ATNI assesses responsible marketing practices of world’s largest infant formula producers

11 Apr 2024 --- The 2024 Breast Milk Substitutes (BMS) Index by the global NGO Access to Nutrition Initiative (ATNI), based in Utrecht in the Netherlands, analyzes the responsible marketing compliance with internationally-set norms of 18 of the world’s largest companies producing BMS, including industry giants Abbott, Danone, FrieslandCampina, Nestlé and several Chinese players.

The index report asserts: “Inappropriate promotion of BMS remains a threat to the protection and support of breastfeeding worldwide, undermining informed choice among parents and caregivers and leading to suboptimal breastfeeding practice in high-income and low-income settings alike.”

“Actions that companies can take to achieve higher compliance ranking include adopting the provisions of the latest international guidance on the responsible marketing of BMS, such as the WHO Guidance on Ending the Inappropriate Promotion of Foods for Infants and Young Children, supported by World Health Assembly resolution 69.9,” Marina Plyta, partnerships manager at ATNI, tells Nutrition Insight.

The 18 companies assessed by the 2024 index cover 76% of global BMS sales. These are a2 Milk (New Zealand), Abbott (US), Beingmate (China), Danone (France), Feihe (China), FrieslandCampina (Netherlands), Hain Celestial (US), H&H (China), Hero (Switzerland), HiPP (Germany), Junlebao (China), Lactalis (France), Mead Johnson China, Morinaga (Japan), Nestlé (Switzerland), Reckitt (UK), Vinamilk (Vietnam) and Yili (China).

The companies produce BMS, including milk and milk alternatives in liquid or powdered form, marketed for older infants and children up to the age of three. 

Companies were ranked based on a corporate profile assessment, examining global corporate policies, procedures and level of disclosure, as well as based on country studies measuring companies’ marketing practices in the countries of China, Germany, Indonesia, Vietnam and the US. 

Inappropriate promotion of BMS undermines the informed choice of caregivers and can lead to suboptimal feeding practices.Report findings  
The ATNI index assesses BMS companies’ compliance with the 1981 International Code of Marketing of Breast-milk Substitutes (the Code).

The companies with the highest compliance are FrieslandCampina, followed by Danone, Hain Celestial, H&H and Nestlé. A2 Milk, HiPP and Morinaga Milk also scored well for compliance, while Abbott and Reckitt were ranked at below 10%. 

Eight companies scored 0%.

Discussing the differences in compliance rates and marketing practices among companies operating in different regions or countries, Plyta points out that “where local Code regulations are more aligned with the Code, companies’ marketing practices were more compliant with the Code — more appropriate product labels, less media advertising and promotions at retail sites.”

While none of the companies assessed fully align with the Code, some improvements have been made since 2021 in relation to the update of policies and the enhancements of practices. 

Notable improvements 
Plyta explains that companies like FrieslandCampina and Nestlé have improved the scope (product types) and the application (countries and markets) of their policies. “They have achieved this by committing to uphold their BMS marketing commitments to infant formula (BMS products intended from birth) in all markets. Previously, the commitments were only applied to selected high-risk markets.”

“FrieslandCampina now also commits to uphold its BMS policy on marketing formula for children between six months up to three years of age in countries where local regulations cover these products but where marketing provisions are weaker than the company’s policy. 

Nestlé, however, excludes formulas for special medical purposes in this new commitment.”

Discussing the actions being taken by companies with the highest compliance scores, such as FrieslandCampina, to achieve better alignment with the Code, Plyta asserts that companies should develop robust management systems to ensure BMS marketing policies are effectively implemented in all markets.

“Other steps include increasing the scope of BMS products covered by BMS marketing policies to include products for children up to three years of age. For example, FrieslandCampina increased the scope from birth to 12 months up to birth to 36 months and ensured no product types are excluded, such as formulas for special medical purposes.” 

The rise of the digital market
One of the key findings of the report is that digital platforms are now the major driver for BMS marketing while also representing 61% of the incidence of non-compliance. 

Companies should develop robust management systems to ensure BMS marketing policies are effectively implemented in all markets, ATNI recommends.“Marketing on digital platforms is less regulated, as identified in the UNICEF and WHO 2022 Status of the Code report, and it has a higher reach for a lower price,” explains Plyta.

“WHO has been documenting this rise in digital marketing, specifically of BMS, in reports such as the Scope and impact of digital marketing strategies for promoting BMS (2022) and has produced guidance in 2023 on regulatory measures aimed at restricting digital marketing of BMS to encourage governments to monitor marketing in this sphere and take appropriate action accordingly,” she explains.

“In light of the rise in BMS digital marketing, tools such as VIVID have been developed to use AI to scan the internet for BMS Code violations. For the purposes of our in-country research, ATNI has also made use of online monitoring tools to screen websites, social media platforms, online retail channels and traditional media (TV, radio and print).”

Improving responsible marketing 
Based on these findings, ATNI’s report presents recommendations to BMS companies and investors. 

“Companies that have the responsibility to appropriately market their BMS products in the interest of public health can act quicker and should take additional steps beyond local regulatory requirements to comply with the Code until its provisions are fully incorporated into regulatory frameworks globally. Companies that take such steps set a best practice standard for all companies to follow,” Plyta asserts. 

 “While ATNI also provides recommendations to policymakers and investors, it is important to note that the processes to achieve regulatory changes require the involvement of many stakeholders beyond policymakers alone and may take longer periods of time,” she concludes. 

By Milana Nikolova