Published in Social Science & Medicine, a team of researchers from the John Hopkins Bloomberg School of Public Health investigated how the health sector in peri-urban Peru influenced use of infant formula use among mothers. Findings suggested doctors were recommending and prescribing formula brands to mothers, in some cases without a medically indicated need – action lead author Dr. Jessica Rothstein said had a “really big role in mothers' decision-making”.
Interviews with healthcare professionals also indicated industry representatives were visiting health centers and hospitals, distributing marketing material, leaving formula samples and providing incentives to doctors for formula sales through subsidized courses, conferences or scientific trips.
Rothstein said: “My interviews really show that there were these ethical quandaries in these interactions.” To read our coverage of Dr Rothstein's paper, please click HERE.
Peru, like many parts of the world, has regulations in place under the World Health Organization's (WHO) International Code of Marketing of Breastmilk Substitutes that stipulates breastfeeding must be protected and promoted and if breast-milk substitutes are necessary adequate information and appropriate marketing and distribution must ensure proper use.
Nestlé Peru: 'We would like to have an open dialogue with the authors of the report'
Speaking to NutraIngredients-LATAM in light of the findings, Nestlé Peru – implicated through two of its infant formula brands NAN and S-26 – said it was “firmly committed to promoting breastfeeding and protecting it”.
“We apply an industry-leading policy for the marketing of breastmilk substitutes. We comply with the WHO Code for Marketing of Breastmilk Substitutes and WHA resolutions, as implemented by national governments everywhere in the world, including in Peru. When the local law is weaker than our policy, we apply our policy,” the company said.
“...In Peru, Nestlé fully complies with the provisions of local legislation (Supreme Decret 009-2006-SA) which allows sharing evidence-based scientific information exclusively with healthcare professionals, including lending support to their continuing medical education.”
The infant formula major denied distributing formula samples in the peri-urban region near Lima, stating it did not distribute samples intended for babies 0-24 months either to healthcare professionals or mothers.
“We would like to have an open dialogue with the authors of the report to better understand the details of the study and to provide information on our policies and practices, as we were not contacted by them prior to the publication of the results. We always investigate all concerns related to our breastmilk substitute marketing practices and promptly address any instances of non-compliance reported to us,” Nestlé Peru said.
Reckitt Benckiser 'pleased' with exclusive breastfeeding rate in Peru
Reckitt Benckiser (RB) – implicated through its Enfamil brand – said it “supports and promotes” World Health Organization recommendations for exclusive breastfeeding in the first six months of life and the introduction of safe, age-appropriate and nutritious complementary foods thereafter.
A RB spokesperson said: “Further, we advocate continued breastfeeding up to two years of age and beyond. Our commitment to the Code is clear in both our Infant and Child Nutrition Pledge and our Policy and Procedures on the marketing of breastmilk substitutes. For mothers that cannot breastfeed, or choose to supplement breastfeeding, we offer compelling scientific nutritional products to support good nutritional outcomes for children.”
Considering the Peruvian market, they added: “We are pleased that the rate of exclusive breastfeeding in Peru for 0-6 months is 68%, compared to the global average of 38%.”
But Dr. Rothstein said Peru and other countries should not become complacent and more had to be done to monitor and enforce legislation around exclusive breastfeeding with efforts from both the healthcare system and industry.
“An important thing is for the Ministries of Health in Peru to realize this battle isn't over. Sometimes countries can become, maybe, complacent. You see from these health surveys that there are higher rates of breastfeeding than a few years ago, so maybe the finite resources should be put towards other health problems. But what I hope would be the main message of our study is you can't become complacent because industry threats are going to continue.”