Acceptance speech – International Baby Food Action Network (IBFAN)

Madam Speaker, Honourable Representatives of the Swedish Parliament, Jakob von Uexkull, Fellow Awardees, Ladies and Gentlemen,

The International Baby Food Action Network is a network of more than 150 member groups and individuals working in 94 countries. There are IBFAN groups in every region: Asia and the Pacific, the Middle East, the Republics of Central Asia, the Commonwealth of Independent States, the Baltic States, Eastern, Central and Western Europe, in all the countries of Africa, French-, English- and Portuguese-speaking, in Latin America and the Caribbean, and North America.

All our members cannot be represented here, but on their behalf we should like to thank the Right Livelihood Foundation and the Jury for awarding this prestigious prize to IBFAN.

Every IBFAN group is independent and self-reliant, and each group has its own name in its national language. But all groups share the first hand experience of babies damaged by the “baby-bottle syndrome”, otherwise known as “commerciogenic malnutrition”. Our experience fuels our commitment to organize together in international solidarity to end the suffering caused by bottle-feeding – the malnutrition caused by diarrhoeal diseases, the respiratory infections, the cycle of sickness and weakness. It is this vision which binds us together as a network, by our constant exchange of experiences and sharing of information to campaign for action: Action is the key word in our International Baby Food Action Network.”

UNICEF’s 1997 The Progress of Nations report estimates that only 44 % of infants in the developing world receive adequate breastmilk. In Pakistan, which has an infant mortality rate of 95 per 1000 births, exclusive breastfeeding from birth to three months is only at 16%; diarrheal infections and acute respiratory disease causes more than half of infant deaths; 67 million people have no access to safe drinking water and the average cost of formula feeding is the same as the average monthly income.

It is in places such as Pakistan with a birth rate of 5.5 million babies born every year, that the baby food industry persists with its unethical marketing practices, luring mothers away from breastfeeding and using the health care system to market its health damaging products.

One of the aims of the Right Livelihood Award is to reward work contributing to healing our planet. Breastfeeding not only heals people but prevents ill-health. Breastfeeding lowers the risk of a baby contracting diarrhoeal diseases, acute respiratory tract infections, urinary tract infections and parasites.

UNICEF and WHO estimate that 1.5 million infant lives can be saved each year if they are exclusively breastfed. In poor settings, artificially fed children are 15 times more likely to die from diarrhoea.

Breastfeeding is of great benefit to mothers: as long as a mother fully  breastfeeds she is 98% protected from a further pregnancy for the first six months and 96% after 6 months as long as her menstrual period does not return. In poor settings with little or no contraceptive coverage, breastfeeding is important in spacing births and saving women’s lives by contributing to safe motherhood.

Despite the vital benefits of breastfeeding, what are the reasons for the dramatic declines in breastfeeding: what are the obstacles to exclusive breastfeeding and how can they be overcome? For over fifty years, artificial baby milks and feeding bottles have been relentlessly promoted as the Western, modern way to feed all babies.

Every form of advertising gimmick has been used to persuade mothers, parents, health workers that bottle-feeding is as good as or better than “old-fashioned” breastfeeding. The baby-bottle has become a status symbol, and the breastfeeding mother has been relegated to the background. She no longer receives the support and encouragement she needs from her community.

Industry promotion has infiltrated not only our societies, but also our health care systems. Many health workers lack training in the advantages and techniques of breastfeeding. Doctors and nurses attend in-service training provided by the baby milk companies or conferences sponsored by these firms and their professional associations receive financial and research funding. All this to give medical endorsement to their artificial feeding products.

Why has something as natural and as beneficial as breastmilk been devalued and how has the practice of breastfeeding been undermined? The letter-head of the Right Livelihood Award gives an explanation: The world has enough for  everyone’s need but not for everyone’s greed. There is certainly enough breastmilk in the world for every baby’s need, but breastmilk is for free. There is no money to be made here.

Marketing baby milks, baby foods and bottles and teats is big business. In the USA alone, baby milk sales were expected to reach 2.59 billion $ in 1993, and the market had grown by 54% since 1989. Millions of babies are born every year and if they are not breastfed, their parents need to purchase expensive baby milks. These baby milks are processed from cheap raw materials: cows milk or soy. Profit margins are high and companies have every incentive to increase their market share. Huge profits are there for the shareholders, but at the expense of infant and maternal health.

The Right Livelihood Award is given for vision and work contributing to making life more whole. For nearly twenty years IBFAN groups have worked to restore breastfeeding to its natural and rightful place as the foundation of healthy living. IBFAN was founded in 1979 after the Joint WHO/UNICEF Meeting on Infant and Young Child Feeding. This joint meeting stated: “Breastfeeding is the only natural method of feeding babies and it should be actively protected and encouraged in all countries.

