Bottle Babies

A week ago in the clinic, a healthylook woman brought her 3 months old baby because the child was having diarrhea on and off and was crying a lot. She and her husband lived in one of the suburbs of Nairobi city. I examined the baby and the baby weighed 2 and 12 kg that is 5 lb and was very emasciated with skin wrinkled eyes depressed and with the front nail also depressed. She was obviously suffering from arasmus and dehydration. Dehydration had resulted from the diarrhea disease. I asked her how she was feeding the baby. And the reply was that she bottle fed. In the pediatric hospitals of Africa, Asia and Latin America, cases such as this one are on the increase. Dehydrated babies with diarrhea and gastroenterteritis, undernourished babies with the classical nutrition diseases, morasmas and quashio. But these babies don't come from famine areas. Their mothers are neither ill nor undernourished. What these babies have in common is that they have been bottlefed. They come from the big cities and from the villages. Their desperate mothers cannot understand that their baby should lose weight, visibly shrink, and often die. For they believe that they are giving their children the best there is, powdered milk from the bottle. Once again, Professor Bubo from Kenya National Hospital in Nairobi. The problems of malnutrition, diarrhea disease are very commonly seen in this hospital and they stem from bottle feeding. One of the slums of Nairobi, it is not different from other big city slums in the third world. They all harbor poverty. Electricity and running water are unknown in these shacks. Few people have regular work and money is scarce. They only have the hope for a better life for a small share of the progress taking place around them which at the moment is out of their reach. So they reach for the small symbols of progress like powdered milk and a feeding bottle. These represent prosperity and modern living. A 10-w weekek old baby will need three of these cans per month. Soon it will need four. The price for these cans often corresponds to a third or a half of the family's monthly income here. But this mother believes that it is the best for her baby and she scrapes together what money she has. To make drinkable milk out of the powder, one must follow the instructions exactly. Wash the bottle and te in soap and water. Rinse in clean water. Place them in boiling water to sterilize them. Wash your hands before preparing the feed. The water must be make sure you add exactly the right number of spoonfuls. Keep the bottle and teeth away from dust and flies. Very strict hygiene is necessary. Any neglect on your part may make your baby ill. Reality in the slums, however, is different. The water from the common tap is seldom drinking water. She can only boil it if she has enough fuel. So, the bottle is usually rinsed in cold, dirty dish water. How can she know what sterilizing means and what it does? Perhaps she boiled the bottle once when it was new and thought that she need not do it again. The way the mixture is made up depends less on the instructions on the can than on the parents income, and that is rarely sufficient for three or four cans a month, especially when many children have to be fed. So, she dilutes the milk. Nobody told her that this is harmful. As long as the liquid is white, it is milk. And all right, so she assumes Some mothers put nothing but water in the bottle, believing that the bottle itself has the power to make the baby grow. But instead, the baby rapidly loses weight and unceasingly cries from hunger. [Applause] While the mother works, the oldest daughter usually takes care of the baby. She knows even less about the dangers of the bottle. She therefore probably dilutes the milk even more, and thus the child gets only lightly colored water for weeks on end. Water and bottle, moreover, are contaminated. And so the milk, often prepared in the morning to last through the day, becomes a breeding ground for bacteria, which find little resistance in the small weakened body. Since the minimal calorie requirement is not provided, malnutrition sets in. Diarrhea and vomiting occur, infections of the skin, ears, and throat. Without immediate medical attention, the baby soon will die of malnutrition, infections, and dehydration. For the parents, this is all inexplicable because they believe that they have done the best for their baby. In the rural areas, the picture is often similar. More and more mothers here are also reaching for powdered milk and the feeding bottle since both are available in every little village shop. Someone convinced this mother that she could not breastfeed. But in reality, such cases are extremely rare. All too often, mothers squeeze out their own milk and throw it away. While at the same time, they bottlefeed their babies with diluted and contaminated artificial milk. Here in the country, everything speaks against the bottle. The mother can take her baby to work with her and even during her work in the fields she could easily breastfeed. Bottlefeeding on the other hand requires much hard work. Water is usually precious and has to be brought long distances. In this case water is abundant but one can hardly call this muddy liquid drinking water. Still people drink it unboiled because there is nothing better and they don't know otherwise. [Applause] [Applause] Man can resist much illness in his environment for he has built up his immunity against it. Babies, however, do not yet have this immunity. They have to rely on the immune bodies they receive before birth from the placenta and after birth in the mother's milk. Powdered milk, cows or goats milk does not contain the same valuable immune bodies found in breast milk. Unprotected, these babies consume countless bacteria which breed in bottles like this one under the hot tropical sun. My [Applause] [Applause] mom, these pictures may suggest a happy family scene. But in truth, they reveal a drama. The drama of bottle babies. Babies who start out with this bottle only too often end up under this one. Drip room in Kenyatta National Hospital in Nairobi. Every day, some 30 babies are brought in who are so dehydrated from diarrhea that only the drip running into a vein of the body to replace the missing water can save them. [Music] [Music] [Music] Ah, I love you. [Music] Most of these babies suffer not only from diarrhea but also from malnutrition. A large percentage are bottle babies. Despite intensive efforts by the doctors, help comes too late for