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An article published at BioMed Central entitled What could infant and young child nutrition learn from sweatshops? concludes: "Lessons from the sweatshops debate could serve as a model to promote cooperation and trust between public and private groups, such that they learn to work together towards their common goal of improving infant and young child nutrition."

The article misses the point that campaigners are in ongoing communication with company executives. The failure of executives to abide by marketing requirements and the way they try to excuse practices and discredit critics demonstrates their focus is not on a 'common goal of improving infant and young child nutrition', but on maximising profits. They can comply with marketing requirements when forced to do so - as in Brazil and India, for example (breastfeeding rates have recovered in the former and the formula market is failing to grow in the latter) - but elsewhere violations are commonplace and it takes public pressure to stop them. There are offers on the table for meeting when companies indicate they are serious about complying with the marketing requirements. Until they do so, methods that have helped to protect the vulnerable in many countries will continue to be pursued.

I have posted the following response as a comment to the article.

This article has been brought to my attention as it refers to Baby Milk Action, where I am Campaigns and Networking Coordinator. Others will no doubt also have views on the inaccurate portrayal of the issues related here.

Baby Milk Action is in ongoing correspondence with Nestlé, as are other members of the International Baby Food Action Network (IBFAN). This article gives the impression that campaigners do not communicate with companies. Not only are we in direct communication with executives, we raise issues before shareholders at the company's annual meeting.

Regarding the specific case cited above regarding Nestlé's marketing of powdered whole milk in Argentina, the presentation of this issue is incomplete. Baby Milk Action raised concerns with Nestlé that it promotes whole milk in the infant feeding sections of supermarkets and pharmacies - something it continues to this day. Whole milks are unsuitable for feeding to infants under one year of age, but they are typically a third of the price of infant formulas and it is documented that poor mothers who use powdered milk often use powdered whole milk rather than infant formula (one Brazilian study found 70% of mothers who use powdered milk use whole milk rather than infant formula for infant feeding). Nestlé refused to stop promoting whole milk alongside infant formula when we asked, arguing that no marketing restrictions apply as it is not a breastmilk substitute. Baby Milk Action's point was also that it is not a breastmilk substitute and for that very reason should not be marketed in the infant feeding section. 

Other World Health Assembly Resolutions relate to marketing of foods for older babies and these state that such marketing should not undermine breastfeeding. So aside from being irresponsible, Nestlé should agree to remove formula from infant feeding sections to comply with these Resolutions.

This article also ignores the fact that Baby Milk Action has proposed repeatedly to Nestlé that we meet - once Nestlé accepts the validity of the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions of the World Health Assembly and that it needs to change its policies and practices to come into line. This will provide a basis for discussion, as part of our four-point plan for saving infant lives and ultimately ending the boycott. Nestlé, however, claims to already 'fully comply' with the Code and Resolutions and dismisses the suggestion that it needs to make changes. For example, it dismissed all but 4 of the 130 violations it counted in IBFAN's last global monitoring report, Breaking the Rules, Stretching the Rules 2010. That does not demonstrate a willingness to change practices to protect infant health. Nestlé instead invests heavily in public relations campaigns to try to improve its image and divert criticism. Its response to IBFAN's monitoring can be contrasted with that of Danone - a company over which IBFAN has serious concerns and may yet be the target of a consumer campaign. However, in response to the Breaking the Rules 2007 monitoring report Danone promised a 'root-and-branch review' of new companies it had acquired, which were a significant source of violations. We were disappointed that the situation had not improved in findings of the 2010 report, but whereas Nestlé dismissed 97% of the examples of violations in its profile, Danone stated it had taken action to deal with 50% of its violations and promised action in other areas. If Danone accepts the validity of the Code and Resolutions and that it need to change its policies and practices further to come into line, then there is a basis for meeting its executives. 

The article suggests the issue comes down to one of interpretation. To be more accurate, it comes down to baby food companies disputing the interpretation of the World Health Assembly (which has clarified interpretation in many areas in subsequent Resolutions), UNICEF (which provides support and guidance to governments on implementing the Code and Resolutions in legislation), governments (that find themselves under great pressure from corporations to water down regulations implementing the Code and Resolutions), development organisations and campaign groups. 

