HALF is Wholly Wrong from the Start: An Open Letter to the American Academy of Pediatrics

HALF is Wholly Wrong from the Start: An Open Letter to the American Academy of Pediatrics


To the American Academy of Pediatrics (AAP) and the AAP Representatives from the Healthy Active Living for Families Initiative:

I was dismayed to learn that you recently partnered with the Nestlé Nutrition Institute in your Healthy Active Living for Families (HALF) project.

I find this corporate partnership particularly troubling considering that the HALF Project’s goal is to:

develop and test a series of positive, family-focused messages specific to obesity prevention and care for the following developmental stages: infancy, toddlerhood, and early childhood/preschoolers, which can be used at pediatric well-child visits.

Taking into account 1) Nestlé’s unethical business practices, 2) its aggressive and misleading marketing of infant formula and toddler and preschooler meals,  and 3) the high sugar and sodium content of many of the child and family-targeted Nestlé brand foods, it does not seem that Nestlé’s products and practices align with the goals of the HALF Project.

In fact, it seems abundantly clear that Nestlé’s products and practices are antithetical not only to the HALF Project but also to many of the other practices and policies that the AAP promotes.

For one, Nestlé’s aggressive formula marketing undermines breastfeeding.  And as reported by the Centers for Disease Control (CDC), breastfeeding (and especially early exclusive breastfeeding) is associated with a reduced odds of child obesity.

The problem is not that Nestlé makes infant formula.  The problem isn’t even so much that parents choose (or in some cases, need) to feed their babies formula.

The problem is that Nestlé markets their formula in the United States and elsewhere in a way that is aggressively mendacious and misleading.  This sort of marketing undermines breastfeeding, and it undermines one of the steps that parents can take to help prevent childhood obesity.

In fact, these marketing efforts even violate the AAP’s own Policy Statement on Breastfeeding and the Use of Human Milk.  For contained within this statement are a list of “obstacles to initiation and continuation of breastfeeding,” including (but not limited to):

…media portrayal of bottle feeding as normative; commercial promotion of infant formula through distribution of hospital discharge packs, coupons for free or discounted formula, and some television and general magazine advertising.

This statement also encourages pediatricians and other health care professionals to:

Work actively toward eliminating hospital policies and practices that discourage breastfeeding (eg, promotion of infant formula in hospitals including infant formula discharge packs and formula discount coupons, separation of mother and infant, inappropriate infant feeding images, and lack of adequate encouragement and support of breastfeeding by all health care staff).

Nestlé does little to remove these breastfeeding obstacles in their own marketing campaigns.

In fact, the website for the Nestlé brand, Gerber, includes a promotion for a “FREE Gerber Generation Backpack” (which includes a free sample of Gerber Good Start infant formula).  This promotion encourages parents to:

  1. Ask for your FREE Gerber Generation backpack when you deliver at a participating hospital.
  2. Print your gift certificate [for the sample backpack] to take with you to the hospital.
  3. Present your certificate to the nurse when Baby arrives to receive your FREE BACKPACK!

With just a single promotional page, Gerber not only offers up  an “obstacle to the initiation and continuation of breastfeeding” but also engages in one of the very practices that the AAP recommends that health care professionals work to eliminate.

What’s perhaps even more disturbing (and ironic) about the AAP’s corporate partnership with the Nestlé on a project aimed at promoting healthy nutrition and preventing childhood obesity is that many of the Nestlé brand products aimed at infants, children, and families (including but not limited to Gerber Good Start infant formula, Gerber Graduates meals, Stouffer’s, and Buitoni) contain remarkably high levels of sugar and sodium.  In fact, the sodium levels in the vast majority of Gerber Graduates brand preschooler meals are higher than that of a large order of McDonald’s french fries.

These are not the sorts of foods that the AAP recommends that families eat in order to prevent and respond to childhood obesity.

And they are not the sorts of foods that the AAP should be implicitly promoting through a corporate partnership.

In response to these concerns, I ask the AAP and its representatives working on the HALF Project to consider the following questions:

  • Will the HALF Project promote breastfeeding in a way that is not only accurate and transparent but also socially and culturally sensitive?
  • Will the HALF Project materials state unequivocally that processed foods (including but not limited to those produced by Nestlé brands such as Gerber, Stouffer’s, and Buitoni) and the associated aggressive marketing of these foods do more to undermine than to promote good nutrition and health?
  • Will the HALF Project offer tips, resources, and information on how families can avoid processed foods and purchase and prepare more whole grains, vegetables, fruits, and healthy proteins in ways that are still convenient and affordable?
  • Will the HALF Project encourage media and marketing literacy skills to help parents identify and navigate aggressive and misleading formula and food marketing  (such as those that offer false promises of a “healthy meal”)?

