Tag Archives | WHO Code

El Código Internacional: ¿Sigue siendo relevante en la era de la información? {Parte 2}

We are proud to offer this Spanish translation to our popular post “The International Code: Is It Still Relevant in the Information Age? {Part 2}“.

Estamos orgullosos de presentar la segunda de dos entradas al blog sobre el Código Internacional de Comercialización de Sucedáneos de la Leche Materna (Puede leer la primera parte aquí). Este documento es vital para nuestro trabajo y es una pieza clave de apoyo a las familias que servimos. Después de nuestro post anterior, que era un “Código 101 de la OMS ” básico, la entrada de hoy cuestiona “¿Y ahora qué?”, ​​ Se discute cómo nuestras interpretaciones y aplicaciones del código tienen que cambiar con la llegada de nuevos estilos de marketing, incluido el uso de los medios sociales.

Por Norma O. Escobar, IBCLC (Con el aporte de Annelies Allain del Centro de Documentación del Código Internacional)

La mayoría de nosotros estamos familiarizados con las violaciones más comunes al código, publicidad directa en los medios impresos, muestras gratuitas en los hospitales y consultorios médicos, cupones para descuentos. Pero ¿qué pasa con los métodos de marketing que han surgido con el advenimiento de las redes sociales y el teléfono inteligente (smart phone) “siempre presente”?

¿Qué hay de nuevo?

Los mayores cambios en los últimos años han sido la explosión de los medios sociales y la ampliación del uso de los teléfonos inteligentes. Los medios sociales ocupan un estimado de 20% del tiempo que los estadounidenses gastan en línea en sus computadoras y el 30% de su tiempo en sus dispositivos móviles.

Las mujeres, y las personas de 18-34 años, son más propensas que otros grupos a visitar los sitios de medios sociales. Por ejemplo, las mujeres representan el 62% de todas las visitas de páginas en Facebook. Estas estadísticas sugieren que para muchas mujeres estadounidenses, los acontecimientos importantes de la vida como el embarazo, el parto y la maternidad están siendo influenciados por los medios de comunicación social. Y estas cifras crecen cada año. Según el informe de Nielsen, el tiempo que se gastó en los medios sociales en 2011 fue de 88 minutos al mes. En 2012, ese número había aumentado a 121 minutos.

De acuerdo con Nielsen: “Los días en que las empresas podían controlar muy bien los mensajes de la marca y su avance en los consumidores a lo largo de un línea de compra ordenada, hace tiempo que terminó. Los medios sociales han cambiado fundamentalmente la decisión del consumidor. Las decisiones de consumo y comportamientos cada vez están más impulsados por las opiniones, gustos y preferencias de una manera exponencial, grupo de amigos, compañeros y personas influyentes “.

sherylabrahamsComo resultado de estos cambios, la comercialización de los productos dentro del ámbito del código también ha cambiado. Sheryl Abrahams, una estudiante graduada en el Instituto Global de Lactancia Materna de Carolina, pensó que sería un buen proyecto de investigación averiguar cómo el código se está siguiendo, o no, en los campos de juego de los medios sociales. Sus resultados han sido publicados en el Journal of Human Lactation, agosto de 2012. Yo estaba haciendo mi propia investigación informal cuando tuve la oportunidad de hablar con ella en el otoño de 2011.

Los intereses comerciales tienen una presencia muy fuerte en los medios sociales: Varios fabricantes han establecido una presencia en Facebook y Twitter, incluyendo Gerber y productos PBM, el mayor fabricante de marcas de fórmulas en EE.UU., el cual ha lanzado páginas para sus diversos nombres: Bright Beginnings, Parent’s Choice, Vermont Organics y Member’s Mark. Earth’s Best, que fabrica fórmula, también tiene una página en Facebook. Todas estas páginas están configuradas para permitir comentarios de los miembros y permitir a los usuarios a darle “me gusta” o “seguir” a la página. Después, los usuarios quedan en el registro como “gustando” la página, un hecho que da motivo a sus  propios contactos de revisar estos sitios.

gerberLa página de Facebook de Gerber, en una sección dirigida a embarazadas, contiene un enlace a la información sobre una bolsa de regalo para cuando esté de alta del hospital, incluyendo un enlace para ver los hospitales participantes que están repartiendo la bolsa. También contiene biografías de dietistas registrados “expertos” que están a su disposición para responder a las preguntas publicadas. Hace un tiempo el sitio tenía un vínculo a cupones de fórmula.

Gerber, Parent’s Choice, Bright Beginnings y Member’s Mark de tiempo en tiempo patrocinan concursos de fotografías, en el que los usuarios envían fotos de sus hijos al sitio para oportunidades de ganar tarjetas de regalo y otros premios. Los usuarios a menudo tienen que  dar clic al “me gusta” o convertirse en un fan de la página para poder ganar. Estas fotos o las ganadoras, son publicadas en el sitio para que otros las puedan ver.

No hay datos sobre la superioridad de la leche materna en ninguna de estas páginas, excepto la página de Facebook de Earth’s Best, que son fabricantes de fórmula y alimentos complementarios. Ninguna de estas páginas contiene la lista completa de los avisos requeridos en el Código, como la información sobre los efectos adversos sobre la lactancia materna con la introducción parcial de la alimentación con biberón.

similacLuego están las “aplicaciones”. ¿No todas las mamás desean añadir una mayor previsibilidad a su vida? ¿Y quién no quiere ser una “madre fuerte”?

¿Qué tipo de información están estas madres recibiendo? Una de las seguidoras de Unlatched, una página de Facebook de apoyo a la lactancia, envió este correo electrónico que recibió cuando su bebé tenía 5 semanas de edad.

containterSe puede ver que la intención es promover un producto, no promover la lactancia materna. ¡Y usted puede conseguir fórmula GRATIS para que pueda empezar!

Otro aspecto de los medios de comunicación social son los blogs, “celebridades” en línea que las personas siguen y leen para obtener gran parte de su información. Para mi gran sorpresa, hay patrocinio de estos bloggers, se les paga para revisar productos y servicios. Muchas madres creen que estas son opiniones “independientes”, pero en realidad están muy sesgadas. La fuente de estos pagos es a través de terceros. Uno de estos terceros, se llama Collective Bias.

¿Y quiénes son estos clientes de Collective Bias? Su sitio web dice:

“Collective Bias es una empresa de marketing de contenido que asocia contenido social orgánico con historias reales para crear millones de impresiones, la unidad orgánica de SEO y en última instancia, las ventas de marcas y minoristas como Starbucks, Nestlé, Elmer’s y Walgreens.”

¿Quiénes son las personas que desean crear comunidades dedicadas a fomentar conversaciones compartidas, crear una plataforma que fomente la promoción en un diálogo orgánico. . . en última instancia, mejorar la lealtad y las VENTAS? Son las empresas multinacionales que ponen las ganancias por delante de la salud de millones de madres y bebés.

Las redes sociales se están utilizando en clara violación del Código Internacional.

Algunas prácticas, tales como la activación de contenido generado por usuarios, como fotos, vídeos, comentarios, endorso con un solo clic, y patrocinio a blogs de terceros, plantea cuestiones no previstas por el Código original.

Abraham concluye su investigación diciendo: “Las futuras revisiones del Código deberían considerar nuevas estrategias de marketing permitido por los medios sociales, incluyendo el uso de contenidos generados por usuarios, divulgación de patrocinio de críticos, bloggers y creadores de otros medios de comunicación y vínculos financieros que proporcionan educación a las madres y familias”.

Por lo tanto, ¿sigue siendo el Código relevante?

SÍ. El hecho de que la comercialización sea menos transparente y obvia que antes, no significa que nos vamos a rendir. Mientras a la Asamblea Mundial de la Salud puede que le tome un tiempo para aclarar las nuevas cuestiones que los medios sociales han generado para el Código, no tenemos que esperar hasta la próxima resolución. ¡Aun así, podemos y debemos hacer una diferencia! De hecho, propongo que, gracias a los medios de comunicación social, sea aún más fácil hacer que su voz se escuche.

