A debate over breast-feeding vs. bottle feeding went to the top Philippine court Tuesday, with health officials arguing that aggressive advertising by U.S. and British companies has some women believing formula is better than their own milk.
With breast-feeding rates declining across Asia, the Philippine Health Department last year proposed regulations to strengthen its national milk code, which already bans formula companies from advertising products made for babies less than a year old.
New rules would extend that ban to cover ads for formula made for children up to 2 years old.
“We have seen a dramatic decrease of our breast-feeding rates. We have seen an increase of the profits and sale of infant formula companies,” Health Department Undersecretary Alexander Padilla said. “They say (formula) makes geniuses out of babies, promotes love and affection, promotes family ... everything positive about infant milk formula.”
The Pharmaceutical and Healthcare Association of the Philippines has sued the Health Department, arguing only Congress has the power to change the regulations. The Supreme Court, on appeal, ordered a temporary halt to the stiffer rules, which also call for labeling that would include warnings that formula can be harmful if contaminated or inappropriately prepared.
Labels already include messages that breast milk is best for babies, but health officials want additional statements saying there is no substitute for breast milk and that formula should only be used under advice from a health worker.
Companies that violate the regulations could face fines or lose their license to operate for repeated violations. Individuals convicted of breaking the rules can be fined or face up to one year in jail.
On Tuesday, both sides presented further arguments. The attorney for the Pharmaceutical and Healthcare Association, Felicitas Aquino-Arroyo, told the justices the Health Department went beyond its authority.
She said U.S.-based formula makers Wyeth, Mead Johnson Nutritionals and Abbott Laboratories, along with British-based GlaxoSmithKline, stand to lose about $208 million because they will have to change labels, destroy milk products already in circulation and lose sales.
And she argued the advertising ban deprives women of information that would allow them to freely choose whether to use formula.
“The milk companies have been painted to look like corporate ogres, motivated by nothing more than corporate profits,” she said after court adjourned. “That is not the issue in this case. We are not battling breast-feeding.”
Protesters bared chests
About a dozen mothers lined up outside the court to protest. They bared their chests, which had been spray-painted with slogans like “God’s milk is life” and “Greedy milk companies.”
Tracey Noe, a spokeswoman for North Chicago, Ill.-based Abbott, said the company believes breast milk is best for infants, but formula is a suitable alternative. “The real focus here is that infant formula is the only healthy, safe, physician-recommended alternative for moms who can’t breast feed,” she said.
Kevin Wiggins, a spokesman for Madison, N.J.-based Wyeth, said the Philippine ban overlooked the educational value of company promotions.
“We think that’s important because it’s a channel for education and awareness around infant formula. Our company, like the rest of the industry believes that breast milk is absolutely the best for babies ... But there are other requirements for older children and we think that our products provide a good balance for diet and nutrition,” he said.
The row prompted the U.S. Chamber of Commerce to intervene. Its chief sent a letter to Philippine President Gloria Macapagal Arroyo urging her to re-examine the Health Department’s plan or risk the country’s “reputation as a stable and viable destination for investment.”
Attorney Agnes Devanadera, representing the Health Department, argued that exceptions would be made for some ads.
“It is a matter of explaining to our people, for those who have forgotten, that there is no substitute for breast milk,” she told the court. “We are not prohibiting the sale of milk substitutes, but we are prohibiting the advertisements.”
The World Health Organization recommends mothers breast-feed exclusively for the first six months and continue providing breast milk along with complementary foods until age 2. Research has shown that babies given breast milk develop fewer respiratory and intestinal diseases, and those given formula have a greater chance of developing asthma or allergies, along with obesity. WHO estimates up to 1.45 million children die annually in poor countries because of low breast-feeding rates.
Exclusive breast-feeding rates during the first four to five months have dipped from 20 percent in 1998 to 16 percent in 2003 in the Philippines, where more women are working full time and juggling busy lifestyles like many women in the West.
But unlike some mothers in the United States and the European Union, who are moving toward breast-feeding in the first few months, many in developing Asian countries are abandoning the practice.
Thailand has the region’s lowest exclusive breast-feeding rate during the first six months, with only 5.4 percent of mothers nursing. Vietnam’s rate has fallen from 29 percent in 1998 to 15 percent in 2002, while Indonesia dropped from 42 percent in 1997 to 40 percent in 2002.