If the AAP cannot answer yes to all of these questions–particularly if the HALF Project’s association with Nestlé prevents the AAP from answering as such–then I fear that the project itself will be doing more to promote Nestlé than to promote the health of children in the United States.

Notably, I do understand that corporate partnerships can help to finance and sustain projects such as the HALF initiative.  I realize that this is not the first time that Nestlé has donated money to an AAP initiative.  I even realize that this is not the first time that a medical organization in the United States has partnered with an unlikely (and unseemly) corporate sponsor.

But Nestlé is not an appropriate partner for this project, nor is it an appropriate partner for the AAP.

I implore you to rethink your partnership with the Nestlé Nutrition Institute.  Failing to do so may undermine not only the HALF Project itself but also the credibility of the entire American Academy of Pediatrics.


Kristen Oganowski


In the comments section, please feel free to “sign” your name in support of this letter!

I will also be sending a revised version of this letter to the offices of the American Academy of Pediatrics, and I plan to write an informative letter to my children’s pediatrician and to other local pediatricians.

Would you consider writing a letter to the AAP and (if applicable) posting it on your blog?  Will you contact your children’s pediatrician about this issue?  Please come back and share if you do!

And finally, many thanks to Annie from PhD in Parenting for remaining ever-vigilant in her efforts to expose the truth about Nestlé’s products and practices.

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  1. Nan Jorgensen
    Nan Jorgensen10-07-2010

    I agree whole heartedly and I “frown at the bad” against Nestlé!

  2. Nicole Brouwer
    Nicole Brouwer10-07-2010

    I agree wholeheartedly!

  3. Ann Marie
    Ann Marie10-07-2010

    I’ll sign! Ann Marie Walsh. Mother of a 22 month old boy and 6 weeks pregnant with number 2.

  4. Rachael

    I’ll sign, too. Also, we’re seeing the Critter’s doctor tomorrow for his regular check-up. What shall we urge the doctor to do, in addition to expressing his disapproval to the AAP? Based on our pediatrician’s support of breastfeeding and his rants about the disconnect between farming, food, and health care policies in this country, I don’t doubt that he disapproves.
    Rachael´s last blog post ..Too Many Good Things

    • BirthingBeautifulIdeas

      I would definitely encourage your doctor to contact the AAP (and other like-minded local physicians) about his disapproval. If he has the time to chat, you could also ask him if he has any ideas about how to meet the goals of the HALF project locally–and without relying upon a Nestle sponsorship!

      (FWIW, it does seem that the research that the HALF initiative wants to put into this project is well-intended, and the people who do this research deserve to be paid. I just wish there were a different way to fund it than to rely upon Nestle and thereby have the Nestle brand stamped all over the materials. I’m hoping to brainstorm some ideas about other, more ethical and sustainable organizations that could help to fund, promote, and implement the goals of the HALF project.)

  5. Elita @ Blacktating
    Elita @ Blacktating10-07-2010

    Consider me another signee.
    Elita Kalma

  6. FoxyKate

    You make excellent use of the word ‘mendacious.’

    Feel free to sign me on there as well: Kathleen Lopez.
    FoxyKate´s last blog post ..I’m driving your milk helmet!

  7. Suchada @ Mama Eve
    Suchada @ Mama Eve10-07-2010

    Please add my name to the signatures: Suchada Eickemeyer

  8. Darrah Sikora
    Darrah Sikora10-07-2010

    AGREED!! The irony astounds me! Awful, just awful

  9. Brandie Brown
    Brandie Brown10-07-2010

    I agree and would sign!!

  10. melissa martin
    melissa martin10-07-2010

    Sign my name. Nestle is making money on the back of our ill informed and their children.

  11. Hannah B
    Hannah B10-07-2010

    I’m signing!

  12. Kathryn

    Signed! Kudos Kristen, this is very well written!

  13. Liz Brooks
    Liz Brooks10-07-2010

    Hmm. When you write to AAP, ask them how they feel this relationship with Nestle is even possible, since the American Academy of Pediatrics is a member organization of the Council of Medical Speciality Societies (CMSS) … one that has prominently co-signed the CMSS Code for Interactions with Companies. Hmm. While the CMSS Code is a voluntary document, pledging allegiance to it ought to count for something. CMSS describes their Code as “designed to ensure that societies’ [i.e. AAP] interactions with companies are independent and transparent, and advance medical care for the benefit of patients and populations. [B]y adopting this Code, societies demonstrate their commitment to the highest level of ethical standards in their activities.” Hmm. Read more at cmss.org; see who the co-signers are; read the CMSS press statement.

