Jul 28, 2023
Breastfeeding provides numerous benefits, not only for the child but also for the mother and society as a whole. Despite the overwhelming evidence supporting the importance of breastfeeding, the commercial milk formula (CMF) industry has consistently employed unethical marketing tactics to promote their products and undermine breastfeeding practices. As Gabrielle Palmer puts it in her book Why the Politics of Breastfeeding Matter, “whether a child is breastfed or not is a question of sickness and health in the rich world and a matter of life and death in the poorest regions.” In this blog post, we aim to shed light on the predatory strategies used by formula milk companies and emphasize the vital role that breastfeeding plays in our global society, so that mothers can make an informed decision on how to feed their babies.
The Multibillion-Dollar Formula Milk Industry
For decades, the commercial milk formula industry has capitalized on parents' fears and concerns, transforming the feeding of young children into a lucrative business. The immense economic power of milk formula manufacturers allows them to influence regulations and ensure minimal oversight of their industry. This lack of regulation enables the industry to deploy aggressive marketing strategies that exploit parents' vulnerabilities and influence child nutrition.
The commercial milk formula industry utilizes various marketing techniques to promote their products. They often portray common infant behaviors, such as crying and fussiness, as pathological and suggest formula milk as a solution. These behaviors are, in fact, normal and developmentally appropriate. Manufacturers make unsubstantiated claims that their products can alleviate discomfort, improve sleep, enhance brain development, and boost intelligence. These misleading messages create a false narrative that undermines women's confidence in their ability to breastfeed successfully.
The Benefits of Breastfeeding
Breastfeeding is the gold standard for infant feeding and has proven significant health benefits for both infants and mothers. It reduces the risk of childhood infectious diseases, asthma, diabetes, sudden infant death syndrome, and gastrointestinal infections. Breastfed children are less likely to develop obesity later in life. Furthermore, breastfeeding has been linked to a decreased risk of breast and ovarian cancers, type 2 diabetes, and cardiovascular disease in mothers. Despite these benefits, global breastfeeding rates remain disappointingly low, with less than 50% of babies worldwide (25% in the USA and 13% in Germany) being exclusively breastfed according to WHO recommendations.
The Dubious Marketing Practices of the Formula Milk Industry
The formula milk industry's marketing practices are not only misleading, but also violate the International Code of Marketing of Breastmilk Substitutes. This code was established to protect mothers from aggressive marketing practices and ensure the promotion of breastfeeding. However, the commercial milk formula industry continues to cross-promote their products, using the same branding and numbered progression from infant to toddler and growing-up milks. This strategy aims to build brand loyalty and circumvent legislation that prohibits the advertising of infant formula.
Another tactic is offering free supplies or samples to hospitals. Some formula producers have even provided financial incentives (or in some cases bribes) to hospitals, often with the cooperation of government entities, in order to have their products accepted by the hospitals. These companies are well aware that the distribution of free supplies undermines breastfeeding efforts. In fact, when a surplus of artificial baby formula is introduced into a maternity ward, it tends to be used. Faced with a distressed mother and a crying infant, the nursing staff, doctors, or midwives, who are already overwhelmed and possibly lacking sufficient training in breastfeeding support, find it simpler to provide a bottle rather than address the underlying breastfeeding issue. Then when a mother departs from the hospital with a 'gift' of formula, her self-assurance in her breastfeeding capabilities can be impacted. During those first days at home with a baby, a moment of uncertainty can lead a mother to resort to using that formula. Moreover, studies show that mothers generally stick with the brand they were exposed to in the hospital. Even if she initially had intentions of formula feeding, she has been deprived of comprehensive, unbiased information and has essentially been deceived into adopting a brand that she believes carries medical endorsement.
The commercial milk formula industry also engages in lobbying efforts to undermine breastfeeding protection laws and challenge food regulations. Covert lobbying through trade associations and front groups allows the industry to prioritize trade interests over public health. This was evident in 2018 when US officials threatened Ecuador with trade sanctions and withdrawal of military aid for proposing a resolution to protect and promote breastfeeding at the World Health Assembly. In the Philippines, where more than a third of the population lives on less than US$2 a day and a tin of infant milk cost about US$6, back in early 2000's the President of US Chamber of Commerce warned Philippines' president Gloria Arroyo of possible US investment implications if she did not re-examine her decision on regulating milk formula sales practices in accordance to the International Code. She reversed her decision and moreover the representatives from WHO and UNICEF, who were fighting for higher regulations, were moved to other positions in other countries. These are just two cases where the interests of companies' profits are treated above the interests of the public good, but such situations happen all over the world. In some cases, where access to clean water is readily available, they are just not life and death decisions.
As Gabrielle Palmer writes, back in the 1970s, before the Code existed, Filipina pediatrician Dr Natividad Clavano declared, ‘We allowed the companies to touch the lives of our babies, not because we did not care, but because we did not realize the consequences of granting such a privilege.’
The International Code
The International Code of Marketing of Breast-milk Substitutes provides a set of standards to prevent inappropriate marketing of formula milk. However, only a limited number of countries have adopted legislation that aligns with the code. Strengthening breastfeeding protection laws and fully implementing the code's recommendations is crucial to hold manufacturers accountable for their misleading marketing practices.
The commercial milk formula industry's marketing tactics should not be interpreted as a criticism of women who choose not to breastfeed or are unable to do so. Women and families make decisions about infant feeding based on the information they receive. It is essential to ensure that this information is accurate, independent of industry influence, and supports informed decision-making.
Is Formula Feeding safe?
It is important to recognize that there is actually no perfectly safe way to artificially feed a baby. The products, equipment, and processes involved in formula feeding introduce the risk of infection. Powdered infant milks can be contaminated with pathogens from raw ingredients and manufacturing techniques. If not prepared and handled correctly, these pathogens can multiply to dangerous levels, leading to severe infections that can be fatal. This risk exists worldwide, regardless of geographic location or socioeconomic status.
The Call for Action
To protect the health and wellbeing of infants and mothers, action must be taken. Governments, health workers, and the baby food industry must unite to end exploitative marketing practices related to formula milk. Strengthening breastfeeding protection laws, investing in supportive breastfeeding policies, and banning the sponsorship of health professionals by formula milk companies are essential steps in promoting breastfeeding.
Breastfeeding is not just a matter of personal choice; it is a global public health issue. Breastfeeding is vital for the health and wellbeing of our global society. It is a powerful tool for reducing child mortality, improving maternal health, and promoting overall well-being. By prioritizing breastfeeding and taking action against the predatory tactics of the formula milk industry, we can create a world where every child has the best possible start in life. By supporting and promoting breastfeeding, we can ensure a healthier future for our children and create a more equitable society.
Palmer, Gabrielle. Why the Politics of Breastfeeding Matter (Pinter & Martin Why It Matters Book 6). Pinter & Martin.
Unveiling the predatory tactics of the formula milk industry. The Lancet,The Lancet, Volume 401, Issue 10375, 409