ALTERNATIVE REPORT ON THE SITUATION OF INFANT AND YOUNG CHILD FEEDING IN SPAIN

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1 COMMITTEE ON ECONOMIC, SOCIAL AND CULTURAL RIGHTS (CESCR) Session 46, May 2011 ALTERNATIVE REPORT ON THE SITUATION OF INFANT AND YOUNG CHILD FEEDING IN SPAIN April 2011 Data sourced from: UNICEF ILO IBFAN Breaking the Rules Stretching the Rules, 2010, International Code Documentation Centre (ICDC) This report was prepared by 1 : GIFA Geneva Infant Feeding Association 1 The report has been adapted from the alternative report prepared in September 2010, for the 55 th Session of the Committee on the Rights of the Child (CRC). 1

2 1) General data Neonatal mortality rate (2000) 3 Infant mortality rate (expressed per 1000 live births) Under 1 (2006) 4 Under 5 (2006) 4 Maternal mortality ratio (per 100,000 live births) n.d. Adjusted 6 4 Source: UNICEF Underweight prevalence <5 ( ) 6% 2) Breastfeeding and Infant Nutrition situation Spain lacks a system for collecting comprehensive data on infant and young child nutrition: there is no data on breastfeeding, or any other type of infant and young child feeding. Exclusive breastfeeding Within the first hour nd <6 months nd Timely complementary feeding 6-9 months nd Continued breastfeeding rate months nd Source: UNICEF 3) Legislation related to the International Code of Marketing of Breast-milk Substitutes and subsequent relevant World Health Assembly resolutions. Spain has adopted the EU Directive 2006/141/EC on infant formulae and follow-on formulae, as a measure to implement the International Code of Marketing of Breastmilk Substitutes. This directive contains only a few of the provisions of the Code. Marketing practices of baby food companies show that they do not comply with its requirements, and promotion of products covered by the Code (infant formula, follow-on formula, as well as bottles and teats) persists. 2

3 The following example was taken from the last report on Code violations published by the International Code Documentation Center (ICDC): Breaking the Rules Stretching the Rules, (From the section: Nestlé) In Spain, the weekly El Pais carried a full-page advertisement for Nidina 2 Premium and Nidina 3 Premium with the heading Mother instinct, protection instinct to complement the picture of baby asleep in mother s loving embrace. The ad vaunts the quality of prebiotics, of DHA (omega-3 fatty acids) and optimized protein profile. It projects followup formula as necessary: From birth, the best protection for your baby is mother s milk to reinforce mother s immune system. When your pediatrician advises you to start follow-on, it is important that you continue giving your baby the best one. Another statement declares Because we, just like you, are concerned about his feeding to protect him from the first day. This commercial constitutes a violation because: - It contains health claims (the formula protects the baby and vaunts the quality of is ingredients DHA and pre-biotics and proteins). These claims are prohibited by the Code 2, because they represent idealizing text that denotes breastmilk substitutes to be similar or close to breastmilk. Although true for breastmilk, there is no scientific evidence that just adding these elements in artificial milk will have the same effects. Earlier in April this year, the European Parliament voted with a majority to stop a health claim on DHA to be used on follow-on formulas and baby foods. - The push for toddler milk: Advertising and other promotion of these milks which are numbered starting from 2, 3 and so on causes confusion and undermines breastfeeding, as they represent indirect advertisement for the infant formulas the ones numbered with 1. - Article 4.2 of the Code requires information to advocate for breastfeeding and not contain pictures or texts which idealize the use of breastmilk substitutes. Parents have a right to information free from commercial influence. Please see Annex 1 for a full view on the extract and the associated pictures. 4) Baby-Friendly Hospital Initiative (BFHI) In 2002, only 4 hospitals were certified BFH, which is an extremely low number. (Source: UNICEF, 2002) 2 WHA Resolution prohibits nutrition and health claims unless specifically provided for in national legislation. 3

4 5) Maternity protection at work Legislation: Maternity protection legislation is found in several different Acts: Royal Decree No. 1 on Social Security General Act ( ), as amended in the Constitutional Act 3/2007 for effective equality between women and men; Act No. 31 on the Prevention of Risks at Work ( ), as amended by Act No. 39 concerning the conciliation of work-family life of workers ( ); Royal Decree No.1/1995 enacting the Worker s Charter ( ) as amended in the Constitutional Act 3/2007 for effective equality between women and men; Royal Decree No. 53 to issue regulations on protection against ionizing radiations ( ); Royal Decree No on Cash Benefits of the Social Security System concerning Maternity and Risk during Pregnancy ( ). Scope: all women workers voluntarily performing services in return of remuneration from another person (employer) who organises and directs the work. Leave: 16 consecutive weeks, including 6 weeks of compulsory leave after giving birth. In case of multiple births, 2 extra weeks are given per child after the second child. Sickness benefits can be added, thus extending maternity leave. Payment: paid 100% by social security system which is financed by the State, insurees, employers, interest owed, fines Other leaves: Paternity leave: 2 days paid by the employer. Parental leave: up to three years for the father or the mother. Health protection: Time off is allowed for medical examinations; if the post reveals possible risk for the pregnancy measures have to be taken by the employer to prevent exposure to the risk. Breastfeeding breaks: One hour per day until the child is 9 months old, either 2 times 30 minutes or one time 60 minutes, or shorter work day (30 minutes less). Fathers are also entitled to this break (or to the shorter working day). These breaks are paid. Source: ILO website, ) Our recommendations Given the gaps and obstacles identified above, we make the following recommendations: Develop a comprehensive breastfeeding policy including provisions for a Breastfeeding Committee, an independent monitoring system, data collection on infant and young child feeding. Press for a stronger law on marketing of breastmilk substitutes as well as its implementation and monitoring. Designate a clear monitoring authority to examine violations. Develop the Baby-friendly Hospital Initiative that is practically inexistent in Spain. 4

5 Maternity protection legislation is quite strong and it would be relevant that Spain consider ratifying ILO Convention No. 183 (2000) on maternity protection. This would not mean lowering the national entitlements that are stronger (length and payment of maternity leave for example), but would on the contrary mean protecting these measures in the long term. 7) CRC Recommendations in 2010 Spain was reviewed by the Committee on the Rights of the Child in September 2010 (session 55) in relation to its combined 3 rd and 4 th periodic report. The information contained in this report was sent to the CRC Committee. In the concluding observations, the CRC Committee expressed its concern about the fragmented approach to data collection in all areas of the Convention on the Rights of the Child, and it urged the government to strengthen its mechanism for collecting and analyzing data in a systematic and disaggregated manner (paragraph 17-18). The CRC also expressed its concern with regards to the increase of obesity rates among the children and adolescents in Spain, and it recommended that the government manage obesity among children and pay close attention to child and adolescent health (paragraph 50-51). 5