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Thursday, August 2, 2012

Subversive marketing tactics: Nestle "milk nurses"

In light of the recent flak Mayor Michael Bloomberg has been getting for his breastfeeding campaign in NYC hospitals, it's important to go back in history a little and explore the origins of that "little bag of freebies" - which might not be as harmless as we think.

For more than a century, Nestle has become a household name - associated with everything sweet and good. But what you may or may not know is that when it comes to marketing their infant formula, they often left a very bitter taste in the mouths of many mothers and infants worldwide.
"Milk nurses" in South Africa. "Some firms
used "milk nurses" as part of their promotions.
Dressed in nurse uniforms, "Milk nurses" were
assigned to maternity wards by their companies
 and paid commissions to get new mothers
to feed their babies formula. Mothers who did
so soon discovered that lactation could not be
achieved and the commitment to
bottle-feeding was irreversible." -
Business: Its Legal, Ethical, and
Global Environment, by Marianne M. Jennings

Nestle made its presence known in South Africa more than half a century ago with "milk nurses," women who were either actually nurses or those dressed to look like ones - who represented the company. Poor women with little, if any, access to clean, running water were then persuaded to try their products, and soon the baby would be accustomed to getting a bottle of formula instead of mom's breast. In time, the breast milk would dry up - but so would the cash flow necessary to buy more formula to feed the baby.

Problems ranged from mothers reconstituting formula with contaminated water, which often led to diarrhea and even death, or watering it down to make the product last longer - which led to malnutrition. One blogger notes:
A fellow nutrition student of mine was formerly head of the Nestle milk nurses in Kenya. She told me that she and her staff not only were qualified, they were among the most senior nurses in the country and wore uniforms indicating this. She said that regular government nurses then had to “obey” the Nestle milk nurses!
Meaning, there is a systematic method of coercion: whether real or portrayed as such, these "milk nurses" were an established presence on behalf of the company, and by showing a special uniform as a display of power and authority, seems to suggest that anyone who questioned them was "in trouble."

Nowadays we think of those typical goodie bags as no big deal, and with heavy government subsidization of formula, it's not that difficult to obtain more when you run out. However, the problem of reconstituting weakly to make it last longer, doesn't seem to be isolated to foreign countries with indigenous tribal people: the same thing happens here in the US. Whether it's simply greed or ignorance, I don't know, but hearing comments like this one make me want to scream - is it still a mother's choice not to breastfeed, even if it's a completely ill-informed one?
People here in America do this too. I've seen a woman water hers down and sell the remaining WIC cans on craigslist.
Although there are WIC programs that do encourage breastfeeding among low-income mothers, it's obvious that the memo might not be as widely-circulated as it should be.

Some ask, "How is Nestle responsible for people who water down their baby's formula?" By marketing heavily to a nation who cannot sustain using their product. The level of abject poverty in many African nations is something even our poorest cannot comprehend, and seemingly few understand the role that these powerful milk "nurses" played in convincing a woman that her own milk was inferior.

One blogger says she was told by a high school teacher about this situation in South Africa, and promptly thought those women must be "stupid" for believing these nurses. Then when she grew up and nursed her own babies, she said, she ran across this image and it opened her eyes:

Photo credit: UNICEF. Source:
The babies in this photo are actually twins. At the mother's permission, she posed for this photograph, taken by a UNICEF worker, after learning that even some breast milk could have helped her daughter to thrive like her brother. Healthcare workers convinced this mother, however, that there was no way she could provide enough milk for both babies, so she faced a difficult decision. Her daughter apparently died the day after this photo was taken. Now that's guilt.

Some ask, "Why didn't workers do this? Why didn't workers tell her that?" Because they have a product to sell. Much like drug reps, hospitals and doctors are often given copious amounts of the stuff for those who truly cannot nurse or don't wish to, in exchange for other goods, I've read. When you have healthcare professionals spewing out this kinds of misinformation, vulnerable mothers are more likely to believe it.

Many have chosen to boycott Nestle as a result; still others ask, "How does this affect me?" The same thing happens here all the time: studies have shown that poorer families are more prone to water down infant formula to make it last, even while getting government subsidies. What if, when those women were in the hospital, they were actually encouraged to breastfeed? With generations of dysfunctional attitudes and perpetuating myths about breastfeeding, how can you expect them to?

More reading:
Poor parents found to water down baby formula: study
Cash-strapped parents warned after Florida infant nearly dies from watered-down formula
China finds cancer-causing toxin in baby formula
Nestle dupes moms, kills babies in Indonesia - DailyMomtra


deirdre said...

Thank you for posting this. I've read about milk nurses but this is a great go-to post to send people to when they ask about formula "programs".