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Baby Milk Action  response to the Department of Children Schools and Families consultation: Assessing the Impact of the Commercial World on Children's Wellbeing - A Call for Evidence    July  2008

 “All too often the education process is entrusted to people who appear to have no understanding of industry and the path of progress...The provision of education is a market opportunity and should be treated as such"  European Round Table of Industrialists, 1988

 The US Centre for Disease Control and Prevention (CDC) considered that there are only two potential, cost-effective interventions that can be put into place immediately to deal with the childhood obesity epidemic: decreased television viewing and breastfeeding promotion.

 “Artificially fed infants consume 30,000 more calories than breastfed infants by 8 months of age” (equivalent to 120  Mars bars - 4 a week). Student Study Guide for Breastfeeding and Human Lactation KG Auerbach, J Riordan – 1993

 “States Parties recognize the right of the child to be protected from economic exploitation and from performing any work that is likely to be hazardous or to interfere with the child's education, or to be harmful to the child's health or physical, mental, spiritual, moral or social development.”Article 32 of the Convention on the Rights of the Child.

 “States Parties shall protect the child against all other forms of exploitation prejudicial to any aspects of the child's welfare.”  Article 36 of the Convention on the Rights of the Child. 

Introduction 

There has been a marked increase in recent years in the number of teaching materials for schools funded by food and other companies marketing products for children, many of which claim to have public health objectives.     Baby Milk Action’s work over the last 30 years has involved an examination of the public relations strategies which are used by industry to gain the trust of parents. Although some companies may have truly philanthropic motives the majority will be doing this for other reasons. For example, to: 

• involve NGOs, teachers and others potential critics in partnerships which will stop them speaking out about harmful marketing practices and threaten the independence of monitoring schemes;

• use education facilities as a channel for commercial propaganda; 

• project a healthy, responsible corporate image and so gain the trust of children;

• undermine public health messages and so mislead children

• influence policy makers and promote a self regulation and partnership approach to marketing rather than regulation; 

• provide evidence of Corporate Social Responsibility (CSR) 

• divert attention from/ ‘engineer consent’ for actions which are anti-social and which harm sustainable development, the environment and human survival. 

Baby Milk Action’s interest 

Baby Milk Action is the UK member of the global network, the International Baby Food Action Network (IBFAN) .  We have worked for over 30 years to  protect infant and young child health from inappropriate marketing, through the monitoring and implementation of safeguards recommended by the World Health Assembly – the world’s highest health policy-setting body – such as the International Code of Marketing of Breastmilk Substitutes and the Convention on the Rights of the Child. 

Our work has inevitably entailed an examination of the public relations strategies used by some of the world’s largest transnational corporations to persuade parents to use their products.  One strategy has been to sponsor health and educational facilities and materials which  build trust in the company and an image of corporate social responsibility. The baby food market was created and maintained through this trust and the one and a half million infants that WHO and UNICEF estimate die each year as a result of inappropriate infant and young child feeding continue to pay the price. 

The protection and promotion of breastfeeding is the most cost-effective intervention for child survival and could prevent 13–15% of child deaths in low-income countries.  Breastfeeding is also the optimum and natural way to feed all babies, regardless of where they live, and in the light of its importance to child health the International Code was adopted as a ‘minimum requirement’ to be adopted ‘in its entirety’ by ALL countries. 

Artificial feeding places an unnecessary burden on the environment. There can be no food more locally produced, more sustainable or more environmentally friendly than a mother’s breastmilk - a naturally renewable resource which requires no packaging or transport and results in no wastage.  Breastmilk substitutes, in contrast are the product of the dairy industry and a number of industrial processes, which are all high energy consuming and polluting of our environment.   

Breastfeeding also provides an ideal window of opportunity for obesity prevention.  Exclusive breastfeeding protects against rapid weight gain during infancy and may also help in the development of taste receptors and appetite control. Systematic reviews have demonstrated an association between not breastfeeding and an increased risk of obesity in childhood which is dose dependent, ie babies who are exclusively breastfed for longer are less likely to develop obesity. 

In recognition of the health benefits and health savings that can be made, the UK Government has made numerous commitments to increase breastfeeding rates.   However, the UK has not yet adequately addressed the fact that breastfeeding competes in a highly competitive and lucrative market and has the disadvantage of not being packaged and marketed for sale.

Baby Milk Action is a member of many coalitions which are concerned with children’s health, education and development, including Sustain, the Alliance for Better Food and Farming (as Trustee) , the UK Food Group , the Children’s Food Bill, the UK Baby Feeding Law Group (as Secretariat)  , the Breastfeeding Manifesto Coalition (as Steering Group member) and the CASE Privatisation Group. 

We have also sat on numerous committees dealing with education including the Department of Health Working Group on Guidelines on Educational Materials (1994-95) and the National Food Alliance Working Group on Health Education Materials from Commercial Sources (1991-1992). Baby Milk Action’s Policy Director was Co-founder and Advisor to Parents Opposed to Opting-Out (1993-98) and we have submitted comments to numerous consultations regarding best practice principles for commercial activities in Schools.   

As a result of our campaign in 2004, the GCSE Examinations Board included a reference to the International Code in the Home Economics (Child Development) course.  