    • BirthingBeautifulIdeas

      Thank you so much for sending this information along, Liz. I’ll be sure to check out the CMSS Code.

  14. Kirsten Williams
    Kirsten Williams10-07-2010

    I support this letter 100%. I am deeply disturbed by the partnership between Nestle and the AAP. Rev. Kirsten Williams, mother of a 14-month-old daughter who is still breastfeeding on demand.

  15. Mary Ellen Sweeney
    Mary Ellen Sweeney10-07-2010

    Thank you, Kristen, for writing such a great letter!! You have said what I would had I the talent you have. Too bad for Nestlé!!

  16. Renee

    Sign me up! Renee Centore-Kelly Enfield, CT

  17. Michelle Hutchison
    Michelle Hutchison10-07-2010

    Count me in

  18. Nestle, AAP Partnership half-baked « Breastfeeding Medicine
    Nestle, AAP Partnership half-baked « Breastfeeding Medicine10-07-2010

    […] announcement on the AAP web site about the Health Active Living for Families (HALF) initiative.  In an open letter to the AAP, Birthing Beautiful Ideas outlines the many, many ways that Nestle’s marketing of both infant […]

  19. Lisa

    I agree Nestle should not be a corporate sponsor for the HALF initiative for all the reasons listed.

    Lisa Hoang

  20. Annie @ PhD in Parenting
    Annie @ PhD in Parenting10-07-2010

    Thank you for this great letter. I’m fully in support.
    Annie @ PhD in Parenting´s last blog post ..The high-fructose corn syrup bloggers- A symptom of a larger problem

    • BirthingBeautifulIdeas

      Thank you for bringing attention to this in the first place! Your work is, as always, inspiring.

  21. JenKC

    I coult not agree more. This is an eloquent letter and I stand 100% behind its sentiments.

  22. Elizabeth P
    Elizabeth P10-07-2010

    Consider me signing, too.

  23. Sara

    I strongly agree with this letter. The relationship with Nestle is entirely inappropriate and taints the AAP’s image and ability to give objective advice.

  24. Bettina at Best for Babes
    Bettina at Best for Babes10-08-2010

    Bettina Forbes, Co-Founder & President, Best for Babes Foundation
    Bettina at Best for Babes´s last blog post ..My Breast Cancer- Why I Won’t Race for the Cure

  25. Kristine Redlien
    Kristine Redlien10-08-2010

    Great letter. I am shocked that the AAP shocked with Nestle. Consider me a signee, too.
    Kristine Redlien´s last blog post ..Funny Article

  26. Kara Sweeney
    Kara Sweeney10-08-2010

    I agree with this letter.

  27. Kerri Flesch
    Kerri Flesch10-08-2010

    I completely agree with this letter. Add my name, Kerri mother of a 3 year old and TTC baby #2.

  28. Maria

    I agree completely!
    Maria Wegner-Johnson

  29. Heather Burris
    Heather Burris10-08-2010

    I would like to sign as well and will also send a message to my pediatrician. Thanks much for this idea ;)

  30. Cornelia Mazzan
    Cornelia Mazzan10-08-2010

    I totally agree–thanks for your wonderful research and writing!!

    • BirthingBeautifulIdeas

      I wouldn’t be giving credit where credit’s due if I didn’t at least acknowledge that at least half of the research came from investigations that Annie from PhD in Parenting has done regarding Nestle.

      But thanks for the kind words! And thanks for signing!

  31. Jennifer Hamner
    Jennifer Hamner10-08-2010

    I completely agree. Thank you for such a thoughtful and well-written letter.

  32. Mary Johnson
    Mary Johnson10-08-2010


    Thank you for your publishing this letter.

  33. Krystal

    Consider me another signee!

  34. Paloma

    Paloma Mercado

  35. Renee

    also signed,
    Renee Titelbaum

  36. Amy Romano
    Amy Romano10-08-2010

    Great letter, to which I would be more than happy to sign my name.
    Amy Romano´s last blog post ..Midwifery Week- Disparities- and Models of Collaborative Care

  37. Andrea von Schoening
    Andrea von Schoening10-08-2010

    Add me as a signer, please! Thank you for writing this letter – you have awesome language skills and that is so important in these interactions – they have no basis to discredit you on! You are speaking for many others …

  38. Brenda Dalton
    Brenda Dalton10-08-2010

    I totally agree with your letter. The AAP should actually think before acting; it seems so inappropriate on so many levels.