¿Qué puede usted hacer?

  • ¡Ya hace mucho! Ayudar a las madres a amamantar es una gran manera de ayudar a derrotar a los intereses comerciales. Hable con las madres sobre los riesgos de los suplementos innecesarios y su impacto en la producción de leche incluyendo la dificultad de restablecer el amamantamiento
  • Familiarizarse con el Código. La Red Mundial de Grupos Pro Alimentación Infantil (IBFAN) es un recurso maravilloso y su sitio web contiene una gran cantidad de información.
  • Comprometerse a cumplir con las disposiciones del Código para “Trabajadores de la Salud” al hablar con las madres, profesionales de la salud, y cualquier persona involucrada con las madres y los bebés de la importancia del Código. Escribir cartas a revistas, páginas de Facebook y medios de comunicación que violan el Código. No aceptar comidas, regalos o patrocinio para su educación o conferencias que sean patrocinadas por compañías que violan el código.
  • Supervisar mediante la recopilación de muestras de revistas, exposiciones, tiendas, sitios web y consultorios médicos. Tome fotos de tiendas y exhibiciones en conferencias.
  • Informe violaciones a IBFAN o su red local “Vigilantes del Código” como la Alianza Nacional para la Defensa de la Lactancia Materna (NABA) o la Coalición para la acción en alimentación infantil (INFACT).
  • Asegúrese de no utilizar o proporcionar afiches, materiales educativos, libretitas, revistas, bolígrafos, imanes, etc. que le hayan obsequiado o que llevan el logotipo de los infractores del código.
  • Utilice los medios sociales, ¡tweet, post, me gusta y compartir!

benkenobiUsted puede hacer una diferencia. Tenemos que hacer una diferencia. Siempre me gusta contar la historia de los bebés del río cuando se habla del código, es una historia común que se aplica a muchos problemas de salud pública, pero creo que vale la pena repetirlo aquí. Es algo parecido a esto:

Un verano en un pueblo, la gente de la ciudad se reunieron para un picnic. Mientras compartían comida y conversación tranquilamente, alguien se dio cuenta de un bebé en el río, luchando y llorando. ¡El bebé se iba a ahogar! Alguien corrió a salvar al bebé. Entonces, se dieron cuenta de otro bebé gritando en el río, y sacaron a ese bebé. Pronto, vieron más bebés ahogándose en el río, y la gente del pueblo los sacaban tan rápido como podían. Tomó un gran esfuerzo, y comenzaron a organizar sus actividades con el fin de salvar a los bebés que llegaban por el río. Mientras todos estaban ocupados en las tareas de rescate para salvar a los bebés, dos personas del pueblo empezaron a correr por la orilla del río.

“¿A dónde van?”, Gritó uno de los rescatistas. “¡Los necesitamos aquí para ayudarnos a salvar a estos bebés!”

¡Vamos río arriba para detener a quien los está lanzando!”

El Código fue puesto en marcha para detener a los bebés de ser arrojados al río de la avaricia corporativa. Por favor ayude a detenerlos y a darle seguimiento y ojalá algún día todos nuestros países tengan una legislación gubernamental fuerte que pueda ayudarnos. Hasta entonces, no podemos renunciar y debemos seguir educándonos y a las madres que servimos para que no caigan presa de los intereses comerciales. Tienes una voz, utilízala.

 normaOriginaria de la Ciudad de México, Norma Escobar ha estado trabajando con las mujeres que amamantan a partir de 1994, primero como líder de La Liga de la Leche, y luego como consultora de lactancia certificada por la Junta (2002). Su trabajo actual se centra en atender a madres de bajos ingresos en Wilmington, Carolina del Norte. Ella es la madre de dos hijos sin lo cual nunca habría descubierto las alegrías y los retos de la lactancia materna. Norma postea mensajes en Facebook a través de la Tri-County Breastfeeding Coalition  y La Leche League of Wilmington NC.

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ILCA Sends Strong Message to PAHO and WHO—Don’t Engage with Organizations That Violate the WHO Code!

By Jennie Bever Babendure, PhD, IBCLC

nestlefailLast October, I learned that the Pan American Health Organization (PAHO), which serves as the Regional Office for the Americas for the World Health Organization (WHO) had accepted a $150,000 donation from Nestle, an unrepentant violator of the International Code of Marketing of Breastmilk Substitutes along with its subsequent relevant resolutions, also known as the WHO Code. (For an overview of how the WHO Code impacts infant feeding, check out our recent Lactation Matters post by Norma Escobar.)  Both frustrated and outraged, I sat down and wrote this post to call the breastfeeding world to action to defend the WHO Code from a loss of integrity from an office of WHO itself.  In the days that followed, I was amazed and inspired as hundreds of IBCLCs, breastfeeding supporters, health care providers, public health advocates, mothers and fathers came forward to advocate for the health of moms and babies.  People from all over the world worked tirelessly to defend the WHO Code through Twitter and Facebook, and many advocates took to their blogs to spread the word even further (PhD in Parenting, The Leaky Boob, Human Milk News, BoycottNestle to name just a few). Through this work, over 2000 people signed the petition to Urge the WHO to Cut Ties with Nestle, and  just this month, both Lamaze’s Science and Sensibility and MomsRising posted articles on this topic, thanks to the advocacy work of Jeanette McCulloch, IBCLC and our own Lactation Matters Editor, Amber McCann, IBCLC. As of earlier this week, our dedicated group of advocates had reached 1000 strong, as we continue to work together to defend the WHO Code through social media as the Friends of the WHO Code.

7220_159273157696_4699634_nNow ILCA is taking the campaign to the next level by making a strong public statement against the acceptance of $150,000 of Nestle funding by PAHO.  In a letter to incoming PAHO director Carissa Etienne, the ILCA Board of Directors write:

“…we would like to record our extreme disappointment at PAHO’s decision to continue to accept funding from the food and beverage industry, including Nestle….. It is inappropriate and a distinct conflict of interest for the Pan American Health Organization to rely on funding and advice from the food and beverage industry on how to tackle these diseases.  The implications of such a commercial interest-public health nexus are profound.  Our experience in combating such inappropriate commercial influence in the area of breastfeeding and maternal-child health is long-standing.  Indeed, the International Baby Food Action Network (IBFAN) and International Code Documentation Centre (ICDC), WHO monitors for the International Code [of Marketing of Breastmilk Substitutes], have tracked and published reports of Nestle non-compliance with the International Code for decades…

With your appointment as Regional Director of PAHO, we hope this presents an opportunity for PAHO to revisit its policy on acceptance of funds from the food and beverage industry. ”

ILCA’s sentiments are in line with those of 7 former PAHO representatives from both North and South America who wrote an open letter to the PAHO director, decrying the acceptance of funds from Nestle and other food and beverage manufacturers and asking PAHO to put policy in place to prevent this from happening.

“The fact that PAHO received money from the Coca-Cola Company and other food and beverage corporations has damaged its reputation as the leading UN organization concerned with nutrition and public health in our Hemisphere. It has signaled that PAHO policies might be constrained in advancing policies and public health actions in conflict with the commercial interests of these corporations.…We also request that you state a policy that such industries will not be invited to participate in PAHO initiatives or other work designed to formulate public health and nutrition policies.”

Adding to this message, as an NGO in official relations with WHO, ILCA responded to WHO’s March 23, 2013 request for consultation on relationships with NGOs, sending them a clear message to never engage with:

“Commercial for-profit entities that market products detrimental to health including those companies who are not meeting their obligations under the International Code of Marketing of Breast-milk Substitutes and all subsequent WHA resolutions”

Why are these steps by ILCA so significant?

