“For a couple of weeks, they sent us useful messages with no reference to formula at all. They underlined the importance of breastfeeding. Then the messages subtly changed,” Sezai says. “They started warning us against under-nourishment. We were told: ‘If you think your baby isn’t getting enough nutrition you can call our hotline.’”
As the young couple’s daughter grew, the warnings continued. “We were told that after six months the baby would need 500ml milk. If the mother couldn’t deliver it, we were advised to use supplements. We never called the hotline but the messages kept coming. They were very disturbing,” Mr Ozan Zeybek says.
Mr and Mrs Ozan Zeybek were just one couple on the receiving end of a massive and very successful campaign in Turkey by multinational food company Danone, which owns baby milk brands Milupa, Aptamil and Bebelac.
The initiative tells mothers to give 500ml of breast milk to their children once they reach the age of six months and to use formula if they don’t have enough. It was a campaign that dramatically increased sales of Danone infant formula in Turkey, but has led to breastfeeding mothers moving their babies on to powdered milk unnecessarily.
The Bureau of Investigative Journalism recorded a free infant nutrition seminar held at a Baby World store in Istanbul on 12 May. In this workshop a Danone nutritionist recommended formula for children not being given enough breast milk and distributed Aptamil samples.
“We hold conferences in conjunction with the World Health Organisation throughout the year,” the nutritionist said. “And they say to us: ‘If a baby is aged 0-6 months, you should give at least 750ml breast milk or bottle milk per day. If the baby is between six months and 36 months, at least half a litre of breast milk or bottle milk.’”
Numil, a subsidiary of Danone, says that in the early stages of the campaign more than 19,000 mothers responded, of which 71 per cent were said to be giving less than 500ml. The website advises these mothers to use formula.
Most experts agree that measuring the amount a child takes from the breast is extremely difficult. Mary Renfrew, professor of mother and infant health at Dundee University and a board member of Unicef UK, says: “There is no scientifically validated online test for breast-milk volume that we are aware of.”
She adds: “Breast milk varies in composition according to the age and stage of the baby and through the day. So 50ml of milk at one point in the day will have very different composition from 50ml of the same mother’s milk at another point. Using a set amount is not relevant. It is also very difficult to measure accurately.”
And several experts have expressed concern about the Danone campaign. Dr Gonca Yilmaz, director of paediatrics at the Dr Sami Ulus Training Hospital in Ankara – one of the largest paediatrics departments in the country – says: “It is influencing mothers to doubt whether their breast milk is sufficient.”
Any public health advice to mothers that questions the quality or quantity of their breast milk is controversial.
Many international studies have shown that the most common reason mothers give for stopping breastfeeding is fear that their milk is not meeting their babies’ needs.
During the baby milk scandals of the 1970s, formula companies were criticised for telling parents that “when mother’s milk is not enough, our product will help to make up the difference”.
Danone says that mothers’ estimates of their daily breast milk provision rose to 337ml from 214ml during the campaign, though no further details of these findings have been made public.
The company, which markets semi-solid products in Turkey for children aged four months, also said it had contributed to a 17-year rise in rates of exclusive breastfeeding during the first six months of a child’s life.
“Numil follows Danone’s global policy, which in line with the WHO recommends exclusive breastfeeding for the first six months,” it says.
The Turkish National Paediatric Association, with which Danone has previously worked, supports the campaign. “This is our third year of collaboration,” it said. “Over the years, we have observed that Danone (Numil) has the ultimate aim of increasing breast milk usage for babies.” Whatever the intention behind Danone’s campaign, its effect on formula sales has been notable.
By the end of last year Numil was the most successful of Danone’s European Baby Nutrition branches, with its general manager citing 26 per cent growth.
Danone insists it is not competing with breast milk and that sales growth is a result of parents choosing formula over inappropriate foods like rice flour.
But the company’s actions have left parents like Sezai Ozan Zeybek disillusioned. “They use the media, chain stores, hospitals, doctors. They offer seminars in almost every city in Turkey and supposedly educate parents. And our doctors prefer not to comment,” he says. “I am a father and I find all this unbearable.”
Market place: The spin
Activia
yoghurt
Comes in 20 “mouth-watering” flavours and said to be great to enjoy as part of a balanced diet.
Evian
mineral water
Its journey from the French Alps to millions of bottles is said to take 15 years.
Actimel
yoghurt drink
Contains 10bn L.Casei cultures, calcium and vitamins B6 and D. The “perfect way to start the day”.
Badoit
fizzy water
Tasting slightly sulphurous, Danone says of the product: “A geological miracle, Badoit emerges from the ground naturally sparkling.”
Cow & Gate
baby products
A range of milks and foods that while giving toddlers the nutrition they need, also actively encourages breastfeeding as the “best start to life.”