From 1997-2000, together with IBFAN groups in Germany, Luxembourg and the Netherlands,  Baby Milk Action carried out an education project, part-funded by the European Commission, which developed an education resource for teachers called  Seeing through the Spin, public relations in the global economy.  (See Section 6) 

Baby Milk Action currently represents IBFAN on the European Commission’s Platform on Diet, Physical Activity and Health and plays a key role in the discussions about the role of industry in the funding of education and lifestyle resources At the last meeting in July 08 the discussion reached an impasse as industry members were asked to provide evidence that their many nutrition education programmes do in fact work in a sustained and affordable way and that there are no unintended consequences or risks. (See Section 5) 

2 International obligations 

The UK Government was one of the strongest advocates of Resolution WHA34.22 by which the World Health Assembly adopted the International Code of Marketing of Breast-milk Substitutes in 1981. WHA34.22  stressed that adherence to the International Code  "is a minimum requirement and only one of several important actions required in order to protect healthy practices in respect of infant and young child feeding". While the International Code is not a legally binding instrument as such, it nevertheless represents an expression of the collective will of the membership of WHO as a 'minimum requirement' to be adopted by 'all member states...in its entirety.' The International Code was adopted as a recommendation for the entire membership of WHO, not just for developing countries.  The UK has since endorsed the adoption of the more than 12 subsequent relevant WHA Resolutions that have strengthened and clarified the Code.  

The WHA Resolutions passed in 1996 (WHA 49.15) and 2005 (WHA 58.32) highlight concerns that: “health institutions and ministries may be subject to subtle pressure to accept, inappropriately, financial or other support for professional training in infant and child health” and urge Member States to ensure that “the financial support for professionals working in infant and young child health does not create conflicts of interest” 

The UK has also ratified the Convention on the Rights of the Child (CRC) and is legally bound by its provisions: it can be held legally accountable for action which hinder the enjoyment of its rights and freedoms. The CRC:

• Stresses the right to protection from commercial exploitation.  

• Recognises the fundamental role that breastfeeding plays in fulfilling the right of every child to the highest attainable standard of health.

The CRC Committee   views the International Code as a tool to help governments fulfil their obligations to Article 24 of the Convention, and in  2002 called on the UK to implement the Code and report back in 2008.

In 2007 the UN Special Rapporteur on the Right to Food, commented on the UK and EU policies on the International Code, and recalled government obligations contained in human rights measures relating to the right to food and children’s rights: The Universal Declaration on Human Rights; the International Covenant on Economic, Social and Cultural Rights; the Convention on the Rights of the Child as well as General Comment 12 of the Committee on Economic, Social and Cultural Rights.

The UK is also a signatory to the European Charter on Counteracting Obesity, the Blueprint for Action to Protect, Promote and Support Breastfeeding, the Global Strategy on Infant and Young Child feeding, the Global Strategy on Diet, Physical Activity and Health, the European Charter on Counteracting Obesity, the Universal Declaration on Human Rights; the International Covenant on Economic, Social and Cultural Rights; the Convention on the Rights of the Child as well as General Comment 12 of the Committee on Economic, Social and Cultural Rights, the ILO Maternity Protection Convention No 183.  Also of relevance is the WHO Regional Office for Europe, Food and Nutrition policy for schools, and the EU Strategy for Europe on Nutrition, Overweight and Obesity related health issues COM(2007) 279 FINAL SEC(2007) 707

All the above contain commitments to protect child rights, to protect, promote and  support, breastfeeding, and to avoid conflicts of interest. 

3 Why do companies sponsor education? 

"Sincerity is the key to success in the modern world. Once you can fake this, you've got it made." Jean Giraudoux (1882-1944).

Although in some cases the sponsorship of education can be philanthropic, in general, and especially when it involves large for-profit commercial enterprises, it is not.  Companies that have an interest in selling products to children (or parents) inevitably have dual motives for sponsoring educational materials, as do certain religious and other interest groups. However, since companies have a fiduciary duty to their shareholders to maximise profits, any investment by them must show a financial return, either in the short or the long term. This can be through sales of the products, through the influence on policy makers with the aim of shaping opinion and legal frameworks to favour the companies interests, as evidence of Corporate Social Responsibility (CSR), to silence critics and so to ‘engineer consent’ for actions which would otherwise be censured – actions which can have a profound impact on health, sustainable development, the environment and human survival. 

The 1979 report Hucksters in the Classroom, and the 1985 Corporate Pied Piper by Sheila Harty for the International Organisation of Consumer Unions,  exposed the subtle ways in which business uses its involvement in education and how this can constitute exploitation of children. “Instead of promoting specific products, corporations are now tending to produce materials which look at broader social issues….  ‘issue’ advertising is used to argue the company’s position on current public controversies”

As policy makers consider whether it is best to follow the self regulation or legislation route to control industry’s harmful practices, companies use their ‘contributions’ to education to advocate the need for trust in self-regulation and partnership approach.   

In February 2007 Corinna Hawkes of the International Food Policy Research Institute in Washington gave a presentation to the European Commission’s Platform for Action on Diet and Physical Activity, which examined how self-regulatory systems fail to limit the extent and impact of marketing. Instead they promote trust in advertising amongst consumers and governments, and in so doing tend to undermine their resolve to bring in the legislation that is needed to protect health. Under self-regulatory systems the volume of advertising increases.

