

in 1981. Since then many countries

in the world have enacted national

legislations. India enacted the Infant

Milk Substitutes Feeding Bottles,

and Infant Foods (Regulation of

Production, Supply and Distribution) Act 1992, and

Amendment Act 2003 (IMS Act). The Act prohibits all forms

of promotion and advertisements of Infant Milk Substitutes,

Feeding Bottles, and Infant Foods. The Act also prohibits

providing sponsorship, gifts, fellowship and any pecuniary

benefits to health care providers and their associations.

However, baby food companies constantly find new ways to

influence pregnant and lactating women to increase sales of

their products. They often portray the products to be

'healthy' and more convenient to consume and in the

process, undermine breastfeeding practices.

Companies have understood the importance of trust and

confidence common people have in doctors, therefore they

target them as effective channel to reach out to pregnant

and lactating women as well as other family members.

New age round the clock marketing through e-Marketing

websites are increasingly becoming

latest tool for aggressive promotion.

Despite 20 years of this law, it is

under constant threat from baby

food companies risking health of

million of infants. This situation

demands that the Government of

India should act quickly and enforce

this law effectively to end such

promotions to save mothers and

children. This is the stated objective

of the IMS Act.

This “Breaking the law” series

highlights the provisions of IMS Act and provides several

examples of promotional techniques used by online

marketing web-portals and manufacturers. These include

advertising with health claims and offering discounts etc.

Some examples of sponsoring doctors meetings and use of

health care systems have also been cited.

Central Coordinator

Dr. Arun Gupta

Series 5 (2013)

According to India today, Rise in online shopping in India

2011, India has more than 100 million Internet users, out

of which around 50 million opted for online purchases in 2011.

Various portals are now marketing baby foods (Infant milk

substitutes, infant foods) and feeding bottles hence they also

come under the preview of the IMS Act.

We did an internet search to find out whether these e-

Marketing sites are in compliance with various provisions of the

IMS Act. It was found that a variety of promotional techniques

like advertising using a visual of the product, promotion with

health claims, offer of discounts, incentives with free combo

offers etc. are being used. Obviously these are intended to

increase the saleability of these products and violate provisions

of the IMS Act. Some of such e-Marketing sites we examined are:

http://www.babyoye.com

http://www.healthkart.com

http://www.hoopos.com

Http://www.firstcry.com

The analysis of e-Marketing was done between Feb 2013 to May

2013. Some other examples of violations of the IMS Act

provisions have also been detected. These are given below :

�

�

�

�

Provisions of the IMS Act

The IMS Act prescribes regulations and rules for

marketing of infant milk substitutes, infant foods and feeding

bottles. Some salient features under various sections of this

special law are given below:

Ban promotion or advertisement to the public

Prohibits giving incentives

Restricts donation of products, educational

materials or equipment's.

Prescribes guidelines for labelling

Ensures accurate information through

educational materials

Bans promotions and displays in hospitals,

clinics, and chemist shops etc.

Ban direct or indirect benefits to health workers

or their associations

Ban commission on sales

The IMS Act has prescribed penalties in the form of fines and

imprisonment on violation of the Act

�

�

�

�

�

�

�

�

Section 3:

Section 4:

Section 5:

Section 6:

Section 7:

Section 8:

Section 9:

Section 10:

1. e-Marketing on the Rise!

‘Advertisement' is defined in IMS Act as

Section 3 (a) of IMS Act says, No person shall -

Inspite of a complete prohibition of advertisement of

products under provision of IMS Act, baby food products

are being advertised on several e-Marketing websites with

photographs and promotional text. (See picture 1-4)

“any notice, circular,

label, wrapper or any other document or visible

representation or announcement made by means of any light,

sound, smoke or gas or by means of electronic transmission or

by audio or visual transmission.”

“advertise, or

take part in the publication of any advertisement, for the

distribution, sale or supply of infant milk substitutes, feeding

bottles or infant foods”

Series 5 (2013)

Picture 1: babyoye.com, advertises the “Nestle Cerelac Stage 1

Wheat Apple” for 6+ months of infants

VIOLATIO

N

Picture 2: firstcry.com, advertises the “Similac - Infant Formula

Stage -1” for 0-6 months of infants

Picture 3: healthkart.com, advertises the “Nestlé Nan Pro

Infant Formula Powder Stage 1 Refill Pack” for upto 6 months of

infants

Picture 4: babyoye.com, advertises baby feeding bottles from

various brands, which are available in different price range,

attractive colours and nipples made of hygienic silicon.

