The Minneapolis Star from Minneapolis, Minnesota • Page 6

SATURDAY Sept. 9, 1978 estle ovcotte Infant milk formulas fill a genuine need OpinionPro Con By HENRY G. CIOCCA Assistant Secretary, Nestle Corp. White Plains, N.Y. Infant milk formula products are nutritious foods that have made a significant contribution toward improved child health worldwide.

Availability of processed milk products, and especially infant formula, has coincided with reductions in infant mortality. nore basic facts: That formula products usually are purchased by people who can afford them working women and women in upper-income groups; that Nestle provides formula at low cost to some government health authorities who, in turn, sell them at a reduced cost to low-income consumers; that price of formula is sometimes controlled by governments, as in Brazil, and that formula products usually are used as a supplement to, not in place of, breast-feeding. Finally, critics are ignoring the large-scale powdered milk distribution programs sponsored by church groups and government agencies and targeted at low-income groups in developing countries. Sen. Edward Kennedy, has asked the World Health Organization "to convene a conference of local representatives, industry critics, nutrition experts and appropriate government officials and health professionals from developing nations to consider these matters on a global basis.

Because infant feeding is an international issue and because Nestle is committed to making high quality food products and distributing them in a socially responsible manner, Nestle supports efforts to initiate such a conference and will participate in it. countries, agrarian societies are gradually giving way to urban and industrial areas. Since 1921, Nestle has contributed to the local economy by making capital investments in and transferring technology to developing countries. The local conditions apply to whatever food is consumed by the people in those areas not just to infant formula products. Safe use of infant formula products requires boiled water, a principle understood by many people in developing areas.

Since all milk products, not just formula, may become bacterially contaminated if unrefrigerated for long periods, Nestle advises consumers to prepare single servings and feed them promptly if refrigeration is not available. Nestle employs qualified medical representatives to assist local health authorities in nutrition and health education work. These representatives are not permitted to sell formula products and do not give formula samples to mothers. In addition, each label emphasizes the superiority of breast-feeding and contains instructions on proper use, along with details in the major vernacular languages and step-by-step illustrations. Industry critics suggest that industries, including Nestle, exploit the poor by inducing them to buy products they do not need and cannot afford, implying that profits are valued above all else.

They ig In developing countries, the phenomenon of urbanization is growing, and when families migrate from rural areas to large cities, mothers often are forced to work to help support the family. Supplementation thus is necessary. Mothers in developing countries use bottles to feed babies a variety of foods, including local gruels and paps. According to a study by a British Medical Research Council team in West Africa, "Intelligent use of local food resources may well produce a multimix supplement for the older infant and preschool child, but the problem for the young baby is more difficult to solve. Since most nutritionists believe that the optimum food for young infants is milk, especially human milk, supplements should resemble breast milk as closely as possible." Infant formula products are scientifically formulated to resemble breast milk as closely as possible and to provide the nutritional requirements for growing babies.

Critics of the infant formula industry acknowledge the quality of formula products but maintain that conditions such as polluted water, lack of refrigeration, illiteracy and poverty lead to consumer abuse of the products. They are oversimplifying. With the introduction of industrial and commercial development into developing Manufacturers of infant foods have a unique opportunity to participate in the improvement of infant health. That opportunity carries with it certain responsibilities: to produce high-quality, nutritious food and to educate consumers on correct use of the products. In addition, manufacturers must promote such products as supplements rather than as substitutes for breast milk and emphasize the importance of breast-feeding.

It is undisputed among leading experts in infant nutrition that supplements to mothers' breast milk will be needed to meet the energy requirements of a growing child. When supplementation should begin varies according to quantity and quality of available breast milk. Recent studies have found that in developing countries, supplementation often is necessary from the third or fourth month. Baby formulas linked to infant deaths overseas cational. The "breast is best, but slogan in tiny black print on colorful Nestle formula cans or posters is hardly educational for illiterate mothers and has little Impact on those who can read.

Too often Nestle's education of doctors takes the form of free medical equipment, personal gifts and kickbacks. Moreover, no amount of education can provide mothers with clean water or enough money to buy adequate amounts of formula. Problems of underdeveloped countries will not be solved by "educating" people to spend scarce money on a dangerous and largely unnecessary product. Sen. Edward Kennedy, has asked the World Health Organization (WHO) to sponsor a conference on infant feeding.

