A code was set up by WHO in 1981 in a bid to regulate the industry after scandals in the 1970s when Nestle was accused of discouraging mothers, particularly in developing countries, from breastfeeding.

The report's authors and several external experts say it is time to reform the International Code of Marketing of Breast-milk Substitutes.
The report's authors and several external experts say it is time to reform the International Code of Marketing of Breast-milk Substitutes. (Reuters)

The United Nations has slammed baby formula makers for "unethical" marketing strategies, accusing them of aggressively targeting expecting parents and health workers and putting shareholder interests before children's health.

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, UNICEF and M&C Saatchi said on Wednesday.

"This report shows very clearly that formula milk marketing remains unacceptably pervasive, misleading and aggressive," WHO chief Tedros Adhanom Ghebreyesus said in a statement.

UNICEF chief Catherine Russell called for "robust policies, legislation and investments in breastfeeding to ensure that women are protected from unethical marketing practices".

Health workers are also targeted, with gifts, funding for research and even commission from sales, all practices that are banned under international guidelines for the marketing of formula milk.

The WHO recommends exclusive breastfeeding for newborns, where possible, as the healthier option.

Women who breastfeed also have a reduced risk of breast and ovarian cancer, research shows.

Call for reforms

The report's authors and several external experts said it was time to reform the International Code of Marketing of Breast-milk Substitutes. 

The code was set up by WHO in 1981 in a bid to regulate the industry after scandals in the 1970s when Nestle was accused of discouraging mothers, particularly in developing countries, from breastfeeding.

Nigel Rollins, lead author of the report and a WHO scientist, said: "Are there areas for strengthening the code? Unquestionably."

Formula milk and tobacco are the only two products for which there are international guidelines to prevent marketing.

Despite this, only 25 countries have fully implemented the code into legislation, and over the last four decades, sales of formula milk have more than doubled, while breastfeeding rates have only slightly increased, the WHO said.

The formula milk industry is now worth $55 billion annually.

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.

Titled "How marketing of formula milk influences our decisions on infant feeding", the report also included interviews with marketing executives and 300 health workers, and is the largest of its kind.

In China, 97 percent of women surveyed had been exposed to formula milk marketing; in the United Kingdom it was 84 percent and in Vietnam, 92 percent. 

More than a third of women across all of the countries said that health workers had recommended a specific brand of formula to them.

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Danone's marketing is 68 percent in line with the rules, and Nestle, 57 percent.
Danone's marketing is 68 percent in line with the rules, and Nestle, 57 percent. (Reuters)

Misleading messages

While the code allows factual information about formula to be provided, and the authors acknowledged the importance of formula milk for women who cannot or do not want to breastfeed, they said the marketing practices were a key reason for low breastfeeding rates worldwide.

The WHO recommends exclusive breastfeeding for at least the first six months of life, but at the moment, only 44 percent of babies this age are fed this way.

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

An index compiled by the Access to Nutrition Initiative in 2021 found that some companies were more compliant with the code than others: for example, Danone's marketing is 68 percent in line with the rules, and Nestle, 57 percent. 

However, three of the leading companies operating in China – Feihe, Mengniu and Yili – all scored zero.

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Source: TRTWorld and agencies