Http://www.babyoye.com/nestle-cerelac-stage-1-wheat-apple-refill-300-gms.html Http://www.firstcry.com/similac/similac-infant-formula-stage-1-400-grams/229721/product-detail

Http://www.healthkart.com/product/nestl%C3%A9-nan-pro-infant-formula-powder-stage-1-refill-pack/BAB032?productReferrerId=9&productPosition=1/19

Http://www.babyoye.com/catalogsearch/result/?cat=&q=bottle%20feeding

VIOLATIO

N

VIOLATIO

N

VIOLATIO

N

Series 5 (2013)

2. Promotion Unlimited!

IMS Act defines

Promotion continues unlimited. Examples are below.

IMS Act defines means

Babyoye.com and firstcry.com promotes the “HEINZ

Breakfast Creamy Oat Porridge Cereal” and “HEINZ Baby

Breakfast - Oat and Apple Cereal” on their websites.

Promoting the use of cereal foods at 4+ months of age is

illegal, unscientific and misleading the mothers. This is

serious violation of IMS Act which strictly prohibits

promotion of any products for babies below 2 years of age.

(See picture 5-6)

“promotion”

(HEINZ

Cereals for 4+ of Infant)

means to employ directly or

indirectly any method of encouraging any person to purchase

or use infant milk substitute, feeding bottle or infant food.

any food (by whatever

name called) being marketed or otherwise represented as a

complement to mother’s milk to meet the growing nutritional

needs of the infant after the age of six months and up to the

age of two years.

a. Promotion with misleading Information

“infant food”

Http://www.babyoye.com/heinz-breakfast-creamy-oat-porridge-cereal-125-g.html

VIOLATIO

N

VIOLATIO

N

Picture 5: babyoye.com, promtes the “HEINZ

Breakfast Creamy Oat Porridge Cereal” for 4+ months

of infants.

Picture 6: firstcry.com, promotes the “Heinz-Baby

Breakfast - Oat & Apple Cereal” for 4+ months of infants.

Http://www.firstcry.com/heinz/heinz-baby-breakfast-oat-and-apple-cereal/1003/product-detail

b. Use of Health Claims

Section 3 (b) of IMS Act says, No person shall-

Health claims are used to lure unsuspecting buyers to purchase

the product. It is evident that e-Marketing sites are using

unsubstantiated claims, in an attempt to convince parents that

the infant milk substitutes and infant foods provide nutrients

which can contribute in infant growth and development,

immune system, healthy vision, strong bone, easy to digest, DNA

synthesis and brain cell growth etc. Such claims are misleading

and distorts parent's perceptions of the safety and nutritional

values of individual ingredients and influences the mothers to go

for using these products and therefore risk infant's health. (See

picture 7-8)

“give an

impression or create a belief in any manner that feeding of infant

milk substitutes and infant foods are equivalent to, or better

than, mother's milk.”

Series 5 (2013)

Http://www.babyoye.com/nestle-nan-pro-1-infant-formula-refill-400-gms.html

VIOLATIO

N

PreBlend:

-A protein blend containing whey protein. NAN Pro 1 is predominant in whey protein.

Whey proteins are easy to digest. The protein content is suitably modified to reduce

the overload on infant’s kidneys.

Immunonutrients:

-Nutrients like Nucleotides, Zinc, Selenium, Vitamin A and C support the immune

system.

Bifidogenic:

-Bifidobacteria are predominant in the gut of infant fed on breast milk. NAN Pro 1

contains a combination of nutrients that support the growth of bifidobacteria. A

healthy gut flora helps in supporting the immune system.

LA/ALA:

-LA (omega 6 fatty acid {FA} & ALA (omega 3 FA) are precursors of ARA and DHA

which are important for defence system.