some. Fortunately, in many developing countries, mothers can stay with their sick children and health workers such as Sister Wuru can use the time spent in the hospital to teach the mothers about the causes of their baby's sickness. The majority of the mothers who come to us in the observation ward have usually got children who are not just in newborn but maybe about 2 weeks over and their main problem is diarrhea and vomiting. And when they come to us, what we try to talk to them is on mainly what could have caused that diarrhea and how they feed their children. If they use a bottle or if they are feeding on the breast or if they are using a cup and spoon or a plate and spoon at home and we find majority of the children whom we have in our observation world with diarrhea and vomiting are fed and we only have about maybe one out of 10 of those children who are on breastfeeding. We try to prove to the mother that mother's milk is the best because if you have to go and mix any other milk it will be in between they either get dirty but her breast milk the breasts are covered by clothes and so they are not at any risk of any contamination. If they use any other milk, it means the either it is going to be very expensive or if they are going to use it, they can't give as much as they want. And if a mother who feeds on the breast, she can give as much as she has on her breast. For many of these mothers, the advice to breastfeed comes too late. They have weaned their babies too long ago. Their own milk has dried up. Sister Wuru can only teach them the elementary rules of hygiene and artificial feeding. But this does not make powdered milk cheaper, nor the water cleaner. And so many children soon return to the hospital with new infections. There is no lack of vivid examples in Sister Wuru's classes. Along with their half starved and emaciated babies, the mothers bring the bottles of which they are so proud, but which probably have caused their baby's misery. In the maternity ward of the hospital, breastfeeding also is encouraged. The new barn is always within reach of the mother. There is no doubt among doctors that mother's milk is superior to any artificial product. Dr. Amy from Kenyatta National Hospital says breast milk has inherent advantages over artificial feeding. Human milk contains sufficient quantities of all the essential food stuffs for the first few months of life. It is convenient, economic, always readily available at the proper temperature, fresh and free of contamination. One of course of these great advantages is psychological satisfaction. both for the mother and for the infant. We for instance know that physical contact it's a very important aspect in the growth of the infants so that uh they develop to be mature more balanced adults and Dr. ongary adds human milk has some immune substances which protect the child from getting any infection mainly of the gut. It is this protective effect which is one of the most important characteristics and advantages of mother's milk because the newborn baby is dependent on it in the first few months of life. Since powdered milk lacks these antibodies, it is no wonder that in developing countries, infant mortality is usually at least twice as high for bottle babies as it is for breastfed [Applause] babies. Of course, there are if rare cases in which artificial feeding cannot be avoided. But here doctors advise cup and spoon feeding which is more hygienic and has less risk of infection even if a drop is spilled now and then. But what is it that causes a healthy mother to give up breastfeeding for expensive powdered milk in the first place? One of the most important factors is advertisement. Radio spots, posters, and calendars suggest to mothers that powdered milk is at least as good, if not better, than their own. In all languages and dialects, powdered milk is praised as a sure guarantee for healthy, happy babies. It is a symbol of progress and prosperity. Vitamins and proteins to make babies grow. Even hospital walls are plastered with posters and calendars advertising the company's products. In return, the firms donate large publicity effective packages of their milk for clinical use. Free kits with sample milk, bottle and color brochures are given away to mothers outside and even inside maternity wards to build their body. In comparison, the resources which doctors and health services have to promote breastfeeding are rather limited. A few black and white posters, but primarily the tireless effort of nurses and doctors at the clinics who explain, advise, and educate. They are often the only lobby the babies have. While they reach only relatively few mothers and usually only after the babies are in a critical state, advertisements are everywhere in the city slums and in the countryside. [Laughter] [Laughter] [Music] [Laughter] [Music] As soon as a baby is out of danger, it returns home to make room for the next one. Sister Wuru sometimes goes to visit the family to check on the child's further recovery. Only too often she finds that the mother has started using the bottle again. Partly because she has to go to work and can't take her baby with her and partly because she again succumbed to the promises of advertising. For this mother, it was not too late to return to breastfeeding. Her undernourished baby survived the worst in the hospital and is slowly gaining weight. But since the brain undergoes its most rapid growth in the first 6 months of life, malnutrition in this period may easily damage the growing brain and handicap the child for life. For the mother, extended breastfeeding also means less risk of becoming pregnant again. Wider spacing between births not only slows down the birth rate and therefore population growth, but it also helps to feed all children sufficiently. Mothers throughout the world want the best for their babies. Even when making mistakes, they make them in the belief of helping their child. The grasp for the feeding bottle can be a fatal grasp. Many children could still be alive. Many could be spared sickness and malnutrition if their mothers had known about the dangers of bottle feeding. If they had known of the advantages of breastfeeding, if they had not been exposed to the often misleading sales promotion for milk powder, and if they would be provided with facilities that would enable them to breastfeed their babies while working. Not only the babies are victims, their families are financially weakened and the economies of developing countries are burdened by expensive