As an international NGO, ILCA is one of only 183 non-governmental organizations with official relations with the World Health Organization. This means that in addition to the massive amount of work we’ve done voicing the message to WHO and PAHO with tweets, blogs and on Facebook, ILCA is sending the same message formally in an official capacity, as an organization with an on-going relationship with WHO.  In addition, by sending these messages, ILCA is paving the way for other organizations to formally speak out against conflicts of interest in WHO funding.

Imagine the impact if every public health organization, advocate and IBCLC sent letters to WHO and PAHO asking them to reconsider their acceptance of funding from Nestle and others in the food and beverage industry. Already ILCA, the International Baby Food Action Network (IBFAN) and 7 former PAHO representatives have voiced their concerns.

Let’s use our resources to encourage other organizations and individuals to formally register their discontent on this issue with both PAHO and WHO!

Here is ILCA’s letter, what will yours say?

Want to get involved?  Join us at The Friends of the WHO Code.

Pic for Jennie post 4Jennie Bever Babendure, PhD, IBCLC: I am mother to 2 active boys and an Assistant Research Professor in the College of Nursing and Health Innovation at Arizona State University. As breastfeeding researcher, I am constantly scanning the literature for articles that guide my research and inform my clinical practice. One of my goals is to increase the evidence base of our profession as lactation consultants. I feel it is important for lactation professionals to be aware of and contribute to breastfeeding research, especially when so much of it is fascinating! As an ongoing contributor to Lactation Matters, it is my hope that you will find the articles I highlight as interesting and informative as I do, and that you will use them to guide you in the important work of lactation professionals and breastfeeding advocates. For more research news and commentary, check out my blog at www.breastfeedingscience.com. I can be reached at jennie.bever@gmail.com.

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El Código Internacional: ¿Sigue siendo relevante en la era de la información? {Parte 1}

We are proud to offer this Spanish translation to our popular post “The International Code: Is It Still Relevant in the Information Age? {Part 1}“.

Originalmente publicado en inglés el 12 de marzo de 2013 por lactationmatters.

Estamos orgullosos de presentar la primera de dos entradas al blog sobre el Código Internacional de Comercialización de Sucedáneos de la Leche Materna. Este documento es vital para nuestro trabajo y es una pieza clave en la defensa de las familias que servimos. El post de hoy es un “Código 101 de la OMS”, destacando la historia y los fundamentos del Código. Continuaremos en nuestra siguiente entrada al blog que explica cómo nuestras interpretaciones y aplicaciones del código tiene que cambiar con la llegada de nuevos estilos de comercialización, en particular en el uso de los medios sociales.

Por Norma O. Escobar, IBCLC (Con el aporte de Annelies Allain del Centro de Documentación del Código Internacional)

Photo by Nadia Samperio

Photo by Nadia Samperio

El Código Internacional para la Comercialización de Sucedáneos de la Leche Materna existe desde 1981. Fue escrito en un esfuerzo conjunto por entidades privadas y el gobierno. Los intereses comerciales también fueron invitados a participar y se comprometieron a seguir sus disposiciones. El Código fue adoptado por la Asamblea Mundial de la Salud con 118 miembros a favor, uno en contra (EE.UU.). Desde entonces, varias resoluciones han sido adoptadas para esclarecer los artículos del Código. En la actualidad, unos 32 países de todos los continentes han hecho el código completo parte de su legislación nacional. Setenta y seis países ponen muchas de las disposiciones del código en sus leyes. Algunos otros han adoptado directrices voluntarias para los trabajadores de la industria y de la salud. Incluso en lugares donde el Código no ha sido legalmente adoptado, el Código tiene un peso moral y ético y debe ser seguido.

¿Por qué un código?

¡La publicidad funciona! De acuerdo con un informe de Save the Children “Superfood for Babies” (Superalimento para bebés) la leche artificial para bebés es una industria de $ 25 mil millones dólares por año. El crecimiento se prevé que sea del 31% en 2015. Lo único que hace posible este crecimiento es la comercialización. Sabemos que el objetivo del marketing es vender más productos. El producto que estamos hablando (fórmula) es muy peligroso cuando sustituye la leche materna en la dieta de los lactantes de todo el mundo. En el 2004, $ 50 millones se gastaron en publicidad por las compañías de leche en los Estados Unidos, en comparación con $ 30 millones en 2000. Las tasas de lactancia materna ese año disminuyeron del 70% al 63%.

¿Cómo es la comercialización de los sucedáneos de la leche materna diferente a la comercialización de otros productos?

Aquellos de nosotros que vivimos en los países capitalistas, donde las economías de libre mercado han reinado durante años, conocemos el valor de la competencia. Debido a esta competencia sana, tengo una computadora, televisión o teléfono mejor y más barato, en cualquier momento que lo necesite. Pero aquí no estamos hablando de un producto más barato y mejor. Estamos hablando de sustituir la leche materna con un producto más caro e inferior. Y con el fin de “vender” a las madres este producto, se utilizan técnicas abusivas de marketing dirigidas a los miedos de la madre, su deseo de “encajar” y francamente mentir o exagerar en gran medida, los atributos del producto.

La Asamblea Mundial de la Salud determinó que era necesario un código “en vista de la vulnerabilidad de los lactantes durante los primeros meses de vida y los riesgos involucrados en las prácticas inadecuadas de alimentación, incluido el uso innecesario e incorrecto de los sucedáneos de la leche materna.” Al eliminar la presión generada por la publicidad y promoción, poniendo fin a la entrega de muestras y otras prácticas predatorias, y centrando la atención en la lactancia materna, es más probable que se cree un entorno se donde la lactancia será una vez más la norma.

Lo que el Código no es:

No es una prohibición de la disponibilidad de los productos. Simplemente se prohíbe la promoción y requiere un etiquetado adecuado ya que estas cosas engañan a las madres en el período más vulnerable de su vida: el nacimiento de un nuevo bebé.

¿Qué productos están cubiertos?

  • Fórmula para bebé y otros líquidos que reemplazan la leche materna: fórmula de seguimiento, fórmula casera, agua, jugo o té.
  • Cualquier alimento que se comercializa para un bebé menor de 6 meses
  • Los biberones o tetinas

En pocas palabras, ¿qué dice el Código?

  • No a la publicidad directa al público
  • No a las muestras gratuitas a las madres
  • No a la promoción de productos en los centros de salud incluyendo ninguna fórmula gratis o a bajo costo
  • Ningún representante de productos comerciales para asesorar a las madres
  • Ningún regalo o muestras personales a los trabajadores de la salud
  • No a palabras o imágenes idealizando la alimentación artificial, incluyendo imágenes de bebés en los productos
  • La información a los trabajadores de atención a la salud debe ser científica y factual
  • La información sobre alimentación artificial, incluyendo las etiquetas debe explicar:
    • los beneficios de la lactancia materna
    • costos y riesgos asociados con la alimentación artificial
    • Los productos inadecuados, como la leche condensada, no deben promocionarse para los bebés
    • Todos los productos deben ser de alta calidad y tener en cuenta las condiciones climáticas y de almacenamiento del país en el que se utilizan.

En 2004, tuve el privilegio de visitar el Centro de Documentación del Código en Penang, Malasia y participar en su formación para la implementación del Código. Desde entonces, he hablado con muchos proveedores de atención médica que no entienden el Código y su lugar en la promoción, protección y apoyo de la lactancia materna. Algunos creen que el Código es una imposición en su trabajo. Los violadores del Código están ofreciendo lo que parece como un alivio en la forma de materiales, educación y muestras gratuitas. Mientras la colaboración público-privada puede sonar bien, especialmente en una época de recursos cada vez más escasos, quiero desafiarte a que no hay tal cosa como un “almuerzo gratis”. Los intereses comerciales quieren que usted se sienta en deuda con ellos. Al aceptar sus “regalos”, aunque pequeños, se corre el riesgo de comprometer su eficacia como defensor de la lactancia.

