More than half of parents and pregnant women have been targeted with marketing from formula milk companies, according to a new joint report published by WHO and UNICEF on Thursday. Much of the marketing is in breach of international standards on infant feeding practices.
The report draws on interviews with parents, pregnant women and health workers in eight countries (Bangladesh, Mexico, Morocco, Nigeria, South Africa, the United Kingdom, Viet Nam and China). It uncovers systematic and unethical marketing strategies used by the formula milk industry – now worth US$55 billion – to influence parents’ infant feeding decisions.
In some of the surveyed countries, exposure to formula milk marketing reaches an overwhelming majority: 84 per cent of all women surveyed in the United Kingdom; 92 per cent of women surveyed in Viet Nam and 97 per cent of women surveyed in China, increasing their likelihood of choosing formula feeding.
The report finds that industry marketing techniques include unregulated and invasive online targeting; sponsored advice networks and helplines; promotions and free gifts; and practices to influence training and recommendations among health workers.
The messages that parents and health workers receive are often misleading, scientifically unsubstantiated, and violate the International Code of Marketing of Breast-milk Substitutes (the Code) – a landmark public health agreement passed by the World Health Assembly in 1981 to protect mothers from aggressive marketing practices by the baby food industry.
“This report shows very clearly that formula milk marketing remains unacceptably pervasive, misleading and aggressive,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “Regulations on exploitative marketing must be urgently adopted and enforced to protect children’s health.”
UNICEF Executive Director Catherine Russell added that, “False and misleading messages about formula feeding are a substantial barrier to breastfeeding, which we know is best for babies and mothers.”
In previous reports in 2019, WHO found evidence of poor nutritional quality - in particular high sugar content, concentrate fruit juices and sweeting agents - and misleading promotion of foods for infants and children under the age of 36 months. The new report is focused on the promotion of milk formula, which can undermine breastfeeding.
Debunked myths about breastfeeding
Across all countries included in the survey, women expressed a strong desire to breastfeed exclusively, ranging from 49 per cent of women in Morocco to 98 per cent in Bangladesh. Yet the report details how a sustained flow of misleading marketing messages is reinforcing myths about breastfeeding and breast-milk, and undermining women’s confidence in their ability to breastfeed successfully.
These myths include the necessity of formula in the first days after birth, the inadequacy of breast-milk for infant nutrition, that specific infant formula ingredients are proven to improve child development or immunity, the perception that formula keeps infants fuller for longer, and that the quality of breast-milk declines with time.
Breastfeeding within the first hour of birth, followed by exclusive breastfeeding for six months and continued breastfeeding for up to two years or beyond, offers a powerful line of defense against all forms of child malnutrition, including wasting and obesity. Breastfeeding also acts as babies’ first vaccine, protecting them against many common childhood illnesses.
It also reduces women’s future risk of diabetes, obesity and some forms of cancer. Yet globally, only 44 per cent of babies less than 6 months old are exclusively breastfed. Global breastfeeding rates have increased very little in the past two decades, while sales of formula milk have more than doubled in roughly the same time.
Alarmingly, the report notes that large numbers of health workers in all countries had been approached by the baby feeding industry to influence their recommendations. More than one third of women surveyed said a health worker had recommended a specific brand of formula to them.
To address these challenges, WHO, UNICEF and partners are calling on governments, health workers, and the baby food industry to end exploitative formula milk marketing and fully implement and abide by the Code requirements.
A global recommendation by WHO sets the target of exclusive breastfeeding in the first 6 months to at least 50% by 2025. Previous figures show that rates of breastfeeding vary considerably by country. Exclusive breastfeeding rates decline considerably after 4 months and are low in infants under and at 6 months of age.
Have things changed to the better in any way since the previous reports?
Since the reports deal with different products, there is no comparison to make on whether the situation is improving or worsening, a WHO spokesperson replied. Regarding regulations, the EU strengthened its restrictions on advertising and promotion of infant formula directly to the general public or via health workers and facilities in 2016. These restrictions came into effect in 2020.
The composition and labelling of baby foods in EU are regulated in a directive but the member states hold primary responsibility for the implementation and for overall health issues.
The Brussels Times