No Sweeteners
One of the best things about being an academic is the stuff that people send you in the – usually entirely correct – belief that you’ll find it interesting. I’ve had emails about pink slime (for the blog) and on programmes about children’s literature (for my research). Recently, my friend Elizabeth, who’s a lawyer, forwarded me this from Legalbrief:
New draft baby feeding regulations will forbid formula manufacturers from ‘aggressively marketing’ their products to mothers and from sponsoring meals and professional development courses for healthcare practitioners, says a Weekend Argus report. It adds the standards set in the draft regulations, which the Department of Health has released for public comment, intend to promote safe nutrition for babies and young children and restrict inappropriate marketing practices. The department stressed that the regulations would not stop baby formula and complementary foods from being sold at retailers. ‘Although breastfeeding is best, government recognises that some women cannot breast-feed or decide not to breast-feed. These regulations do not in any way compel women to breast-feed against their will,’ the department is reported to have stated.
The proposed regulations, which fall under Section 15 (1) of the Foodstuffs, Cosmetics and Disinfectants Act, 1972, make for fascinating reading. Other than banning trans fats and artificial sweeteners in baby formula, their emphasis is on curtailing the advertising and promotion of artificial foods.
For instance, the packaging of baby formula may not have pictures of infants, young children, or any other ‘humanised figures,’ except for those included in instructions for preparing the product. Tins and containers may not ‘contain any information or make any negative claim relating to the nutritional content or other properties of human milk’, and they’re not allowed to include toys or gifts. Packaging must include in English, in bold letters at least 3mm tall, the message: ‘Breast milk is the best food for babies.’
The regulations will also radically limit the advertising of baby formula shops, in print and online, ban the distribution of gift packs and free samples, and prevent formula manufacturers from sponsoring or donating equipment bearing the logo of their products. These manufacturers may not
provide research grants or any other financial assistance relating to infant or young child nutrition to health care personnel working in a health establishment or health care personnel linked to a health establishment.
Nor may they give doctors, nurses, and health workers gifts, and ‘heads of health establishments, national, provincial and local health authorities shall take measures to promote, support and protect breastfeeding.’
It’s an ambitious piece of legislation, but one which is entirely in line with the World Health Organisation’s International Code on the Marketing of Breast Milk Substitutes. The Code was adapted in 1981, and places stringent regulations on how baby formula is advertised: it advises that baby milk formula should not be allowed to market products directly to pregnant women and mothers with young children, including handing out samples. Products should also state that breast milk is superior to formula.
Implementation of the Code has been slow, and there is evidence to suggest that it has been particularly poorly policed in developing nations where oversight of the activities of powerful multinationals is often lax. The South African regulations are far stricter than the Code, particularly as regards the relationship between the pharmaceuticals industry and academic research, but address a problem which campaigners have long identified: that there is a link between the way in which formula is advertised and how women feed their babies.
This isn’t to suggest that women should have their choices about how they feed their babies curtailed – or that it’s only advertising which causes women to choose to use baby formula. Far from it. The problem, though, is that, particularly in poor nations, advertising or other promotional methods encourage breastfeeding mothers to switch to baby formula when it’s unlikely that they’ll be able to afford to buy more formula, and where they may dilute formula with too much water to make it go further. This water may not be clean, and it’s difficult to keep bottles and teats sterile without electricity or plumbing.
The purpose of these regulations is to ensure that formula manufacturers don’t use the often less than ideal conditions in which mothers in developing nations raise their babies, to their own advantage.
We tend to associate the WHO’s Code with the Nestle Boycott, which was launched in 1977. The Boycott was based on a pamphlet published by War on Want in 1974, titled ‘The Baby Killer’ and, in Switzerland, ‘Nestle Kills Babies’. The charity alleged that Nestle’s advertising strategies were responsible for high rates of child mortality. After a legal tussle as well as an attempt to refute the Boycott’s allegations, Nestle agreed to implement the Code in 1984, although there remains some scepticism as to Nestle’s, and other companies’, commitment to this.
But concern about the advertising of baby formula predated the 1970s, and even the 1940s, when breastfeeding began to decline globally. As I’ve sat in the National Library over the past few months, reading Child Welfare and other child health magazines from the first half of the twentieth century, I’ve been struck by the number of advertisements for baby formula. They all feature fat, healthy babies and testimonials from relieved mothers who claim that the child was fed from birth on Lactogen or whichever other patent food.
