The 3 Minute Activist
America Online

The letter below is to America Online for a questionable link to a formula ad (the letter explains the situation quite clearly)."

America Online
2200 AOL Way
Sterling, Virginia 20166
attn: Steve Case

SteveCase@aol.com

Dear Mr. Case:

I am disappointed to learn that one of your recent "AOL Today" special topics promoted formula feeding for babies. Specifically, there was an adorable girl with the caption "Handle With Care: Don't you wish babies came with an operator's manual? Here's one for you." The link led not to a parenting book acclaimed by pediatricians or parents, but to a special manual sponsored by Carnation. Carnation is a manufacturer of baby formula; thus, it isn't surprising that the "manual" included several references promoting its formula via text and visual images.

If a baby did arrive with an operator's manual, it would certainly include "PLEASE FEED ME BREASTMILK" in the title page as well as most chapters, including those on feeding, nurturing, health, nutrition, allergies, and intelligence. Since such a manual is not reality, the American Academy of Pediatrics (AAP) published guidelines last year, "Breastfeeding and the Use of Human Milk." This policy statement, the result of many studies conducted over several years, specifically recommended that women breastfeed their children for at least the first 12 months and as long as mutually desired thereafter.

While Carnation has the right to sell its product, it is ludicrous to suggest that a baby's "manual" would recommend formula. The current research and statistics, which can be found in the AAP's policy statement (http://www.aap.org/policy/re9729.html), show that formula fed infants have 10 times the risk of hospitalization due to bacterial infection, double the risk of lower respiratory tract infections, 3 to 4 times the risk of otitis media, 3 to 4 times the risk of diarrhea illness (in industrialized nations), and 5 to 8 times the risk of childhood lymphomas. Formula feeding accelerates the development of celiac disease and is a risk factor for Crohn's disease and adult ulcerative colitis. Formulas have been found to contain potentially toxic levels of vitamin D, aluminum, high levels of iodine, and bacterial contaminants including Enterobacter sakazakii. Statistically, formula feeding is associated with a higher incidence of allergies, cognitive deficiencies, cardiorespiratory disturbances, morbidity, and mortality.

With all of these facts at hand, does it not seem absurd that formula be found in any baby's care "manual"? While Carnation should be held accountable for such a misleading mode of advertising, it is a shame that AOL has appeared to sponsor this ploy to gain formula market share, especially given that AOL has such an active breastfeeding community.

The marketing of baby formula is difficult to do without misleading the audience and distorting the facts. So it should not be a surprise that the World Health Organization's 34th Assembly, held on 21 May 1981, adopted the International Code of Marketing of Breast-milk Substitutes in the form of a recommendation. Article 5.1 of the International Code states that "there should be no advertising or other form of promotion to the general public or mothers of products" within the scope of the Code, including infant formula.

The United States' "Healthy People 2000" program has the goal of increasing to 50% the number of women who breastfeed their children until at least 5 to 6 months of age. Sadly, though, less than 60% of mothers are breastfeeding at the time of hospital discharge, and only about 20% are still breastfeeding their babies at 6 months. The media and those who sponsor advertising, including the electronic media such as AOL, have an enormous impact on what we as a culture deem "socially acceptable." Because of this, I believe organizations such as AOL have an inherent responsibility to ensure what is advertised, and even more so what is endorsed (whether intentionally or perceived), is not deceptive nor poses health risks.

I hope that this letter will provide some important education within your organization on how dangerous the advertising of formula can become. And I hope AOL can be more supportive to the positive promotion of breastfeeding for the sake of the health of our future generations.