-ALA, Iron & lodline helps in brain development. Vitamin A contributes to healthy

vision

Picture 7: babyoye.com, promotes “Nestle Nan Pro 1” Infant Formula with health claims

VIOLATIO

N

Features:

-Spray dried formula

-Contains whey protein which is easier to digest and

nutrients that support growth and brain development

-Essential fatty acids LA, ALA and Choline contribute

to the structural building blocks of the brain

-Iron and iodine help in Brain Development and

VitaminAcontributes to Healthy Vision

-Contains 12 minerals and 14 vitamins

Picture 8: babyoye.com, promotes “Nestle Lactogen Stage 1 Infant Formula” with health claims

Http://www.babyoye.com/nestle-lactogen-stage-1-infant-formula-tin-400-gms.html

c. Offering Discounts

Section 3 (c) of IMS Act says,

Section 4 (c) of IMS Act says,

No person shall-

No person shall-

Despite the prohibition by IMS Act for offering inducement of

any kind, the companies and distributors are offering incentives

and cash loyalty etc. to generate more sales.

While analyzing contents of the e-Marketing sites, it was noted

that online shopping stores are offering discounts on purchase of

feeding bottles and baby food products. These are in the form of

cash or combo packs at a better price with savings for increasing

their sale and use. ( See picture 9-11)

“take part in the

promotion of infant milk substitutes, feeding bottles or infant

foods.”

“offer inducement

of any other kind, for the purpose of promoting the use or sale of

infant milk substitutes or feeding bottles or infant foods.”

Http://www.firstcry.com/combopack.aspx?proid=927

VIOLATIO

N

Picture 10: firstcry.com offer a discount of 10% for complete

health baby food combo pack consisting of Heinz breakfast

fruits with yogurts cereals, Heinz puree fruity pear, Gerber

banana with apples & pear and Heinz creamed porridge.

VIOLATIO

N

Picture 9: fisrtcry.com offer numbers of discounts on different brands of feeding bottles

Picture 11: hoopos.com is offering discount by means of

showing a saving of Rs. 145.38 on the purchase of a combo

pack of Cerelac wheat orange with baby cloths detergent.

Series 5 (2013)

d. Offering Gifts

Despite the prohibition by IMS Act for offering inducement of

any kind, website is offering gifts and cash loyalty scheme on

online purchasing of products, which can be redeemed against

future orders. This is another marketing strategy to attract the

mothers for repeated purchase for want of higher loyalty cash

points which in-turn creates regular customer base for the

companies. (See picture 12, 13)

Series 5 (2013)

Http://www.firstcry.com/combopack.aspx?proid=926Http://www.firstcry.com/combopack.aspx?proid=1077

Picture 12: firstcry.com offer free Baby on Board Game with 3

packs of Heinz infant food products (2 packs of Heinz baby

breakfast and 1 pack of Heinz baby dinner) for 4+ and 7+

months of infants.

VIOLATIO

N

VIOLATIO

N

3. Misusing Health Care SystemsHealth professionals and health clinics are the most effective

routes frequently adopted by the infant food companies to

promote their products. Through this channel they may

indirectly reach to the mothers and infants.

Inspite of a prohibition for such promotions through health

care facilities, baby food (infant milk substitutes and infant

foods) manufacturers aggressively indulge in activities to

violate the IMS Act. As an example:

No person shall-

We found the display in a pediatric clinic in Varanasi in the

waiting room showing picture of mother with her chubby

baby with a message

clearly

targeting the innocent mothers visiting the health centre.

This is educational

programme claiming to create a strong generation by

providing healthy nutrition to the infants. Nestle misuses the

health systems.

a. Poster Display at Health Clinics

Section 8 (1) of IMS Act says,

“Your little one's world is growing, so is

her power for protection against infections!!”

“Nestle Start Healthy Stay Healthy”

“use any health

care system for the display of placards or posters relating to,

or for the distribution of, materials for the purpose of

promoting the use or sale of infant milk substitutes or feeding

bottles or infant foods.”

Photo by: BPNI

VIOLATIO

N

Picture 13: firstcry.com offer Mee Mee Non Spill cup with 3

packs of Heinz infant food products (2 packs of Heinz baby

breakfast and 1 pack of Heinz baby dinner) for 4+ month of

infants.

?Who provided funds for the events

Who provided logistic support

What is the relation of NNI and Nestle

Series 5 (2013)

b. Conducting Seminar/ Symposium for Doctors

Section 9 (2) of the IMS Act says-

It's a matter of serious concern that despite such explicit

provisions in the IMS Act and clear instructions by the

Government of India. See the letter jointly signed by the

Ministry of Women and Child Development and the Ministry

of Health and Family Welfare, Government of India sent to

Chief Secretaries of the states on 17th August, 2010 (D.O.

No.5-20/2010-ND/Tech).

