You’re a mom browsing social media, and you’re not sure whether you want to continue breastfeeding your baby as he approaches six months or switch to formula feeding.
You join an online baby group and discover an influencer. Before you know it, you’re being targeted with posts about baby formula.
The World Health Organization says these are the new frontiers in its campaign to restrict the “exploitative” marketing of what it calls “breast-milk substitutes”, also known as formula milk.
It recommends that children should be breastfed during the first six months of their lives, and that governments should provide mothers with the necessary health and social support to do so. After that, cow’s milk, goat’s milk, or any other milk is generally recommended.
The World Health Organization has been campaigning for more than 40 years to boost breastfeeding rates, which currently stand at 44 percent.
A code was launched in 1981 to regulate the formula industry after a report in the 1970s highlighted problems of malnutrition in formula-fed children in developing countries.
Formula milk for babies under 6 months and tobacco are the only two products for which there are international guidelines preventing their marketing to consumers.
Despite this, only 32 countries have fully implemented the Code into legislation.
The WHO Executive Board is scheduled to meet in Geneva from January 22 to 27 to discuss how to restrict digital marketing.
But the formula industry is worth $55 billion annually, so the World Health Organization faces strong opposition.
“My baby won’t get enough milk”
Tip (not her real name), a new mother from Thailand, says she often sees advertisements for baby formula products on her social media pages as many companies use influencers or TV stars to showcase their products.
Tip has given her baby formula milk since he was born in the hospital. She was worried that she would not be able to produce enough breast milk, even though this was not the case.
Her baby is now three months old. She continues to buy the same formula that costs $50 every month.
“I chose the same brand because the hospital offered it to my child, and he didn’t have any allergies or bad reactions,” Tip explains.
Currently, she is breastfeeding him and also gives him an additional ounce or so of formula at each feeding.
“I’m worried my baby won’t get enough milk, so I give him both.”
Tip told the BBC that the ads she sees on social media could have an impact on her decisions in the future. “I’ve already saved the ads I’ve seen, and that may influence my decision about when my baby will need to transition from infant formula to toddler formula.”
who is in Charge?
The World Health Organization says dairy manufacturers are using marketing strategies that are not usually recognized as advertising.
It says they include: social media posts, streaming video, gaming, podcasts, “dark” posts (which are company posts that target a user and do not appear on the company’s social channel), influencer marketing, and online baby clubs.
The Geneva-based organization published guidelines in November 2023 with a list of recommendations on how to combat this online activity.
She said content producers, publishers and content distributors who promote the use of “breastmilk substitutes” should be held accountable.
The World Health Organization also recommended that governments should immediately reduce, prevent, liquidate or eliminate such marketing.
Its Executive Board will consider the report at its January meeting and consider how to strengthen it.
But there is still no new initiative to pressure countries to implement these directives, although some countries support this.
“milk for young children”
When a baby is six months old, the World Health Organization recommends that they begin receiving solid food, while continuing to breastfeed until the age of two years.
However, many mothers stop breastfeeding at this stage and are targeted with advertising or marketing suggesting they give their babies “toddler formula.”
In October 2023, the American Academy of Pediatrics (AAP) published a report stating that there are no nutritional advantages to infant formula aimed at children over twelve months of age.
The American Academy of Pediatrics said that the use of formula “offers no benefit over cow’s milk, which is much less expensive, in most children over 12 months of age.”
She also said parents can be apprehensive when reading labels claiming things like “improved brain development or improved immune function” for these age groups.
Adding to the confusion is that toddler formula products are marketed similarly to infant formula as they both have similar branding and packaging.
The American Academy of Pediatrics warns that “advertising messages that position these products as the next stage or next step for young children causes confusion and can discourage breastfeeding.”
Unlike infant formula, the FDA does not regulate infant formula.
The American Academy of Pediatrics also said that these “toddler formula” products should be labeled as something other than infant formula and not placed next to infant formula on store shelves.
Last year, the British medical journal The Lancet published a report criticizing the international marketing strategies used by commercial formula manufacturers to target parents, healthcare professionals and policy makers.
She cited several labels on formula bottles in different countries, including Enfamil and Aptamil.
For example, Enfamil Neuro Pro, part of Reckitt, a British-Dutch multinational food company, claimed to “build brains.”
Dr. Cecila Tomori, an assistant professor at Johns Hopkins University School of Nursing and co-author of the Lancet report, told the BBC that these claims make parents believe that added ingredients in formula will support brain development and enhance cognition and intelligence.
The breastfeeding expert pointed out that the use of scientific terminology in advertisements creates the false impression that there is a strong body of scientific evidence that supports these claims.
“Some of the claims are verbal, some are pictures suggesting that the child will be very smart, and the text usually says something about IQ, brain structure, etc.,” Dr. Tomori said.
In other examples, cited in the Lancet report, advertisements claim that the products relieve “discomfort, crying, gas and spit-up.”
These could just be normal behaviors for children, according to Dr. Tomori.
Danone, the global food and drink company that makes Aptamil, told the BBC that the company spent more than 50 years researching formula milk before arriving at its key marketing message of: “science-based, research-backed formulations.”
“We follow strict regulations coupled with our industry-leading global marketing policy when it comes to health claims and advertising of our products, and this ensures that we apply responsible marketing standards,” Danone said in a statement.
Reckitt did not provide any comment but referred the BBC to the Specialty Food Industry International (ISDI), the trade body it represents.
All industry communications, to both consumers and healthcare professionals, are highly regulated, scientific and factual, the International Private Food Industry Association told the BBC. The health and nutrition claims made by member companies are based on scientific and medical research, licensed by the relevant authorities and fully compliant with relevant local, national and international regulations.