Infant Formula Product Placement in Chemistry Matric Exam

School and university exam writers often invent scenarios. They play with made-up names for people, they dream up companies, they have fun devising original scenarios and puns to spice up their questions.

But what happens when they get bored doing that, or don’t have time, or when an alternative is shoved under their noses?

There is a national government Senior High school examination for 18-year-olds in the Netherlands. The chemistry exam is a 3 hour exam consisting of four questions, each with a series of sub-questions. This year’s exam has just taken place, on May 26. You can download and read the exam questions and the technical appendix.

Scroll to page 6 of the exam.

The Question

The entire question three, one quarter of the exam, is a clever piece of product placement for branded infant formula.

This is aimed at a large group of 18-year-olds likely to end up working in scientific and healthcare fields. As you can see, the question is based around clearly marked brand names of a Nutricia infant formula, Nenatal, complete with registered trademark signs. The question includes promotional language incidental and irrelevant to the scientific content of the question. The appendix text file provided by the manufacturer contains the technical specifications of the product, and another piece of promotional language.

The question reads, in part [and in approx. translation]:

Nenatal (R)

Over 6% of babies are born early. These infants have a great need for nutrition with the right fats. Nutricia, a well-known manufacturer of infant feeding, developed a special product for this group and marketed it under the name Nenatal (R). The manufacturer has provided a lot of information about this new baby feeding. Part of this information is printed in the appendix belonging to this exam. Read this information and answer the questions below. [...]

The appendix reads, in part:

Nenatal (R) Beta-palmitate

Palmitine acid

Palmitine acid is the most common fatty acid in mother’s milk (about 20-25% of the milk fat). The palmitine acid in mother’s milk is predominantly present bound to the beta-position of the glycerol molecule (60-70% of the total palmitine acid). In the present milks for preterm babies the palmitine acid is mainly bound to the alpha-position. [...]

from: The new generation premature milkfeedings, Nutricia.

How exactly this question made it into the exam is obscure at the moment, as is the issue of whether the placement was paid. This information came from somewhere. Those tech specs came from somewhere. And there was absolutely no academic need for this question to contain brand names and promotional language extolling the New! Scientific! Beauty! of a cow’s milk infant formula aimed at the babies most vulnerable to its risks, preterm infants. Feeding formula to premature babies increases their risk of necrotising enterocolitis (by 6-10 times) and infections such as meningitis dramatically, and also hampers cognitive development. NEC and infections are the biggest killers of babies born too soon, and they can be largely prevented by feeding mother’s milk or donor breastmilk.

Background on Nutricia/Numico

Some of Nutricia/Numico’s Code-breaching activities in the past are detailed at IBFAN’s (International Baby Food Action Network) Codewatch site. They include having boasted in the Dutch press “We have imitated Nature“, and claiming to have made “an exact copy of mothers’ milk“. Also in the Netherlands, Nutricia feeds new parents promotional leaflets via healthcare facilities and shops, they send new mothers “congratulations” packages with lollies in a formula tin and a 24-hour “counselling” phone number.

Nutricia’s subsidiaries approach new mothers by telephone and mothers’ clubs and pharmacies in Taiwan and Hong Kong to promote their formulas, they give out promotional “first taste is free” samples in Bolivia and Malaysia and Taiwan and Italy and Russia, they send reps to shops and offer sales commissions to shop owners in Malaysia, Russie, the UAE and Mexico, they distribute branded goods including feeding bottles through healthcare facilities in Taiwan and the UAE, they provide a wide variety of promotional “educational” activities for healthcare workers and parents, they advertise formula in Bulgarian parenting magazines. They promote formula in China (in the wake of the melamine poisoning disaster) by sending CDs of children’s songs to parents with the slogan “For over 100 years, Nutricia has been committed to making babies smarter” all over them – and the list goes on.

IBFAN has rated Nutricia as being in substantial violation of the WHO Code for the Marketing of Breastmilk Substitutes in a number of categories.

Where to next?

When you’re banned from marketing directly to parents and healthcare workers, what’s the next step? Why, you start marketing to people who are soon to become parents; you start marketing to people who are soon to become healthcare workers. You market to people who are still making up their minds about the world, who have not yet learned about why your message is tainted. You get ‘em while they’re young.

You get your brand name associated with the idea “good-for-babies”, and cement it in the heads of teenagers. You get your brand name not just in the current exam, but in future curricula. This question is now officially in a Past Paper, so it will be used for teaching, revision, and exam preparation purposes for many years to come. That’s some damn good bang for your buck.

Commercial industry will do anything to get the eyes, ears and minds of young people. We’ve been concerned about Scholastic’s heavy pushing of licensed Disney merchandise through their “book club”. We’ve been pissed off about Coke and Pizza Hut and McDonald’s promotions in schools. Now do we need to start worrying about unethical product placement advertisements in government matriculation exams? How does one boycott those?

Where does this end?

Local NGOs are involved in questioning the government on this issue. Updates as they occur.

[Story and translations via Marianne Vanderveen-Kolkena on Lactnet]

[photo is via thedayhascome on flickr and Creative Commons licensing.]

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• Infant formula industry fights back in China, lies about WHO Code breaches by Lauredhel
• Everyday Codebreaking in Australia, vol.1 by Lauredhel
• Nestlé moves from obfuscation to outright lies by Lauredhel
• 13 000 babies hospitalised from melamine in infant formula by Lauredhel
• Quiz oTD by Lauredhel