The same week in February in which Abbott, one of the main producers of formula for infants in the United States, began to withdraw a series of products causing shortages in the country, the World Health Organization (WHO) made public an important report which, however, went almost unnoticed. The researchers added one more to the catalog of problems with this class of preparations: much of the world is overly dependent on them due to aggressive and deceptive marketing techniques from manufacturers.
“Formula milk marketing knows no bounds. It misuses information and distorts it to influence decisions and practices,” the authors denounced. The report looked at the marketing practices of infant formula in eight countries around the world, but was largely overshadowed by other news in the United States.
The current shortage of formula milk for babies in the US shows that it is a necessary product that, in certain circumstances, is essential, especially for working mothers, those of premature babies, or those who have problems breastfeeding. The need is so basic that, last June, the Joe Biden administration announced that it would import from Switzerland nearly 20,000 kilos of Nestlé infant formula for distribution throughout the United States.
Breastfeeding strengthens the immune system of babies and reduces the risks of the mother suffering from diabetes or cancer
However, there is a global health consensus that, whenever possible, breast milk is better for the baby’s health than commercial products. The benefits of breastfeeding are well documented: strengthens the immune system so that it better protects babies against infections and reduces the risks of the mother suffering from diabetes or even cancer. In rich countries, thanks to major public health campaigns – coupled with tighter controls on company advertising – mothers are more likely to make informed decisions about when to use formula.
In contrast, according to the WHO, in Vietnam the companies that manufacture the substitutes carry out some of the most aggressive marketing strategies in the world. Women are bombarded with TV ads and social media posts that often distort scientific evidence to legitimize their claims and sell their products. Company representatives, known as “promo girls,” even hang out in hospital lobbies to bond with unsuspecting new mothers.
A third of new mothers in Vietnam say they have received product samples, a higher figure than that of any other country in which the WHO conducts surveys, with the exception of China
The practices are effective. About 76% of babies in Vietnam are partially or fully fed replacement milk. The United Nations has set itself the goal of reducing this figure to 50% worldwide by 2025, a goal that will surely not be achieved.
“They put a lot of energy into rapidly advancing economies like Vietnam,” explains Laurence Grummer-Strawn, a WHO nutrition expert. “They know that the market is going to grow in them. People’s incomes are rising, women are becoming more active in the workforce, and that’s why they do a lot of advertising.”
Around a third of new mothers in Vietnam say they have received product samples, a higher figure than any other country surveyed by the WHO except China. But the problem is global. The World Health Organization research team found the same aggressive tactics in Bangladesh, Mexico, Morocco, Nigeria, and South Africa, among others. One of the most serious cases is that of Mexico, where the WHO verified that health personnel separated babies from their nursing mothers and began to administer formula milk unnecessarily to newborns.
In Mexico, the WHO found that health personnel were separating babies from their lactating mothers and began to unnecessarily administer formula milk to newborns
These strategies endure despite the International Code of Marketing of Breast-milk Substitutes, a similar best practice framework to the global agreement on tobacco. In fact, both products are the only ones for which there are global recommendations on their marketing. However, due to the non-binding nature of the document, companies continue to prioritize their economic benefits over people, especially in countries where public health infrastructures and enforcement mechanisms are weaker.
The WHO adopted the framework in 1981, after the non-profit organization War on Wantbased in London, will publish a report entitled The Baby Killer (The baby killer). The report investigated the aggressive and inaccurate marketing tactics of the multinationals of breast milk substitutes of the time. Investigators accused Nestlé and Abbott – still the biggest players in the market today – of selling artificial milk to mothers who could not afford it and who would have been better off breastfeeding. From Jamaica to Jordan, they documented how early introduction of substitute formulas resulted in higher infection rates and, in the most extreme cases, infant malnutrition, as the product was expensive and mothers tried to make it last longer by diluting the formula. solution. The report shocked public opinion and caused the world to act.
However, the WHO states that, today, only 44% of children under six months in the world are exclusively breastfed. On the other hand, the value of the formula milk manufacturing sector has increased to 53.6 billion euros. These benefits partly reflect the growing number of mothers around the world who are joining the workforce and turning to substitute formula because they are less likely to breastfeed their babies. But it is also the result of coercive marketing practices in countries where health infrastructures are weak and lactation advice services are overwhelmed. Since China until Nigerianew mothers are faced with an array of information that sings the praises of formula milk over breast milk.
The WHO states that, today, only 44% of children under six months in the world are exclusively breastfed.
The Internet provides these companies with a powerful and convenient tool that they did not have decades ago. Digital marketing is cheap, and using influencersFrom Facebook parent groups to Google search ads, baby-substitute companies promote their products—and their questionable health claims—in ways that aren’t easily recognized as advertising.
To Huong, 35, lives in Vietnam and witnessed the marketing tactics of formula companies firsthand when she gave birth to her first child by caesarean section seven years ago. Because of her friends, her relatives, and the chaos of information she found here and there on the internet, she believed that women who had a C-section could not breastfeed. “I felt insecure,” she confesses, “and after giving birth I didn’t have any milk right away, so I switched to formula.” She then did not know that, with the help of a lactation consultant, she probably would have been able to breastfeed her child.
Choosing the brand of the substitute was just as stressful as his decision to use it. She says she was “overwhelmed by the different ads” promising everything from improving a baby’s digestive health to reducing crying.
Last year, Alive & Thrive, a global organization dedicated to maternal and child health, worked with a team of technicians to analyze the Vietnamese market. After examining more than 16,000 online posts, from social media content to e-commerce websites, she found more than 4,000 violations of the International Code of Marketing of Breast-milk Substitutes. The Japanese GuunUp MBP was the main offender in the country: 80% of its publications did not comply with the rules of the code. Other multinationals, from America’s Mead Johnson to Switzerland’s Nestlé, have also been caught using questionable tactics.
For example, Alive&Thrive investigators found that Mead Johnson was discounting its Enfagrow brand of infant formula, in violation of the code for marketing products to children under 24 months. In the advertisement, the company included a photo of its product for older children as a way of complying with the regulations. The organization also discovered that Nestlé was trying to contact parents directly through its Facebook page in Vietnam, which is another violation of the code.
Manufacturers have even seized on parental fears of Covid-19 and focused their marketing strategy on vague claims that their products boost immunity. According to him International Journal of Environmental Research and Public Health (International Journal of Environmental Research and Public Health), a Vietnamese brand used a photo WHO Director-General Tedros Adhanom Ghebreyesus from a Facebook post about the pandemic, to imply by association that his milk substitute could fight the virus.
A Vietnamese brand used a photo of the WHO director-general, from a Facebook post about the pandemic, to imply by association that its milk substitute could fight the virus
Nestlé Vietnam did not respond to the specific accusations, but issued a statement saying the company responsibly markets breastmilk substitutes and has “a strict policy and a strong compliance and governance system to be held accountable for its actions.” . The other companies mentioned in this article did not respond to requests for comment.
Vietnam passed legislation in line with the code a few years ago, which means the government can take action against those who break advertising rules. However, Vu Hoang Duong, regional technical specialist for Alive&Thrive, considers that “there are few personnel to examine all the infractions on digital platforms.” The Ministry of Health has only three inspectors in charge of enforcing the Code. The ministry did not respond to requests for its version for this article.
Consequently, the job of countering the pseudoscience and confusing hype often falls to mothers committed to publicizing the benefits of breastfeeding versus milk substitutes. To Huong, who regrets feeding her child with artificial products, has a message for the women of Vietnam: “Thoroughly investigate the origin and ingredients of formula milk before giving it to your babies. And if you have problems, seek the help of lactation consultants”.
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