How to market breast milk and breastfeeding aggressively

Adequate nutrition for children, especially in the first 3 years of their lives, is important, because it plays a key role in their growth and development. Several factors, including personal, cultural and social factors, influence a mother’s choice of infant feeding method. Ideally, this important decision making should be driven by evidence rather than commercial interest. However, the reality is that formula milk marketing is a major influencer of children's feeding practices.

In an effort to regulate the formula milk industry’s activities, the 34th World Health Assembly adopted a Code to regulate the marketing of breast-milk substitutes in 1981. Over four decades later, the Code has not served as a deterrent, as evidenced by the findings in “The impact of marketing of breast-milk substitutes on infant feeding decisions and practices” report. This report, commissioned by WHO and UNICEF, draws from an extensive study conducted over a 2-year period. It covered eight countries; Bangladesh, China, Mexico, Morocco, Nigeria, South Africa, the United Kingdom of Great Britain and Northern Ireland, and Viet Nam. The data from the study reflects direct feedback from speaking with women in urban populations on their experiences of and exposure to formula milk marketing.?

The key findings from the report include:

1. Formula marketing informs decision making and undermines breastfeeding and child health and not the baby formula itself.?
2. The formula milk industry uses several tactics to engage with women on both online and offline platforms. They leverage data to make their marketing strategies more effective.
3. The industry deploys manipulative tactics that play to parents’ anxieties and aspirations.
4. The industry makes scientific claims that present formulas as similar, or even better than, breast milk when the evidence says otherwise.?
5. The industry targets health professionals to promote baby formula by leveraging on the trust relationship between health professionals and parents.
6. Formula milk marketing makes women doubtful about breastfeeding.

On clubhouse, I facilitated a discussion to discuss the report and its key findings. The panelists shared about baby formula marketing in their countries and the regulatory frameworks in place. From the discussion, several countries are adopting stricter regulations to restrict the marketing of baby formula. In developing countries, more stringent regulation of baby formula is particularly important considering the history of exploitative marketing practices that led to a boycott in the 1970s.

Understandably, breastfeeding is a mother’s personal choice and might not even be an option because of circumstances beyond the mother’s control. Formula milk is and should remain the option for such exceptional cases without taking away from the primacy of breast milk as the perfect food for babies. The baby formula industry's marketing strategies are actively trying to make the exception a norm.

Although several industries adopt aggressive marketing strategies, the formula milk industry is different because of the health implications of infant feeding methods for the mother and the child. Awareness of the benefits of breast milk is insufficient for encouraging more mothers to breastfeed without addressing the challenges of working mothers. Globally, women's participation in the labor force has increased and working mothers make up a significant portion.

The formula milk industry is filling a void by responding to the needs of mothers that are unable to breastfeed and working mothers. It is about time that public health stakeholders pay more attention to the mothers’ needs and concerns. The lack of a conducive environment that encourages breastfeeding in several countries is a major pain point and leverage for the formula milk industry’s marketing activities.?Creating a conducive environment for breastfeeding is in itself a form of aggressive marketing of breastfeeding that goes beyond promoting its benefits. Some important questions need answers;??

1. How much work has been done to better understand the barriers to breastfeeding?
2. How many countries have laws that entrench reasonable maternity leave periods?
3. How many organizations have created work environments that are breastfeeding friendly?
4. What is the percentage of health professionals that are trained to help mothers that have difficulties with producing milk?
5. Is the current percentage of professionals that provide breastfeeding support commensurate with the need?
6. What investments are being made to create products and innovations that encourage breastfeeding, better expressing and storage of breastmilk??

The answers to these questions could provide actionable information for addressing the concerns of mothers who are capable of breastfeeding but face numerous hurdles. The formula milk companies are unlikely to back down because people are more aware of their aggressive marketing strategies. Public health stakeholders need to also market breast feeding aggressively by making it an easier choice for mothers. A good way to do this is to advocate for more investments that will focus on creating conducive environments for breastfeeding.