Las tecnologías modernas añaden otra capa de complejidad, por lo que el marketing moderno es aún más específico y depredador. Los defensores de la lactancia son desafiados diariamente a competir con mentes más brillantes de marketing en el mundo por los corazones y en la leche de madres lactantes. El primer paso en la lucha contra este ataque a la lactancia materna es la comprensión de lo que sucede y luego usar nuestra influencia para exponer las tácticas comerciales cuando las vemos. Podemos utilizar las mismas tecnologías para defendernos. Vamos a hacerlo.

Por favor, esté pendiente a nuestro próximo post donde vamos a seguir discutiendo cómo vamos a continuar utilizando este documento fundacional sobre como los estilos de comunicación y la comercialización de productos han cambiado con el advenimiento de las redes sociales.

normaOriginaria de la Ciudad de México, Norma Escobar ha estado trabajando con las mujeres que amamantan a partir de 1994, primero como líder de La Liga de la Leche, y luego como consultora de lactancia certificada por la Junta (2002). Su trabajo actual se centra en atender a madres de bajos ingresos en Wilmington, Carolina del Norte. Ella es la madre de dos hijos sin lo cual nunca habría descubierto las alegrías y los retos de la lactancia materna. Norma postea mensajes en Facebook a través de la Tri-County Breastfeeding Coalition  y La Leche League of Wilmington NC.

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The International Code: Is It Still Relevant in an Information Age? {Part 2}

We are proud to present the second of two blog posts about the International Code of Marketing of Breastmilk Substitutes (You can read the first part HERE). This document is vital to our work and is a critical piece of advocacy for the families we serve. After our previous post, which was a basic “WHO Code 101”, today’s posts asks “What Now?” as we discuss how our interpretations and applications of the Code have to change with the advent of new styles of marketing, including in the use of social media.

By Norma O. Escobar, IBCLC
(with input from Annelies Allain from the International Code Documentation Center)

Most of us are familiar with the most common Code violations, direct advertising in print media, free samples in hospitals and doctor’s offices, coupons for discounts. But what about the marketing methods that have popped up with the advent of social media and the “ever present” smartphone?

What is new?

The biggest changes in the last few years have been the explosion of social media and the expanded use of smart phones. Social media use accounts for an estimated 20% of all time Americans spend online on their computers and 30% of their time on their mobile device.

Women, and people aged 18-34, are more likely than other groups to visit social media sites.  For example, women account for 62% of all page views on Facebook.  These statistics suggest that for many American women, important life events like pregnancy, birth and early motherhood are playing out against a backdrop of social media use. And these figures are growing yearly.  According to the Nielsen report, time spent in social media in 2011 was 88 minutes per month.  In 2012 that number had jumped to 121 minutes.

According to Nielsen: “The days when companies could tightly control brand messaging and progress consumers along a linear purchase funnel have long ended. Social media has fundamentally changed the consumer decision journey. Consumer decisions and behaviors are increasingly driven by the opinions, tastes and preferences of an exponentially larger, global pool of friends, peers and influencers.”

sherylabrahams

Sheryl Abrahams

As a result of these changes, marketing of products within the scope of the code has also changed.  Enter Sheryl Abrahams,a graduate student with the Carolina Global Breastfeeding Institute, who thought it would be a good research project to find out how the code is being followed, or not, in the social media playing field.  Her results have been published in the Journal of Human Lactation, August 2012.  I was doing my own informal research when I was able to talk to her in the fall of 2011.

Commercial interests have a very strong presence in social media: Several manufacturers have established a Facebook and Twitter presence, including Gerber and PBM products, the largest US manufacturer of store brand formulas, which has launched pages for its various labels: Bright Beginnings, Parent’s Choice, Vermont Organics and Member’s Mark.  Earth’s Best, which manufactures formula, also has a Facebook page.  All of these pages are set up to enable member comments and to allow users to “like” or “follow” the page.  Users would then be on record as “liking” the page, a fact which might give their own contacts reason to check it out.

gerberThe Gerber Facebook page, in a section marked for pregnant moms, contains a link to information about a hospital discharge bag, including a feature to search for participating hospitals that are currently giving out the bag.   It also contains bios of registered dietician “experts” who are on hand to answer posted questions.  The site in the past has linked to formula coupons.

Gerber, Parent’s Choice, Bright Beginnings and Member’s Mark at certain times sponsor photo contests, wherein users submit photos of their children to the site for chances to win gift cards and other prizes.   Users are often required to “like” or become a fan of the page to be eligible to win.  These user-posted photos, or the winners, are then posted on the site for others to view.

No information on superiority of breast milk found on any of these pages, except the Facebook page of Earth’s Best, which manufacturers formula and complementary foods.  None of these pages contained the full list of warnings called for in the Code, such as information on the adverse effects on breastfeeding of introducing partial bottle feeding.

similacThen there are the “apps”.  Doesn’t every mom wish to add more predictability to their life?  And who does not want to be a “strong mom”?

What kind of information are these moms receiving?  One of the fans of the Unlatched, a breastfeeding support Facebook page, sent this email she received when her baby was 5 weeks old.

containter

You can see that the intention is to promote a product, not to promote breastfeeding. And you can get a FREE container of formula to get you started!

Another aspect of social media are blogs – on-line “celebrities” that people follow and read to get much of their information.  Much to my surprise – there is quite a bit of sponsorship of these bloggers – they get paid to review products and services.  Many moms believe that these are ‘independent’ opinions, but they are in fact, very biased.  The source of these payments is through third parties.  One such third party is called Collective Bias.

And who are these Collective Bias clients?  Their website says,

“Collective Bias is a content marketing company that weaves organic social content into real-life stories to create millions of impressions, drive organic SEO and ultimately sales for brands and retailers like Starbucks, Nestlé, Elmer’s and Walgreens.”

Who are the people wishing to build dedicated communities to foster shared conversations, creating and advocacy platform that fosters organic dialogue. . . ultimately enhanced loyalty and SALES? They are the multi-national companies that put profit ahead of the health of millions of mothers and babies.

Social media is being used in clear violation of the International Code.

Several practices, such as enabling of user-generated content like photos, videos, comments, one-click endorsements, and sponsorship of third-party blogs, raise issues not anticipated by the original Code.

Abraham concludes her research by stating: “Future revisions of the Code should consider new marketing strategies enabled by social media, including  use of user-generated content, disclosure of sponsorship  of reviewers, bloggers and other media creators, and financial ties to those providing education to mothers and families.”

So, is the Code still relevant?

YES.  Just because the marketing is less transparent and obvious than before, does not mean we give up.  While the Wold Health Assembly may take the time to clarify the new issues that social media has generated for the Code, we don’t have to wait around for the next resolution.  We can and should still make a difference! In fact, I propose that thanks to social media, it is even easier to make your voice heard.

What can you do?

  • You already do a lot! Helping moms breastfeed is a great way to help defeat commercial interests! Talk to mothers about the risks of unnecessary supplementation and their impact on milk production including the difficulty of reestablishing breastfeeding
  • Become familiar with the Code. The International Baby Food Action Network (IBFAN) is a wonderful resource and their website contains a wealth of information.
  • Commit to abide by the Code provisions for “Health Workers” by talking to mothers, health professionals, and anyone involved with mothers and babies about the importance of the Code.  Write letters to magazines, Facebook pages and media outlets that violate the Code.  Don’t eat lunches provided by Code violating companies, take their gifts, or accept their sponsorship for your education or conference.
  • Monitor by collecting samples from magazines, exhibits, stores, web sites and doctor’s offices. Take pictures of store and conference displays.
  • Report violations to IBFAN or your local “Code Watcher” like the National Alliance for Breastfeeding Advocacy (NABA) or the Infant Feeding Action Coalition (INFACT).
  • Make sure you do not use or provide posters, educational materials, pads, magazines, pens, magnets, etc. that are given to you by or that bear the logo of code violators.
  • Use social media yourself – tweet, post, like and share!

benkenobi

You can make a difference.  We must make a difference.  I always like to tell the story of the River Babies when talking about the Code– it is a common story that applies to many  public health issues lots of public health issues, but I believe it bears repeating here. It goes something like this:

One summer in a village, the people in the town gathered for a picnic. As they leisurely shared food and conversation, someone noticed a baby in the river, struggling and crying. The baby was going to drown! Someone rushed to save the baby. Then, they noticed another screaming baby in the river, and they pulled that baby out. Soon, more babies were seen drowning in the river, and the townspeople were pulling them out as fast as they could. It took great effort, and they began to organize their activities in order to save the babies as they came down the river. As everyone else was busy in the rescue efforts to save the babies, two of the townspeople started to run away along the shore of the river. 

