IBFAN-GIFA raises lack of compliance with the International Code and informs shareholders about the release of the movie Tigers at Nestlé's AGM

At Nestlé's latest Annual General Meeting, the Geneva Infant Feeding Association (IBFAN-GIFA) raised attention about the movie Tigers, based on the true story of a former Nestlé's sales representative for baby foods, Mr. Aamir Raza, who resigned after becoming aware of the adverse impact of infant formula on child's health. IBFAN-GIFA noted that the stand taken by Mr. Raza, was officially acknowledged and supported by Canada's Minister of Citizenship, Immigration and Multiculturalism. GIFA further recalled that Nestlé's advertising is deceiving many mothers and urged the company to finally bring its policies and practices into line with the International Code of Breastmilk Substitutes.

Baby Milk Action/IBFAN UK was also present and asked Nestlé Chairman, Peter Brabeck-Letmathé, to drop the public relations approach and address people’s concerns before he retires. He has attempted to rebrand the company as a Nutrition, Health and Wellness company, but many people see Nestlé as a Malnutrition, Death and Water Stealing company. Last year a survey found it to be the least ethical company of the past 25 years, which will otherwise be his legacy. (Read the text of Baby Milk Action's intervention)

There were 2,446 shareholders present to hear the intervention, representing 73.5% of voting rights. IBFAN was the only campaign group raising concerns about Nestlé’s business practices.

Text of GIFA's intervention and the response from Mr Brabeck (Nestlé Chairman), Mr Schipper (Head of Nestlé Nutrition) and Mr Bulcke (Nestlé Chief Executive Officer) are given below.

Intervention of Ms Camille Selleger (IBFAN-GIFA):

Dear Mr. President, dear shareholders,

My name is Camille Selleger, and I speak on behalf of the Geneva Association for Infant Feeding, Swiss member of IBFAN.

Company’s managers just told you about Nutrition, Health and Well-Being, but the story I will now tell you is rather different.

Last February, at the Geneva’s International Film Festival on Human Rights, a movie was screened to sold-out packed rooms. This movie, Tiger, is based on the true story of Syed Aamir Raza, who worked as a Nestlé sales representative in Pakistan in charge of promoting baby foods to hospitals and doctors. During one of his visits to a hospital, he discovers a room full of babies dying because they were not breastfed, but rather fed with infant formula. Alarmed by the effects of the products he promotes on child’s health, he resigns and sends a legal notice to Nestlé calling on it to stop the practices he had been part of. The film then tells how Nestlé tried to keep him to tell his story and how he came to IBFAN for help. It finally became impossible for him to return to Pakistan and he remained separated from his wife and children for seven years.

On the occasion of the film's premiere in Canada, the Minister of Citizenship, Immigration and Multiculturalism declared: 'The account of Mr. Raza’s principled stand in defence of the health of babies and their families is one that deserves to be told, and one which reflects the best of Canadian values.'

Ancient history, will say the leaders of the company ... actually not that old! The dying babies who appear in the film are real babies filmed in 2013 in Pakistan. Indeed, babies fed formula milk are more likely to get sick than breastfed and in areas affected by poverty, they even run the risk of dying from diseases. Despite this, many mothers, seduced by brands’ advertising discourse, sincerely believe they are giving their child good nutrition by feeding them with infant formula.

We welcome Nestlé’s recent commitment to renounce the logo 'Natural Start'. However, this is a very small step following years of campaign and monitoring by IBFAN. In fact, the whole business strategy of the company must be revised to comply with the International Code of Marketing of Breastmilk Substitutes.

Mr Bulcke, earlier on you spoke about respect. My question is a very simple one indeed. When is Nestlé going to put its money where its mouth is and adhere to the International Code [of Marketing of Breastmilk Substitutes] instead of just paying lip service to it?

Response of Mr Peter Brabeck-Letmathé, Nestlé Chairman

Thank you very much Ms Selleger. I think what we are going to try and do is to see if we can convince you by calling on another speaker to try to explain what we’re about. So we are going to ask Mr Schipper, who’s in charge of nutrition, and he’s a newcomer. He has a lot of energy and perhaps he will be more successful than we have been Heiko to convince Ms Selleger.

Mr Heiko Schipper, Head of Nestlé Nutrition

Thank you Mr Brabeck and thank you for the question, Ms Selleger. First I would like to start to talk about our Nestlé Nutrition business. Our mission is to nurture a healthier generation and we do this by focusing on the first 1000 days of life. Both through our products that are safe and science-based. 

