The commercial milk formula (CMF) industry has, for decades, used “underhand marketing strategies, designed to prey on parents' fears and concerns at a vulnerable time, to turn the feeding of young children into a multibillion-dollar business,” according to a new editorial published by <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31136-X/fulltext" target="_blank" rel="noopener noreferrer">The Lancet</a>, the lay media's go-to scientific journal.The <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00118-6/fulltext" target="_blank" rel="noopener noreferrer">editorial</a>, entitled, "Unveiling the predatory tactics of the formula milk industry," is accompanied by the medical journal's three-paper <a href="https://www.thelancet.com/series/breastfeeding-2023" target="_blank" rel="noopener noreferrer">Breastfeeding 2023</a> series.Worse than not regulatingThe $55 billion formula industry uses its clout to avoid regulatory clamp downs on its advertising practices, according to the editorial. This, even as the public relies on government regulatory agencies, in lieu of performing their own research, to protect them from misleading advertising.&nbsp;<blockquote>The immense economic power accrued by CMF manufacturers is deployed politically to ensure the industry is under-regulated and services supporting breastfeeding are under-resourced . . .The industry's dubious marketing practices are compounded by lobbying, often covertly via trade associations and front groups, against strengthening breastfeeding protection laws and challenging food standard regulations.&nbsp;In 1981, the World Health Assembly adopted the International Code of Marketing of Breast-milk Substitutes, a set of standards to prevent inappropriate marketing of formula. It includes prohibition of advertising of CMF to the public or promotion within health-care systems; banning provision of free samples to mothers, health-care workers, and health facilities; no promotion of formula within health services; and no sponsorship of health professionals or scientific meetings by the CMF industry.&nbsp;However, despite repeated calls for governments to incorporate the Code's recommendations into legislation, only 32 countries have legal measures that substantially align with the Code. A further 41 countries have legislation that moderately aligns with the Code and 50 have no legal measures at all. As a result, the Code is regularly flouted without penalty.&nbsp;</blockquote>In some cases, even the regulations that have been enacted are openly violated.<blockquote>Infant feeding is further commodified by cross-promotion of infant, follow-on, toddler, and growing-up milks using the same branding and numbered progression, which aims to build brand loyalty and is a blatant attempt to circumvent legislation that prohibits advertising of infant formula.</blockquote>If the government stopped regulating formula makers and announced as much, many parents would likely be prompted to check the benefits and drawbacks of formula on their own.CloutThe formula lobby turns out to be so strong that they can not only affect US policy they can even get the US to influence foreign nations' approach to the industry.<blockquote>The prioritisation of trade interests over health was brought to the forefront in 2018, when US officials threatened to enforce trade sanctions and withdraw military aid to Ecuador unless it dropped a proposed resolution at the World Health Assembly to protect and promote breastfeeding. Some CMF lobby groups have cautioned against improved parental leave. Duration of paid maternity leave is correlated with breastfeeding prevalence and duration, and absence of, or inadequate, paid leave forces many mothers to return to work soon after childbirth. Lack of safe spaces for breastfeeding or expressing milk in workplaces, or facilities to store breastmilk, mean that breastfeeding is not a viable option for many women.</blockquote>Exploiting fearFormula makers, not fearing regulatory action, were found to regularly use fear to their own benefit, persuading mothers to switch to formula, depicting normal baby behavior as being due to insufficient breast milk and needing rectification.<blockquote>[T]ypical infant behaviours such as crying, fussiness, and poor night-time sleep are portrayed by the CMF industry as pathological and framed as reasons to introduce formula, when in fact these behaviours are common and developmentally appropriate.&nbsp;</blockquote>Fake scienceFormula makers have gone so far as to make unsubstantiated claims about the alleged benefits of formula, even claiming that children's brains developed better with their factory product than with natural mother's milk.&nbsp;<blockquote>[M]anufacturers claim their products can alleviate discomfort or improve night-time sleep, and also infer that formula can enhance brain development and improve intelligence—all of which are unsubstantiated. [Emphases added].</blockquote>A Jerusalem Post <a href="https://www.jpost.com/health-and-wellness/article-731024" target="_blank" rel="noopener noreferrer">report</a> quotes series co-author Prof. Rafael Pérez-Escamilla of Yale University School of Public Health explaining that the truth is the exact opposite.&nbsp;<blockquote>Babies are most likely to survive and grow to their full potential when breastfed. Healthy breastfeeding promotes brain development and protects infants against malnutrition, infectious diseases and death, while also reducing risks of obesity and chronic diseases in later life.&nbsp;Yet, globally, many women who wish to breastfeed face multiple barriers, including insufficient parental leave and lack of support in healthcare systems and at the workplace, in the context of exploitative marketing tactics of the commercial milk formula industry.</blockquote>Children sufferReal science paints a different picture in the comparison of breast milk with formula, pointing to damage to children unnecessarily deprived of their natural source of nutrition, as explained by The Lancet.<blockquote>Breastfeeding has proven health benefits across high-income and low-income settings alike: it reduces childhood infectious diseases, mortality, and malnutrition, and the risk of later obesity . . . [Emphases added].