Profit and power: Organizations decry formula industry marketing in the midst of humanitarian emergencies

05 Aug 2022 --- The formula industry may be engaging in “profit-driven” and “unethical” marketing practices in emergency and conflict situations, according to statements issued by the World Health Organization (WHO) and the South African Breastmilk Reserve (SABR). The suggested practices range from donations, which the WHO says is a form of marketing, to social media blanketing.

Following NutritionInsight’s earlier reporting on the matter in light of World Breastfeeding week, part two of the coverage speaks to nursing advocates and industry professionals to discuss the implications of these accusations.

“The challenge of infant feeding in humanitarian emergencies, and especially supporting mothers to breastfeed, should be considered a first priority issue versus one of many matters that responders deal with over a period of weeks,” says Dr. Nigel Rollins, technical lead for the department of maternal, newborn, child and adolescent health and aging at the WHO.

“While the international emergency community has an agreed position on infant feeding in emergencies, it is not uncommon that groups who are not experienced in emergencies but somehow find themselves involved in an emergency respond in inappropriate ways,” he explains.

“The unethical marketing of formula often negatively affects breastfeeding practices because mothers are convinced through imagery of happy babies and happy moms and the feeling that they are understood by companies, who, on the other hand, use artificial intelligence to study their target group and behaviors,” elaborates Staša Jordan, executive director at SABR.

Rollins says that supporting breastfeeding mothers should be part of the first response in humanitarian emergencies.Companies ignoring international guidance?
Both of these organizations have issued statements on the occasion of World Breastfeeding Week calling for world leaders and governments to increase their support of exclusive breastfeeding for infants and to help curb the influence of the formula industry on breastfeeding mothers, especially those in humanitarian emergencies.

“Humanitarian emergencies include everything from acute crises such as post-earthquake to protracted scenarios with populations displaced and with or without transit over many months,” explains Rollins. “International guidance is very clear on the matter such as free donations of formula milk; it should not happen.” 

“Despite this, several companies continue to offer donations without regard for either the immediate complexities such as quality of water supply, ease of safe and hygienic preparation, cleaning of feeding utensils, opportunities to store prepared milk,” Rollins stresses. 

Jordan agrees with this summation saying, “in times of conflict, women are further impacted because they may lose their homes and food supply, and they may be on the receiving end of free formula handouts that originate from well-meaning individuals or organizations that do not realize the long term effect a tin of formula can have on a household that can’t afford to continue purchasing formula thereafter.”

Though Nestlé declined to speak on the subject and other industry leaders did not respond in time for publication, a representative from Danone pointed to a statement on the company website. 

“Danone supports the WHO’s global public health recommendation and government policies calling for exclusive breastfeeding for the first six months of age and continued breastfeeding up to two years and beyond, combined with the safe introduction of appropriate complementary foods.”

“We believe that it is the industry’s responsibility to adopt, implement and enforce strict policies to ensure marketing practices do not negatively affect the choice and ability of mothers to breastfeed their infants optimally, in line with the WHO International Code of Marketing of Breast-Milk Substitutes.”

“We aim to foster a proactive, constructive and evidence-based dialogue supporting breastfeeding around the world and endorse the principles of openness, transparency and integrity in our advocacy activities,” it concludes.

Devastating effects of “one tin”
In a humanitarian crisis, there are many needs that must be met. Rollins affirms that support for breastfeeding mothers should be an item of first response in any humanitarian activity. Jordan further states that the effects of neglecting to support breastfeeding immediately, at the beginning of a crisis, can have severe consequences for nursing children. 

“One tin of formula can lead a breastfeeding mother to dry up and result in food insecurity for the baby,” Jordan stresses. “The consequences are devastating for the dyad (mother-infant pair) and can cause malnutrition of babies in the first 1000 days of life. Breastfeeding is a life-saving strategy that promotes food security and improves outcomes.”

“Free donations – a form of marketing – and any other type of promotion is highly inappropriate for the reasons above and will always be unethical in these settings,” concurs Rollins.

“Money and power”Jordan says using even one tin of formula can cause a breastfeeding mother to be unable to produce milk.
Both groups agree that the responsibility for this lies not only with the formula industry but on the policymakers as well and, in turn, the citizenry.

“For politicians to react and introduce legislation that impacts on economics – this is all about money and power – their constituency needs to convey that current practices are unacceptable and change is required,” Rollins underscores. “Without this, politicians will not risk their position.”

Moreover, Jordan states: “Breastfeeding is a poverty alleviation strategy that protects families and budgets for infants globally. For instance, during the July 21 looting, the exclusively breastfed babies were more secure than exclusively formula-fed babies whose parents found the food distribution centers burned to the ground. The ‘Warm Chain’ of breastfeeding protects the infant as he or she only needs to rely on the mother as opposed to external food sources.”

“Having access to impartial, objective, truthful information and support is a human right,” expounds Rollins. “Marketing practices have successfully shifted societal norms such that in many countries it is assumed that giving formula milk is the norm, that it is inevitable.” 

“Governments and health professional associations need to act to reverse this state of affairs which requires civil society to understand the health and development consequences for their children and demand change,” he concludes.

By William Bradford Nichols