Sponsorship is also often used as defensive public relations to offset the bad publicity generated by unfair and harmful trade practices and environmental damage.  For example in 1999, in an exposé on Nestlé, Marketing Week magazine asked Marjorie Thompson of Saatchi & Saatchi how Nestlé should respond to the bad publicity surrounding a UK Advertising Standards Authority ruling. The magazine reported her suggesting that: “the way to counteract the bad publicity is to go on the offensive by using advertising showing the benefits of Nestlé's financial contributions to charities, such as Kids Club Network which provides after-school care for children."   The Which reports Food Fables, expose the weaknesses of company policies, comparing them to actual marketing practices. 

For these reasons education materials present an even more complex problem than crude brand promotions. Not only do they blur the boundaries between advertising, marketing and education but they can be confusing and deceptive. If a company selling unhealthy foods links its name to a healthy activity such as a sport or healthy eating practice, there is a halo effect which can lead children to believe that the company as a whole is a force for good in society and that it must follow that all its products are healthy. This effect is exacerbated when reformulations are made to foods and accompanied by health and other claims such as – additive free, organic, low fat, ‘fitness’, contains vitamins etc.  If a soft drinks manufacturer claims to be taking a lead in environmental protection, will students using its teaching materials assume they are saving the planet each time they buy the drink?

In this increasingly complex, globalised world, our children’s lives are inextricably linked with people and communities in places they know little about.  It is essential that we provide children with tools which will help them develop their ability to question information and to challenge commonly-held assumptions. Only then will they become active, aware 21st century global citizens. 

It is dishonest to ignore the fact that a reliance on commercially-driven materials or other sponsorship can do the opposite, and can act as a form of censorship: creating pressures on teachers and trainers which can discourage debate about controversial topics – especially if this involves the sponsors’ activities. Baby Milk Action is contacted on a regular basis by parents and teachers who are afraid or unable to challenge Head Teachers about sponsorship schemes which they are often not consulted about. (see Section 10).

Allowing companies the privilege to use their disproportionate wealth in public services and schools creates the potential for undue influence at a very basic level and threatens parents and children’s right to unbiased health and education services.  

4 Governance issues: Partnerships, Academies 

Current UK Government policies actively encourage partnerships between businesses and schools and at policy level there seems to be a complete lack of understanding of the risks.  (see also Section 5). There is a school of thought that if you can persuade companies through partnerships to look good and make strong pronouncements, eventually their actual practices will change.  What is forgotten is that real change in company practice depends on accountability procedures which are in turn dependent on monitoring (which must be entirely independent of the company) and reporting – key safeguards which are under threat in public private partnership schemes.   

Although there is now a reference to the International Code of Marketing of Breast-milk Substitutes in the Curriculum, the overall framework under which schools operate does little to ensure children’s rights to protection from commercial exploitation.  

The promotion of Academies further increases these risks and challenges the commonly held assumption that it does not matter where money comes from as long as the governance of a school is appropriate. The sponsors of Academies appoint and have control over the governing body and many of the Statutory Terms and Conditions and prevailing Local Authority frameworks that operate in State Schools do not apply to these schools. There are also real concerns that the Freedom of Information Act will not apply to Academies. 

It has to be borne in mind that many large corporations have created non-profit entities (Business Interest NGOs or BINGOS) through which they masquerade as charities, NGOs, or Trusts (Public Interest NGOs or PINGOS). The purpose, funding and governance of BINGOS is rarely transparent.

To ensure the protection of child rights, it is essential that any provision of public services should be transparent and not bound by rules of commercial confidentiality. 

There have been several guidelines produced for teachers and businesses which purport to address commercial activities in schools, the latest being Working with Schools – Best Practice Principles, drawn up by the Department of Children Schools and Families (DCSF) and the Institute of British Advertisers (ISBA). However, instead of safeguarding child rights, this leaves the door wide open to abuse with weak and misleading recommendations such as, “Explicit sales messages should be avoided where possible” or  “Where possible, the company should seek permission before forwarding materials to the school” and“Is the level of branding and logo use appropriate to the activity?” 

In 2006 the Baby Feeding Law Group wrote to Ruth Kelly, then Secretary of State for Education about our concerns about the Education White Paper, Higher Standards, Better Schools for All,  and the implications of business sponsorship on infant and young child health the lack of guidance regarding appropriate sponsors. She responded with many assurances, including that no school would be forced to become an Academy. 

“Academies and voluntary aided schools already benefit from such relationships.  However, schools will not be forced to make this change. The decision is for the individual school. It will be for the governing body to decide whether to make the move to form partnerships with Trusts, following consultation with parents and other stakeholders.  The School Commissioner will be able to advise schools on Trusts to avoid. But he/she will never be able to force a Trust on a school. He/she will not decide school organisation matters, that will be for local authorities, but will help to facilitate links with potential Trust sponsors and headteachers, as a broker, focusing efforts on disadvantaged communities to ensure that they can benefit from Trusts.”

We would welcome assurance that failing schools will not be forced to become academies and that before pursuing the above strategies further, careful note will be taken of the submissions to this consultation, including those from the NUT and the National Heart Forum, Baby Milk Action, the Breastfeeding Network and the many others urging caution. 

  5 European Platform: EU and Global impact

Baby Milk Action represents IBFAN on the European Commission’s Platform on Diet, Physical Activity and Health which brings Europe’s largest food and advertising companies and leading health NGOs together to find strategies - in the form of voluntary commitments -  to combat the rising levels of obesity and food-related ill-health.  The overall aim is to encourage physical activity and reduce consumption of unhealthy foods. 