[Note: In a presentation to investors in September 2013, Mr Schipper highlighted the ‘product solutions it promotes during the first 1000 days – including follow-on milks and toddler milks’, which the World Health Organisations says are ‘unnecessary’].

We also market our breastmilk substitutes responsibly in line with OUR commitments to the WHO Code. I think you are also familiar that our policy is the strictest in the industry.

[Note: Nestlé refers to its own policies, whereas it should ensure its activities at every level comply with the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions adopted by the World Health Assembly. By Nestlé's own assessment of the violations of the Code and subsequent relevant WHA resolutions documented by IBFAN, 90% are permitted by Nestlé’s narrower policies].

Our compliance is the most strict within the entire industry.

[Note: Nestlé is a greater source of violations in IBFAN’s monitoring than any other company, with the possible exception of its main rival, Danone, the second biggest company – see who is the worst]

We are training our employees. We have internal and external auditors in place. In fact, last year, we increased our level of audits to 43, which is an increase of 25%. And also our compliance policies towards our WHO Code commitments are also recognised through our inclusion in the FTSE4Good Index where since 2011 only Nestlé has been present. So for the last four years we are the only player in the industry who is recognised to have strict compliance policies in place. We are in fact audited every year on 104 points when it comes to our commitments and we have passed them in the past four years.

[Note: FTSE has warned Nestlé several times not to suggest that inclusion in the FTSE4Good investment index signifies compliance with the WHO Code. Companies are assessed on their own policies, not the Code and Resolutions and Nestlé was only included after the criteria were weakened – and it weakened its own policies shortly before being included, knowing it would be assessed against those. IBFAN, Save the Children, UNICEF Lao and others have called on FTSE to strengthen its criteria].

So I believe that we have a very industry leading and strict policy in place.

When it comes to the movie you are referring to, we are aware of this movie. This is a movie that is set, I believe at the end of the ’90s, but these allegations made are highly questionable and certainly are not consistent at all with our policies that we execute in the markets.

[Note: Tigers is based on the true story of former Nestlé salesman, Syed Aamir Raza. Internal company documents provided by him show that he was performing the duties required of him. Indeed, a job description for the equivalent post in Canada in 2014 states the main responsibility is to ‘[s]timulate retail sales through the promotion of infant formulas and cereals to gain Healthcare Professionals recommendations.’]

Mr Peter Brabeck-Letmathé, Nestlé Chairman

Perhaps Paul you would like to come in.

Mr Paul Bulcke, Nestlé Chief Executive Officer

Ms Selleger, you said that we are very cynical. I find that you are very cynical in your speech. Respect for the truth. The truth, Madam, the events that are described in the film took place decades ago, based on the allegations of one person. And they are entirely false and wrong. There is nothing to be added. There is nothing more to say. These are false.

[Note: In addition to the documentary evidence substantiating the allegations by Syed Aamir Raza, there were contemporary surveys conducted in 33 cities in Pakistan and published as the report Feeding Fiasco, which found evidence from health workers of the activities of company representatives. A Save the Children survey in 2012 found health workers continued to report being targeted by company reps. with Nestlé most prominent]

Camille Selleger, IBFAN-GIFA

Well, I suggest that your shareholders make up their own minds.

Mr Peter Brabeck-Letmathé, Nestlé Chairman

Thank you for that, Madam.

Camille Selleger, IBFAN-GIFA

I invite shareholders to view the film that will be shown in Switzerland in the Autumn 2015 and perhaps they will be able to make up their own minds.

[Note: As Camille Selleger said in her opening comments, the film includes actual babies, malnourished after being formula fed, who were filmed in 2013. Mike Brady spoke to shareholders next, showing a picture from a Bangladesh report from 2014 ‘Tragedies of infant formula and sub-optimalbreastfeeding’. Despite knowing babies die from unsafe formula feeding, Nestlé promotes its infant formula in Bangladesh as the ‘gentle start’ for babies. Mr Schipper told investors in 2013 that this marketing campaign is a‘growth engine’. See Mike Brady’s intervention and Mr Brabeck’s response.]

