The United Nations-affiliated World Health Assembly tabled a resolution this spring in Geneva, to promote breastfeeding which they expected to be passed easily. Decades of medical research have established that mother’s milk is the healthiest and safest for children as breastfeeding reduces the mother’s risks to cancer, diabetes and obesity, and restoring her pre-pregnancy health. As a result, as early as 1981, an international code of ethics was passed by members of the World Health Organization (WHO) preventing companies from promoting breast milk substitutes such as formulas to mothers with an overwhelming majority of 118 yes votes, with only one no and three abstentions. This was in response to Nestlé’s efforts to market its formula as superior to breast milk. Widespread civil protests followed after formula-fed babies fell sick or lost their lives after being fed from poorly sterilised bottles. The Code recognised the importance of breast milk in infant nutrition and survival and also emphasised sensible supplementary nutrition including locally grown produce.
Recently, the Trump administration sought to reverse the gains of decades by embracing the interests of infant formula manufacturers in Geneva this year. They wanted to rescind the call to governments to ‘protect, promote and support breastfeeding’; as well as remove restrictions on promoting food products harmful for young children. The resolution was finally passed with the intervention of Russia. It did not stop there. President Trump also sharply criticised the New York Times who reported on US threats of trade restriction and military aid sanctions to defeat the resolution. Ironically, several American medical associations themselves promote breast milk, including the American Academy of Pediatrics, the Public Health Association and the American College of Obstetricians and Gynecologists based on the mounting evidence of its benefits.
Over the years, data from the National Family Health Surveys (NFHS) shows that there has been a decline in Infant Mortality Rate (IMR) with increase of exclusive breastfeeding practices in India. This association can be seen through the graphs below. Undoubtedly, exclusive breastfeeding is beneficial to the health and wellbeing of infants, and reduces their risks to various diseases and death. However, formula milk companies continue to use aggressive, clandestine and often illegal methods to target mothers to get them to choose powdered milk over breastfeeding. An investigation by the Guardian and Save the Children in some of the most deprived areas of the Philippines found that Nestlé, Abbott, Mead Johnson and Wyeth (now owned by Nestlé) earned the loyalty of doctors, midwives and local health workers by offering trips to conferences, meals, tickets to shows and the cinema, and even gambling chips (in clear violation of the national law). Representatives from baby food industries were constantly present in hospitals, reportedly handing out ‘infant nutrition’ pamphlets to mothers, which were advertisements for specific brands (sometimes with money-off coupons) under the guise of medical advice. Hospital staff recommended specific formula brands in lists of ‘essential purchases’ handed to new mothers. The study found that, in this context, only 34 per cent of mothers exclusively breastfeed in the first six months.
Leading infant formula companies spend £36 on marketing per baby worldwide. South and East Asia, with its growing economies and high birth rate, is a key target. Promotional strategies targeting mothers and midwives directly violated national laws of the Philippines as well as the internationally recognised WHO code of 1981. In spite of the industry’s claims that it has cleaned up its act, practices globally condemned four decades ago are still evident.
The Save the Children Report points out that companies systematically continue to violate the milk code with devastating consequences for infant health and mortality. While the companies concerned reject allegations of illegal promotions, powerful corporate lobbies work to curb government regulations on formula marketing. Across the world, targeted advertising on Facebook and partnerships with influential ‘mummy bloggers’ expose mothers to more unregulated formula promotion than ever before.