The immense benefits of breastfeeding for the physical and emotional health of both baby and mother are well-documented. To mark World Breastfeeding Week, Lucy Westerman, Policy and Campaigns Manager at NCD Alliance, reflects on infant formula industry interference during the pandemic. 

Protect Breastfeeding. So simple. So fundamental. I mean, why do we need this as a theme for World Breastfeeding Week in 2021?

The immense benefits of breastfeeding for the physical and emotional health of both baby and mother are well-documented. Breast milk provides babies with all the nutrients they need in their first months of life – supporting the development of a healthy immune system and protecting against childhood malnutrition and poor health throughout the life course. As a natural and sustainable food source, it also has economic and environmental benefits and is an essential element of the food system not sufficiently appreciated.

So, it just seems obvious that we ‘protect and promote breastfeeding'. But around the world, some actively work to seed doubt in the minds of parents around how they feed their babies and young children, intending to shift them to using breast milk substitutes.

In March 2020, I was scrolling through my social media and an advert popped up with an image of a sweet newborn in arms. The tagline read, ‘Emma, born into a pandemic’. The advert was for a ‘maternal support’ service operated by breast milk substitute company, Aptamil, a subsidiary of the multinational, Danone. Following the links, I was invited to join the AptaClub for parents, where the small print told me this would mean I was happy to receive promotional materials from time to time.

No thanks.

This strategy was not uncommon, as we documented in our report with SPECTRUM Signalling Virtue, Promoting Harm. Similar activities have been  reported by Baby Milk Action and in the WHO UNICEF IBFAN Marketing of breast milk substitutes: national implementation of the international code, status report 2020.

In China, the dairy industry worked hard to ensure that their milk formula products were seen as both immune-boosting and 'safer' as part of the pandemic response, with brands providing medical care, virtual assistance, and home delivery of formula to stranded mothers. In Mexico, breast milk substitute brands partnered with pharmacies to promote their milk formulas alongside giveaways to people in poverty.

These practices are a direct breach of the International Code of Marketing Breast Milk Substitutes, which sets out a policy framework for regulating marketing of infant and follow-on formulas for babies and young children. Published in 1981, it was put in place to ensure that breast milk substitutes are never promoted over breastfeeding – following a decline in breastfeeding rates around that time.

Despite the intent of this globally recognised Code to stop these kinds of practices, in Indonesia, Cambodia and across South East Asia, local community retailers amplified common messages that immunoglobulins in infant formula replicated that of breast milk and provided immunity-boosting qualities essential for babies, falsely suggesting their products were necessary to protect infants from the coronavirus.

This type of fear-mongering preyed on the anxieties of parents, encouraging them to boost the immune systems of their babies with a commercial product. One even had the gall to use a photo of WHO Director-General Dr Tedros in one of their promotions, suggesting that he was endorsing their products. Both the WHO and UNICEF clearly articulated throughout the pandemic the advantages of continued breastfeeding, as well as guidance as to how babies could be safely fed by mothers should they develop the virus, and the importance of protecting child nutrition from big businesses pushing their products to vulnerable families.

Decades of evidence, including that arising in the last 18 months, has asserted that breast milk provides supreme immunity boosting functions when compared with breast milk substitutes, and in fact, is often safer as doesn’t require sterile water and conditions for babies to be fed.

While rates of breastfeeding have increased since the Code of Marketing Breast Milk Substitutes was endorsed there is still a very long way to go. We hope to see more countries endorse the Code and enact recommendations to ensure that industry practices, such as those prolific during this pandemic, don't harm babies’ health. Protecting, promoting, and supporting breastfeeding remains one of the most important things we can do for child health and development. There is no doubt that breastfeeding is something we should all be protecting.

About the author

Lucy Westerman (@lewest) is Policy and Campaigns Manager at NCD Alliance. Lucy leads NCD Alliance’s NCD prevention and health promotion policy activities, particularly focusing on alcohol, nutrition, physical activity, and cross-cutting issues such as the influence of social, commercial and environmental determinants on health.