1. Provisions of the Infant Milk Substitutes, Feeding Bottles & Infant Foods (Regulation of Production, Supply & Distribution) Act,1992, as Amended in 2003 (IMS Act) & present status of implementation Dr Arun Gupta MD Member, PM’s Council on India Nutrition Challenges Co-Chair Global Council International Baby Food Action Network(IBFAN) and Regional Coordinator Asia

2. Objectives of IMS Act 1. Prohibit any kind of promotion. 2. Educate pregnant women & lactating mothers. 3. Restrict & Control use of Infant Milk Substitutes & Infant Foods. 4. Define roles & responsibilities of health care institutions & health workers.

3. Key Provisions of the IMS Act

4. Section 3: Bans Promotion or Advertisements to the Public  If you come across any company or any person advertising or promoting these products in any manner, REPORT to notified agencies

5. Section 4: Prohibits Giving Incentives  If you come across any company offering incentives such as free samples, gifts, tied up sales, discounts etc. in any way in these products; and contacting any pregnant or lactating women, REPORT to notified agencies

6.  If you come across any company distributing baby foods, educational materials or equipments, REPORT to notified agencies Section 5: Restricts Donation of Products, Educational Materials or Equipments

7. Section 6: Prescribes Guidelines for Labelling  If you come across any label not in accordance with the IMS Act or it has pictures of a mother or baby or any graphic material like a bird, teddy bear, cartoons etc. or bear a health claim, REPORT to notified agencies

8. Section 7: Ensures Accurate Information through Educational Materials  If you come across any educational material which promotes baby foods or carries company logo or does not carry date of printing extra or caring wrong or incomplete information, REPORT to notified agencies

9. Section 8: Bans Promotions and Displays in Hospitals, Clinics, Chemist Shops etc.  If you come across any promotional activities of baby food manufacturers in a hospital or a chemist shop etc., REPORT to notified agencies

10. Section 9: Bans Direct or Indirect Benefits to Health Workers or their Associations  If you come across any baby food manufacturer giving benefits to health workers or their associations, REPORT to notified agencies

12. Section 10: Bans Commission on Sales  If you find any baby food company providing commission to it’s staff or indulge in educating mothers or pregnant women, REPORT to notified agencies

13. Violations of The Act- Penalties Imprisonment: not < 6 months upto 3 years Fine: not < Rs.2,000/- upto Rs.5,000/-

14. 1. Breastfeeding Promotion Network of India (BPNI) 2. Association of Consumer Action on Safety and Health (ACASH) 3. Indian Council for Child Welfare (ICCW) 4. Central Social Welfare Board (CSWB) Where to report Violations

15. What IMS Act has achieved and What more needs to be done?

16. No Advertisement of baby foods in print media Here is bold and underlined statement from this advert to use Cerelac during 4 th month Your baby is born with a 3-months gift of Iron Doctors recommended Farex Baby’ s ideal solid food for rapid all round growth After 3 months milk alone cannot give him iron he need

17. Advertisements : TV / Cable / Radio No Advertisement of baby foods on TV Completely Banned since 2000 The Cable Television Networks (Regulation) Amendment Act,2000

18. Free gifts to promote infant food Farex offering baby care book Under Control

19. Affirmative step by the professionals organizations

20. No promotional activities like incentives, gifts, discounts Scratch card is not valid for Infant milk Substitutes, Infant Food and feeding Bottles

21. Violation are still happening !!

22. Poster with picture of mother and infant displayed in the one of the Health facility, Varanasi Promotion in health system through display Nestle Start Healthy and Stay Healthy Yours little one’s world is growing, so is her power for protection against infections !!

23. Chennai, 2010 New Delhi, 2009 Kolkata, 2010 Amravati, 2011 Ranchi,2011 Ferozepur,2009 Organizing seminar through NNI Ludhiana, 2013

24. Reaching to mothers through pamphlets distribution in Health Centres

25. Heinz Baby Break Fast Creamy Oat Porridge for 4+ months Infant (http://www.firstcry.com/heinz/heinz-baby - breakfast -creamy -oat- porridge)http://www.firstcry.com/heinz/heinz-baby Promotion through E-marketing 4+ Months Facilities/ Health Claims Easy Return Policy Dispatched in 24 Hrs Free shipping Facilities/ Health Claims Easy Return Policy Dispatched in 24 Hrs Free shipping

26. Promotion of infant formula with health claims NAN PRO 1 PreBlend: -A protein blend containing whey protein. NAN Pro 1 is predominant in whey protein. Whey proteins are easy to digest. The protein content is suitably modified to reduce the overload on infant’s kidneys. Immunonutrients: -Nutrients like Nucleotides, Zinc, Selenium, Vitamin A and C support the immune system. Bifidogenic: -Bifidobacteria are predominant in the gut of infant fed on breast milk. NAN Pro 1 contains a combination of nutrients that support the growth of bifidobacteria. A healthy gut flora helps in supporting the immune system. LA/ALA: -LA (omega 6 fatty acid {FA} & ALA (omega 3 FA) are precursors of ARA and DHA which are important for defense system. PreBlend: -A protein blend containing whey protein. NAN Pro 1 is predominant in whey protein. Whey proteins are easy to digest. The protein content is suitably modified to reduce the overload on infant’s kidneys. Immunonutrients: -Nutrients like Nucleotides, Zinc, Selenium, Vitamin A and C support the immune system. Bifidogenic: -Bifidobacteria are predominant in the gut of infant fed on breast milk. NAN Pro 1 contains a combination of nutrients that support the growth of bifidobacteria. A healthy gut flora helps in supporting the immune system. LA/ALA: -LA (omega 6 fatty acid {FA} & ALA (omega 3 FA) are precursors of ARA and DHA which are important for defense system.

27. Offering Discounts http://www.firstcry.com/farlin/farlin-wide-neck-feeding- bottle/16797/product-detail 13 % Discount 10 % Discount

28. Labelling Violation by new Company Graphic symbol represents mother holding her baby… alphabet “M” represent as a figure of female with open arms with big “Bindi” depicting love & care for her infant Promoting MMS 2 and MMS3 in different graphics

29. Advertisement of infant food in Indian Journal of Pediatrics, July 2013 Advertisement also uses the logo of World Health Organization along with statement “Choose the Organic Advantage for the babies”. WHO Logo Choose the Organic Advantage for the babies

30. What Needs to be Done

31. Administrative action Implement section 21(1) (b)-to authorize an officer not below the rank of a Class I, by general or special order by the government

32. Capacity building of stakeholders

33. State administrative should write similar letter to district administration Administrative action

34. District level procedures be defined to register complaints, public should be informed through advertisements. Guidelines should be developed to ensure that concerned persons of medical association are not supported by baby food industries and Civil Surgeons should be authorized to give a clearance for such activities. Medical doctors associations at district and state level should be asked to seek permission and clearance about IMS Act before any conference is organized. Baby food companies and their allies should not be allowed to conduct meetings, or workshops for educating medical or nursing personnel Regular checks on chemists shops to stop promotional practices like special displays of baby foods. District level action to present violation of IMS Act

35. Awareness Generation Place hoardings at prominent places to generate awareness about IMS Act

36. Regular Monitoring of IMS Act in the state District Health Authorities to do regular check Labeling on baby food products Sponsorship of conference & workshop Prominent display of baby food products at chemist shops Private & Public hospital on unnecessary use of formula What needs to be done

37. Nestle continues to Violate !!!

39. Thank You