Human rights recommendations on breastfeeding by the Committee on the Rights of the Child (64th session)

The 64^th session of the Committee on the Rights of the Child (CRC Committee) took place in Geneva from 16 September to 4 October 2013. The Committee reviewed the progress of the implementation of the Convention on the Rights of the Child in 7 countries: China, Kuwait, Lithuania, Luxembourg, Monaco Sao Tome and Principe and Tuvalu.

IBFAN submitted 4 alternative reports on the situation of infant and young child feeding for China, Kuwait, Lithuania and Luxembourg. The reports were written in collaboration with IBFAN groups in the countries.

We regret to see that in its concluding observations, the CRC Committee referred specifically to breastfeeding in only 2 out of the 7 countries (China and Tuvalu). In the case of Luxembourg, even if breastfeeding was largely mentioned in the discussion between the CRC Committee and the government delegation, Luxembourg did not receive any recommendation concerning breastfeeding.

Some of the recommendations on health care and on the business sector and its impact on child rights are of relevance for infant and young child feeding and are reported below.

The CRC Committee recommended China and Tuvalu to promote exclusive breastfeeding. It has also stressed the need to establish Baby-Friendly Hospitals (China) and to adopt the International Code of Marketing of Breastmilk Substitutes and resolutions (China, Tuvalu). It also urged Tuvalu to provide training to all health workers about breastfeeding.

The Committee particularly addressed the issue of children affected by contaminated formula in China and recommended the government to strengthen its legislative framework on food and health standard and ensure sanctions and remedies in cases of violation.

An Emphasis has been put on the importance of respecting the right of the child to the enjoyment of the highest standard of health (China, Lithuania, Monaco, Sao Tome and Principe). Countries have been reminded to pay attention to the 2013 General Comment 15 on the right of the child to health, which explicitly recognizes the importance of breastfeeding for the achievement of the right of the child to health. It urges States, in the effort of diminishing infant and child mortality, to devote particular attention to neonatal mortality and suggests, inter alia, to “pay particular attention to ensuring full protection and promotion of breastfeeding practices”. Moreover, “Exclusive breastfeeding for infants up to 6 months should be protected and promoted and breastfeeding should continue together with appropriate complementary foods preferably until two years of age as feasible. States’ obligations in this area are defined in the “protect, promote and support framework”, adopted unanimously by the World Health Assembly” in the Global Strategy for Infant and Young Child Feeding.

Some of the countries are recommended to provide quality training for the health care personnel (and to increase the budget for health programs in general. China is urged to improve health infrastructure as well as availability and accessibility to emergency obstetric and neonatal care, especially in rural and poor areas, in order to prevent child and maternal mortality. Sao Tome and Principe is recommended to undertake surveys in order to understand the causes of maternal mortality and to intensify its efforts to improve access to safe drinking water and sanitation. Lithuania is demanded to ensure maternal care for women who choose to deliver at home and finally, it recommended Monaco to ensure that all children, including non-nationals, enjoy the same access and quality to health services.

A great focus was placed on the need to regulate the impact of the business sector on children’s rights. The CRC Committee drew attention to the 2013 General Comment 16, which specifically calls on States “to implement and enforce internationally agreed standards concerning children’s rights, health and business including the [...] International Code of Marketing of Breast-milk Substitutes and relevant subsequent World Health Assembly resolutions”.

 Countries are recommended to ensure the implementation by companies of both international and national environment and health standards and ensure appropriate sanctions in cases of violations. Countries are also recommended to require companies to undertake assessments of the environmental health-related and human rights impact of their business activities The CRC Committee also focused on the need to prevent mother-to-child HIV/AIDS transmission by improving access to treatment, follow-up treatments and by ensuring early diagnosis, as well as early initiation of treatment.

Direct link to our website: http://ibfan.org/reports-on-the-un-committee-on-the-rights-of-the-child/118

Kuwait to regulate business activities in child rights

Kuwait presented its 2^nd periodic report on the situation of the implementation of the Convention on the Rights of the Child. The next consolidated 3^rd to 6^th periodic report is expected by November 2018. The Kuwaiti delegation was composed of 19 members headed by H.E. Dhara Abdul Razzak Razzooqi, Ambassador, Permanent Representative of the State of Kuwait in Geneva.

IBFAN presented an alternative report on the situation of infant and young child feeding in Kuwait. The report, prepared by IBFAN Kuwait, shows that there are very low exclusive breastfeeding rates. This is due to insufficient coverage and low quality of antenatal education about breastfeeding management, weak support for the baby-friendly hospital initiative (BFHI) as well as lack of timely follow-up and competent support for mothers after hospital discharge. Concerning maternity at work, the duration of maternity leave is shorter than the ILO recommendation of 18 weeks, and women working in the informal sector do not enjoy the same rights as those in the formal sector.