“Where are you going?” shouted one of the rescuers. “We need you here to help us save these babies!” 

“We are going upstream to stop whoever is throwing them in!” 

The Code was set in place to stop the babies from being thrown into the river of corporate greed.  Please help by upholding it and monitoring and hopefully one day all our countries will have strong government legislation that can help us.  Until then, we cannot give up and we must continue educating ourselves and the mothers we serve so that they do not fall prey to commercial interests.  You have a voice, use it.

normaOriginally from Mexico City, Norma Escobar has been working with breastfeeding women since 1994, first as a Leader with La Leche League, then as a Board Certified Lactation Consultant (2002).  Her current work focuses on serving low-income mothers in Wilmington, North Carolina.  She is the mother of two sons without whom she would have never discovered the joys and challenges of breastfeeding. Norma posts avidly on facebook through the Tri-County Breastfeeding Coalition  and La Leche League of Wilmington NC.

5

The International Code: Is It Still Relevant in an Information Age? {Part 1}

We are proud to present the first of two blog posts about the International Code of Marketing of Breastmilk Substitutes. This document is vital to our work and is a critical piece of advocacy for the families we serve. Today’s post is a “WHO Code 101”, highlighting the history and the basics of the Code. We will follow up with our next blog post which discusses how our interpretations and applications of the Code have to change with the advent of new styles of marketing, including in the use of social media.

We have also published this blog post in Spanish, which can be found HERE.

By Norma O. Escobar, IBCLC
(with input from Annelies Allain from the International Code Documentation Center)

Photo by Nadia Samperio

Photo by Nadia Samperio

The International Code of Marketing of Breastmilk Substitutes has been around since 1981. It was written as a joint effort between private and government interests. Commercial interests were also invited to participate and pledged to follow its provisions. The Code was adopted by the World Health Assembly with 118 members in favor, one against (USA). Since then, various resolutions have been adopted to clarify the articles in the Code. Today, approximately 32 countries on all continents have made the entire Code part of their national legislation. Seventy-six other countries put many of the code’s provisions into their laws. Some others have adopted voluntary guidelines for industry and health workers to follow. Even in places where the Code has not been legally adopted, the Code carries moral and ethical weight and should be followed.

Why a Code?

Advertising works! According to a Save the Children Report “Superfood for Babies” artificial baby milk is a $25 Billion per year industry.  Growth is predicted to be 31% by 2015. The only way this growth is possible is through marketing. We know that the goal of marketing is to sell more product. The product that we are talking about (formula) is very dangerous when it displaces breastmilk in the diet of infants across the world. In 2004, $50 million was spent on advertising by the formula companies in the United States, compared to $30 million in 2000. Rates of breastfeeding that year declined from 70% to 63%.

How is marketing of breastmilk substitutes different than marketing other products?

Those of us who live in capitalist countries, where free market economies have reigned for years, know the value of competition.  Due to this healthy competition, I have a better, cheaper computer, television or phone any time I need one.  But we’re not talking about a cheaper, better product here.  We are talking about replacing mother’s milk with a more expensive and inferior product.  And in order to “sell” mothers this product, predatory marketing techniques are used that target mother’s fears, their desire to “fit in” and downright lie about, or greatly exaggerate, the product’s attributes.

The World Health Assembly determined that a code was necessary “in view of the vulnerability of infants in the early months of life and the risks involved in inappropriate feeding practices, including the unnecessary and improper use of breastmilk substitutes.“ By removing the pressure generated by advertising and promotion, by ending the giving of samples and other predatory practices, and by focusing attention on breastfeeding, it is more likely an environment will be created where breastfeeding will be once again the norm.

What the Code is not:

It is not a ban on the availability of products.  It simply bans promotion and requires adequate labeling as these things mislead mothers at the most vulnerable period of their lives: the birth of a new baby.

What products are covered?

  • Baby formula and other liquids that replace breastmilk: follow-up formula, homemade formula, water, juice or teas.
  • Any food if marketed for a baby younger than 6 months
  • Feeding bottles or teats

In a nutshell what does the Code say?

  • No advertising directly to the public
  • No free samples to mothers
  • No promotion of products in health care facilities including no free or low cost formula
  • No commercial product representatives to advise mothers
  • No gifts or personal samples to health care workers.
  • No words or pictures idealizing artificial feeding, including pictures of infants on the products
  • Information to health care workers should be scientific and factual
  • Information on artificial feeding, including labels should explain:
    • benefits of breastfeeding
    • costs and hazards associated with artificial feeding
  • Unsuitable products, such as condensed milk, should not be promoted to babies
  • All products should be of high quality and take into account the climactic and storage conditions of the country where they are used.

In 2004, I had the privilege to visit the Code Documentation Center in Penang, Malaysia  and participate in their Code Implementation Training.   Since then I have spoken with many health care providers who do not understand the Code and its place in the promotion, protection and support of breastfeeding.  Some believe the Code is another imposition on their work .  Code violators are offering what appears like relief in the way of materials, education and samples.  While public-private partnerships may sound good on paper especially in a time of dwindling resources, I want to challenge you that there is no such thing as a ‘free lunch’.  Commercial interests want you to feel indebted to them.  When you accept their ‘gifts’, however small, you risk compromising  your effectiveness as a breastfeeding supporter.

Modern technologies add another layer of sophistication, making modern marketing even more targeted and predatory. Breastfeeding advocates are challenged daily to compete with the brightest marketing minds in the world for the hearts and milk of nursing mothers.  The first step in fighting this attack on breastfeeding  is understanding what is happening and then using our influence to expose commercial tactics when we see them.  We can use the same technologies to fight back.  Let’s do it.

Please check back for our next post where we’ll continue to discuss how we’re continuing to use this foundational document as communication styles and the marketing of products have changed with the advent of social media.

normaOriginally from Mexico City, Norma Escobar has been working with breastfeeding women since 1994, first as a Leader with La Leche League, then as a Board Certified Lactation Consultant (2002).  Her current work focuses on serving low-income mothers in Wilmington, North Carolina.  She is the mother of two sons without whom she would have never discovered the joys and challenges of breastfeeding. Norma posts avidly on Facebook through the Tri-County Breastfeeding Coalition  and La Leche League of Wilmington NC.

For the Spanish language version of this post, please click HERE.

12

Breastfeeding is a Human Right. What Does That Mean? {A Response from Baby Milk Action}

Editor’s Note:  While Lactation Matters typically publishes original material, occasionally we encounter a blog post that we feel especially deserves to be read by all IBCLCs and breastfeeding supporters.  This is just such a post.  It was originally published by Mike Brady and Baby Milk Action on the Baby Milk Action website. We appreciate their permission to repost it here.

The World Breastfeeding Conference (6 – 9 December 2012) came to an end in Delhi with participants from 86 nations approving a declaration that:

“calls upon all concerned to adopt a human right based approach to the protection, promotion, and support of breastfeeding and infant and young child feeding at international, national, and community levels.”

