Pregnant women in China, Vietnam, UK exposed to formula milk marketing

A World Health Organization (WHO), United Nations Children Emergency Fund (UNICEF) and M&C Saatchi report has revealed that pregnant women in China, Vietnam and the United Kingdom are exposed to “aggressive” formula milk marketing campaigns. These marketing campaigns breach global rules set up after scandals more than 40 years ago.

Titled “How marketing of formula milk influences our decisions on infant feeding”, the report also included interviews with marketing executives and 300 health workers, and is the largest of its kind.

The WHO recommends exclusive breastfeeding for newborns, where possible, as the healthier option.

The report’s authors and several external experts said it was time to reform the International Code of Marketing of Breast-milk Substitutes. The code was set up by WHO in 1981 in a bid to regulate the industry after scandals in the 1970s when Nestle was accused of discouraging mothers, particularly in developing countries, from breastfeeding.

In China, 97% of women surveyed had been exposed to formula milk marketing; in the United Kingdom it was 84% and in Vietnam, 92%. More than a third of women across all of the countries said that health workers had recommended a specific brand of formula to them.

The marketing techniques can push women away from breastfeeding and include everything from giving free samples, to executives setting up or joining “mums’ groups” on popular messaging apps, the report further stated.

Health workers are also targeted, with gifts, funding for research and even commission from sales, all practices that are banned under international guidelines for the marketing of formula milk.

Formula milk and tobacco are the only two products for which there are international guidelines to prevent marketing.

Despite this, only 25 countries have fully implemented the code into legislation, and over the last four decades, sales of formula milk have more than doubled, while breastfeeding rates have only slightly increased, the WHO said. The formula milk industry is now worth $55 billion annually.

The report found that more than half of the 8,500 parents across the eight countries surveyed – Bangladesh, China, Mexico, Morocco, Nigeria, South Africa, the United Kingdom and Vietnam – reported exposure to marketing, much of which was in breach of the code.

While the code allows factual information about formula to be provided, and the authors acknowledged the importance of formula milk for women who cannot or do not want to breastfeed, they said the marketing practices were a key reason for low breastfeeding rates worldwide.

The WHO recommends exclusive breastfeeding for at least the first six months of life, but at the moment, only 44% of babies this age are fed this way.

A major study in 2016 suggested more than 800,000 babies’ lives could be saved annually if breastfeeding rates improved to reach this milestone.

“False and misleading messages about formula feeding are a substantial barrier to breastfeeding, which we know is best for babies and mothers,” UNICEF executive director Catherine Russell said in a statement.

Rollins said digital marketing in particular needs work, because of the potential for personalised targeted messaging and because it is now a major area of expansion for formula milk companies, alongside milks for older children and milks for allergies.

In a statement on behalf of the companies, the International Special Dietary Foods Industries (ISDI) said its members complied with all laws and regulations in the countries in which they operate.

“Our members support efforts by national governments to ensure compliance with all national laws and regulations. Our members are ready to work together with all stakeholders to support optimal infant health and well-being,” it added.

The WHO declined to comment on individual companies, and does not name them in the report, but said that there were no substantial differences between their practices.