Therefore, marketing of breastmilk substitutes and complementary foods should be designed not to discourage breastfeeding.” From this meeting evolved IBFAN’s work to see a universal, workable code of marketing put in place.

The International Code of Marketing of Breastmilk Substitutes was the result of the 1979 Joint Meeting. IBFAN members participated in the consultations for the Code which was adopted as an international public health recommendation by the World Health Assembly, the policy-making body of the World Health Organization. The Code is a minimum universal requirement to protect infant and young child health.

It addresses the promotion of breastfeeding and the marketing practices used to sell breastmilk substitutes; it does not ban these products but curbs their promotion.

IBFAN’s work of promotion, protection and support of breastfeeding is centred on the implementation of the International Code of Marketing of Breast-Milk Substitutes as an essential safeguard for all infants. IBFAN’s task has been to hold governments accountable to their promises. IBFAN groups have worked with their governments and IBFAN’s International Code Documentation Centre has organized x15 regional training courses in Code implementation and trained more than 350 government policy makers and other officials in Africa, the Americas, Asia, Europe and the Western Pacific. There has been progress in establishing effective national measures to implement the International Code.

IBFAN’s 1998 State of the Code by Country shows that to date, breastfeeding is protected by law for over half of infant humanity: 47 countries have most of the Code’s provisions as law, 40 countries have some provisions or voluntary laws and 22 countries have measures drafted.

At international level, IBFAN advocates for strong World Health Assembly Resolutions to clarify the Code, especially in the light of marketing methods which have become far more sophisticated since the Code was passed in 1981.

IBFAN takes the responsibility to monitor compliance with the International Code and World Health Assembly resolutions very seriously. Every two years, extensive surveys of company marketing practices are compiled into a report “Breaking the Rules”.

In 1998, 39 countries participated in these monitoring surveys and the results are published in Spanish, French and English.

IBFAN also works closely with the health care system and health care workers. As the International Code protects health workers against inappropriate commercial pressures, a major task has been informing health workers of their responsibilities under the International Code and stressing the conflict of interest created by inappropriate acceptance of industry funding.

More and more professional bodies now recognize the danger of competing interests and refuse industry sponsorship.

Training health workers in breastfeeding management has been a key to the transformation of hospital practices. IBFAN groups have organized training courses in nearly every country where they are active. Training has been a major component in the success of the WHO/UNICEF Baby-Friendly Hospital Initiative. There are now over 14,000 Baby-Friendly Hospitals worldwide where mothers and babies are kept close together and breastfeeding is initiated immediately after birth and free formula and sample packs have been eliminated.

UNICEF regards IBFAN as a major partner in implementing and sustaining this successful initiative.

Information circulation is the lifeblood of the IBFAN network. We produce and disseminate information for health professionals and parents, in the form of scientific abstracts such as Breastfeeding Briefs, published in five languages or newsletters such as IBFAN Info and IBFAN Africa News.

Supporting breastfeeding mothers at the workplace is a priority for IBFAN. We work to increase day care facilities and to advocate for adequate, paid maternity leave. In 1999, the International Labour Office will revise its Maternity Protection Convention which dates from 1952. IBFAN groups are working to press for sufficient maternity leave for all working women all over the world.

In conclusion, we should like to quote once more from the aims of the Right Livelihood Award: for work contributing to uplifting humanity… Is it too much to hope that our work contributes to uplifting humanity? E

Every child is our future, every happy, healthy baby makes a better future for us all. By placing the well-being of the smallest and most vulnerable members of our society at the centre of our work, we are preparing the way for healthy, responsible adults. By placing every mother at the centre of our concerns, by supporting her and ensuring that she can choose how best to feed her baby free from commercial pressures, we are increasing the dignity of women. In time, we hope that women’s special responsibility in breastfeeding their babies will be once again recognized and valued – and that every woman will be given the support she needs to fulfil this unique role. Lifting barriers, removing obstacles – this is IBFAN’s work. There have been many successes but there are still far too many remaining.

The Right Livelihood Award increases the resolve and determination of all IBFAN members. We hope to see families all over the world taking charge of their existence and making fully informed choices. Often women and their children have no say: IBFAN believes that  babies, children and families have a right to be heard.

IBFAN will continue to use its voice to make their voices heard, by policy-makers, by multinational companies, by employers and by the medical profession. The Right Livelihood Award will help us to be heard more loudly and more clearly.

Thank you! Merci! Danke! Gracias! Tack!