  39. Katherine Flanagan
    Katherine Flanagan10-08-2010

    Consider me another signee

  40. Carolyn Hastie
    Carolyn Hastie10-09-2010

    I agree 100%. Disgraceful that paediatricians get funding by these bully boys and destroyers of health (in the third world in particular). Great idea to write this group letter, kind regards, Carolyn
    Carolyn Hastie´s last blog post ..Sleep- glorious sleep!

  41. Momma Mogg
    Momma Mogg10-09-2010

    I’m signing…Lindsay Mogg – mother of a 2 year old boy and 9 month old boy

  42. Heather

    I agree — please add my name: Heather Johnson, mother of two kids ages 2 and 5.
    Heather´s last blog post ..Groaning Muffins- The Perfect Food for Laboring and Postpartum Women!

  43. Georg'ann Cattelona
    Georg'ann Cattelona10-09-2010

    I agree- please add my name:
    Georg’ann Cattelona,
    childbirth educator, birth doula, and mother.

  44. Jessica


  45. Christa

    Christa Essany

  46. Samara

    signed, Samara Sauls

  47. Evita Singh, MD
    Evita Singh, MD10-09-2010

    Agree! Another prime example of large financially driven corporations controlling medical and government policy.

  48. Pam Candelaria
    Pam Candelaria10-09-2010

    Pamela Candelaria

  49. Brandi Doucet
    Brandi Doucet10-09-2010

    Sign me…Brandi Doucet

  50. Julie Gladney
    Julie Gladney10-09-2010

    I will sign….thank you for doing this!!

    Julie Gladney BS, LPN, IBCLC

  51. Rowan

    Great letter. Are you sending a copy to the Government and news media? I just wrote my own letter but since I’m in Canada and don’t have a US address, I’m having trouble posting messages on the US news media websites.

    • BirthingBeautifulIdeas

      I have considered sending it on to the media! While I would love for them to cover it, I always wonder whether or not certain media partnerships with Nestle would prevent some news outlets from looking into it all that much. But it’s still worth trying!

  52. Paige Watkins
    Paige Watkins10-10-2010

    Thank you for writing this! Signing this with you!!

  53. Lucinda

    I agree. Great job! Signed.

  54. Ashley Fuller
    Ashley Fuller10-10-2010

    Sign my name as well. Mother of a 2 year old and a 3 month old.

  55. Paul Redding
    Paul Redding10-10-2010

    //Signed// Paul J. Redding

  56. Katie Seelinger
    Katie Seelinger10-10-2010

    Adding my name to this. No profit company should attach their name to an organization that should be unbiased and fact based. Too much room for error.

  57. Anna Byrom
    Anna Byrom10-11-2010

    Signed – Mother of one, midwife to many. Congrats on uncovering this.

  58. Sarah Neely
    Sarah Neely10-11-2010

    Sarah Neely´s last blog post ..School-time Confessions of a Dyslexic Student

  59. gwendolyn osborn
    gwendolyn osborn10-11-2010

    Such an embarrassing partnership. Mother of one with another on the way.

  60. Lynn Dunn-Mahon
    Lynn Dunn-Mahon10-11-2010

    Well said Kristen ! Signing in solidarity against the Nestle beast and the AAP that should know better!!

  61. Anna Jonsson
    Anna Jonsson10-11-2010

    Sign me as well. I think Nestle is a very unethical and cynical company!

  62. Fransje Giles
    Fransje Giles10-11-2010

    Signed in strong support. Thank you for leading this proposal.

  63. Christie Haskell
    Christie Haskell10-11-2010

    Sign my name, for sure.

  64. Susan Weinberg
    Susan Weinberg10-11-2010

    Huzzah, Kristen! Bad form, AAP.

  65. Jennifer Zimmerman
    Jennifer Zimmerman10-11-2010

    Signed, Jennifer Zimmerman – mom of 3.
    Jennifer Zimmerman´s last blog post ..Maybe Gay Is Not The Point

  66. Audra

    Signed! Mother of a 24 month old and 4 month old.

  67. Lisa Anton
    Lisa Anton10-11-2010


  68. m2bob


    […]Birthing Beautiful Ideas » Blog Archive » HALF is Wholly Wrong from the Start: An Open Letter to the American Academy of Pediatrics[…]…

  69. Dwayne Lamastus
    Dwayne Lamastus12-28-2014

    Hey there! I just wanted to ask are you on fb?

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