Nestle is still continuing with organising such events,

providing luxurious ambience, gifts and refreshment to

participants.

A scientific conference was organized by the Nestle Nutrition

Institute (NNI) with the collaboration of Guwahati Obstetric

& Gynaecology Society on “Nutrition in first 1000 days of life”

at Hotel Grand Starline, G.S. Road, Christian Basti, Opp-

Mizrom House, Guwahati on 10th March 2013. President of

Guwahati Obstetric & Gynecology Society and Head of

Department of Paediatrics, Guwahati Medical College and

Hospital (GMCH), were invited as guest speakers in this

conference.

Another scientific conference was organized for medical and

health professionals by the Nestle Nutrition Institute ( NNI)

on “Role of Nutrition during Pregnancy & Feeding of the LBW

Infants” at Ludhiana on 16th March 2013 at Hotel Park Plaza,

Kohinoor Hall, Firozepur Road. Dr. Promila Jindal, Professor &

Head Dept. of OBS. & Gynae. DMC & Hospital, Ludhiana and

Dr. V idya Gupta, Senior Consultant Neonatologist

Indraprastha Apollo Hospital, New Delhi were invited as guest

speakers in this conference.

“No producer, supplier or

distributor referred to in sub-section (1), shall offer or give any

contribution or pecuniary benefit to a health worker or any

association of health workers, including funding of seminar,

meeting, conferences, educational course, contest,

fellowship, research work or sponsorship.”

http://bpni.org/IMSACT/Joint_MOH_WCD_Ltr_IMS_Act.pdf

Companies in Denial

Breastfeeding Promotion Network of India

(BPNI) organised a press conference on the

31 of July 2013 revealing that baby food

companies are using Indian e-Marketing portals to

advertise and promote their products, which is

illegal under the IMS Act. BPNI issued a press

release titled, “ Breaking the

Rules, misleading moms”

When contacted by Thomson Reuters Foundation,

the three companies said the allegations against

them were incorrect.

Nestle India said, "Nestle India does not have any

contract and/or commercial relationship with any

external websites for its infant nutrition products and we

do not supply to them,"

Abbott said that while it sells its products to a number of

different channels and distributors, all are legally obliged

to abide by the law.

Babyoye.com, which sells both Nestle and Abbott

products for babies and infants and promotes health

claims on its site, said it sourced products directly from the

brands or their authorised partners.

"For sensitive products associated with baby feeding we

make it a point to ensure that we do not promote them in

any of our campaigns. All feeding products pages have an

explicit statement promoting breast-feeding," said a

statement from babyoye.com's CEO Sanjay Nadkarni.

Heinz's Vice President for Corporate Affairs Mohan V

denied the allegations against the company, saying that

Heinz neither manufactured nor sold infant food products

in India.

He suggested that the products, which were made in

England, were being "smuggled" into India and sold to the

websites by a third party.

Just before the press conference, BPNI purchased a packet

of Heinz-Baby Breakfast Oat & Apple Cereal from

firstcry.com, the online baby and kid's stores by making an

online payment of Rs. 400/- and the product was delivered

to BPNI in week time with a delivery receipt from Digital

Age Retail Pvt. Ltd. Gate No. 53/1, Behind New Babi Da

Dhaba, Village Kuruli, Chakan, Pune.

The import of food products is governed by the Food Safety

and Standard Authority of India and thus violates the

under the Section 25-

Provisions relating to import, which says-

st

Heinz, Nestle, Abbot:

This confirms the

availability of Heinz products in Indian market for sale.

Food

Safety and Standard Act, 2006

“All imports of articles of food to be subject to this Act-(1)

No persons shall import into India-

I. any unsafe or misbranded or sub-standard food or

food containing extraneous matter;

II. any article of food in contravention of any other

provision of this act or of any rule or regulation made

there under or any other like IMS Act.