Those who take the time to look at the actual text of the Code and Resolutions also see that it is not difficult to understand that widely-used marketing practices are violations.

It is not for Baby Milk Action or other campaign groups to sit with Nestlé to negotiate away the protection provided in the measures adopted by the World Health Assembly. There is a process through the World Health Assembly system to re-examine this issue. Our interest in meeting with companies is to discuss how and when they will comply - and we have engaged with companies that are serious about coming into compliance. 

To seek a way forward with Nestlé, Baby Milk Action long ago proposed to Nestlé that we organise an independent, expert tribunal to examine claim and counter claim. Experts could be called to settle these issues of 'interpretation' in an open and transparent way. We asked Nestlé to set out its terms and conditions for attending, but it has refused to do even this.

Meeting with companies is not an end in itself and in the past Nestlé has used the fact that meetings have taken place to falsely suggest that its critics are no longer concerned about its activities, but working with it. If companies are serious about engaging, then they could show that in the ongoing correspondence we have with executives.

It is also important to be aware how much is being achieved by campaigners as they stand by the World Health Assembly marketing requirements. In the latest IBFAN assessment, 63 countries have implemented all or most of the provisions of the Code and Resolution in legislation. This includes countries such as India - where exemplary legislation covers products for children up to 2 years of age, empowers NGOs to bring criminal cases and has a sanction of imprisonment for the managing director of any company found to break the law. Industry analysts Euromonitor noted in 2008: "The huge disparity in the retail value of milk formula sales between China and India is mainly due to the significant differences between their official regulatory regimes." The market in India has basically remained static since 2001, whereas that in China has grown exponentially.

In Brazil, where regulations have been progressively strengthened since 1985, breastfeeding duration has increased from a median of 3 months to over 10 months today. 

This demonstrates that companies can comply with the marketing requirements when forced to do so. And when companies are compelled to market their products appropriately, they do not grow their market at the expense of breastfeeding, or they even see sales fall as breastfeeding rates recover. Hence the reluctance by executives to follow the requirements independently of government measures, as called for by Article 11.3 of the Code.

Consumer campaigns such as the Nestlé boycott and email and letter-writing campaigns to other companies also have an impact, forcing changes in policies and stopping some marketing practices. For example, the four violations in the Breaking the Rules 2010 monitoring report that Nestlé said it will take 'remedial action' on includes a pamphlet claiming its formula is 'The new "Gold Standard" in infant nutrition'. Breastmilk is regularly referred to as the 'gold standard' and this is clearly idealising language to use for a breastmilk substitutes. Thousands of boycott supporters emailed Nestlé on this specific claim and in response Nestlé said it had discontinued the leaflet. 

So campaigning works.

A third strand to Baby Milk Action and IBFAN's work to hold corporations to account alongside legislation and civil society action (such as monitoring and campaigns) is to call for an effective international regulatory framework. This does not presently exist. The UN Global Compact and OECD Guidelines for Multinational Enterprises are both voluntary initiatives which have shown themselves ineffective when we have registered complaints. However, they are worse than ineffective because they provide public relations cover to companies: Nestlé was a patron sponsor of the Global Compact 10th anniversary event in New York in 2010 and uses its involvement to counter widespread criticism of its business practices, which are not confined to its baby food marketing.

It would be far easier if Nestlé and other companies simply met their responsibilities under the Code and Resolutions - that was the hope when the Code was adopted 30 years ago in 1981. However, knowing that it has taken hard work on legislation and determined campaigning to achieve the significant progress that we have made, it is naive and misinformed to suggest that corporations will simply change if campaigners sat down with them without first securing the minimum agreement on the terms for a meeting.

If a company states in writing that it accept the validity of the Code and Resolutions and it is prepared to change policies and practices to come into line, then the offer to meet has been there for years. If a company such as Nestlé wishes to dispute interpretation then there is the World Health Assembly mechanism for adopting additional Resolutions or our proposed independent, expert tribunal to examine in depth the existing requirement.

While there are some hopeful noises from Danone in this regard, Nestlé is as obstinate as ever in putting its own profits before infant health. And so we will continue with the strategies that have helped bring in protection to billions of people around the world.