Breastfeeding and the role of the commercial milk formula industry

Our interest was piqued by the Series paper by Nigel Rollins and colleagues.1Rollins N Piwoz E Baker P et al.Marketing of commercial milk formula: a system to capture parents, communities, science, and policy.Lancet. 2023; 401: 486-502Summary Full Text Full Text PDF PubMed Scopus (16) Google Scholar The paper raises awareness about the dangers of misrepresenting scientific evidence to sell products and underscores the need for greater transparency and accountability in the marketing practices of the infant formula industry. The paper serves as a call to action for health-care providers, policy makers, and parents to question the validity of marketing claims made by the formula industry, and to promote evidence-based recommendations that prioritise breastfeeding and healthy infant feeding practices. The marketing strategies used by the commercial milk formula (CMF) industry to exploit parental concerns and desires for their children's health and development are not limited to any specific region or country, but they are prevalent globally. In India, there is a diverse range of cultural practices related to lactation and breastfeeding. These practices encompass a spectrum from exclusive breastfeeding to incorporating different amounts of prelacteal and supplemental feeding, which could involve the use of infant formula or various types of animal milk.2Bandyopadhyay M Impact of ritual pollution on lactation and breastfeeding practices in rural West Bengal, India.Int Breastfeed J. 2009; (published online March 26.)https://doi.org/10.1186/1746-4358-4-2Crossref Scopus (69) Google Scholar Apart from this, due to the trend of women in urban areas being employed, the habit of supplementing breastfeeding with CMF has emerged.3Ashwini S Katti SM Mallapur MD Comparison of breast feeding practices among urban and rural mothers: a cross-sectional study.Int J Med Public Health. 2014; 4: 120-124Crossref Google Scholar The CMF industry uses marketing strategies to target parents' concerns about their children's health and development. For example, the industry markets CMF products claiming to relieve infant discomfort, promote better sleep, and enhance intelligence. Advertisements and packaging often use terms such as gentle, comfort, brain development, and intelligence to appeal to parents' emotions and create a positive image of their products. However, it is essential to note that India is a diverse country with considerable socioeconomic and cultural differences across regions. In many low-income and rural areas, breastfeeding is the norm and CMF usage is limited due to affordability and accessibility issues. In contrast, in urban and high-income settings, CMF usage is more common and the industry's marketing tactics are more prevalent. The National Family Health Survey-5 reports that in India, although 88·6% of births occur in health-care facilities, only 41·8% of women can initiate breastfeeding within the first hour after delivery.4India TodayExperts raise concern over 'exploitive' formula milk marketing, call for clampdowns in Lancet series.https://www.indiatoday.in/health/story/experts-raise-concern-over-exploitative-formula-milk-marketing-call-for-clampdowns-in-lancet-series-2332185-2023-02-08Date: Feb 8, 2023Date accessed: April 1, 2023Google Scholar This statistic is concerning and highlights the need for improved breastfeeding practices in the country. Additionally, India has regulations and guidelines for the marketing and advertising of infant and young child feeding products. India has made a considerable effort to protect the health of infants and young children with The Infant Milk Substitutes, Feeding Bottles, and Infant Foods (Regulation of Production, Supply, and Distribution) Act 1992, and Amendment Act 2003. This law prohibits any type of advertising or promotion of infant formula, feeding bottles, and infant foods for children aged 0–2 years. The Infant Milk Substitutes Act designates the Breastfeeding Promotion Network of India as a child welfare non-government organisation to oversee and enforce the law's provisions, as recognised by a notification in the Gazette of India since 1995.5Breastfeeding Promotion Network of IndiaIMS act monitoring and implementation.https://www.bpni.org/national-policy-programme-4/Date: 2023Date accessed: April 1, 2023Google Scholar However, there have been instances of non-compliance with these regulations, leading to concerns about the marketing tactics used by the CMF industry in India. Demographic changes and shifts towards urbanisation have increased the sales of baby formula milk in India. Although regulations exist to prevent misleading and unethical marketing practices, there is a need for greater awareness and enforcement to protect the health and wellbeing of infants and young children. We declare no competing interests. Breastfeeding and the role of the commercial milk formula industry – Authors' replyThe Correspondence from Dhanraj Ganapathy and Saravanan Sekaran, Kirtan Rana, Melissa A Theurich, Jonas Lander and colleagues, João Guilherme Bezerra Alves and colleagues, Keiko Nanishi and Hiroko Hongo, and Jean-Christophe Kremer and Beat Späth highlight the persistent, multimodal, global, and decades long marketing practices of the commercial milk formula (CMF) industry. To enable breastfeeding to thrive, multidimensional societal and government responses are required.1 Full-Text PDF