The BPNI, an NGO founded in 1991, appealed to the health ministry to ensure "effective implementation" of India's Infant Milk Substitutes, Feeding Bottles and Infant Foods (Regulation of Production, Supply, and Distribution) Act 1992, which prohibits the public promotion of manufactured foods for children below two years of age.
It also prohibits infant food manufacturers from offering any contribution or pecuniary benefit to individual healthcare professionals or health worker associations. This includes funding seminars, conferences, and educational courses.
In a letter to the health ministry, the BNPI wrote that the authorities needed to "beat market forces that undermine breastfeeding", and encouraged them to instruct district health officers to better enforce the act.
BNPI's central coordinator, paediatrician Arun Gupta, said infant nutrition firms might have been promoting their products through doctors under the pretext of educational initiatives, a suspicion that formed the motivation for its letter to the health ministry.
Sustained attack
This letter came shortly after the BNPI had alerted the New Delhi branch of the Indian Academy of Paediatrics (IAP) to the Nestlé Nutrition Institute's (NNI) planned 'scientific session', titled Infant formulas: Paediatricians' dilemma, which was to feature two paediatricians as speakers.
An invitee had alerted the BPNI, whose doctors saw the session as an industry event designed to influence paediatricians into prescribing infant formula to parents of young children.
An NNI spokesperson defended the session, saying the institute organises scientific workshops where healthcare professionals discuss various scientific topics and share science-based nutrition information.
The spokesperson said: "Participation in these sessions is voluntary. The objective of the planned session in New Delhi had been to share nutrition information and not to promote infant formulas. The IMS Act does not discourage or prohibit the dissemination of scientific information.
"Scientific conferences are organised by the NNI and no payment or pecuniary benefit is provided to the participants. Furthermore, infant nutrition products are not discussed or displayed at such scientific conferences."
Vigilance to stamp out violation
However, Gupta remains adamant that doctors should rely on medical journals and academic research instead of infant food manufacturers.
He also said he and his colleagues fear that such promotional tactics could continue should government health authorities and the Indian medical community fail to exercise greater vigilance.
Speaking to NutraIngredients-Asia, he said: "Companies do this through the health system. For example, the NNI sponsors conferences and invites doctors. They also do this through e-marketing on websites, including social media platforms, and by offering discounts on their products to hospitals and clinics.
"Such actions undermine breastfeeding and promote formula, which is unhealthy and dangerous for babies, and goes against the laws in India."
Maternal health or monetary gain?
Recent findings from the Global Nutrition Report highlighted severe problems in Asia and especially India when it came to anaemia in women of reproductive age, and malnutrition, wasting, stunting and mortality in children under the age of five.
In light of this, NutraIngredients-Asia raised the question of whether it was wise to push for exclusive breastfeeding while placing stringent restrictions on infant formula manufacturers, since micronutrient deficiencies in pregnant and breastfeeding women are bound to affect their offspring.
Gupta replied: "We don't need formula to help mothers who have micronutrient deficiencies. It's better to invest in the nutrition of the mother rather than to put her baby on formula, which is much more dangerous than breastfeeding."
Indeed, governments at the national and state levels in India have been making concerted efforts to fight widespread malnutrition in the country, which disproportionately affects women and children.
Programmes to get suppliers and manufacturers to provide fortified ingredients and staple foods, as well as to enable farmers to grow fortified crops, have sprung up in numerous states in the last few years.
Still, when it came to the issue of women who had trouble expressing sufficient breastmilk, Gupta remained resolute: "Women can decide what they want to feed their babies after consulting their doctors, but our problem is with the promotion of infant formula."
He added that while organisations like the NNI were free to conduct their own privately funded research and hold their own conferences and seminars, they should not be inviting medical professionals to their events.
"Why should a nutrition institute founded and promoted by Nestlé sponsor doctors' registration fees or even invite them (to attend their conferences and seminars)? It doesn't matter whether they sponsor flights (to overseas events) or simply invite them to attend a conference. To me, it is the same thing.
"Whether they are just hosting or sponsoring, these companies are spending money to bring doctors to their events, and they shouldn't be doing it."