The Plenary meeting of the Platform on 2nd July focussed on Nutrition Education and a Working Paper examining the many commitments made by the food industry on ‘education’, parenting skills and lifestyles. Baby Milk Action and other NGOs have consistently expressed concern about the predominance of such schemes and the conflict of interest that exists when they are funded by the very companies contributing to causing the problem of obesity and ill health. Many of the commitments, especially those where baby food companies such as Nestlé are advising young mothers, are in direct conflict with World Health Assembly Resolutions. We have recommended that such schemes should not be promoted or included as Platform Commitments unless they conform the Resolutions and there is uncontested evidence that they are likely to have a positive effect on health and do no harm. This evidence seems to be lacking. Meanwhile sales of chocolate   and baby foods continue to rise. 

IBFAN and the NGOs maintain that industry should instead be encouraged to focus on improving the environment in which children live by halting all promotion of sugary, fatty foods to foods to children and bringing their marketing of baby foods into line with WHA Resolutions. 

The food industry maintains that legal bans on advertising are not necessary, that self-regulation is best and are determinedly pursuing the ‘education’ line - keen to convey the message to children that they have all indeed been  transformed into health and nutrition companies.  The presentation from the CIAA representative on the 2nd July demonstrated that overall only a small proportion of its members and the industry had indeed attempted to change their profiles and there was considerable resistance to the proposition that reformulation to improve the nutritional health value of food products was necessary.

At the 2nd July meeting in answer to a question from the Commission about the motivation of companies to fund education, the CIAA representative, working for Mars, said that the role of education is to help the whole population to understand, appreciate and enjoy their products, but not in excess.    

The meeting went on to examine the undue influence large corporations may exert on Governments over public health policies when they provide essential services. The EU Commission representative said that to his knowledge such pressure had not occurred at Commission level, but that he was aware that it does occur at Member State level and that the Commission had been asked to step in to help.

The EU Nutrition Strategy identifies the need to know more about the  "drivers for preventing obesity in target groups such as  infants, children and adolescents"  identifies schools as important settings which should be protected environments and calls for any partnerships to be undertaken in a transparent and non-commercial way. 

The EU should not arbitrarily support food or related industry funding of health education materials or media-literacy schemes in schools. There is no consensus on the benefits of 'media literacy education' and the effectiveness of immunising children against advertising and other commercial pressures. The inherent conflict of interest and risks involved in having commercially-driven media literacy activities must be honestly acknowledged. 

The EU and the UK have a duty to protect children from such potentially harmful pressures and to acknowledge the significant global influence of their decisions. The drive to increase competitiveness should not outweigh the horizontal obligation of all EU member states to protect health, the environment and human rights. The EU and the UK should seek to raise standards of consumer protection globally, not lower them as it is now doing with policies that encourage business partnerships and corporate funding of education and other essential services.

6: Media literacy: Seeing through the Spin  

In response to repeated requests for information about the campaign to protect infant health for use in schools and aware of the growing phenomenon of commercial sponsorship of education materials generally, from 1997- 2000, together with IBFAN groups in Germany, Luxembourg and the Netherlands,  Baby Milk Action carried out an education project, part-funded by the European Commission.

The project developed an education resource for teachers, Seeing through the Spin, public relations in the global economy, which has been translated into Italian, and has been used as an education resource in UK  schools and in many other countries. The 13 excercises contained in the pack are also available free on line. (www.babymilkaction.org/spin). 

During the preparation of the pack we carried out a survey of 248 Head Teachers which showed that teachers had no formal way of assessing material that which  was sent to them, the vast majority of which was unrequested.

Seeing Through the Spin examines how public relations (PR) influences our perceptions of transnational corporations (TNCs) and non-governmental organisations (NGOs), and how these organisations affect development, public health and the environment. It questions whether commercial sponsorship of education is justified, and whether its benefits are outweighed by its risks to health and society.

Some comments on Seeing through the Spin 

"Seeing through the Spin is a powerful piece of corporate counter-spin, a crucial and trustworthy tool for teachers to help their students understand the barrage of public relations disguised as education."     Naomi Klein

"The corporate takeover of schools is one of the most terrifying aspects of the domination of public life by big business. Seeing through the Spin is an invaluable guide to the transformation of young people in the UK into marketable commodities."  George Monbiot

"A valuable resource for everyone working in health, education and the voluntary sector. Its should be in every university, college and school library. Service providers would be well advised to read this pack before embarking on sponsorship deals." Anne Bramley, midwife

"Schools are increasingly being targeted by companies keen to market their brands and images. Educational resources are distributed by companies and it isn't always easy for youngsters, or indeed for teachers, to deal with all this complex information. This pack is exactly what teachers need as they work to encourage their pupils to make up their own minds." Glenys Kinnock MEP

"Every school should have this pack! Students will love to discuss the issues it raises. This is what education should be about." Prof Michael Reiss, Univ. of London, Inst of Education, _Ethics Adv.,UK Gov Committee on Novel Foods & Processes, Dir of Educ., Royal Society.

7 Media literacy: Media Smart

Media Smart is a media literacy programme that claims to have similar aims to Seeing Through the Spin.  It claims to benefit primary school children and provide them with the “tools to help them interpret, understand and use information provided in adverts to their benefit. The programme teaches children to question their sources of information and helps them think about the influences on their every day choices. The advertising business has a long track record of responsible advertising to children. Media Smart® continues this tradition”   (www.mediasmart.org.uk)

Although referred to as ‘not for profit’ Media Smart is funded by corporate sponsors including the Advertising Association, the British Toy and Hobby Association, Cadbury, GMTV, Heinz, Kellogg's, Mars UK, McDonald’s and Procter & Gamble. 