Discussion on health care

The delegation of Kuwait informed the CRC Committee that particular attention was being paid to the social and health aspects of the life of the child, which has led, among other things, to reduce mortality rate. The government allocated a considerable budget to health care.

The issue of breastfeeding and infant and young child feeding has not been directly addressed in the dialogue between the CRC Committee and the government delegation.

The Kuwaiti delegation also specified that specialized centres had been established for HIV and AIDS tests and other sexually transmitted diseases. To date, there is in Kuwait a very limited number of HIV-positive cases thank to the effective programme established by the Government.

Concluding Observations

Kuwait did not receive any direct recommendations on breastfeeding in the Concluding Observations of the CRC Committee.

However, the CRC Committee has addressed to Kuwait recommendations on the impact of the business sector on child rights.

The CRC Committee recalled Kuwait the content of the General Comment no. 16 (2013) on State obligations in regard to the importance of the impact of the business sector on child rights. It recommended to Kuwait to establish and implement regulations in order to ensure that the business sector respects the international and national human rights and complies with labour, environment and specifically with children’s rights.

The CRC Committee therefore recommended Kuwait to: “(a) Ensure effective implementation by companies, especially industrial companies, of international and national environment and health standards; set up effective monitoring of implementation of these standards and appropriate sanctioning and providing remedies when violations occur, as well as ensure that appropriate international certification is sought; (b) Require companies to undertake assessments, consultations, and full public disclosure of the environmental, health-related and child rights impacts of their business activities and their plans to address such impacts”.

The Committee also mentioned the importance of respecting the environment in order not to contaminate water. It urged Kuwait to: “(c) Take immediate measures to relocate all families and children subjected to pollution that endanger their life and health status; and (d)  Be guided by the United Nations “Protect, Respect and Remedy” Framework, accepted unanimously in 2008 by the Human Rights Council, while implementing these recommendations” (para 23-24).

63rd CRC Committee: Recommendations on breastfeeding to Armenia, Guinea-Bissau, Israel, Rwanda, Slovenia and Uzbekistan

The 63rd session of the Committee on the Rights of the Child (CRC Committee) took place in Geneva from 27 May to 14 June 2013. The Committee reviewed the progress of the implementation of the Convention on the Rights of the Child in 6 countries: Armenia, Guinea-Bissau, Israel, Rwanda, Slovenia and Uzbekistan.

IBFAN submitted alternative reports on the situation of infant and young child feeding for all the countries under review. Some of the reports were written in collaboration with IBFAN groups and contacts in the countries and the regional offices.

In its concluding observations, the CRC Committee referred specifically to breastfeeding in 5 out of the 6 countries. With the exception of Israel, all the other countries received concluding observations on infant and child nutrition, and breastfeeding in particular.

The Committee recommended states to promote adequate infant and young child feeding practices including exclusive breastfeeding of children up to the age of 6 months (Armenia, Guinea-Bissau, Rwanda and Uzbekistan), to support exclusive breastfeeding and ensure that parents and communities are informed about it and its advantages (Guinea-Bissau and Uzbekistan). The Committee has stressed the need to collect data on breastfeeding (Slovenia) and to adopt international definitions for data collection in order to, inter alia, identify intervention for infant mortality reduction including BFHi and breastfeeding information (Uzbekistan). Adopting a national law or policy on breastfeeding is another recommended action (Armenia and Guinea-Bissau).

All countries that received direct recommendations on breastfeeding issues are urged to revitalize or start to implement the Baby Friendly Hospital Initiative.

Emphasis is put on the importance of controlling marketing practices of breastmilk substitutes. Some countries are recommended to monitor, or strengthen the monitoring of, existing marketing regulations and to take action against violations (Armenia and Slovenia), while others are urged to adopt and enforce the International Code of Marketing of Breastmilk Substitutes (Guinea-Bissau, Rwanda and Uzbekistan), with Uzbekistan specifically recommended to adopt it as national law. In the case of Slovenia the recommendations on the Code are quite elaborated, with mention to regulation of also bottles and teats and to safeguarding against marketing in Maternity Care Institutions.

