In The Lancet 2023 Series on Breastfeeding, researchers review exploitative baby formula milk marketing practices by industry leaders.
Fewer than half of infants globally are breastfed as recommended by the World Health Organization (WHO), and baby formula milk sales are steadily rising despite formula not offering the same nutrition, health and development benefits as breastfeeding.
To address exploitative marketing tactics, The Lancet 2023 Series on Breastfeeding argued that baby formula milk companies are taking advantage of parents’ emotions and manipulating scientific information to generate sales at the expense of the health and rights of families, women, and children.
Why is the baby formula milk market so manipulative?
Baby formula milk marketing continues to exploit women and their families, and experts are calling for an international legal treaty to end irresponsible formula milk marketing and political lobbying with more effective breastfeeding support worldwide.
In the new three paper Series, the findings illuminate the need for regulations to be strengthened and properly implemented.
Series co-author, Professor Nigel Rollins, WHO, commented: “The sale of commercial milk formula is a multi-billion-dollar industry which uses political lobbying alongside a sophisticated and highly effective marketing playbook to turn the care and concern of parents and caregivers into a business opportunity. It is time for this to end. Women should be empowered to make choices about infant feeding, which are informed by accurate information free from industry influence.”
He continued: “Our Series finds society, politics, and economics all contribute to why fewer than half of infants globally are breastfed as recommended. Breastfeeding should be considered society’s collective responsibility, not the sole concern of women. We need to see wide-ranging actions across different areas of society to better support mothers to breastfeed for as long as they want.”
Taking advantage of parent’s vulnerability
The Series outlined several exploitative tactics used by baby formula milk companies, including taking advantage of parents’ worries about their child’s health and development. Many women introduce formula milk to unsettled babies who may cry persistently or have disrupted sleep because they believe their breast milk is insufficient.
“The formula milk industry uses poor science to suggest, with little supporting evidence, that their products are solutions to common infant health and developmental challenges. Adverts claim specialised formulas alleviate fussiness, help with colic, prolong night-time sleep, and even encourage superior intelligence. Labels use words like ‘brain’, ‘neuro’ and ‘IQ’ with images highlighting early development, but studies show no benefit of these product ingredients on academic performance or long-term cognition. This marketing technique violates the 1981 Code, which says labels should not idealise the use of formula and exploits poor science to create an untrue story to sell more products,” said Professor Linda Richter, Wits University, South Africa.
The Series explained how baby formula milk marketing exploits the lack of support for breastfeeding by governments and society and uses gender politics to sell its products. The formula milk industry continues to frame breastfeeding advocacy as a moralistic judgement that is anti-feminist and damaging to women whilst presenting baby milk formula as a convenient and empowering solution for working women.
In recent years, digital communications have shifted, leading to blurred lines between advertising and the provision of nutrition and care advice. The Series highlighted examples of exploitative marketing, such as industry-paid influencers sharing the difficulties of breastfeeding and industry-sponsored parenting apps that enable product placement, offer free samples or deals, and promote online sales. The researchers have argued that there is little regulation of the formula milk industry online.
A new review analysed 153 studies detailing marketing practices in violation of the voluntary International Code of Marketing of Breast-milk Substitutes, and subsequent resolutions (the Code) have continued in nearly 100 countries and in every region since its adoption more than 40 years ago.
Urgent policy change is needed
It is necessary that exploitative marketing by formula milk companies is ceased urgently. Furthermore, the industry influence of formula milk companies and broader actions across workplaces, healthcare, governments, and communities are needed to effectively support women who want to breastfeed.
It is reported that half a billion working women globally are not entitled to adequate maternity protection. A systematic review of studies found women with a minimum of three months of maternity leave, paid or unpaid, were at least 50% more likely to continue breastfeeding compared to women returning to work within three months of giving birth. Governments and workplaces should recognise the value of breastfeeding through actions, such as extending paid maternity leave duration to six months to meet the WHO recommendation of breastfeeding exclusively for a six-month period.
Furthermore, women face a lack of breastfeeding promotion, protection and support within healthcare systems due to limited public budgets, skilled support by health workers, influence from the baby milk formula industry, and an absence of care that is culturally appropriate, led by the needs of women. The Series raised that breastfeeding outcomes improve when health systems empower women and enable experienced peers to support women during pregnancy, childbirth and onwards.
Sonia Hernández-Cordero, Universidad Iberoamericana, Mexico City, said: “We are seeing improvements in some countries. A case study which we commissioned for the Series found that, despite lacking federally mandated paid maternity leave, the US continues to recognise an increasing number of Baby-Friendly [9] hospitals each year, and the National Supplemental Nutrition Program for Women, Infants and Children (WIC), which reaches half of annual births in the US, is increasingly providing breastfeeding counselling as it continues to support more women to choose breastfeeding.”