Baby Milk Action has expressed its concern about the inclusion of Media Smart as a Platform Commitment and believes that despite its supposedly wide-ranging governance and popularity with primary school teachers, its funding has fundamentally influenced its remit and content  to the extent that it is educationally harmful.  It falsely implies that advertisers in the UK are generally ‘responsible’ and that the advertising controls in the UK are effective. 

Media Smart also subtly undermines the health messages teachers are trying to convey. For example, many of its excercises and games  reward children directly in proportion to the amount of television they watch.    The Smart quiz asks: “Which supermodel is the “face’ of the Rimmel UK TV advertising campaign -  Jordan,  Kate Moss or Naomi Campbell?” The child cannot move on to the next page until they give the right answer.

In another game, called Product Match,  children are asked to match reasons why they might buy certain products.  A chocolate bar must be matched with “Tastes great!”; a trashy comic with “A great read!” and a toy tractor with “Only £9.99!”

The European Platform Working paper on Lifestyles and Education (June 2008) which was discussed at the Plenary Session in 2nd July raised concerns about the effectiveness of Media Smart:“Media Smart is a media literacy programme for 6 to 11 year olds running in Belgium, Finland, Germany, Hungary, Netherlands, Portugal, Sweden and the UK. The programme teaches children to think critically about advertising and provides free materials for schools using real examples of adverts, funded by the advertising industry. Critics of the initiative have asked for the evidence base to be provided for the rationale of the ‘innoculation approach’ of ‘vaccinating’ children against future exposure to advertising....The available studies on Media Smart centred on schools in which their materials have been used in Britain. Although feedback from teachers has been  extremely positive, with 98% of those using the material intending to use it in the future and 86% of these teachers rating it “extremely valuable or very useful”. A closer examination of feedback from teachers who have used the material indicates somewhat mixed results and questions about longterm impact. Much of the data indicates little more than high levels of content recall levels with little further

impact.” 

8   Education on Infant and Young Child Feeding

“The problem with nutrient-by-nutrient nutrition science is that it takes the nutrient out of the context of food, the food out of the context of diet and the diet out of the context of lifestyle"  

Marion Nestlé, New York University.

In the absence of a pre-authorisation procedure for new ingredients in formulas or of evaluation by an independent scientific body prior to introduction onto the market,  baby food companies are rushing to add new ingredients to formulas and baby foods before their safety and efficacy has been established -  simply to gain commercial advantage. 

Companies have applied for patents to engineer cows and sheep to produce the whey protein and other ingredients  in human milk and are using claims that aim to convince the public that such technology results in milks that match the 'gold standard' of breastmilk.  This is extremely deceptive. A mother's milk, in contrast to any genetically engineered product, is a living substance, tailor made for her baby. Its anti-infective, anti-viral and growth factors are still not fully understood, and it can actively destroy many bacteria, viruses and parasites - practically anything the new-born infant may confront. It is also delivered in a uniquely safe way.

The position of the leading health professionals in the UK is that if an ingredient has been unequivocally demonstrated to be essential and beneficial by an independent review of data which includes a substantial proportion of independently-funded research, it should be a mandatory ingredient in all formulas.

The use of health or nutrition claims that highlight one or other ingredient out of the context of the other ingredients is misleading in any food. On breastmilk substitutes it is especially deceptive because it suggests that the product has a health advantage over breastfeeding. Many claims go further and suggest that the ingredient will make children cleverer,  protect them from infection, or tackle 'problems' such as wakefulness, colic, crying, constipation, vomiting or allergies. Information on ingredients should be presented in a nutrition panel following Quantative Ingredient Declarations (QUID) guidelines. 

IBFAN’s monitoring in 69 countries shows a marked increase in the promotion of health and nutrition claims, most of which are based entirely on industry-funded studies.  More worryingly still, the systems in place in most countries, including in the UK and EU, are unable to effectively evaluate and screen the thousands of claims used.  Companies are left to exploit the market, confusing people with scientific sounding names, which few health workers, let alone parents or children, can hope to understand.. .    ,  

Breastfeeding instructions produced by manufacturers of breastmilk substitutes are connected to an increased frequency of artificial feeding so it is especially important that information on infant feeding and parenting skills is objective and funded by a disinterested party.  “Accordingly, although information on breastfeeding is usually included in these [commercial] materials, the messages are mixed at best and emphasize the challenges of breastfeeding. A health provider who distributes materials that are ultimately designed to maximize formula sales is inadvertently strengthening the formula promotion message, potentially at the expense of patients’ plans to breastfeed. In a randomized controlled trial studying the impact of educational packs on infant feeding, women who received formula company-produced infant feeding materials at their first prenatal visit were more likely than those who received noncommercial materials to stop breastfeeding before hospital discharge and before 2 weeks postpartum.”   

The NHS paper, Breastfeeding for longer – what works? provides an overview of key findings from a series of systematic reviews of studies of interventions and concluded that the provision of materials produced by formula companies on infant feeding in early pregnancy was not effective in extending the duration of breastfeeding and should not be used without further evidence of effectiveness. 

