WHO report exposes formula milk marketing, offers steps forward

Over 8,000 people registered for two live-streamed Marketing the $55 billion formula milk industry events last week where Director-General of the World Health Organization Dr. Tedros Adhanom Ghebreyesus, the United Nations Children’s Fund (UNICEF) and partners presented the eagerly-anticipated release of a new report, How the marketing of formula milk influences our decisions on infant feeding. The report is the largest of its kind to date.  

The report draws on the experiences of over 8,500 women and 300 health professionals across eight countries exposing the aggressive marketing practices used by the formula milk industry and highlights how marketing impacts families’ infant and young child feeding decisions. The document also shows how the formula industry positions health professionals in their tactics, using them as key players in their efforts to gain access to consumers and influence their bottom line. 

It is important to note that this report solely focuses on the marketing of formula and not on the commodity itself. It argues that consumers have the right to accurate information and support, placing value on public health over commercial interest. 

On a daily basis, we are all exposed to and influenced by marketing, but the marketing of formula products is different from other commodities. That’s because it:

M&C Saatchi World Services– a specialist research division within one of the world’s largest communication networks–prepared the key findings in this study which include that formula milk marketing is pervasive, personal and powerful; formula milk companies use manipulative marketing tactics that exploit parents; they distort science and medicine to legitimize their claims; the industry systematically targets health professionals to promote their products; and formula milk marketing undermines parents’ confidence in breastfeeding. It is theorized that counter measures against the formula industry can be effective but must be comprehensively expanded and scaled up by governments, health professionals and their associations, civil society and other actors. (p. x)

It is expected that the formula milk industry will try to manipulate the findings in this report.

Attempts will be made to reframe the debate, pitting breastfeeding against formula feeding, calling it an attempt to limit access to formula or restrict women’s rights over children’s rights. And while the industry has massive power, a power that spends three to five billion dollars per year on marketing alone (an amount greater than WHO’s operating budget every two years), our collective action has the potential to pull more weight.

The report calls on us to recognize the scale and urgency of the problem, on national governments to legislate, regulate, and enforce, on health professionals to protect the integrity of science and medicine, safeguard children’s health on digital platforms, and on those with economic leverage to invest in mothers and families while divesting from formula milk companies. (p. 18) 

Individuals and organizations can start by signing on to the open letter that seeks to #EndExploitativeMarketing here

In an interesting intersection, in many ways, the formula milk industry is not unlike the tobacco industry. But even as the 1964 surgeon general’s report came out convincing Americans that smoking is unhealthy, cigarette sales continued to increase until the 1970s.  It wasn’t until the environment was modified– cigarette vending machines were removed, bans on smoking in public places were instituted, and cigarette sales were taxed– that sales started to decline.

“All of that took huge political decision making and commitment to make it happen,” psychologist Wendy Wood points out on the Hidden Brain podcast

Positioning formula companies at the same level as the tobacco industry only goes so far though. There’s no practical reason to use tobacco; but with formula, there can be. 

Another recently released report, The clean energy claims of BP, Chevron, ExxonMobil and Shell: A mismatch between discourse, actions and investments, uncovers the way that global energy companies “greenwash” their actions, similar to the way formula companies purport their products on unfounded scientific claims. Oil companies have “misled the public about the dangers of climate change for years and are now doing too little to address the warming planet,” claiming strategies related to decarbonization and clean energy… which are dominated by pledges rather than concrete actions. [https://www.npr.org/2022/02/16/1081119920/greenwashing-oil-companies

The WHO/UNICEF report calls on us to expand coalitions to drive action across society, not just within maternal child health. (p. 18) There are lessons we can learn from advocacy groups challenging oil companies, as well as an opportunity to partner against exploitative marketing.

We might also draw lessons from what the formula companies excel at.

Employing a user-centric approach, they empathize with the tired, new parent. Maternal child health advocates may consider focusing messages about healthy infant feeding in ways that are desirable to new parents. For example, research shows that parents of infants who were breastfed in the evening and/or at night slept an average of 40-45 minutes more than parents of infants given formula. 

One of the event panelists used this analogy: In Uganda, public health specialists tried to get individuals to start sleeping with bed nets in order to prevent malaria. Behavior didn’t change, because hypothetically contracting malaria wasn’t powerful enough. When PSAs were reframed urging people to sleep with bed nets to get a better night’s sleep (net equals less bugs buzzing around your face and head), people started using them.  

As Dr. Arun Gupta has pointed out, many of the findings in this report are not necessarily “new”. We have known about manipulative formula milk marketing and its effects for decades. As a society, we’ve simply not done enough about it. Combatting the industry requires action at many levels, and this recent report gives us unfettered proof that that time is now. 

Visit WHO’s website on the launch of the new report complete with poignant videos and social media infographics. 

Sign on to the call to immediately halt  immediate halt a new study that is randomly allocating infant formula to exclusively breastfed low-birth-weight babies in Uganda and Guinea-Bissau assuming that this might prevent wasting and stunting.The study, uses ready-to-use infant formula made by a major violator of the International Code and WHA Resolutions.

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