Regarding maternity protection at work, Uzbekistan is recommended to extend the post-birth period of the maternity leave in order to facilitate exclusive breastfeeding for 6 months, while Guinea-Bissau is advised to ratify the ILO Convention concerning the revision of the Maternity Protection Convention (Revised), 1952 (No.183).

On health more generally, the CRC Committee focused on the need to ensure equal access to health care services, with regard to both urban-rural differences and ethnic differences (Armenia, Israel, Rwanda and Slovenia). Access should also not impeded by the practice of informal fees, that should be eliminated (Armenia and Uzbekistan). The Committee highlighted the importance of quality of health care services that should be pursued by allocating adequate human, financial and technical resources to the health sector (Armenia, Guinea-Bissau, Israel, Rwanda and Uzbekistan).

Combating and preventing childhood obesity (Armenia and Slovenia) and preventing mother-to-child transmission of HIV (Armenia, Guinea-Bissau, Uzbekistan) are other important issues addressed in the concluding observations.

For the full report read here

Children’s Rights in Guinea-Bissau at the CRC Committee

The situation of children’s rights in Guinea-Bissau has been reviewed by the Committee on the Rights of the Child (CRC Committee) at its 63^rd session, on June 7^th 2013.

IBFAN presented an alternative report on the country situation vis-à-vis infant and young child feeding. The report shows how, although improving, breastfeeding rates are still insufficient: only 38% of infants were exclusively breastfed for 6 months in 2010, and in 2012 72% of babies were initiated to breast within one hour from birth, while the introduction of complementary food is not timely for more than half of infants.

Inadequate breastfeeding practices contribute to the high child and maternal mortality rates in Guinea-Bissau, where 9% of children die before their first year of life. Breastfeeding promotion activities took place in the country thanks to international cooperation partners, however projects are expiring this year and the country does not have the means to maintain them on its own.

Maternity protection at work is another challenge for Guinea-Bissau, where maternity leave is as short as 2 months and the relative benefits are paid by the employer, situation which carries the risk of generating a discriminatory effect against women, as employers may want to avoid paying such benefits.

During the interactive dialogue between the CRC Committee and the country delegation, the issue of breastfeeding has not been addressed in detail but only briefly mentioned in the context of health care. On this point, the country delegation assured the Committee that the national health system extends to all national territory, including rural and remote areas. The country is engaged in developing health plans, including a strategic plan on HIV/AIDS, on water and sanitation, and a financial strategic plan to reach the millennium development goals that will cover breastfeeding promotion and maternal mortality reduction programs. Regarding reproductive health services, the country delegation noted that prenatal consultation is free and includes counselling to pregnant mothers.

Other issues debated at the session included a wide range of topics: child adoption, juvenile justice, birth registration, infanticide, paedophilia, violence against children, child labour, children in street situation, education, child marriage and children with disabilities.

The dialogue between Guinea-Bissau and the Committee has been very collaborative and the country delegation was well aware of Guinea-Bissau’s shortcoming in realizing children’s rights in the country; however it stressed that due to financial constraints many improvements are not achievable at the moment.

Breastfeeding situation in Slovenia

The situation of the implementation of the Convention on the Rights of the Child in Slovenia has been reviewed at the 63^rd session of the Committee on the Right of the Child (CRC Committee), on Wednesday 6^th June.

IBFAN presented its alternative report where it highlighted that Slovenia has only few provisions of law implementing the International Code of Marketing of Breastmilk Substitutes.

The issue of breastfeeding has been touched upon during the interactive dialogue between the CRC Committee and the country delegation.

Slovenian delegation reported that their country puts a special emphasis on breastfeeding, in laws, policies and guidelines (e.g. in the ‘Guidelines on Healthy Diet for Young Children’), where it has pledged to increase exclusive breastfeeding for the period 0-6 months of the baby’s life.

According to the delegation, breastfeeding rates are high in Slovenia, with 97% of breastfed babies up to 3 months and 2/3 exclusively breastfed in 2010.

Slovenia has also adopted a ban on marketing of breastmilk substitutes, while many maternity clinics are mother-friendly hospitals.

Breastfeeding is included in labour legislation according to which mothers have the right to breastfeed breaks until the baby is 18 months of age, without loss of payment.

The problem of high incidence of obesity in the country was also addressed by the delegation. In a US-EU countries ranking on obesity, Slovenia falls in the first third with the most obese population. Obesity is a complex issue and it is mentioned in several policies: on physical activity, on nutrition, etc. Vending machines have been abolished in schools and a policy on healthy diet in schools is subsidized by the State.