</blockquote>Society in general also suffers from elevated formula use, with the added health care costs reaching into the hundreds of billions of dollars.<blockquote>[L]ess than 50% of babies worldwide are breastfed according to WHO recommendations, resulting in economic losses of nearly US$350 billion each year. Meanwhile, the CMF industry generates revenues of about $55 billion annually, with about $3 billion spent on marketing activities every year. [Emphases added].</blockquote>Mothers tooMothers are also deprived of health benefits when they do not breastfeed.<blockquote>[M]others who breastfeed have decreased risk of breast and ovarian cancers, type 2 diabetes, and cardiovascular disease . . .</blockquote><blockquote>Perceived pressure, or inability, to breastfeed—especially if it is at odds with a mother's wishes—can have a detrimental effect on mental health . . .Under the Convention of the Rights of the Child, governments have a duty to tackle misinformation—and governments need to embrace the breastfeeding Code without further delay to ensure that manufacturers making misleading claims about their products are held to account. [Emphases added].</blockquote>WHO agreesThe WHO endorsed the research findings in a <a href="https://www.who.int/news/item/08-02-2023-experts-call-for-clampdowns-on-exploitative-formula-milk-marketing-in-new-lancet-series" target="_blank" rel="noopener noreferrer">report</a> entitled, “Experts call for clampdowns on exploitative formula milk marketing in new Lancet series.”&nbsp;<blockquote>The formula milk industry’s marketing tactics are exploitative and urgent clampdowns are needed to tackle misleading claims and political interference, according to a new three-paper series published in The Lancet today. Industry influence – which includes lobbying against vital breastfeeding support measures - seriously jeopardizes the health and rights of women and children, the papers show.“This new research highlights the vast economic and political power of the big formula milk companies, as well as serious public policy failures that prevent millions of women from breastfeeding their children,” said Professor Nigel Rollins, Scientist at WHO and author of a paper on formula milk marketing. “Actions are needed across different areas of society to better support mothers to breastfeed for as long as they want, alongside efforts to tackle exploitative formula milk marketing once and for all.”</blockquote>The WHO has been promoting policy changes in confronting formula makers for decades, having developed an International Code of Marketing of Breast-milk Substitutes in 1981 in the wake of an &nbsp; investigative report into harmful results of Nestle’s marketing of formula milk in low and middle-income countries in the 1970s — a report entitled “<a href="https://www.theguardian.com/sustainable-business/nestle-baby-milk-scandal-food-industry-standards" target="_blank" rel="noopener noreferrer">Baby Killer</a>”.The WHO report reemphasizes the “immense and irreplaceable benefits” of breastfeeding and quotes Professor Linda Richter from the University of the Witwatersrand, South Africa describing the formula industry's use of “poor science,” improper labeling and "front groups".<blockquote>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. This marketing technique clearly violates the 1981 Code, which says labels should not idealise the use of formula to sell more product . . .&nbsp;</blockquote><blockquote>In particular, the dairy and formula milk industries have established a network of unaccountable trade associations and front groups that lobby against policy measures to protect breastfeeding or control the quality of infant formula. [Emphases added].</blockquote>Industry representatives in the doctor's officeThe Jerusalem Post <a href="https://www.jpost.com/health-and-wellness/article-731024" target="_blank" rel="noopener noreferrer">detailed</a> the formula maker's marketing tactics, including bombarding family doctors with free formula, to get babies started on the product, and free dinner for the doctors.<blockquote>Next month’s issue of Breastfeeding Medicine will highlight a survey of some 200 practicing American pediatricians about their routine interactions with infant formula companies and their representatives. Over 85% of them reported that a formula company representative visited their clinic and in 90% of the time distributed free formula samples. . . . 64% of the pediatricians reported that medical educational conferences they attended were sponsored by formula companies and that routinely they partook in meals sponsored &nbsp;by the “reps.” These results inevitably raise concern as to how these practices impacted the pediatricians’ breastfeeding support and advocacy and recommendations regarding infant feeding practices, [Emphases added].</blockquote>Influencers, chat services, government officials as board membersThe report concludes with a look at how the formula industry uses modern techniques to increase their bottom line.<blockquote>… In recent years, digital communications have greatly increased the reach of marketing in ways that blur the difference between advertising and the provision of nutrition and care advice. The series highlights examples of digital marketing such as industry-paid influencers sharing the difficulties of breastfeeding as preludes to formula milk marketing, and industry-sponsored parenting apps with 24/7 chat services that enable product placement, offer free samples or deals and promote online sales . . .This outsourcing of lobbying allows the corporations themselves to project an image of benevolence and corporate social responsibility, suggesting that they can adequately self-regulate . . .the authors argued that formula companies draw on the credibility of science by sponsoring professional organizations, publishing sponsored articles in scientific journals and inviting leaders in public health onto advisory boards and committees, leading to unacceptable conflicts of interest within public health.</blockquote>

Government officials sit on boards of formula makers

$55 billion milk formula industry using ‘dubious marketing' to 'prey on parents’ fears’ — The Lancet

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