A Department of Health Survey in 2004 found that over a third (34%) of women in the UK believe that infant formulas are very similar or the same as breast milk. The ONS infant Feeding Survey 2005  and others commissioned by UNICEF, Save the Children and the National Childbirth Trust in 2005 and 2007 show a profound lack of understanding about the risks of artificial feeding especially amongst younger and less educated parents. In one study around a third of the respondents said advertising gave the impression that infant formula milk was ‘as good as' or ‘better than' breastmilk. 

In 2006 the Baby Feeding Law Group wrote to the Secretary of State for Health about the failure of the Health Bill to distinguish between who is and who is not an appropriate provider of health services and that allowing manufacturers of baby foods the privilege of being involved in the production of infant and young child feeding education would undermine the Government’s health messages and its aims set out in the Choosing Health. The Baby Feeding Law Group offered to review materials for use in health facilities, to ensure compliance with the UN requirements.  

In acknowledgement of the risks of commercial involvement in education, the National Institute for Clinical Excellence (NICE) Guidance, Improving the nutrition of pregnant and breastfeeding mothers and children in low-income households, published in April 2008, in Recommendation 14 urged managers to:   “Avoid promoting or advertising infant or follow-on formula. Do not display, distribute or use product samples, leaflets, posters, charts, educational or other materials and equipment produced or donated by infant formula, bottle and teat  manufacturers.

Infant nutrition and the health food market.

“It is puzzling – with the benefit of hindsight – why a large part of the food industry took its eye off the ‘nutritional’ ball during the 1990’s. Unfortunately, while we were focussed on issues of taste, convenience and value, consumers were getting fat, unfit and progressively unhealthier … It is important to acknowledge that the issues we face as a European food industry are partly an outcome of our own success.”

Speech by Patrick Cescau, Group CEO, Unilever at CIAA Congress, October 2006.

Nestlé, the world’s leading manufacturer of breastmilk substitutes, systematically violates the WHO/UNICEF International Code of Marketing of Breast-milk Substitutes and subsequent relevant WHA Resolutions, and as a consequence has been the focus of consumer criticism and boycotts for over 30 years.  Nestlé is now keen to transform its image and to be seen as a health and nutrition company and the following quote from Flex News  (20.6.2008)  illustrates the importance of infant nutrition in this strategy.

 “Nestlé Nutrition doubled its sales between 2005-2007 to over CHF 10 billion (EUR 6.1 billion) thanks to a combination of organic growth and robust acquisition, investors were informed this week. In a bullish statement, the company said it expected the performance of the Nutrition division to spearhead Nestlé's bid to become the world leader in its field of health and wellness, with sales from its infant nutrition segment alone estimated to rise to CHF 8 billion (EUR 4.9 billion) in 2008…..The Swiss-based company said organic sales within Nestlé Nutrition had grown by CHF 1 billion (EUR 617 million) during the two-year period. This healthy growth had been augmented by three successful strategic takeovers that had brought in a further CHF 4 billion (EUR 2.4 billion) into the company. Jenny Craig, a weight management company, had added CHF 0.5 billion (308.9 million) , Novartis Medical Nutrition  a further CHF 1.2 billion (EUR 741 million) while The Gerber takeover had boosted sales by CHF 2.3 billion (EUR 1.4 billion) By the end of 2007, Nestlé Nutrition’s sales had soared to CHF 10.3 billion, with almost three quarters of revenue coming from infant nutrition. ….Nestlé has high expectation of the  performance of it entire infant nutrition division in 2008 with sales rising to CHF 8 billion compared to under CHF 5 billion two years ago. – with strong growth expected across its infant formula and its infant meals and drinks more than trebling compared to 2006.”  

DANONE has similar aspirations:

“By acquiring Numico, DANONE has become the leader in the infant nutrition sector in Western Europe and number 2 worldwide. It is, therefore, on a par with some of the historic players in this sector and has become the first player in the food industry to position itself so clearly in the health foods market. Thanks to this unique positioning, DANONE’s ambition is to become the world leader in food for health. This ambition will also mean that the Group increases its social and environmental commitment…. The ambition of DANONE is to double its geographical spread in emerging countries. In this, our main challenge is not financial but human.” 

In July 2007, Danone  bought Dutch Numico for €12.3 billion - 4.5 times estimated revenues. Danone now owns Nutricia, with leadership positions in Western Europe, Eastern Europe, Asia and the Middle East. Nutricia owns Cow & Gate, Milupa, Mellin and Dumex.  Danone   already wholly owns Blédina, the biggest supplier of baby food in France, dominating 45% of the market and selling to 55 other countries with large market shares in sub-Saharan Francophone Africa and in the Middle East.  

All Danone owned companies, like Nestlé, are systematic violators of the International Code of Marketing of Breastmilk Substitutes and Resolutions and the Danone 07 Sustainability Report outlines the limitations of its policy relating to them. Danone was exposed in a study published by the British Medical Journal in 2003 as being worse than Nestlé for labelling violations in the West African countries surveyed. NUMICO is particularly problematic in Asia. ,  

Danone boasts of its humanitarian ideals. For example the Grameen Danone project: “The mission of Grameen Danone Foods speaks for itself: to reduce poverty by bringing health through food to children using a unique community-based business model. __A joint venture launched by DANONE and Grameen (the “Bank of  the poor”) in March 2006, Grameen Danone Foods is a business—and as such must turn a profit—but its priorities are reversed. Grameen Danone Foods has placed social and environmental concerns at the heart of its business model. Although the company has to be profitable – profits from the first plants are needed to finance the construction of new plants – the success of the project will above all be judged on non-financial criteria: the number of direct and indirect jobs created (milk producers, small wholesalers, door to door sellers), improvements to children's health, protection of the environment etc…”

The Proof of the Pudding 

In several publications and presentations, the Investment Bank JP Morgan together with  Insight Investment,     has identified how companies can gain competitive advantage  from ‘health’ and ‘wellness’ foods “which should translate into sustainable sales growth and margin expansion”  The reports also show how the threat of regulation on labelling, advertising, health and nutrition claims and food composition creates a pressure to “promote healthy lifestyles.” 