Even Truby King, early twentieth-century breastfeeding evangelical and founder of the global mothercraft movement, developed artificial baby food which was produced in New Zealand and then shipped all over the world. Kariol, Karilac, and Karil were meant to be prescribed for babies who were not, for whatever reason, breastfed either as a supplement to cows’ milk, or to be taken on their own.
Although King’s patent foods seemed to contradict his enthusiasm for breastfeeding – and he came under enormous criticism in New Zealand and Australia for his promotion of Kariol and Karilac – there was a certain logic to his decision to manufacture wholesome baby formula. During the early decades of the twentieth century, doctors in Britain and the United States noticed that bottle-fed babies were considerably more likely to die during early infancy than those who were breastfed. Artificial foods – which ranged from thin porridges and condensed milk to baby formulas – were often nutritionally inadequate, particularly in poor families who could not afford better and more expensive substitutes.
But they also identified a link between bottle feeding and diarrhoea, then, as now, one of the main causes of death in infancy. William J. Howarth, the Medical Officer of Health for Derby
arranged in 1900 to receive weekly lists of the births registered during the past seven days from the local registrar. From November of that year until November 1093 women inspectors enquired into the feeding method of each registered child by personally visiting the mother and infant at home.
The results of the study, published in 1905, were telling. Of the infants surveyed, 63% were breastfeed, 17% were partly bottle-fed, and 19% entirely bottle-fed:
The mortality rates from ‘diarrhoea and epidemic enteritis’ in addition to those from ‘gastritis and gastro-enteritis’ were as expected: 52, or 10 per 1,000 of the breastfed, 36 or 25.1 per 1,000 of the mixed-fed, and 94 or 57.9 per 1,000 of the bottle-fed babies died. In other words the mortality rate of the bottle-fed infants was nearly six times greater than that of the breast-fed babies.
Howarth concluded: ‘In not one single instance does the death-rate in any class of disease among hand-fed children even approximate that recorded among children who are breastfed; the rate is invariably higher.’
The problem, in terms of the link between bottle feeding and diarrhoea, was not so much the nutritional content of artificial foods, but the difficulties in keeping them free from contamination, and particularly during summer when infant mortality rates soared.
Indeed, South African advertisements for Lactogen emphasised that the product did not spoil in warm weather. As criticism of artificial foods grew louder, so advertising became more subtle, and better adept at appealing to mothers aware of the potential problems of bottle feeding. Doctors were, though, also aware of the effects of advertising on mothers’ choices, as a medical officer based in Johannesburg wrote in 1925:
No one can deny the fact that the proprietary foods of today are a vast improvement upon those of twenty years ago. They all contain very sound instructions as to the preparation of the food and the amount to be given. The advertising of such foods is carried out on a most extensive scale and in a clever and attractive manner. No hoarding today is without a picture of a flabby and over-fat infant alleged to have been reared solely on the proprietary food advertised thereon. Many a mother who for one reason or another, is not satisfied with the progress of her baby, sees this advertisement, and immediately rushes off to secure this particular food for non-thriving infant.
But not only mothers were influenced by this advertising. He admitted that it was ‘only too true that many medical men and trained nurses are also gulled by such advertisements and circulars’. Dr Cicely Williams, best known for her identification of the condition kwashiorkor in the 1930s, worked in the Colonial Medical Service in West Africa and southeast Asia before World War II and became particularly interested in the treatment of the diseases of early infancy.
She was critical of the introduction of baby formula to Singapore and Malaya, where white-coated sales reps distributed samples of artificial foods to poor mothers. In 1939 she published a pamphlet, ‘Milk and Murder,’ in which she pointed out the benefits to both mothers and babies of breastfeeding.
Nevertheless, Nestle and other companies were still using the same strategies to convince mothers in developing nations to use baby formula in the 1970s, and there are still concerns that they are not fully compliant with the Code on breast milk substitutes. The new South African regulations, if passed, are aimed at remedying this.
The cause for these new regulations and other measures introduced internationally to encourage mothers to breastfeed for the first six months of life, is a concern that rates of breastfeeding remain low in comparison to what they were during the early twentieth century. For all the good that the Code and other laws have done, it remains the exception, rather than the rule, for women to breastfeed for such an extended period of time.