Series 5 (2013)

Media expose

�

�

�

�

Breastfeeding week kicks off amid concerns over unlawful

tactics by baby food companies, DownToEarth , Aug 2,

2013

India to probe claims multinationals break baby milk law,

REUTERS, 1 Aug 2013

India to probe claims multinationals break baby milk law,

Thomson Reuters Foundation, 1 Aug 2013

Baby food giants Heinz, Nestle and Abbott violating

promotional parameters, allege activists in India , ANI,

Aug 1, 2013

http://www.downtoearth.org.in/content/breastfeeding-

week-kicks-amid-concerns-over-unlawful-tactics-baby-

food-companies

http://in.reuters.com/article/2013/08/01/india-baby-mil-

mncs-law-idINDEE9700E420130801

Http://www.trust.org/item/20130801154021-aq4e6/

?source=hpeditorial&siteVersion=mobile

http://www.aninews.in/videogallery8/13941-baby-food-

giants-heinz-nestle-and-abbott-violating-promotional-

parameters-allege-activists-in-indi.html

Series 5 (2013)

We Continue to Report and Follow-up

BPNI is regularly monitoring and reporting the compliance

with the IMS Act for the last 21 years. BPNI follows up

with the Government of India for effective enforcement of the

IMS Act.

Therefore as a part of internet search BPNI continue to calls

upon the Ministry of Women and Child Development,

Government of India:

i. To intervene with the Ministry of Communication and

Information Technology to get the ban on advertisements

and offers of discounts on products under the scope of the

IMS Act and Regulate e-Marketing.

ii. To pursue the matter with Ministry of Company Affair to

ensure effective implementation of the IMS Act.

iii. To interact with the Ministry of Import and Export, so that

at the time of import, labeling regulations are implied on

baby food products as per the Indian Law.

iv. To init iate legal act ion against the website

www.firstcry.com and Heinz Co.Ltd.UK for misleading

labeling and promotion on the website.

v. To ask for investigation on Mr. Mohan V claim for smuggling

of Heinz products in India by competent law enforcing

agencies.

Even as any form of promotion of infant milk substitutes, infant foods and feeding bottles is prohibited under the

IMS Act, baby food manufactures and marketing companies continue violate the IMS Act through advertisement,

promotion with health claims, offer of discounts and gifts etc. They also convey unscientific and deceptive

information to mothers. This is nothing else but to increase the salability of the products and profits.

These findings are just a tip of the iceberg and a lot more must be happening that goes unreported. There is an

urgent need to take action to stop misleading promotion, which is known to influence mothers and displace healthy

eating practices.

Just do not get carried away with attractive promotional offers health claims by the baby food companies.

Refuse to buy processed artificial baby food products and spread awareness on breastfeeding practices.

Reject discounts and other offers as these violate a law.

Refuse sponsorship / gifts from baby food manufactures.

Refuse to participate in conferences sponsored or organised by baby food companies or their front organizations.

Disseminate accurate information on optimal infant feeding practices on systematic, daily basis in local

languages.

Enforce IMS Act and appoint nodal officers at state and district level.

Launch a report of the compliance with IMS Act in each state.

Public - what can you do?

Health Professional - what you can do?

Governments- what you can do?

�

�

�

�

�

�

�

�

Way forward…..

Series 5 (2013)

Series 5 (2013)

Breastfeeding Promotion Network of IndiaBP-33, Pitampura, Delhi-110 034Tel: 91-11-27343608, 42683059. Fax: 91-11-27343606e-mail: [email protected]

Compiled and Edited by

Reviewed by

Designed by

Dr. Neelima Thakur

Dr. Arun Gupta, Dr. JP Dadhich,Dr. Shoba Suri, Nupur Bidla, Manish Kumar

Amit Dahiya

BPNI is a registered, independent, non-profit, national organisation that works towards protecting, promoting and supporting breastfeeding and appropriate complementary feeding of infants and young children. BPNIworks through advocacy, social mobilization, information sharing, education, research, training and monitoring the company compliance with the IMS Act. BPNI is the Regional Focal Point for South Asia for the WorldAlliance for Breastfeeding Action (WABA) and Regional Coordinating Office for International Baby Food Action Network (IBFAN) Asia

As,a policy,BPNI does not accept funds of any kind from the companies producing infant milk substitute,feeding bottles,related equipments,or infant foods (cereal foods) or from those who have been ever found to violatethe IMS Act or the International Code of Marketing of Breast-milk-Substitute or from organization/ industry having conflict of interest.

Information Sheet No. 28

The Concept: The form is inspired by the universal Yin and Yang, a symbol of the balance of nature. This

symbol is interpreted as the fine balance of health and vitality achieved through breastfeeding. The symbol

forms the body of a mother holding her child while the head is composed of a flaming orange bindi

representing the power and aura of the empowered woman.

breaking the law - bpni (breastfeeding promotion … · aggressive promotion of ... breastfeeding...

Documents