WHO and UNICEF decry infant formula influence during emergencies, marking World Breastfeeding Week

03 Aug 2022 --- Less than half of newborns receive breastmilk within their first hour of life, according to a joint statement issued by the World Health Organization (WHO) and UNICEF. The two organizations say this threatens the nutrition and health of millions of infants and children and denounces undue industry influence during emergency situations.

The statement was issued by Dr. Tedros Adhanom Ghebreyesus, the director-general of the WHO and Catherine Russell, the executive director of UNICEF. Both organizations call on governments to increase efforts and resources toward promoting breastfeeding, especially for those in emergency situations such as Yemen, the Ukraine, Afghanistan, the Horn of Africa and the ten countries that make up the Sahel region of Africa.

“Health professionals – whose recommendations are influential – are co-opted and incentivized by the industry to promote formula milk products. Countering this industry’s marketing practices and promoting the benefits of breastfeeding should be a top priority in emergencies,” Fatmata Fatima Sesay, nutrition specialist, infant feeding, UNICEF, tells NutritionInsight.

Aggressive interferenceUNICEF and the WHO state that breastfeeding is effectively an infant’s first vaccination.
The statement also asks that stakeholders implement policies that will give breastfeeding mothers the space and time they need to nourish their babies and protect the mothers, caregivers and healthcare workers from the influence of unethical marketing practiced by some in the formula industry as undermining breastfeeding in humanitarian settings.

“The unethical marketing of breastmilk substitutes creates a significant barrier to breastfeeding. Many studies, including the recent UNICEF and WHO report, show that these aggressive marketing tactics reduce breastfeeding rates, influence feeding decisions, and put both childrens’ and mothers’ health at risk.” 

“Women’s positive attitudes toward formula milk correlate with their exposure to marketing, and their fears and doubts often mirror the themes and messaging of formula milk marketing,” she continues. “Formula companies distort science and shift social norms about breastfeeding by promoting appealing claims and positioning formula as close to ‘equivalent’ or superior to breastmilk.”

“To overcome these barriers, mothers must be provided with skilled support from compassionate breastfeeding counselors to help them initiate and continue breastfeeding, maintain mothers’ confidence and provide practical support to solve breastfeeding difficulties,” Sesay adds. 

She stresses that the mothers “must also have priority access to food and items such as appropriate clothing and clean water, as well as protection, accommodation, psychosocial support, and other interventions to meet their essential needs. Providing safe and comfortable spaces for mothers to feed and care for their infants is critical in maintaining breastfeeding in emergencies.”

More important now than ever
The joint statement affirms that breastfeeding is vital, giving babies the “best possible start” for a healthy life, guarantees them a nutritious and safe food source. It notes that breastfeeding is, for all practical purposes, the first vaccination a child ever receives. It also helps to populate the microbiome and helps protect them from common illnesses.

 It further attests that only 44% of newborns receive exclusive breastfeeding during their first six months. That number is 6% lower than the 2025 goal set by the World Health Assembly. It states this is “not just for protecting our planet as the ultimate natural, sustainable, first food system, but also for the survival, growth and development of millions of infants.”

“During emergencies, the lifesaving protection of breastfeeding is more important than ever, yet there are many barriers that affect a mother’s choice to breastfeed,” explains Sesay. “These include poorly trained responders promote misinformation or myths that may affect a mother’s confidence, as well as emotional distress, physical exhaustion, lack of space and privacy, and poor sanitation.” 

“Step up” and take actionSesay says that we must boost a mother’s confidence in breastfeeding as it provides a safe and constant source of nutrition, even in emergency situations.
According to the statement, the challenges mothers in crisis, emergency and conflict settings must endure directly affects their children, who miss out on the lifesaving nutrition breastfeeding offers. It asserts that children deprived of mother’s milk early in life are more vulnerable to malnutrition, wasting, disease and death.

This underscores the importance of this year’s World breastfeeding Week theme, “Step Up for Breastfeeding: Education and Support.”

Sesay says: “It’s a collective responsibility of governments, health professionals, investors, and industry to disseminate accurate information about the value of breastfeeding, its lifesaving importance - including in emergency settings - and the heightened risks associated with the use of breastmilk substitutes in emergencies. We can all share positive messages – via social media and other channels – that promote protecting and supporting breastfeeding.”

“Additionally, upholding the Code on Breastmilk Substitutes in emergencies, and protecting mothers and families from the aggressive marketing of breastmilk substitutes, is crucial to ensure that emergencies are not exploited for commercial interests,” she concludes.

For their part, many in the industry have always maintained that they do not seek to influence health providers, caretakers or breastfeeding mothers’ in their decisions on whether or not to use formula over breastfeeding. Companies have stated that they adhere to “the WHO’s International Code of Marketing Breast Milk Substitutes and complies with national legislation and national code.” 

By William Bradford Nichols