Jennifer Rigby

LONDON (Reuters) – Almost all parents and pregnant women in China, Vietnam and the UK are exposed to “aggressive” formula milk marketing campaigns that breach global rules set up after scandals more than 40 years ago, according to a new report.

The marketing techniques can push women away from breastfeeding and include everything from giving free samples, to executives setting up or joining “mums’ groups” on popular messaging apps, the report from the World Health Organization (WHO), UNICEF and M&C Saatchi said.

Targeted gifts are given to health professionals, including funding for research or commissions. This is all prohibited by international guidelines on formula milk marketing.

WHO suggests exclusive breastfeeding of newborns whenever possible as a healthier choice.

The authors of the report and several other experts agreed that it was now time for reform of the International Code of Marketing of Breast-milk Substitutes. WHO established the code in 1981 to regulate the industry following scandals in 1970s, when Nestle was accused in particular of encouraging mothers not to breastfeed in poor countries.

Nigel Rollins, NYSE:, lead author of this report and a WHO Scientist scientist said to Reuters: “Are these areas for strengthening code?” Unquestionably.”

International guidelines are only applicable to tobacco and formula milk.

The WHO stated that only 25 countries had implemented the code in their laws. In addition, formula milk sales have increased more than twice over the past 40 years, while breast-feeding rates have dropped slightly. Annually, the formula milk market is valued at $55 million.

The report found that more than half of the 8,500 parents across the eight countries surveyed – Bangladesh, China, Mexico, Morocco, Nigeria, South Africa, the United Kingdom and Vietnam – reported exposure to marketing, much of which was in breach of the code.

This report is titled “How marketing formula milk influences our decisions about infant feeding”, and includes interviews with 300 health professionals.

China had 97% of the women who were surveyed having been exposed to formula-milk marketing. In the UK, it was 84%, and Vietnam 92%. In all the countries, more than one third of women said they had been recommended formula by their doctors.

The code permits factual information about formula to be given, and while the authors acknowledge the value of formula milk to women who can’t or won’t breastfeed, the authors stated that marketing practices are a major reason why breastfeeding rates around the world are so low.

Although exclusive breastfeeding is recommended by the WHO for the initial six months of a baby’s life, 44% of infants this age receive it.

A major study in 2016 suggested more than 800,000 babies’ lives could be saved annually if breastfeeding rates improved to reach this milestone.

UNICEF Executive Director Catherine Russell stated that misleading and false information regarding formula feeding can be a barrier to breastfeeding, something she believes is the best option for mothers and babies.

Rollins noted that digital marketing, in particular, is a need for work because it offers the possibility for personalized targeted messaging. Also, this area represents an important expansion opportunity for formula milk company, along with milks to older children or for those who have allergies.

The International Special Dietary Foods Industries made a statement for the companies, stating that its members adhere to all laws and regulations of their countries.

“Our members stand with national governments in their efforts to enforce all applicable laws and regulations.” “Our members are willing to work with all stakeholders in order to promote optimal infant health” it said.

While the WHO refused to discuss individual companies in detail and did not identify them in their report, they stated that there was no significant difference between their practices.

An Access to Nutrition Initiative 2021 Index found some companies more conformant to the code than other: Danone’s marketing follows the rules 68%, Nestle at 57%, Nestle at 57%. However, three of the leading companies operating in China – Feihe, Mengniu and Yili – all scored zero.

External experts stated that more reform is needed to bring companies and nations into compliance.

Gerard Hastings (emeritus professor of Marketing at University of Stirling in Scotland) said that regulators such as the Food and Drug Administration should get more involved.

He told Reuters that “we need to rethink the way it actually works (the code), so it can be enforced more strongly.”

“These agencies should really go back to the drawing table and consider infant formula products as drug-like.”