Breaching the breastfeeding code.

I cannot begin to tell you how disappointed T was to see a Nestle advert for artificial baby milk "Nan" in the inside front cover in the March edition of Kai Tiaki Nursing New Zealand. I imagine many lactation consultants, baby friendly hospital initiative (BFHI) co-ordinators, midwives and nurses involved in baby and child health are concerned about this. I was under the impression NZNO supported the World Health Organisation/ UNICEF international code and BFHI.

Under the Ministry of Health's The Code in New Zealand document, adverts must not breach the code by using pictures of a baby that could idealise artificial feeding, or advertise first milks (the tin on the left clearly says "suitable from birth").

The script also appears to imply that babies born by Caesarian section are at greater risk of gut problems which could be sorted out by using this product. Yes, the ad does say the protection provided by breast milk is matchless, but what about nurses who have little training in this area who are asked about baby milks by friends/family? These nurses will remember the product "Nan", as it was advertised in their own nursing magazine.

May I remind you that Nestle's marketing practices during the 1970s in the Third World included giving free samples and gifts directly to breastfeeding mothers, aid workers and health workers until the mothers milk had dried up. These firms have millions of dollars to spend in this area--which they do, as their adverts work! These practices are believed to have resulted in the unnecessary deaths of thousands of babies, whose mothers did not have access to sterilising equipment or clean water (see www.ibfan.org/site2005). Breastfeeding academics have likened Nestle's marketing practices, ethics and morals to those of heroin pushers (see American nutritionist Ted Greiner's breastfeeding website www.geocities.com/ HotSprings). It was because of these practices that the Innocenti Declaration came, followed by WHO/UNICEF's "Ten steps to successful breastfeeding".

I am proud New Zealand has one of the highest initiation of breastfeeding rates in the world (around 95 percent in some areas). All maternity facilities here are required "to achieve BFHI status and to maintain it." Please help us continue doing this by printing an apology to the health professionals who work so hard in this area to improve child health. Your advertising department should also be told that Nestle adverts are no longer acceptable, unless they meet the Code in New Zealand's standards. [abridged]

Eleanor Gates, RN, RM, MMid(Hons), BFHI co-ordinator and BFHI assessor, North Shore Hospital, Auckland