This is a very powerful concept, backed by international law, which campaigners can use in calling on policy makers to act. We can use it to challenge governments that have failed to provide maternity protection or to regulate the marketing of breastmilk substitutes or that invest in the baby milk industry to boost economic growth while failing to protect, promote and support breastfeeding.

But what does it mean to say breastfeeding is a human right? And what about babies who are not breastfed and mothers who do not breastfeed? Here’s the way I understand it.

Mike Brady, Baby Milk Action’s Campaigns and Networking Coordinator, at the World Breastfeeding Conference 2012 alongside campaigners from the Philippines

Human rights apply universally and it is the responsibility of governments to deliver and protect these rights.

The right to breastfeed is seen as applying to the mother/child dyad.

In other words, the mother and child as a unit have a right to breastfeed. It is not the unconditional right of the child to breastfeed, or that would oblige the mother to breastfeed regardless of her own situation. The right to breastfeed means that no outside party has the right to interfere with the relationship between the mother and child.

This is an interpretation of existing rights, such as the right to adequate food in the Universal Declaration of Human Rights, the International Covenant on Economic, Social and Cultural Rights, and the Convention on the Rights of the Child, amongst others. Professor George Kent of the University of Hawaii, who has written and spoken extensively on this topic and has provided the bibliography given below, wrote in a paper on Human Rights and Infant Nutrition prepared for the World Alliance for Breastfeeding Action Global Forum in 2002:

“The principles are based on the concept that mothers should not be legally obligated to breastfeed, but rather they should be supported in making their own informed choices as to how to feed their infants.”

Protecting the right to breastfeed does not force mothers to continue breastfeeding if they want to stop. We have the right to free speech, but that does not mean we are forced to give an opinion on every subject under the sun; if we want to speak, that right is protected.

In the UK, 90% of women who stop breastfeeding before six weeks do so before they wish to (Bolling et al, 2007 cited in UNICEF, 2012 – full Infant Feeding Survey details available at http://www.ic.nhs.uk/pubs/ifs2005). If the Government had protected the right to breastfeed, might the situation have been different?

Speaking at the Conference, Miriam Labbok suggested that instead of talking of “protecting, promoting and supporting” breastfeeding, we could speak of “empowering, inspiring and counselling” mothers and the wider public with regard to breastfeeding.

To protect and empower, we need to provide an environment that makes breastfeeding possible. Many societies present obstacles to breastfeeding, rather than remove them. Maternity leave for working women needs to be sufficient, at least for the recommended period of 6 months exclusive breastfeeding (so those who wish to do so, can do so), and working conditions must be conducive to continued breastfeeding into the second year of life and beyond. Convention 183 (2000) of the International Labour Organisation states:

“A woman shall be provided with the right to one or more daily breaks or a daily reduction of hours of work to breastfeed her child… These breaks or the reduction of daily hours of work shall be counted as working time and remunerated accordingly.”

Not all countries have ratified the Convention – click here for those that have. The UK has not yet done so.

There are many other areas where the right to breastfeed may be undermined and action should be taken. For example, in the UK mothers are sometimes abused for breastfeeding in public and the Government has acted by protecting the right for the mother/child dyad to feed in public in legislation.

Mothers also need protection from aggressive marketing of breastmilk substitutes. In part, the right to breastfeed derives from the Convention of the Rights of the Child. Article 24 speaks of the:

“right of the child to the enjoyment of the highest attainable standard of health… States Parties shall pursue full implementation of this right and, in particular, shall take appropriate measures… To ensure that all segments of society, in particular parents and children, are informed, have access to education and are supported in the use of basic knowledge of child health and nutrition, the advantages of breastfeeding…”

Ensuring parents have the required information and support on breastfeeding entails implementing the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions of the World Health Assembly. The aim of the Code is clearly stated:

The aim of this Code is to contribute to the provision of safe and adequate nutrition for infants, by the protection and promotion of breastfeeding, and by ensuring the proper use of breastmilk substitutes, when these are necessary, on the basis of adequate information and through appropriate marketing and distribution.

Note that the Code also aims to protect mothers who use breastmilk substitutes, who also have a right to accurate, independent information. Its provisions prohibit companies from advertising and seeking direct and indirect contact with pregnant women and the mothers of infants and young children. Companies are required to label products correctly and are limited to providing scientific and factual information to health workers, who are responsible for advising parents and carers.

The Committee on the Rights of the Child now routinely looks at how governments have implemented the International Code and Resolutions when assessing their progress in complying with the Convention. It has twice called on the UK Government to implement these minimum standards in national measures, but the calls have so far gone unheeded. The Committee commented in 2008, “it is concerned that implementation of the International Code of Marketing of Breastmilk Substitutes continues to be inadequate and that aggressive promotion of breastmilk substitutes remains common”.

To promote breastfeeding and inspire mothers and their families may require investment in social marketing.

In the UK, the coalition government scrapped the Infant Feeding Coordinator posts at the Department of Health, even though these posts are called for in the Global Strategy on Infant and Young Child Feeding.

It is also short sighted if the intention is to save money. UNICEF UK issued a report this year on the unnecessary illness that could be prevented and costs saved if breastfeeding rates increased, if the mothers who stopped breastfeeding earlier than they wanted were able to continue for longer.

The theme of the World Breastfeeding Conference was “Mom-made, not man-made”. Perhaps “Mum-made, not manufactured”works better in our culture and helps us to highlight that the European Union prioritises trade and growth over health.

So we see the Irish Government’s Enterprise Ireland and Danone announcing investment of €50 million in a baby milk factory to boost the economy by exporting formula around the world. According to Enterprise Ireland “98% of the output from [the] Macroom [facility] will be exported and commercialized in more than 60 countries worldwide”. This will inevitably displace breastfeeding in other countries as well as its own. To benefit its economy, the Irish Government could instead invest in mothers, the “real milk” producers, in a country where less than half (47%) of mothers are breastfeeding on discharge from maternity services (NPRS, 2008 cited by the Health Service Executive).

In the Philippines, Nestlé is leading an industry effort to replace strong marketing regulations with a new weak law (I was honoured to share a platform with campaigners from the Philippines at the conference, pictured above) and the Department of Trade and Industry has written to Members of Congress calling on them to back the draft bill because otherwise US$400 million of investment could be cancelled by the corporations and because of the revenue infant formula sales generate for the Government. The Philippines Department of Health, UNICEF and WHO have said in a statement that the draft bill: “aims to support multinational companies while damaging the Filipino society: families, the mothers and children.”

To support breastfeeding requires provision of health care services, a supportive environment and counselling and seo services, particularly in countries where breastfeeding is not entrenched and visible.

As Prof. George Kent comments with regard to the right to adequate food :

“There is increasing recognition at the international level that good nutritional status is an outcome that depends not only on good food but also on good health services and good care. Health services consist of a broad range of measures for the prevention and control of disease, including the maintenance of a healthy environment.”

In the UK we have the National Health Service, free at the point of use, and an increasing number of hospitals are entering the UNICEF Baby Friendly Initiative, which aims to ensure support is provided to pregnant women and mothers in hospital and in the community. However, there are growing concerns about the way health workers are being targeted in the UK and other countries by baby milk companies, including through funding training and other events.

Mother support groups provide counselling services in the UK and the Department of Health does provide a grant towards the National Breastfeeding Helpline operated by a coalition of them. This is one example of the Government acting on its human rights obligations. However, a coherent approach is needed as the failure to adequately regulate the baby food industry means companies encourage pregnant women and mothers to contact company-branded telephone “carelines” for support on infant feeding and to sign up to their mother and baby clubs for information. There is an intrinsic conflict of interest in baby milk companies with products to sell making direct and indirect contact with pregnant women and mothers, and this is prohibited by the Code. The fact this is a marketing strategy was demonstrated last month when Baby Milk Action won a case against Pfizer/Wyeth before the Advertising Standards Authority (ASA) over its illegal advertising of infant formula when ostensibly providing breastfeeding support.