While going some way to admitting the food industry’s role in ill-health, the report fails to address the impact that the promotion of highly-processed, packaged foods with long-shelf lives has on the consumption of less profitable foods such as breastmilk, fresh fruits and vegetables. Nor do they address the need for truly independent monitoring to evaluate the impact of new technologies and reformulations – the unintended consequences. (See Section 10) The reports are based entirely on company reports, strategies and testaments and include no independent assessment.  The crucial difference between what a company says and what a company actually does, consistently exposed by NGO monitoring, is completely glossed over: 

“At present, US and EU governments are backing voluntary approaches, giving the industry a few years to demonstrate that it can tackle these problems without the need for intervention.  We believe it is essential for companies to demonstrate that they are doing a comprehensive, effective job in order to avoid regulation in the future and to demonstrate that they are ‘responsible corporate citizens’ to consumers and other stakeholders.”

Corporate involvement in nutrition education is therefore scored highly as evidence of CSR, as are any foods that which claim to be healthy. “Nestlé also appears to be doing a good job of educating customers and encouraging an active and healthy lifestyles.”….“Healthy food is the key driver of sales growth in food and beverage and offers significant pricing power and margin pricing. For example, any costs associated with reformulation of foods could be more than offset if the company is able to market it as (for example) a lowfat/ low-salt/low sugar "healthy" product to a growing number of health conscious consumers.”  

10 Reformulations, novel foods – unintended consequences

The safety and nutritional value of reformulated products using novel processes is controversial – especially in the context of infant nutrition, but also in other foods.  Many companies are now replacing the salt, sugar and fat with artificial ingredients and additives that which maintain the intense sweet taste.   There is a need for more research into the impact of reformulated products and whether their presentation as a healthy option increases overall calorie consumption.  

Children have a right to truly objective information on what is and is not a healthy diet and this cannot be provided if the sponsor of core nutrition education (and the research on which it is based) has an interest in the outcome. 

When chocolate is promoted as an aid to concentration or as an aid to fitness, what message does this convey to children?    Should children learn about the safety of the artificial sweetener, Aspartame from Coca Cola which says Aspartame “is one of the most thoroughly studied ingredients used in food and drink and has consistently been found to be safe.” The European Ramazzini Foundation (ERF) (an independent institution in Italy) stated  that it is a “multipotential carcinogenic agent” in rats. The European Food Safety Authority (EFSA) stated that ERF’s study did “not provide a scientific basis for reconsidering its use in foods. If any new information would become available in the future, EFSA will review these as a matter of priority.” 

In Section 11 and in Baby Milk Action’s briefing paper, Tackling Obesity – watch out for undue corporate influence, are examples of inappropriate and misleading education materials.  

10 Examples of inappropriate commercial involvement in education

The following examples are not all current, but give some idea of the concerns that parents, teachers and students have expressed over the years.  

Many of the examples relate to Nestlé, because, as the largest food company in the world,  it is most actively sponsoring materials in schools globally. Following exposure through our monitoring some have been discontinued, such as the Times100 Polo Mint worksheet (Injecting new life into the Product Life Cycle) below. Others have become more subtle.

• Times 100 website claims to be a “A resource centre for business studies students and teachers who want to improve course work, portfolios, research, examinations or homework, this site will improve your grades. The material, which is centred on well known businesses, has been designed by teachers and written by respected published authors to cover all the key topic areas.” It includes Case Studies of a range of companies including Nestlé, McDonalds and Marks and Spencer. www.thetimes100.co.uk  

For example:

• Nestlé Doing better by the Environment  (Times 100) Nestlé claims to support ‘sustainable development’, ‘Rio’ and ‘Kyoto’ etc. Listing as a major achievement its: ‘removal of the inner plastic sleeve from Kit Kat Bumper packs saving 160 tonnes per year”, but failing to mention the new plastic wrapping on individual bars of Kit Kat.

• Nestlé. Injecting new life into the Product Life Cycle. (Times 100) laminated worksheet. One of the educational tasks was to “Carry out a survey of 30 mint consumers to find out which of the four variants of Polo they find most appealing.”

• McDonalds The Route to Fast Food Franchising  (Times 100) This promotes the product as  a“well established, high quality product…recognised all over the world. 

• Coca Cola’s Corporate citizen in the Community: presents the company as a leader in environmental protection. 

• Nestlé: Food a Global industry: An education project for GCSE Geography and Business Studies. “The core section provides information about agriculture, the food processing industry, marketing food brands and a case study of Nestlé. A supplementary pack of chocolate also accompanies the Core.” 

