Baby food firms flout Indian laws, endanger kids’ health: survey

A study says that more than 14 million babies in India risk their health as baby food companies flout laws and continue promoting their products in the market.

According to breastfeeding protection watchdog Breastfeeding Promotion Network of India (BPNI), the baby food industry has violated the Indian Medical Services (IMS) Act at least 54 times if not more between 2008 and 2016 before being brought to the attention of the government regulatory authorities.

Promotion any kind of baby food and feeding bottles for children 0-2 years of age, including advertisements, inducements on sales, pecuniary benefits to doctors or their associations including sponsorship is banned under the IMS Act.

To understand the state of health services and formula feeding from the mothers' perspective, an online survey was conducted within Breastfeeding Support for Indian Mothers (BSIM), a Facebook group with over 29,000 members. More than 950 mothers who delivered in private hospitals responded.

More than half were given artificial baby milk; out of these two-third said it was given without their consent. Analysis of the survey also revealed that children were given formula food without knowledge of women. Health workers often doubted their ability to produce milk and undermined their confidence in breastfeeding.

Dr Arun Gupta, central coordinator, BPNI and Regional coordinator, IBFAN Asia said, "Aggressive marketing of baby food companies and sponsorship contribute to increased use of formula at the time of birth and later by undermining breastfeeding and every effort should be made to curb such invasive promotion."

Top firms among violators
A number of violations have been identified by BPNI as a part of the monitoring programme. Top violators include Nestle, Abbot, Heinz and Danone. These companies have violated provisions of the IMS act in more than once and continue to mislead mothers through various misleading tactics.

The recent decision by Nestle to set up 1,000 exclusive breastfeeding rooms in 150 cities and help raise 'superbabies' indirectly promote infant formula milk violates section seven of the IMS act that bars companies from entering healthcare facilities.

This campaign due to its sheer scale has the potential to change mothers' behaviour towards breast feeding and adversely impact the newly launched "MAA" programme of the Union government that seeks to create awareness on breastfeeding. Nestle was also found sponsoring a conference of the Institute of liver and Biliary Sciences in October in New Delhi this year.

Products of Nestle and other baby food companies are delivered via marketing websites on discounts, which are banned under the IMS Act. There are a few examples where BPNI has found Nestle advertising some of its other products of similar nature on the containers. By definition of promotion and advertisement, these are not allowed.

Putting profits before children's health Heinz, for instance wooed mothers to give its cereal food "Oat and Apple" at '4+ months' through the label on the container and various websites. It was also offering free 'gifts', 'discounts' and even loyalty schemes to mothers for using the website, which is also banned under the law which is not only illegal but unscientific.

Danone Nutritia 'Farex' infant formula uses health claims like brain development on its labels. As per the law, use of health claims is not allowed for such products of the company.

Many popular e-marketing companies are promoting infant formula, baby foods and feeding bottles by giving discounts on purchase. These companies include Snapdeal, Flipkart, Ediff.com, jungle.com and amazon.com. Bottle manufacturers such as Pigeon, Farlin, Winnie-the-Pooh, Morrison, Baby Dreams and MeeMee Feeding Bottles have been selling bottles and cereal foods on discount on e-marketing websites which is banned under IMS Act.

In February 2015, BPNI filed a complaint in the court of law in Delhi against the global baby food manufacturer Heinz along with the E marketing portal 'Shopclues.com', for selling an infant food product "Heinz cereals 4m bf 125g - fruit and yogurt cereal".

Despite the strict directives by the Union government issued in the past, the baby food manufacturing and bottle companies are still violating the IMS Act. The baby food industry continues to grow at a steady pace promotions and marketing.

According to Euromonitor report, 10,847 tonnes of standard infant formula (for 0-6 month's age group) was sold in India in 2012, which is 10,847,000 Kg of milk powder. Converting this into containers of 400 grams, it means India sells about 27 million containers of 400 gm each year, almost equal to its babies born. Going by the estimated growth of formula industry in 2022 this figure will be 32.7 million.

According to the World Health Organization (WHO), artificial feeding is an established risk factor for child health like causing more of diarrhea, respiratory or newborn infections, allergies as well as obesity and adult health diseases like diabetes and heart disease.

As per 2016 Lancet report, improvements in breastfeeding would help achieve the SDG targets for health, food security, education, reducing inequalities, development and climate change. According to BPNI's analysis of Lancet breastfeeding series; if India can universalize breastfeeding it can reduce under-five mortality by 13 per cent, prevent 3,900,000 episodes of diarrhoea, prevent 3436560 episodes of pneumonia, prevent 4915 deaths due to breast cancer, reduce obesity by 26 per cent, reduce type-2 diabetes by 3 per cent, improve IQ in children by 3 points and add Rs4,300 crore to the economy.

In addition to the health advantages of breastfeeding for mothers and their children, there are economic benefits associated with breastfeeding that can be realized by families, employers, private and government insurers, and the nation as a whole. For example, families who follow exclusive breastfeeding could save more than Rs2,000 per month with a 1-month old baby and more than Rs4,000 per month with a 6 month old baby in expenditures for infant formula. In addition, better infant health means fewer health insurance claims, less employee time off to care for sick children, and higher productivity, all of which concern employers.

Increasing rates of breastfeeding can help reduce the prevalence of various illnesses and health conditions, which in turn results in lower health care costs. It reduces the carbon footprint by saving precious global resources and energy as it generally requires no containers, no paper, no fuel to prepare, and no transportation to deliver.

BPNI in its recommendations have urged government to ensure that all hospitals have lactation counsellors to assist mothers during their antenatal and postnatal period. In addition, existing maternity staff should be provided adequate training to support mothers at the time of birth. The government should also come up with a notification, which can specially deal with issues of consent before the use of infant formula and secondly put an end to inappropriate promotion of baby foods and sponsorship in the health systems.