BREASTFEEDING IN UZBEKISTAN AT THE CRC COMMITTEE

At the 23^rd session of the Committee on the Rights of the Child (CRC Committee) the situation of children’s rights in Uzbekistan has been reviewed on Tuesday 4^th May. IBFAN presented its alternative report on the state of infant and young child feeding in the Country, noting the high infant and maternal mortality rates and the very low rate of exclusive breastfeeding at 6 months of age (only 26%).

The CRC Committee asked information on measures to prevent infant and maternal mortality and on breastfeeding practices and the implementation of the International Code on Marketing of Breastmilksubstitutes.

The Uzbek delegation mentioned two programs designed and implemented in the Country in collaboration with UNICEF, namely the ‘Growth and development for young children’ program and the ‘Breastfeeding’ program to monitor the health of newborns. As a result of these efforts, over the last 10 years the proportion of breastfeeding has increased to 80%.

It is not clear if the data provided by the delegation concerns exclusive breastfeeding and if it reports a national average or it relates only to focus communities involved in UNICEF programs, therefore such data does not provide a clear picture of the situation of breastfeeding rates in Uzbekistan.

The question on marketing of breastmilk substitutes remained unanswered.

Concerning maternal and infant mortality, the Country delegation reported a 10% of maternal mortality in 2012 and a 4% of infant mortality in the same year. These data are much lower than those reported by UNICEF in 2010-2008 (30% of maternal mortality and 44% of infant mortality) and it might be due to discrepancies in data collection, a general problem acknowledged by the Uzbek delegation and being tackled at the national level.

Breastfeeding in Rwanda

On Thursday 30^th and Friday 31^st May the situation of children’s rights in Rwanda has been reviewed by the CRC Committee at its 63^rd session, where the question of breastfeeding has arisen.

IBFAN has submitted an alternative report on the situation of infant and young child feeding in Rwanda. The report notes that there are no baby-friendly hospitals; there is no legislative measure that implements the Code in Rwanda, only a draft measure; the policy on children’s health defines breastfeeding as a duty of mothers, putting the burden on women, and putting them in a vulnerable position and that the duration of maternity leave is short, only 12 weeks, and starting from the second 6 week mothers are entitled to receive only 20% of the salary. In addition, maternity benefits are paid for by the employer, which may result in employers discriminatory employment practices against women.

During the CRC session, the Rwandan delegation reported efforts to educate parents on breastfeeding and train pregnant women during the prenatal and postnatal period, in addition to campaigns on food production that is appropriate for young children.

It further explained that exclusive breastfeeding for 6 months is the practice followed in Rwanda. After a Committee member clarified that for the first 6 months of a baby’s life exclusive breastfeeding is the best feeding practice and that no other milk should be given, the Rwandan delegation added that soy milk is given as a complementary feeding after the first 6 months of age to combat child malnourishment.

The situation of BFHi has been briefly touched upon by a Committee member in the context of Rwanda’s Early Childhood Development Policy but the Country delegation did not elaborate on that.

More broadly on reduction of malnutrition, the delegation provided information on efforts to combat the problem through a national program for elimination of malnutrition. It also reported a 2009 screening program that reached each child in all villages where malnutrition is an issue. The screening program has been followed by an emergency program to accelerate the elimination of malnutrition. Other interventions include information on how to prepare local foods, economic empowerment of families, home gardens and kitchens for villages.

Other questions pertained to education, children with disabilities, leisure time and recreation, refugee law, mechanisms to tackle violence against children, discrimination of minorities, child labour, juvenile justice and adolescent reproductive health.

Armenia to Adopt the Draft Law on the International Code and Strengthen BFHI Monitoring

In view of the 63^rd session of the CRC Committee, IBFAN presented an alternative report on the situation of infant and young child feeding in Armenia, prepared by Confidence Health NGO in collaboration with GIFA. The report showed in particular how the International Code on Marketing of Breastmilk Substitutes is heavily violated in hospitals and how NGOs registered violations of the International Code also in some baby-friendly certified hospitals since the implementation and monitoring of the Baby-Friendly Hospital Initiative (BFHI) has been discontinued in 2008. In addition, the report mentions the existence of a draft law on the marketing of breastmilk substitutes, its weaknesses and possible improvements. However, after the report was written there have been some positive developments that resulted in a strengthening of the draft law.