INFACT supports the idea. Only because of public concern were the hearings held and the WHO conference proposed. But experience with a similar conference in 1970, various "dialogues," court orders and negotiations held since, would lead one to be skeptical of the industry's Rood faith in such a forum. The the proposed conference is no reason to halt the boycott. Sustained pressure is a most important vehicle for ensuring that Nestle will make real concessions at any such conference.

Past experience shows that without this pressure, Nestle and the other formula companies continue their current practices, convinced that Americans are unconcerned with the tragedy of infant formula By the staff of the INF ACT Clearinghouse On July 4, 1977, a group of Minnesota church officials, international development experts and local citizens started the Nestle boycott. Since then, it has grown Into a national movement with wide-ranging support. Boycott endorsers include Gov. Rudy Perpich; Sen. Dick Clark, D-Iowa; Sen.

James Abourezk, Ralph Nader; the DFL; the American Medical Student Association; the American Lutheran Church Women, and chairpersons of the nutrition departments of Cornell, UCLA and Berkeley. The National Council of Churches is expected to endorse the boycott at its November board meeting. Why are these people and groups supporting the national Nestle boycott? The reason is clear and compelling: Nestle unethically promotes artificial baby milk products in developing countries where their misuse results in infant disease, malnutrition and death. The safe use of infant formula requires clean water, fuel for sterilization and literacy to follow preparation instructions. If the user lacks these conditions, as is usually the case in the developing world, formula becomes a deadly transmitter of severe bacterial infections leading to diarrhea, dehydration and death.

Moreover, infant formula is expensive, so poor mothers dilute it to make it last longer. Breast milk, on the other hand, is considered by experts to be the Ideal infant food. But Nestle's aggressive promotion in developing countries has convinced millions of mothers that formula use will result in healthy, happy babies. Nothing could be further from the truth. Testifying May 23, 1978, to the Senate subcommittee on health, one infant nutrition expert estimated that more than 10 million infants suffer each year from the adverse effects of formula feeding.

In some areas, rates of illness and mortality are two to three times higher for formula-fed infants than for breast-fed babies. Criticism of Nestle's promotion is not new. Third-world pediatricians first voiced objections in the early 1970s. In 1976, after a two-year lawsuit, a Swiss court warned Nestle to "fundamentally rethink its advertising practices." The International Pediatrics Association and the European Working Group of the World Health Organization also recommended severe restrictions on formula promotion. Nestle's response to these years of discussion and criticism has been insignificant.

They've issued "codes of ethics" containing slight modifications that divert public criticism but do not address the basic problem. Dr. Derrick Jelliffe, head of UCLA's Department of International Health and a world authority on infant nutrition, recently remarked, "There have been some changes since this criticism began, but these are peripheral, marginal, cosmetic and probably temporary." (Jelliffe has since endorsed the boycott.) Frustrated by Nestle's intransigence, the Minnesota chapter of Infant Formula Action Coalition (INFACT) called for a boycott of Nestle products. Because Nestle is a Swiss-based corporation with stock sold only in Europe, U.S. legislation and stockholder pressure can't have an Impact.

A consumer boycott can. The boycott demands an end to all forms of promotion (not sales) of infant formula. Formula should remain available to those few mothers who do need it and can use it safely. Nestle has responded to the boycott with a massive public-relations campaign, arguing that mothers need to "supplement" breast milk and that their promotion is educational. Do mothers need supplemental milk? Extensive evidence has shown that more than 95 percent of women are physiologically able to breast-feed for 4 to 6 months (even if they're mildly malnourished).

Less than 6 percent of mothers in developing countries are unable to breast-feed because of work outside the home. And Nestle allegations of insufficient milk at three months hardly justify the company's aggressive promotion of formula use in hospitals from the day of birth. Furthermore, since breast-milk flow is directly related to the amount of sucking a baby does, supplementing with formula leads to progressively smaller amounts of breast milk but to increased sales and profits. The occasional need to supplement mothers' milk can be better satisfied by safer and less expensive local foods for weaning. Nestle claims that its advertising is edu.