milk powder imports. No country can really afford to replace a product such as mother's milk produced in every country at low cost, in sufficient quantities, and of incomparable quality with an expensive, inferior, and even dangerous artificial product. Self-sufficiency in food stuffs should begin with mother's milk. In the industrialized countries, too, voices warn of the trend towards bottle feeding. In 1974, the British charity organization War on Want published a report titled The Baby Killer. This report noted that the milk company's advertising and sales practices at least helped accelerate the trend. The terms pediatricians use to describe the new phenomena commercialgogenic malnutrition, lactogen syndrome or simply bottle illness also pointed at the role of the industry. Among the criticized firms, one stood out. Nestle, makers of lactogen, the top selling milk in the third world. In the Swiss Lake Geneva Resort, Vet stands the headquarters of this after unilver second largest food corporation in the world. With over 300 factories, Nestle can rightfully claim to be the most multinational corporation of all. The modern extension wing of the headquarters is partially paid from the profits that Nestle makes in the third world baby food business. For other than in the industrialized countries where declining birth rates led to stagnating sales, the markets in the population rich developing countries seem unlimited. But the beaming babies on advertisements cannot hide the fact that there are other pictures too. It borders on cynicism to see in medical journals milk powder ads next to those of drug companies advertising their diarrhea medications. But Nestle saw its reputation only endangered when the Swiss Third World Working Group translated the report into German and published it under the new title Nestle Kills Babies. Esther Enderly, a member of the group, explains some of the criticisms of the report. Nestle grew furious because we called its advertising methods unethical and immoral. But in its anniversary book entitled 100 years of Nestle, the firm involuntarily confirms some of our criticisms. Nestle often claims to sell its products primarily in the big cities of the third world and to direct its products mainly at the upper classes that is at people who have the means to use the products properly. On this picture in the anniversary book, one can however see clearly how penetrant Nestle's promotion is and that in fact people in rural areas too are supposed to be reached. Here for example, a sales girl carries the whole line of production on her head. Or here a so-called nutrition course is being held where mothers are told of the quality of Nestle products. A special problem for third world countries are the so-called milk nurses. Nestle and other milk companies hire nurses from the public services by paying them higher wages for example and use them for promotion of their products. This is not only disastrous in connection with artificial feeding but also because the public health services are being deprived of important personnel. Since the nurses wear their nurses uniforms, people believe in their authority and are not aware that behind them stands only the sales strategy of a corporation. The legal proceedings that Nestle instituted against its Swiss critics so far at least had the result of informing the public about the side effects of bottle feeding in the third world. The milk companies had to face the question, was it their hunger for profit that was at least partially responsible for the malnutrition and even the death of many thirdw world babies? Mother, help your baby grow a full of power and vitality with Celerac, the bodybuilding food. It contains milk with its protein, cereal, vitamins, and mineral salts. Makes your baby healthy and strong. Nestle's annual turnover, far above 5 billion US, is bigger than the gross national product of many developing countries. The products of the company and its subsidiary firms offer anybody who can pay for it a food paradise. That cafe stimulates more more more happiness. Happiness more more. Nes Cafe. Nes Cafe. The refreshing coffee that stimulates, gives you energy, and brings happiness any time of the day or night. Stimulating Nescafe. Nestle profits from abundance in rich industrial nations as well as from poverty in many developing countries. These are children's graves near Lusaka in Zambia. Mothers put empty lactogen cans and feeding bottles on their dead babies's graves, for they believed to the end that powdered milk and feeding bottles were the most valuable possessions their babies ever had. The bottle baby scandal doesn't begin and end with Nestle. Other large companies are competing in this lucrative third world market. These products sold in third world markets come from American multinational companies. Church sponsored shareholder resolutions have asked these companies to disclose fully the details of their sales and promotional practices. Concerned groups both at home and abroad are trying to get the milk and formula companies to stop questionable advertising and promotion. This is especially important in countries where many of the people can neither afford nor safely use this replacement for mother's milk. This includes stopping the use of the Mothercraft personnel to sell the products and stopping the giveaway of free samples of formula and bottles. Concerned groups are also supporting the efforts of developing countries to regulate the sale of infant formula in accord with the needs of their people. And they are encouraging government, voluntary, and health care agencies to do everything possible to educate about and encourage breastfeeding. Here's what you can do to help. Bring the baby bottle scandal to the attention of your local citizens action group, World Hunger Organization, and church. Arrange for showing this film in your community. Ask the media for coverage of the bottle baby issue. Investigate possible bottle feeding problems in your own community. Write protest letters to the US corporations, Abbott, American Home Products, and Bristol Meyers. Also to Nestle USA, members of Congress and United Nations agencies question investments in infant formula corporations by your church, pension fund, union, or insurance company. Challenge the companies by supporting shareholder initiated lawsuits and shareholder resolutions. For further information, write or phone the Interfaith Center on Corporate Responsibility, 475 Riverside Drive, New York, New York 1027.