The CRC Committee reviewed the situation of children’s rights in Armenia on Wednesday 29^th May. The issue of breastfeeding and infant and young child feeding were raised by the Committee, in particular in connection with the issues of the International Code and of BFHI. Questions were answered by the representative of the Ministry of Health (MOH).

The International Code of Marketing of Breastmilk Substitutes

The Committee inquired on the plans of the government to finalize the draft law on the marketing of breastmilk substitutes and to adopt it as law and monitor it.

On this point, the Armenian delegate noted that the Country is in the process of adopting a law[i] prohibiting advertising of artificial food, including infant formula, and providing for measures to punish health workers that cooperate with distributors of infant formula. The parliament has just had a hearing on this law, and the MOH representative expressed her persuasion that the law will go through, despite lobbying against it by companies, because legislators look very favourably at it.

Baby-Friendly Hospital Initiative

The Committee asked information on government’s plans to monitor practices in hospitals, where breastfeeding is not always properly encouraged and where infant formula can be provided to mothers.

MOH representative reported that 60% of babies are born in baby-friendly hospitals, where infant formula provision is not allowed, and explained that monitoring of baby-friendly hospitals is carried out by NGOs.

The CRC Committee expressed its disappointment on the lack of government initiative in monitoring of baby-friendly hospitals practices and on the lack of countrywide implementation of the initiative, and asked the government to justify it.

The MOH delegate explained that in all Armenian hospitals babies are kept with the mother; however she acknowledged that the supply of infant formula to mothers is indeed an actual practice. She also explained the lack of State monitoring of BFH with the fact that very active NGOs – especially IBFAN – are carrying it out and the State works hand in hand with them in this area. The delegate further acknowledged that sometimes medical personnel work with distributors of infant formula and may encourage mothers to use it. In this case she considers the State collaboration with NGOs a positive practice.

Undernourishment

More broadly on nutrition, the representative acknowledged that the Country faces a problem of undernourishment mostly related to lack of vitamins. In Armenia children are not going hungry but they are not developing fully: there is a problem of undergrowth that a strategy developed with the assistance of UNICEF tries to tackle. The government delegate reminded that it is not only a health problem, but also of poverty and education.

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[i] The draft law is named "Breastfeeding promotion and regulation of infant food marketing”

MALTA Committed to Protect Breastfeeding

The situation of the implementation of the Convention on the Rights of the Child in Malta has been revised by the Committee on the Rights of the Child (CRC) at its 62^nd session on January 17^th 2013. IBFAN has prepared an alternative report on the situation of breastfeeding in Malta. 

During the interactive dialogue with the Committee, the issue of breastfeeding was tackled.

The Committee members raised questions concerning the measures Malta is taking for increasing breastfeeding – whose rates are very low in the Country – as it is an important component for raising emotionally healthy children. The Maltese delegation stated that health campaigns to encourage breastfeeding have raised the rate of breastfeeding from 35% in 1990 to 56% in 2011*. There are ongoing efforts and initiatives to promote breastfeeding such as guidelines for breastfeeding rooms in public places, new breastfeeding policy in hospitals (created last November).

The Committee asked the delegation what measures are in place to regulate the marketing of infant formula which may explain the low rates of breastfeeding in the country. The Committee wanted to know whether there are baby friendly hospital initiatives in the country and what support is given to mothers in the hospitals, noting that births mostly occur in those premises and data in the possession of the Committee show very low initiation to breastfeeding. The Maltese delegation informed that services for breastfeeding are available within the hospitals and in community health centers. There are regulations on the marketing of baby formula and a directive is being discussed that, once adopted, will put Malta in line with the European Union.

The Committee members also noted that maternity leave from work has been recently elevated to 18 weeks and this could have an effect on breastfeeding. The delegation pointed out that it is not yet possible to assess the impact of the new law on breastfeeding as it has been operative for only 3 weeks now. In any case, working mothers have the possibility to use family friendly measures, work more from home, have more flexible work hours or have a reduction of working hours.

Overall, breastfeeding is on the increase, even though the statistics are still not satisfying. The delegation agreed that breastfeeding is the best solution for the child and they committed to increase awareness campaigns on breastfeeding.

 *The delegation of Malta probably referred to the rate of exclusive breastfeeding at 0 months, as it is the only data available along with initiation to breastfeeding.