In June 2016, a paediatric journal was pulled up for publishing an advertisement that spoke of a formula milk product as an effective supplement for mother’s milk. Soon after, the journal had to apologise. This is just among one of the violations of The Infant Milk Substitutes, Feeding Bottles and Infant Foods (Regulation of Production, Supply and Distribution) Act.
Even as the law lays down guidelines for anyone manufacturing, supplying or selling infant products, violations by manufacturers, producers, suppliers and medical representatives are rampant. Even as the Act prohibits advertising for any infant food (for children between six months and two years), several of them continue to appear in journals, television and social media.
With a single body in the country and a handful doctors fighting the cause, there is not much happening to stop manufacturers convincing consumers that these substitutes are as good as breastmilk for the new born.
The Breastfeeding Promotion Network of India, a gazetted organization by Government of India has been demanding that the Union Government has a separate body in place to implement the Act. The Infant Milk Substitutes, Feeding Bottles and Infant Foods (Regulation of Production, Supply and Distribution) Act, 1992 as amended in 2003 (called the IMS Act) covers the different aspects of advertising, promoting and sale of milk substitute products.
Dr Arun Gupta, Central Co-ordinator, Breastfeeding Promotion Network of India spoke to TNM at length about the violations that have been reported over the years.
“Just last week also there was one such in Indira Gandhi International Airport-T3 terminal. An alert onlooker informed us that there is a blatant violation and a company has put up posters advertising infant food. As per law, no one can promote the sale of baby food,” said Dr Arun.
Seminars and workshops
The law clearly states that no producer, supplier or distributor, can offer or give any contribution or benefit to a health worker or any association of health workers, including funding of seminar, meeting, conferences, educational course, contest, fellowship, research work or sponsorship.
However, Dr Arun explained that this was the most common form of violation that they came across.
“In another case recently, we were informed that a baby foods manufacturing company organised a meeting in the name of educating doctors on psychiatry. This is yet another common form of violation. In the name of seminars and lectures, the products are promoted. Now the companies might argue that this was not done for promotion. However, it is against law.
“The law clearly states that these companies cannot sponsor any seminars or bear other expenses of doctors. Yet it is rampant. They continue sponsoring or giving benefits to health workers. Last December, there was a meeting of neonatologists from across the country. We are looking into it and would soon report to the government.”
The law states clearly that no company would be allowed to advertise food products (by whatever names it is called such as supplements, meals or milk). In such a circumstance, it is only the doctors who would be eligible to introduce the products that are available in the market to mothers. With this, it becomes important that doctors or healthcare workers are not made any offer in return of which the products are promoted.
Even as such violations continue to be reported, the slow pace at which cases progress have little impact on the violators. “This is a criminal law and have to go to court to fight these cases. Three years ago, we did file a case against one of the manufacturers. There has been little progress in the case. With slow proceedings of the court, like in several other cases are a concern. There have been other pending cases as well.”
As a gazetted body, BPNI, he said would only give a report to the government every year on the status. “We are a gazetted body under the law. However, BPNI is finding it challenging to handle the same because of lack of resources. We have about six members. There is a need to have a government setup that strictly monitors the implementation of the act.”
Need for dedicated staff
“Support has to begin at hospitals. There is a need to have skilled support persons who explain how breastfeeding is done to the mother and cope up with challenges. Without this, many corrupt doctors could be pushing mothers into switching to formula milk. We have also been pushing for extra maternity leaves. The same was revised recently,” he said.
With doctors giving little post partam care to mothers, he said that there was a need to have dedicated staff who can motivate more women to breastfeed. “We recommend that there be trained lactation counsellors both in private and public sector hospitals who can motivate the mothers. Women who have been advised by health workers also increase their breastfeeding. So having health workers speak to women on the challenges such as sore nipples etc which can be dealt with ease is essential.