Questions raised over Nestlé’s promise to stop infant formula marketing by end of 2022

23 May 2022 --- Nestlé’s commitment to end the promotion of formulas for infants from birth to six months of age in all countries by the end of 2022 has been met with skepticism by the World Health Organization (WHO).

“By the end of the year, we will stop the promotion of infant formula in all countries for babies 0-6 months. This is particularly relevant to the US, Canada and Japan, where no regulations currently exist,” a spokesperson from Nestlé tells NutritionInsight.

The move is in line with the WHO recommendation that infants should be exclusively breastfed for the first six months of life to achieve optimal growth, Nestlé notes. The WHO aims to increase the exclusive breastfeeding rate in the first six months up to at least 50% globally by 2025.

“We welcome this announcement as an important step in the right direction. It represents a recognition that restrictions on marketing of breast-milk substitutes are necessary in industrialized countries, not just those with high mortality rates,” Laurence Grummer-Strawn, unit head, food and nutrition actions in health systems at the WHO, tells NutritionInsight.

“However, we continue to be concerned that Nestle uses many cross-branding techniques to indirectly market its infant formula without specifically mentioning infant formula. As such, it is not yet clear whether Nestle's commitment will actually change much.”

Exploitive marketing techniques in different forms are commonly used by baby formula companies.Deceptive marketing techniques
Nestlé’s pledge was outlined in its 2021 annual report. The company also says it has already prohibited the marketing of breast milk formula for infants 0-to 12 months in 163 countries.

Ada Garcia, senior lecturer in public health nutrition, University of Glasgow, tells NutritionInsight that the age limit of six months is chosen because baby food companies want to promote and sell follow-on milk. These products have added nutrients such as docosahexaenoic acid (DHA), iron or human milk oligosaccharide (HMO) and are heavily portrayed as nutritionally superior, she says. 

Nutrient fortification is linked to health-related claims such as immunity boosting, cognitive development and gut health. 

“The current recommendations for feeding infants during the first year are to breastfeed during the first six months and introduce solid foods that are nutrient-dense and suitable for babies from the age of six months and breastfeeding. Infants can consume cow’s milk at 12 months of age. There is no recommendation to include follow-on-milks,” Garcia adds.

“These claims are mostly unsupported by robust evidence. Still, parental perception and preferences for products can be influenced by the ‘healthy halo’ used in the marketing of follow-on milk used by the baby food industry,” she adds.

Subtle tricks
With cross-branding techniques, Grummer-Strawn states that one commonly used method by manufacturers of commercial milk formulas is to use almost identical labels on formulas for infants between different age ranges.

“Companies then promote their products for 6-12 months and 12-36 months and technically adhere to the commitment not to promote products in the first six months of life, knowing that for consumers, the distinction between products is almost non-existent,” he adds.

Additional marketing techniques are the marketing of child feeding products without referring to them as infant formula. Additionally, “promoting the company as an expert in infant and young child feeding, without specific reference to a product.

“In this way, the restriction of global promotion of milk formulas for infants up to 6 months of age may still allow indirect promotion,” Grummer-Strawn concludes.

Exploitative marketing has previously been flagged across the infant formula companies by the WHO. Another deceptive method is to target women before, during, and post-pregnancy with targeted marketing. They buy data from social media platforms to reach the desired consumer directly, often not recognizable as marketing.The baby formula industry needs to align their promotional activities with the International code of marketing, the WHO says.

“Disappointing” first step
According to Nestlé, the company supports ‎efforts by national governments to regulate the promotion of infant formula for babies aged 0-12 months globally. It also states it is ready to work with the WHO, UNICEF and others to achieve this. 

Grummer-Strawn notes that “a first step is always a first step” and is therefore necessary. He adds, “We had hoped that Nestlé would at least stop the promotion of formulas for infants from birth to 12 months, so it is disappointing that they were only willing to apply these restrictions up to 6 months of age.”

“Perhaps more importantly, we were disappointed that Nestlé has not publicly acknowledged their responsibility to fully comply with the International Code of Marketing of Breast-milk Substitutes, even if it takes them several years to get there,” he concludes.

“It has been more than 40 years now that one of the world’s largest and most influential baby food producers has avoided taking action on this. Still, in their announcement, there is a lack of truthful commitment to adopt the code recommendations to their fullest. They are using parts of the code that suit them,” Garcia comments.

Next steps for market leaders
Previous reports have shown strategies from the WHO to suggest changes in the packaging of milk formula products to make them less appealing, similarly to cigarette packages. Because the packaging often contains graphics and images, those may be appealing and misleading.

“Ultimately, these companies need to adhere to the agreed-upon standards set in the International Code of Marketing of Breast-milk Substitutes. But as steps to move in that direction, we would look for universal application of company policies on limited promotion,” Grummer-Strawn says.

“Many companies only apply these policies in high mortality contexts, restrictions on marketing of infant formulas up to 12 months of age, an end to the practice of cross-promotion of different types of formula, and a prohibition on free samples.”

By Beatrice Wihlander