American Medical Association set up a committee to investigate infant food
advertising and proposed that this should be restricted to doctors only. “Our
interest in this important phase of medical economics springs, not from
any motives of altruism, philanthropy or paternalism, but rather from a
spirit of enlightened self-interest and cooperation because [our] infant
diet materials are advertised only to you, never to the public.” Mead
Renowned paediatrician Dr Cicely Williams, states in a speech to the
Singapore Rotary Club entitled
deaths resulting from “..misguided propaganda on infant feeding should
be regarded as
Worldwide expansion in distribution and marketing of powdered milk for
infants. TV and radio spread the bottle-feeding message with frequent
advertisements. Nestlé saleswomen in nurses’ uniforms (‘Milk Nurses’) gave
out free samples and promoted artificial feeding in maternity wards and
clinics. Health professionals noted increased rates of diarrhoea,
infections, malnutrition and deaths of infants, bottlefed with artificial
milks, in the developing world. Paediatrician, Dr Derrick Jelliffe,
described this as ‘commerciogenic malnutrition’.
The New Internationalist Magazine reports ‘The Baby Food
Tragedy’ and called for a campaign to stop the promotion of baby milks,
foods and feeding bottles.
A UK Charity, ‘War on Want’, publishes ‘The Baby Killer’ which is widely
translated. Nestlé takes legal action against the Swiss publishers. The
case generates worldwide publicity and exposes Nestlé’s practices. The
judge states that the company must change. A boycott of Nestlé products
is launched in the USA and spreads around the world.
The Sisters of the Precious Blood (an order of Roman Catholic nuns) make a
shareholder challenge of Bristol Myers’ unethical marketing practices.
Bristol Myers undertake to change.
The Government of Papua New Guinea legislates to control the sale of
feeding bottles. This leads to a dramatic reduction in infant malnutrition
The US Senate holds a Committee of Inquiry into baby food
marketing. WHO and UNICEF host a meeting and the process of creating an
International Code begins.
The Code is adopted by the 1981 World Health Assembly. In a sudden U-turn
of policy, the USA votes against it.
The companies make a few cosmetic changes but continue to flout the rules.
Most governments fail to act and some bring in industry-drafted Codes. The
Nestlé Boycott is suspended in 1984 when the company publicly promises to
keep to the Code. In 1989 the boycott is resumed when monitoring reveals
widespread violations, including flouting of the WHA Resolution banning
free supplies. It continues in 2006.
The Innocenti Declaration on the Protection, Promotion and
Support of Breastfeeding, an initiative of over 30 governments and 7
agencies, to bring back a global breastfeeding culture, is launched in
Florence, Italy. Its four targets are:
Appoint a national breastfeeding committee and coordinator
Ensure the Ten Steps are practiced in maternity systems
Give effect to the Code
and subsequent resolutions
legislation to protect breastfeeding rights of working women
The Innocenti Declaration’s four targets
are endorsed in a WHA resolution (WHA 45.32).
1990 The Convention
on the Rights of the Child
parents’ right to knowledge of breastfeeding.
Friendly Hospital Initiative (BFHI) launched to reform maternity facility
practices. To gain BFHI status, the facility must implement The Ten Steps
for Successful Breastfeeding and all relevant provisions of the
into the 21st century
Code training, for government and health
officials, NGOs and others, raises awareness and increases skills.
The eight Millenium Development Goals (MDGs)
include that of reducing under five mortality by two thirds by 2015.
The International Labour Organisation (ILO) adopts three Maternity
Protection Conventions protecting maternity leave and breastfeeding breaks
for all women in the workplace.
The Global Strategy for Infant and Young Child Feeding builds on the
Innocenti Declaration and calls on Governments to take urgent action to
implement the Code.
The ‘Innocenti plus 15’ Celebration Meeting takes place in Florence ,
Innocenti Declaration 2005 is welcomed at the World Health Assembly
(WHA59.21) and Member
are urged to renew their commitment to the Code and all subsequent
relevant WHA Resolutions (12 to date)
Apple Rima D, Mothers and Medicine A Social History of Infant Feeding
1890 -1950. University of Wisconsin Press, p94 (1987).