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WHO accuses infant formula makers of abusive business practices


Swiss food giant Nestlé is one of the world’s largest manufacturers of infant formula, along with Danone, Abbott and Reckitt. © Keystone / Gaetan Bally

In the digital age, the marketing of breastmilk substitutes has become widespread. It has also become more insidious, despite decades of efforts to counter these practices, according to a study. Public health experts call for stricter regulations.

This content was published on 03 March 2022 – 11:04

More than half of parents and pregnant women worldwide would be exposed to misleading and unethical marketing by manufacturers of breastmilk substitutes, according to a recent study.external link led by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF), based in Geneva.

This finding comes from a panel survey of approximately 8,500 parents, as well as 300 health professionals in various countries. The survey was carried out by the communication agency M&C Saatchi.

For WHO scientist Nigel Rollins, lead author of the report, the impact of this marketing is not the only problem. Equally alarming is how the ad attempts to “exploit the emotions, fears and hopes of women and families at a time when they may be particularly vulnerable,” he told reporters.

The WHO recommends breastfeedingexternal link exclusive breastfeeding for the first six months of the infant’s life, then mixed breastfeeding for up to two years or even longer. For the WHO, breastmilk substitutes, such as powdered milk, should be available, since they can satisfy a need or a desire. But the organization warns that aggressive and unethical marketing of these products harms breastfeeding, which remains the best food for babies.

Several advertising practices have already been prohibited by the International Code of Marketing of Breast-milk Substitutesexternal link, adopted by the World Health Assembly in 1981: television advertisements, free samples, unsubstantiated scientific arguments or the use of “mom influencers” on social networks are not allowed. The Code arose out of the scandals of the 1970s. The Swiss multinational Nestlé was then criticized for its aggressive marketing, which led many women to prefer breast milk substitutes. Nestlé was then the object of an intense boycott.

The WHO report does not name any specific company. But the magnitude of the phenomenon has recently forced the organization and UNICEF to reiterate their call for restrictive regulations and tougher penalties. Today, only 25 countries have a law that fully incorporates the Code. Switzerland is not one of them, nor are the two largest infant milk markets in the world, China and the United States.

repeated messages

The arrival of social networks, more generally digital, has amplified the penetration force of marketing. Formula makers use algorithms to target their messages to mothers, the study says. The media are diverse: helplines, baby clubs, phone apps… “Women can be directed to these sites without knowing who the sponsors are, depriving them of objective information on baby food,” says Grainne Moloney, UNICEF Nutrition Advisor.

Conducted in eight countries on five continents, the M&C Saatchi survey reveals that 51% of parents and pregnant women have been exposed to manufacturer marketing. Women in urban areas in China were the most exposed to messages promoting formula milk (97%), followed by those in Vietnam and Great Britain (92% and 84%). “These repeated messages undermine women’s confidence,” according to the report.

The deceptive nature of this marketing is also targeted by the report. Because infant formulas are often considered foods rather than pharmaceuticals, regulators (for example, the US Food and Drug Administration) do not require as much scientific data to support certain claims – related, for example, to the purported effects of certain ingredients on infant brain health and development.

“These substitutes are presented as similar, equivalent and sometimes even superior to breast milk,” the report says, noting that such claims are often based on “poor scientific evidence.”


The WHO recommends exclusive breastfeeding for the first six months of the infant’s life. © Keystone / Gaetan Bally

For scientist Nigel Rollins, these commercial practices blur the objective and truthful information that allows women to make the best decision for themselves when they have to choose between breast milk and milk replacement. “Many factors go into this decision, but it should not be influenced by commercial interests,” he adds.

another studioexternal link published last year in the scientific journal Lancet shows that the rate of breastfeeding has been increasing in most regions of the world for two decades. However, at 44%, it remains below the global target of 50% by 2025. At the same time, sales of substitutes are increasing and have more than doubled between 2005 and 2019, according to one study.external link.

Code can be circumvented

The interpretation and application of the International Code of Marketing of Breast-milk Substitutes remains uncertain. In 2020, WHO partnered with NGOs to encourage companiesexternal link to fulfill in the next ten years. Only two of them (Kraft Heinz and Meiji) accepted, representing between them only 1% of the entire market.

“All [les entreprises] they declare that they align with the aspects of the Code that suit them best and then build their arguments around these specific aspects,” Nigel Rollins told SWI swissinfo.ch. “Our research, corroborated by others, shows that no company today fully implements the Code.”

The degree of conformity is also highly variable, depending on the indexexternal link 2021 of the Access to Nutrition Initiative. Of the seven companies surveyed, Danone achieves the best results with a compliance rate of 68%, followed by Nestlé (57%). The three Chinese companies on this list, Feihe, Mengniu and Yili, do not publish any information about their marketing strategy.

The main differences relate to the application of this Code to children older than 12 months, specific countries and types of products. The marketing strategy of Nestlé (the leading manufacturer with 21% of the market share) is thus “guided” by the Code, but the Vevey-based company does not make it a single model either. However, the Swiss multinational has promised to stop promoting its preparations for babies from 0 to 6 months at the end of this year in all the countries it covers.

Rethinking the legal aspect

Political director of the NGO Baby Milk Action since the 1980s, Patti Rundall is convinced that, in the absence of national laws aligned with the Code, the companies concerned will continue to define, according to the places where they do business, how to apply it. . “These are big multinationals,” she recalls. We must ensure that legislation protects fathers and mothers. His health is at stake,” she told SWI swissinfo.ch.

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In world trade, baby formula is worth about $55 billion. In India, where the law on the promotion of these preparations is one of the strictest in the world, sales of these products remained stable last year. Instead, they exploited in China, a country that covers in this sector more than half of the world market (28,000 million). In 2021, Beijing proposed to ban its promotion of health sites.

The United States, the world’s second largest market, is one of 58 countries with no marketing regulations. “Multinationals like Nestlé, on the other hand, have adopted stricter practices than those required by law,” Marie Chantal Messier, the group’s head of public affairs, told SWI swissinfo.ch. According to her, “in order to change the situation, regulations should be adopted in all countries deprived of an ad hoc law”.

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