Formula milk promotions under watchful eyes

Rudijanto, Contributor, Jakarta

Reports on huge numbers of Indonesian children suffering from malnutrition is not too surprising since the majority of the populace are still languishing in poverty, but that infant formula milk producers have been labeled as partly responsible for such malnutrition is very worrying.

While poverty is the main culprit for malnutrition among children, people concerned with family health as well as non- government organizations have started to alert the public about advertising by producers of infant formula milk.

With a growth rate of approximately 1.54 percent per annum in a country of over 200 million people, Indonesia constitutes a huge market for food products for infants and children as well as infant formula milk. It is no wonder that there are dozens of major producers of infant formula milk, including PT Nestle Indonesia, Nutricia Indonesia and Mead Johnson, that operate in this country.

While infant formula milk producers have legitimate reasons to boost their promotion programs, concerned individuals and non- governmental organizations also have their reasons to be concerned about the message conveyed through such promotions.

Child education expert was quoted by a local newspaper as saying that there are many advertisements of infant formula milk that mislead parents. She said this kind of promotion encouraged parents to abandon breast-feeding.

According to the United Nation Children's Fund (Unicef), even though the number of Indonesian mothers who breast-feed their children has increased to 98 percent, only 3 percent breast-feed their children exclusively until they reach the age of four to six months.

This small percentage of women who exclusively breast-feed their children is one of the reasons why many Indonesian children suffer various diseases and malnutrition. The National Economic Census reported in 2000 that there are 32 million children who suffer from malnutrition in Indonesia.

The census also revealed that 5.3 million children below five years of age suffered from malnutrition and another 12.1 million did not receive adequate nutritional intake. The situation worsened when the economic crisis escalated.

Though poverty is the main cause of malnutrition, the fact that only a small percentage of mothers do exclusive breast- feeding exacerbates this problem.

While there may be valid health reasons that prevent mothers from breast-feeding their babies, some people consider that advertising by infant formula milk producers is partly to blame for the decline in exclusive breast-feeding among mothers, especially those from the middle and upper income bracket who can afford their products.

Various infant formula milk products are advertised almost daily on television, in newspapers, magazines and even through hospitals. To boost sales, producers highlight the many additional nutrients, such as Omega 6 and Omega 3, calcium, and magnesium.

In a market that is already full of competitors, such promotions are indispensable for a company that wants to survive. Even marketing expert Hermawan Kartajaya, President of MarkPlus & Co, in an article published by a local magazine encouraged creative marketing for milk producers.

In Hermawan's opinion, the milk market is already mature and has entered what is called the first curve stage. In such a market, milk producers have to be creative in finding a market niche and segment.

As an example of this creativity, he points to the inclusion of added nutrients in milk products that give more added value.

The addition of substances like DHA, calcium, Omega 3 and Omega 6 have certainly added more nutrition to formula milk. Currently, almost all formula milk products contain one, two or even three of these or other substances.

No one doubts that there have been improvements in formula milk products with such additions but the basic concern is that such products are no substitute for a mother's milk.

Any producers that directly or indirectly asserts that their products are equal to a mother's milk or even close in quality to a mother's milk is telling an untruth and violating the law. Certainly, this is not the kind of creativity that is expected from formula milk producers in marketing their products.

The government has actually promulgated a series of laws that regulate the promotions of formula milk. Law No. 23/1992 on health prohibits advertisements for formula milk that is produced for infants below 12 months.

Government Decree No. 237/1997 issued by the minister of health on breast-feeding substitutes prohibits a picture of a baby on the packaging of all formula milk products aimed at infants below 12 months.

The decree also prohibits producers from writing that their products are equal in quality to a mother's milk or that the products can be used as a substitute for breast-feeding. Any violation of the law will result in a warning and ultimately the revocation of the product registration number.

The decree itself is actually an adoption of an international code on formula milk marketing issued by WHO and Unicef in 1981. However, the packaging of formula milk products sold through retailers show that many producers have violated the regulation.

The Indonesian Consumers Foundation (YLKI) revealed in its 1998-1999 survey in Jakarta and Surakarta that some producers have violated the regulation by stating that their products are similar to breast milk.

YLKI also disclosed the results of a telephone survey of 46 hospital in the country that shows that all of those institutions provide infant formula milk to newborn babies. Their main reason is that the mothers produce little milk.

The finding reveals that formula milk is provided free of charge by 8.7 percent of hospital in the survey. In some institutions (15.2 percent), mothers have to pay for the formula milk, while in others (76.1 percent), the payment for formula milk is included in the total hospital bill. Some institutes (69.6 percent) give mothers formula milk when they go home.

YLKI's findings should not come as a surprise as Indonesia is currently placed among countries with the highest degree of violations in the formula milk business.

While YLKI and other concerned individuals are critical of formula milk, one may question whether the product is so dangerous that it deserves such a critical reaction.

Basically, formula milk is not produced to substitute mother's own milk. Brata T. Hardjosubroto, PT Nestle Indonesia's head of public relations, admits that a mother's breast milk provides babies with the best nutrition and protection against diseases.

"Nestle supports breast-feeding for babies up to the age of six months," says Brata.

Brata reveals that Nestle is committed to abide by government's regulation on the distribution of products that substitute breast milk. The company mentions complete information on its products on their packaging.

"In marketing formula milk for babies, Nestle does not make any advertisements or direct promotion to consumers. What we are doing is to communicate with doctors and midwives, who are capable of providing responsible directions to mothers about what is the best for their patients and their babies," says Brata.

Nestle is among the formula milk producers in Indonesia that play fairly in the competition. Other milk producers focus more on milk for would-be mothers or lactating mothers rather than directly compete with existing producers.

By not producing infant milk, these producers do not stand in direct confrontation with people or bodies that promote breast- feeding. New Zealand Milk is one example of such producers.

"New Zealand Milk does not market infant or follow on formula in Indonesia today," says Riki Taiaroa, New Zealand Milk's marketing manager.

Riki reveals that the company recently launched ANMUM milk in the maternal milk segment.

"Through this brand we are communicating the importance of folate and the role this nutrient plays during pregnancy, but of equal importance ANMUM will actively support breast-feeding," says Riki.

The awareness of the importance of breast-feeding constitutes the main reason for the critical attitude taken by some people toward infant formula milk. By producing products that are aimed at supporting this concern, New Zealand Milk has employed a smart marketing strategy.

Formula milk and other milk products are aimed at supporting the growth of infants and breast-feeding. In cases where a mother's health does not allow her to breast-feed her child, infant formula milk becomes a great help. There is no doubt about this.