A human rights approach requires action on many fronts. It helps us to think coherently and logically about what is required to protect and deliver the rights in question.

In the cultural context of the UK and Europe, we need to articulate that protecting the mother/child dyad’s right to breastfeed is to provide space for all mothers to breastfeed, particularly those mothers who say they want to breastfeed for longer, but who experience problems that could not be overcome under the current circumstances. At the same time we should understand that not everyone has to exercise the rights they hold.

We need to persuade policy makers to act, because it is governments who are responsible for protecting and delivering rights.

We need to persuade governments to invest in mothers, the “real milk” producers, rather than factories built not to meet existing requirements, but to export baby milk around the world and to create new consumers and markets for economic reasons. Danone aims to supply 20% of the world’s infant formula from Ireland, supplanting the most locally produced and consumed food there is at great environmental and health cost.

We sometimes speak of breastfeeding being free and perhaps this led to it being undervalued by policy makers. But as Anwar Fazal, Chairperson Emeritus of the World Alliance for Breastfeeding Action (WABA), told the Conference in his inaugural address describing the five principles of breastfeeding: it provides medicine, it provides nutrition, it is sustainable, it protects the environment and it plays a special role in the mother/child bond.

For these benefits to be enjoyed as widely and as fully as possible, governments need to invest political effort and funding to meet their obligation to protect the right to breastfeed.

At the conference there were many inspiring stories of governments that have and are taking action and of the situation in countries where breastfeeding cultures continue to exist or have been recovered.

For those of us living in cultures where many mothers are unable to breastfeed as they would wish, this provides welcome reassurance that a new reality is within our grasp if we reach for it.

Bibliography of publications on infant feeding and human rights by Professor George Kent

“Breastfeeding: A Human Rights Issue?” Development, Vol. 44, No. 2 (June 2001), pp. 93-98.http://www2.hawaii.edu/~kent/breastfeedingrights.pdf

“Human Rights and Infant Nutrition,” WABA Global Forum II-23-27 September 2002-Arusha, Tanzania (Penang, Malaysia: World Alliance for Breastfeeding Action, 2004), pp. 178-186.http://www2.hawaii.edu/%7Ekent/HUMAN%20RIGHTS%20AND%20INFANT%20NUTRITION.pdf

“Food is a Human Right,” in Richard Pierre Claude and Burns H. Weston, Human Rights in the World Community: Issues and Action. Third Edition. Philadelphia: University of Pennsylvania Press, 2006, pp. 191-201.

“Child Feeding and Human Rights,” International Breastfeeding Journal, Vol. 1 (2006).http://www.internationalbreastfeedingjournal.com/content/1/1/27

“Breastfeeding; The Need for Law and Regulation to Protect the Health of Babies.” World Nutrition, Vol. 2, No. 9 (September 2011), pp. 465-490. http://www.wphna.org/2011_oct_wn3_kent_breastfeeding.htm

Regulating Infant Formula. Amarillo, Texas: Hale Publishing, 2011. Publisher’s announcement athttp://www.ibreastfeeding.com/catalog/p270/Regulating-Infant-Formula/product_info.html

Also see Global Obligations for the Right to Food, edited by Professor George Kent, with a chapter on Holding Corporations Accountable by myself (Mike Brady) and a chapter on International Legal Obligations for Infants’ Right to Food by Dr Arun Gupta, organiser of the World Breastfeeding Conference. Available in Baby Milk Action’s online Virtual Shop.

0

World Wide Impact in 10 Minutes or Less: Using Social Media for Powerful Change

By Amber McCann, IBCLC

One week ago, Lactation Matters posted a blog entitled If YOU Don’t Advocate forMothers & Babies, Who Will? If there was any doubt that you, the Lactation Matters readers, were willing to step up to the plate, that doubt has been squashed. Within moments of the publishing the post, the initiative to use social media to ask the World Health Organization (WHO) and the Pan American Health Organization (PAHO) about their acceptance of money from major industry, including Swiftmoney Nestle, was gaining ground.

In response to the blog post, over 400 readers have joined a Facebook group, Friends of the WHO Code, to discuss advocacy and activism as it relates to the WHO Code and social media. Discussions this week have centered around gaining the attention of those involved in this situation and those who have the power to influence decisions. The group has worked hard to get the message out that that acceptance of funds that constitute a conflict of interest are unacceptable for an organization whose purpose is to protect the public health of the world. The group is primarily using Twitter as a means to connect and raise a tidal wave of support. And, it has been SUCCESSFUL!

Wednesday morning, those in the group noticed that the World Health Organization was responding to our questions with the following tweets:

In addition, WHO posted the following message on their Facebook page:

The conversation is beginning in the social media space and is a perfect example of how social media has the power to quickly bring all the players to the table. Although the World Health Organization has engaged in conversation with us, there is much work still to be done.

Do you have 10 minutes?

Would you join the conversation?

In a few short minutes, you can play a significant role in this initiative. Please consider taking 10 minutes and doing the following:

  1. Join the Friends of the WHO Code Facebook group
  2. Go to Twitter* and share the following tweets (just copy and paste!):

#WHOCode protects women&babies from predatory marketing. Shame @Nestle for trying to buy seat at the @PAHOWHO table #nonestle #breastfeeding

Tell @PAHOWHO to give back @Nestle $150K #nonestle #WHOCode #breastfeeding #conflictofinterest http://t.co/nnWJCIfX @WHO

We will not be bought! @PAHOWHO please return the money to @nestle . Stand up for mothers and babies. #WHOCode #breastfeeding #nonestle

If you’ve got more than 10 minutes, would you lend your expertise, insight, and skills to the movement?

Two thoughtful ladies responded to last weeks Call to Action with this quote from Margaret Meade:

“Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.”

The time is now.  Let’s change the world.

* If Twitter feels like another language to you, we understand. Check out the support from Birth Swell and Twitter’s Help Center.

Amber McCann, IBCLC is a  board certified lactation consultant in private practice with Nourish Breastfeeding Support, just outside of Washington, DC and the co-editor of this blog.  She is particularly interested in connecting with mothers through social media channels and teaching others in her profession to do the same. In addition to her work as the co-editor of Lactation Matters, the International Lactation Consultant Association’s official blog, she has written for a number of other breastfeeding support blogs including for HygeiaThe Leaky Boob, and Best for Babes. She also serves on the Social Media Coordinator for GOLD Conferences International and is a regular contributor to The Boob Group, a weekly online radio program for breastfeeding moms.  When she’s not furiously composing tweets (follow her at @iamambermccann) or updating her Facebook page, she’s probably snuggling with one of her three children or watching terrible reality TV.

10

If YOU Don’t Advocate for Mothers & Babies, Who Will?

Written by Jennie Bever Babendure, PhD, IBCLC

As IBCLCs, part of our Code of Professional Conduct  (IBLCE November 1st, 2011)calls on us to adhere to the World Health Organization’s (WHO) International Code of Marketing of Breast-Milk Substitutes and Subsequent Resolutions.  For those of us who hold this Code in high esteem, the news that WHO is accepting corporate funding and instant payday loans for its obesity initiative is enough to turn our stomachs many times over. According to the article, the Pan American Office of the WHO (based in Washington, D.C.) has begun to accept funding from fast food makers, among them the food giant and WHO Code violator Nestle.

As I struggled to reconcile the idea that an organization focused on world health would accept funding to fight obesity from the organizations that stand the most to gain from creating it, I began to feel crushing discouragement. How on earth can we, as a small band of mothers and breastfeeding professionals supporting the WHO Code, compete with multinational corporations with seemingly endless supplies of money? How can we succeed at supporting the WHO Code when the WHO is taking money from one of the worst offenders?