However true it may be that advertising does have an impact on women’s choices, it’s certainly not the only factor which influences how women feed their babies. What’s missing from these measures is any attempt to communicate with mothers themselves. As doctors in the early twentieth century believed that mothers, whom they characterised as emotional and irrational, simply followed any and all advice which they read or heard, so campaigners and governments today seem to be too quick to seek only one reason for women’s decision to breast- or bottle-feed.
In fact, we need to make it easier for women to choose to breastfeed: to eliminate the ridiculous prejudice against breastfeeding in public spaces; for work and childcare not to be mutually exclusive; and for sympathetic advice and information to be made available for all new mothers.
Further Reading
Texts cited here:
Linda Bryder, A Voice for Mothers: The Plunket Society and Infant Welfare, 1907-2000 (Auckland: University of Auckland Press, 2003).
Deborah Dwork, War is Good for Babies and Other Young Children: A History of the Infant and Child Welfare Movement in England, 1898-1918 (London and New York: Tavistock Publications, 1987).
Philippa Mein Smith, Mothers and King Baby: Infant Survival and Welfare in an Imperial World: Australia, 1880-1950 (Basingstoke: Macmillan, 1997).
Other sources:
Rima D. Apple, Mothers and Medicine: A Social History of Infant Feeding (Madison: University of Wisconsin Press, 1987).
Linda M. Blum, At the Brast: Ideologies of Breastfeeding and Motherhood in the Contemporary United States (Boston: Beacon Press, 1999).
Marulyn Yalom, A History of the Breast (New York: Ballantine Books, 1997).
Tangerine and Cinnamon by Sarah Duff is licensed under a Creative Commons Attribution-ShareAlike 3.0 Unported License.
Sep 9
Not in my trolley
This has not been a particularly edifying week for white South Africans. After an angry blog post about Woolworths’s hiring policies went viral, a surprisingly large group of white people have threatened to boycott the supermarket. Woolies – an upmarket food-and-clothing store similar to Marks and Spencer in the UK – notes in some of its job advertisements that certain positions are available only to black candidates.
Pierre de Vos, Professor of constitutional law, points out that this is ‘neither illegal nor unconstitutional.’ The purpose of the measure is to address the absence of black South Africans in particular categories of jobs. The company has not introduced a moratorium on hiring whites, and whites may still apply for jobs advertised as being aimed specifically at black candidates.
In a magnificent riposte to the white loons threatening never to shop again at Woolworths – in the strange belief that other supermarkets don’t have similar hiring policies (they do) – Ferial Haffajee, editor of the City Press, explained:
I doubt that the boycott will have any effect on Woolies’ sales this year. The satirical site Hayibo summed up middle-class South Africans’ relationship with the store particularly well:
Indeed.
As this was a lost opportunity to have a constructive discussion about affirmative action and economic empowerment in post-apartheid South Africa – two issues always worth thinking about – this also represents a moment to think about the nature and effects of consumer boycotts.
I was particularly amused by this threatened whites-only boycott because of the impact that international boycotts had on apartheid South Africa. The country’s economy was brought to its knees after the 1986 Comprehensive Anti-Apartheid Act became law in the US, preventing American businesses and banks from exporting and importing some commodities to and from South Africa, and investing in, and extending loans to, the country. Sport and cultural boycotts accompanied these sanctions.
The Anti-Apartheid Movement in Britain originated as a boycott campaign against South African produce in 1959. It organised boycotts of Cape Fruit, Outspan oranges, and a range of other products, as well as of businesses like Barclays and Total which operated in South Africa. Even if this campaign – and others around the world – didn’t pose as much as a threat to the apartheid state as the sanctions of the 1980s, what they achieved was to make ordinary people aware of apartheid by appealing to them not to support the South African economy.
There seems to have been an increase in this kind of political consumer boycott since the 1980s, and probably as a result of a heightened awareness of the connection between the exercise of political power and the emergence of global corporations. One of the best – and most successful – examples of these was the Nestle Boycott organised by War on Want and other groups in 1977, to draw attention to the link between the marketing of infant formula and high rates of child mortality in the developing world.
But political consumerism and consumer boycotts have existed long before then. In fact, the abolitionist movement has been described as one of the first examples of concerted consumer activism in support of a political cause. Not only could early opponents to slavery buy abolitionist-themed crockery from Wedgwood, but, particularly during the nineteenth century, abolitionists all over the world refused to buy American sugar or cotton.
Lawrence B. Glickman writes:
It’s striking how frequently consumer boycotts have been used by those who are politically and socially marginalised, to demand equal treatment and an end to discrimination. They were a key strategy in the American Civil Rights movement, and featured to some extent in the Defiance Campaign against apartheid legislation in the early 1950s, and, later, during the township rebellion in the 1980s.
