In this Public Library of Science blog post, leading academics in infant nutrition examine the challenges that remain in keeping breastfeeding on the global agenda.
One of the main challenges: conflicts of interest from — and unethical marketing of — formula companies.
- “The consequences of current marketing practices by the baby food industry are clearly evident in our recent study. We demonstrated that a boom in global milk-based formula sales is underway, with 41% growth between 2008 and 2013. Growth was particularly rapid in China, Indonesia, Malaysia, Vietnam and Thailand, as well as South Africa, Iran, Turkey, Brazil and Peru.”
- “This raises serious concerns for the health and development of children and mothers deprived of the protective effects of breastfeeding. Available evidence is that fewer than one third of infants worldwide are now exclusively breastfed and only a minority continue breastfeeding to 2 years or beyond as the World Health Organization (WHO) recommends. We describe this as a global ‘infant and young child feeding transition’, as a population-level shift from lower to higher formula diets. This presents a costly and potentially unsustainable burden on future development.”
- “It is important to reflect on how far we have come, and how far we have to go, with regulating the unethical marketing of formula companies. During the 1970s, a strong public backlash against aggressive formula marketing in ‘Third World’ countries delivered the pioneering 1981 WHO International Code of Marketing of Breast-milk Substitutes and several subsequent relevant World Health Assembly resolutions (the Code). The Code placed obligations on industry to behave, and on governments to monitor and enforce compliance.”
- “A few large companies dominate a global infant formula market worth over US$44 billion in sales in 2014, and protect their profitability collectively, including through promoting trade agreements or lobbying and ‘consultation’ with individual governments.”
- “Viewing a world map of countries which have implemented legal protections against aggressive marketing of infant formula highlights the dilemma. Of the 194 WHO Member States, only 32 had systems of formal monitoring and only six of these were budgeted.”
- “There are emerging signs of more coordinated global action to counter weak and fragmented national infant feeding policies and industry influence. In 2014 a coalition of global stakeholders was established to strengthen civil capacity to implement and monitor the WHO Code (NetCode), and in 2015 the Breastfeeding Advocacy Initiative partnered NGOs with international health agencies.”
- “There are also signs that ‘business as usual’ for the formula industry may be changing in high-income countries. In April 2016 the UK Royal College of Paediatrics and Child Health voted to reject sponsorship of health professional meetings and education from formula manufacturers, citing evidence of the health impacts of low breastfeeding rates in high income countries and the reputational risks to the profession.”