Bottle-feeding, good or bad? UN agency takes critical vote

But code advocates are not willing to leave the regulation of formula promotion up to the producers themselves. They worry about the producers' long-term motives. With trends pointing toward increased breast-feeding in the industrialized West the companies may be forced to look for new markets. And markets in the developing countries -- already worth an estimated $1 billion -- could be exceedingly lucrative, since the vast majority of new babies will be born there.

All of this, worry the code advocates, could put enormous pressures on the companies to promote their formula aggressively.

The companies are already organizing campaigns to influence those governments working on codes for baby-food sales ethics, says Edward Baer of the Interfaith Center for Corporate Responsibility. The guidelines being suggested by industry , he says, recognize the need for voluntary restraint by companies but still allow free promotion of their products.

Codes In Malaysia and Singapore have indeed adopted guidelines offered by the International Council of Infant Food Industries (ICIFI), according to the organization's secretary-general, Dr. Stanislas Flache. (ICIFI member companies with major formula sales in developing countries include Cow and Gate from Britain, Nestle of Switzerland, five Dutch companies, four Japanese companies, Wyeth International of the US, and a Danish and a French firm.)

In addition, various companies were influential in formulation of the codes in Peru, Kenya, South Africa and Nigeria, says Dr. Flache.

The Interfaith Center feels that some industry jockeying has been less than ethically upstanding.

Last year, says Mr. Baer, the Nestle Company offered a large money grant to the Indian Academy of Pediatricians, whose president happened also to be on India's committee for drafting a code for baby food marketing. The president proposed guidelines offered by formula industries. But health experts and others got wind of it and prevented passage.

In addition, some industry-promoted codes already in existence seem chock-full of loopholes. Loopholes in Kenya's new code, for example, was criticized recently, according to Monitor special correspondent John Worrall in Nairobi.

On the other hand, the Kenyan code urges that the companies marketing formula should avoid competing with breast milk or creating an artificial need for the product, that mothers should be encouraged to seek competent advice on safe use of the formula and that labels and advertisement to the general public give clear information along these lines. With these guidelines the Kenyan government hopes to restrain food companies from taking advantage of easily persuaded, illiterate women.

However, the Kenyans were not willing to lay down penalties for manufacturers who abuse the code. And some health officials and news commentators in Kenya criticized the code for allowing free infant formula samples in maternity houses and clinics, samples that critics say convince mothers of the merits of specific formula brands at the outset. And too little attention was given, the critics charged, to the poverty and other social factors that can be linked to poor lactation in mothers.

Nevertheless, as final vote now draws near in the World Health Assembly on whether to set up an international standard to guide the marketing of infant formula, uncertainties abound.

Will US opposition pressure other countries to oppose the code? Will the American position force developing countries to harden their own stands even more to demand a code with even stronger regulatory language? And what will be the legacy for the future of cooperation between developing countries and the industrialized West?

Much will depend on whether the delegates can find compromises that put industry and governments at ease about the future of free enterprise, while at the same time keeping in mind the need to ease the suffering of children in countries where poverty already makes basic survival hard enough.

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