Some of the earliest consumer boycotts in the United States and Britain were organised by women, and usually in response to sudden increases in the price of staple foods. For instance, in 1902, immigrant Jewish women in New York organised a boycott after the price of Kosher beef increased by half. By withdrawing their support from local butchers – and, admittedly, rioting in lower Manhattan – they managed to reduce prices.
In 1924 and 1933, Jewish women in Toronto – many of them members of communist groups – also organised boycotts of Kosher butchers to protest rising prices of meat. On both occasions, significant numbers of women were mobilised not only to stop shopping for meat, but to picket butchers.
Indeed, there were widespread boycotts organised by women during the Great Depression. These ‘housewives’ protests’ were part of a broader movement in which women sought to mitigate the effects of the Depression by lobbying government, planting community gardens, establishing bartering systems for food and other goods, and even engaging in acts of civil disobedience. In Cleveland, for instance, black mothers protested a power company’s decision to switch off electricity as a result of non-payment of bills, by hanging wet washing over the power lines. The electricity was switched on the next day.
In 1946, the Washington Committee for Consumer Protection was formed by a group of women – including some who had been active in union politics during the 1930s – to organise boycotts of red meat and other products to protest the increase in food prices at the end of the Second World War. (The American government had kept them artificially low during the conflict.) Other committees organised boycotts of milk and dairy products for similar reasons.
Boycotts demonstrate particularly well that buying power – and the exercise or withholding of this power – seems to function as a replacement of real access to political power for those who are socially marginalised.
I don’t want to suggest for a moment that there’s an equivalence between the heroic housewives of 1930s America and the white nitwits who are trying – and probably failing – to organise a boycott of Woolworths. But I do think that the rage which has propelled this boycott suggests that there is a section of South Africa’s white population which feels – with some justification – that its interests are not being represented by mainstream political parties. And this is worth taking seriously.
Further Reading
Monroe Friedman, ‘American Consumer Boycotts in Response to Rising Food Prices: Housewives’ Protests at the Grassroots Level,’ Journal of Consumer Policy, vol. 18 (1995), pp. 55-72.
Lawrence B. Glickman, ‘“Buy for the Sake of the Slave”: Abolitionism and the Origins of American Consumer Activism,’ American Quarterly, vol. 56, no. 4 (Dec., 2004), pp. 889-912.
Lawrence B. Glickman, ‘The Strike in the Temple of Consumption: Consumer Activism and Twentieth-Century American Political Culture,’ The Journal of American History, vol. 88, no. 1 (Jun., 2001), pp. 99-128.
Matthew Hilton, ‘The Female Consumer and the Politics of Consumption in Twentieth-Century Britain,’ The Historical Journal, vol. 45, no. 1 (Mar., 2002), pp. 103-128.
Stacy Kinlock Sewell, ‘The “Not-Buying Power” of the Black Community: Urban Boycotts and Equal Employment Opportunity, 1960-1964,’ The Journal of African American History, vol. 89, no. 2, African Americans and the Urban Landscape (Spring, 2004), pp. 135-151.
Annelise Orleck, ‘“We Are That Mythical Thing Called the Public”: Militant Housewives during the Great Depression,’ Feminist Studies, vol. 19, no. 1 (Spring, 1993), pp. 147-172.
Kathleen C. Schwartzman, ‘Can International Boycotts Transform Political Systems? The Cases of Cuba and South Africa,’ Latin American Politics and Society, vol. 43, no. 2 (Summer, 2001), pp. 115-146.
Andor Skotnes, ‘“Buy Where You Can Work”: Boycotting for Jobs in African-American Baltimore, 1933-1934,’ Journal of Social History, vol. 27, no. 4 (Summer, 1994), pp. 735-761.
Dietlind Stolle, Marc Hooghe, and Michele Micheletti, ‘Politics in the Supermarket: Political Consumerism as a Form of Political Participation,’ International Political Science Review, vol. 26, no. 3 (Jul., 2005), pp. 245-269.
Lynne Taylor, ‘Food Riots Revisited,’ Journal of Social History, vol. 30, no. 2 (Winter, 1996), pp. 483-496.
Tangerine and Cinnamon by Sarah Duff is licensed under a Creative Commons Attribution-ShareAlike 3.0 Unported License.