• Nestlé Box Tops for Education: This scheme attempts to co-opt teachers into promoting cereals, many of which are high in sugar. If children bring in the tops of Nestlé cereals the school receives some money. Many schools have refused to take part, and some have written to all parents to explaining their concern about the company's marketing of baby foods and unhealthy foods.

• Nestlé 'Go free' campaign promotes confectionary and cereals.

• Nestlé  “Education” website (UK): In 2002 parents complained to Baby Milk Action about the use of the Department for Education and Skills (DfES) logo on a website "Key Skills in Context." This was done without DfES approval and was eventually removed. Nestlé provided the section on 'nutrition', which boasted "Nestlé products not only look and taste good but also contribute to our health and well being." The site extolled the benefits of fruit and linked to information on Nestlé's Fruitsome bar which was promoted as high fruit. Nestlé neglected to mention that the bar contained only 9% fruit and is 36% sugar..

• Russia Nestlé’s ‘Programme about Correct Nutrition – working notebook for school children” is used in thousands of schools in Russia. Page 55 shows a mother telling her child that eating chocolate rather than a sandwich before an exam will help her manage the difficult excercises. The clear message was that the more chocolate you eat the cleverer you will be.  

• ‘Healthy’ vending machines: Nestlé promoted its Refuel:Pod vending machine as helping children “to make an informed and healthier choice” about food and “have a balanced lifestyle.... [driving] school vending into an exciting new area… built on six key principles essential to their growth, development and concentration.....” The 50 items listed in the Standard Opening Order were confectionary and snacks, such as Rolo, Kit Kat, Milky Bar, milk shakes and crisps. A ‘fruit pot’ is described as one portion of fruit. (Times Educational Supplement. 24.6.04)

• Kids' Club Make Space initiative: Nestlé sponsors this initiative with a £1.2 million 'development fund'. Materials for the initiative bear the logo 'Nestlé Trust' and press releases prominently mention Nestlé and quote UK Chief Executive, Alastair Sykes, at length.

• In 2002 the makers of Walkers crisps filmed a TV advert in a classroom in Fossdene Primary School in East London. The whole school had a day off and the school received about £2,000 and book tokens in return

• Milo sponsorship of sports. Milo is a milk drink that is 46% sugar.

• Borneo: 2006 Nestlé sponsors the Inter-Schools Swimming Championship with T-shirts and Milo drinks. (Borneo Bulletin Online )

• Nigeria: Nestlé Milo sponsors sports events and reels out “ mouth-watering incentives for the winners, first and second runners-up including prizes for the media.” 

• Jamaica: Nestlé sponsors school sports tracks “Through the brands Klim and Milo, we hope to make them (athletes) so healthy that it shows, and through Milo, as the tag line goes, ‘the food drink of future champions’, we hope that this will be a sterling event in the next month.” (Jamaica Observer, May 06)

• Malaysia: Nestlé sponsored 150 schools: “Year Four pupil Muhammd Irfan Muhamed liked it when his group created a jingle for Koko Krunch using the tune from the children’s nursery rhyme, Twinkle Twinkle Little Star. They did the jingle in front of the other pupils.” (New Straits Times 23.4.06)

• Phunky Foods, UK (www.phunkyfoods.co.uk/) Many parents have complained about this teaching site for Primary schools, sponsored by Northern Foods and Nestlé.   Phunky Foods claims to be a “comprehensive programme to teach primary school children health eating and physical activity messages through art, drama, music, play and hands on food experience.” Its powerpoint presentation for teachers has a Nestlé, Cargill and Northern Foods logo alongside the Government’s ‘Curriculum on Line’ logo on every page and includes the following. 

• “Why is PhunkyFoods Sponsored?

• PhunkyFoods is, and always will be, an independent healthy lifestyles programme developed and written by registered nutritionists and consultant teachers. By substantially subsidising the programme with industry CSR budgets we are able to:

• Lower the costs of the programme to schools to £250 per year and continually work to lower this cost

• Invest in the future development of the curriculum, teacher training and resources in-line with current findings from school surveys

• Invest in vital research to evaluate the impact of the PhunkyFoods programme on children’s health behaviours and outcomes

If we achieve our goal of a food industry consortium we can:

• Lobby Government.”

And finally two examples from  history:

• Misleading Children about HIV/AIDS.  In 1989 the Young Enterprise Group  at Ousedale School in Buckingham found that the profits from a Nestle chocolate vending machine were being slashed because students, prompted by posters put up by the Green and Peace groups, were boycotting the machine. On the invitation of the headmaster, Nestle gave a presentation in front of 200 sixth formers, defending their marketing policy with grossly misleading statements about HIV/AIDS transmission through breastfeeding, generating criticism from Save the Children and the Institute of Child Health.  

• Rewriting History 1996: The Controversy Over the Marketing of Breast Milk Substitutes is a multimedia teaching resource for the 'over 16s’ produced by the Council for Ethics in Economics (CEE). CEE is an ‘NGO’ based in Columbus, Ohio, but was actually set up in 1982 to help resolve the baby milk controversy and end the first phase of the Nestlé Boycott.  Although presented as 'independent' the case study was initiated and funded by Nestlé.  During its preparation, the researchers asked to interview Baby Milk Action but were not able to give an assurance that the Nestlé's sponsorship would be made explicit. Because of this the interview was refused. The CD which is distributed by Nestlé in the UK contains a highly selective and distorted account of the history of the infant feeding issue. http://www.businessethics.org/about.htm

PR 2008 (revised 09)