This is the point in the story when the hero has been soundly defeated. She goes back home with her eyes on the ground kicking stones in the path. She decides she will never win, so she might as well give up and just make noodles for the rest of her life (oh wait, I think that might be from one of my son’s favorite movies).

After a long night of frustration, writing, and a little alcohol, I chose to reframe the issue as a CALL TO ACTION. And if the WHO violating the WHO Code isn’t a call to action slapping me in the face, I don’t know what is!

But what can we do?

Most of us are doing our darndest to help mothers and babies start and continue breastfeeding in the face of tremendous marketing and cultural pressure to do otherwise. We stay awake nights worrying about how to best help a mother struggling with thrush or low supply, pour over research on tongue-tie and search the web for resources for new mothers. What more can we do?

The time has come for us to see our roles expand.  Our job as lactation professionals must not only be to provide individual breastfeeding support, but also to advocate for maternal and child health on a larger scale. If we don’t begin to protest the status quo and work to change the political and cultural barriers that mothers face in their attempts to reach their breastfeeding goals, we will be fighting the same battles for the next 100 years. The International Baby Food Action Network (IBFAN) has long been at this fight. They shouldn’t have to fight alone.

In many places, we are beginning to see policies and legislation changing. We need to harness that momentum to move the tide even further. Now more than ever, mothers and babies need us to advocate for them and they need us to empower them to demand change themselves. Not just in the clinic or hospital, but in the grocery stores and restaurants, in the hallways and on the floor of congress. When mothers and babies protest a mother being asked to leave for nursing in public, we need to show up. When our congressmen and women debate policies that impact breastfeeding, we need to show up. When a news station wants to run a story on breastfeeding, we need to show up. When the WHO takes money from Nestle, we need to show up!

For some, showing up means planning and attending nurse-ins and rallies, for others it is talking, blogging and posting information on the cultural and political barriers to breastfeeding on websites, twitter and Facebook pages. Still others have the ability to influence corporations and other organizations they are a part of by changing the way they do business, who they work with, and how they support their employees. Even beginning to have conversations with the mothers you work with about choosing to support companies that uphold the WHO Code can have an impact!

We can also leverage our resources by joining forces with other organizations working to improve maternal and child health. In addition to IBFAN and the World Alliance for Breastfeeding ActionNatasha K. Sriraman has written about the organization 1000 Days for the Academy of Breastfeeding Medicine.  With a goal of improving life by improving maternal and infant nutrition in the first 1000 days –pregnancy through the second birthday—1000 days seems like a natural ally of lactation consultants and maternal-child health advocates.  Working with like-minded organizations will increase our ability to impact policies and legislation that prevent corporations like Nestle from sabotaging breastfeeding in both developed and developing countries by marketing their products directly to mothers.

When I was younger, I was under the illusion that if something important were happening, someone else would take care of it. As I’ve gotten older I’ve realized that is rarely the case. When the WHO takes money from a formula company, something is terribly wrong. If we don’t do something about it, who will?

If you are interested, please consider joining the “Friends of the WHO Code” Facebook Group to discuss violations of the WHO Code, especially those on social media, and how we can empower lactation professionals, volunteers and mothers to stand up for its importance.

Jennie Bever Babendure, PhD, IBCLC: I am mother to 2 active boys and an Assistant Research Professor in the College of Nursing and Health Innovation at Arizona State University. As breastfeeding researcher, I am constantly scanning the literature for articles that guide my research and inform my clinical practice. One of my goals is to increase the evidence base of our profession as lactation consultants. I feel it is important for lactation professionals to be aware of and contribute to breastfeeding research, especially when so much of it is fascinating! As an ongoing contributor to Lactation Matters, it is my hope that you will find the articles I highlight as interesting and informative as I do, and that you will use them to guide you in the important work of lactation professionals and breastfeeding advocates. For more research news and commentary, check out my blog at www.breastfeedingscience.com. I can be reached at jennie.bever@gmail.com.

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World Breastfeeding Week: New Breastfeeding Bill in Israeli Parliament

In celebration of World Breastfeeding Week, Lactation Matters will post every day this week, highlighting the stories of breastfeeding in different cultures and countries.

Written by Ellen Shein, IBCLC, LLLL

Photo by Shaare Zedek Medical Center in Jerusalem (permission requested)

In 2011, a member of of the Israeli Parliament, Danny Danon,  proposed a bill for encouraging breastfeeding and limiting the activities of formula companies in the hospitals in Israel. Some of the main hospitals are government run, which means that for the past 30 years, the hospitals have had a hand in promoting the use of formula on a widespread level. Up until the present, many hospitals in Israel have received ONE KIND of infant formula for free from the major importers and manufacturers here.  Additionally, these hospitals have been paid millions of shekels for this exclusivity! Money from these companies have funded many salaries of nurses and of course has helped pay for much needed medical equipment. It is therefore, very difficult in today’s financial crunch to imagine hospitals surviving without these large sums.

These practices, of course, are in direct conflict with the directives and recommendations of the World Health Organization’s International Code of Marketing of Breastmilk Substitutes. The current bills states that hospitals will now have to purchase formula by tender and that the formula provided to mothers who choose not to breastfeed will NOT be limited to one specific brand. Statistics show that if a mother is given formula A in the hospital, she will stick with that brand.

Over the years, there have been overtures in Israel which have succeeded in preventing formula reps from handing out free samples in the hospitals, well-baby clinics and physicians’ offices. The companies have managed however to get a hold of statistics lists which include the names and addresses of new families and are still aggressively marketing their products.  This is done by making sure that each new mother receives formula samples by mail or in “gift packages” for new mothers handed out by one of the largest pharmacy chains.  Additionally, there are other private schemes which send stewardesses to the homes of 25,000 babies each year!

There is much dissention and objection to this new law. Many of the parliament members see this as an affront to women making a free choice in regards to how to feed their babies. In my opinion, the main mistake was to refer to this law as “encouraging breastfeeding” when in fact it should be about the “protection of the infant by freedom of feeding choices”. Part of the law includes a paragraph suggesting that the mother who chooses NOT TO breastfeed must sign a form stating that she is aware of the many benefits of breastfeeding yet chooses not to. This form should have nothing to do with breastfeeding and everything to do with formula feeding. Everyone knows the benefits of breastfeeding, but how many moyhers really know what those little bottles of formula are made of and what the negative outcomes can and most likely will be affecting their babies?  Many mothers have already chosen their method of feeding before arriving at the hospital and, here in Israel, we have a great track record of nearly 87 percent of all mothers initiating breastfeeding. We do not have to encourage the masses to breastfeed. What we need to do is inform those that choose NOT TO of the risks of formula feeding.

No one talks of the benefits of clean air when talking about the hazards of smoking, nor do they tiptoe around the damaging results of alcohol and drug consumption. But for some reason, no one seems to have the courage to stand up and point out the potential health risks that mothers who choose formula subject their babies to.

In early July, there was another finance committee meeting in the Knesset (Parliament) to which breastfeeding advocates were invited. There were representatives from La Leche League of Israel, the Israel Association of Certified Lactation Consultants (an ILCA affiliate) and a few other grass roots organizations. Unfortunately, we were not able to speak at this meeting, but are hopeful that this bill will ultimately be passed. It has passed a first reading, and now, it will probably wait til after the summer recess.

With a bit of language changing and letter writing, we are hopeful that most of the parts of this bill will pass. We are doubtful that the signing of any document will go through unless the Members of Knesset change the wording a bit and change the focus towards helping to improve health outcomes for babies, and not on encouraging breastfeeding.

Ellen Shein has been an IBCLC since 1987.  She began with La Leche League International and served on its Board of Directors from 2005 – 2011, representing Africa and the Middle East.  Currently, she is the Chairperson of the Israel Association of Certified Lactation Consultants. In addition, she is in private practice with Malhiv Breastfeeding and Support Center for New Mothers.

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