Unethical, aggressive marketing of formula milk companies influences the breastfeeding decisions of parents

Highlights:

• In Bangladesh, 65% of women exclusively breastfeed their babies up until five months old, the highest in all the countries surveyed
• Nearly 60% of mothers have been recommended a formula milk product by a health professional
• False and misleading messages about formula feeding are a substantial barrier to breastfeeding

Although 98% of pregnant women in Bangladesh express a strong desire to breastfeed, only 65% of them go on to do so exclusively after giving birth due to the systematic and unethical marketing strategies by the formula milk companies.

Nearly 60% of mothers have been recommended a formula milk product by a health professional, a new global report titled 'How marketing of formula milk influences our decisions on infant feeding,' said Wednesday. World Health Organisation (WHO) and Unicef prepared and published the report.

"The overwhelming majority of women in Bangladesh want to breastfeed, yet they often do not receive the support they need. Instead, the marketing of formula milk sows the seeds of fear and doubt. This can only be overcome when mothers are given information based on science, not profits," said Veera Mendonca, Deputy Representative of UNICEF Bangladesh.

In Bangladesh, 65% of women exclusively breastfeed their babies up until five months old, the highest in all the countries surveyed. Although women in Bangladesh are less directly exposed to the traditional marketing of formula milk compared to other countries, many health professionals, including doctors, are influenced by the marketing and view breast milk as inadequate for nurturing infants.

The report draws on interviews with parents, pregnant women and health workers in eight countries, including in Bangladesh.

The growing aggressive marketing, especially during this pandemic, highlights the need for robust implementation, stronger enforcement, and monitoring of Bangladesh national code legislations to protect families from false claims about the safety of breastmilk substitutes, the report recommended.

It uncovers systematic and unethical marketing strategies used by the formula milk industry – now worth a staggering $55 billion – to influence parents' infant feeding decisions.

"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."

More than half of parents and pregnant women (51%) surveyed say they have been targeted with marketing from formula milk companies, much of which is in breach of international standards on infant feeding practices. 

According to the report – which surveyed 8,500 parents and pregnant women, and 300 health workers in cities across Bangladesh, China, Mexico, Morocco, Nigeria, South Africa, the United Kingdom and Viet Nam – exposure to formula milk marketing reaches 84% of all women surveyed in the United Kingdom; 92% of women surveyed in Viet Nam and 97% of women surveyed in China, increasing their likelihood of choosing formula feeding.

Across the surveyed countries, the report finds that industry marketing techniques include unregulated and invasive online targeting; sponsored advice networks and helplines; promotions and gifts; and practices to influence training and recommendations among health workers.

"False and misleading messages about formula feeding are a substantial barrier to breastfeeding, which we know is best for babies and mothers," said UNICEF Executive Director Catherine Russell.

"WHO's guidance on breastfeeding to the infant and young children, and Breast Milk Substitute (BMS) Code monitoring is very clear. It is vital to ensure that breastfeeding mothers do not get targeted by the industry and their marketing so that promoting formula-feeding do not jeopardize breastfeeding by feeding mothers," said Dr Bardan Jung Rana, WHO Representative to Bangladesh.

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 defence 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.