The public health community is a great advocate for breastfeeding–and why not?  Breastfeeding is not only the normal way mammals feed their young, it’s the ideal way, and it’s almost free.

On the other hand, some human mothers struggle with breastfeeding, sometimes because they don’t get the support they need, they have severe postpartum depression, they need to take incompatible medications, they have been sexually abused, or a whole host of other reasons.  Sometimes it just doesn’t work out, and the most important thing a baby needs is loving parents.  The risks associated with formula feeding are relatively slight compared to its benefits for many families.  Guilt tripping women about formula feeding is shameful.

That said, companies spend about 8 billion (yes, billion) dollars per year marketing infant formula, and they also have a trade group, the International Formula Council (IFC), that does lobbying and other advocacy on behalf of manufacturers. The IFC also sets up sham maternal advocacy sites to press the idea that breastfeeding advocates want to take away the right to bottlefeed.  In contrast, La Leche League International (LLL), the best-known breastfeeding advocacy group, has an annual budget of about 3.5 million.  I find La Leche League’s philosophy falls into demagoguery, especially regarding gender and parenting, but that’s what the breastfeeders have.  LLL is certainly a David to the Goliath IFC.

The American Public Health Association (APHA) has been a great supporter of breastfeeding, and they created a new policy statement on the topic at their 2013 annual meeting.  Their press release states that their Breastfeeding Call to Action (emphasis mine):

Continues APHA’s strong support of breastfeeding and recognizes efforts to increase breastfeeding rates and narrow breastfeeding disparities as fundamental public health issues. Calls for increasing access to lactation services, especially among under-served populations, and making sure such services are properly reimbursed. Also urges restricting infant formula marketing practices that can discourage breastfeeding, promoting breastfeeding in developing nations to help decrease HIV infection rates and endorsing the breastfeeding actions outlined in the 2013 federal “Report of the Secretary’s Advisory Committee on Infant Mortality.”

The thing is, there is already a policy on formula marketing practices from the World Health Organization.  It’s official title is the WHO International Code of Marketing of Breast-Milk Substitutes (the WHO Code for short), and it was published in 1981.  The United States was the only member nation in the world that did not vote to adopt the code, and it wasn’t until 1994 that President Clinton finally signed on.  The U.S. Breastfeeding Committee has a quick version of the WHO Code:

  • NO advertising of breast milk substitutes directly to the public.
  • NO free samples to mothers.
  • NO promotion of products in health care facilities.
  • NO company “mothercraft” nurses to advise mothers.
  • NO gifts or personal samples to health workers.
  • NO words or pictures idealizing artificial feeding, including pictures of infants on the products.
  • Information to health workers should be scientific and factual.
  • All information on artificial feeding, including the labels, should explain the benefits of breastfeeding, and the costs and hazards associated with artificial feeding.
  • Unsuitable products, such as condensed milk, should not be promoted for babies.
  • All products should be of a high quality and take into account the climatic and storage conditions of the country where they are used.

The IFC and its members try to portray the WHO Code as discriminatory against mothers who have to or choose to formula feed.  For instance, a press release on one of their websites links to a Cafe Mom piece, “Formula Restrictions are Unfair to New Moms.”  What is the unfair restriction?  China is banning the use of pictures of babies on formula containers (see bullet 6 above).  While the piece makes the important point that bullying or guilt-tripping mothers about their feeding choices is  asshole behavior, I don’t understand how following this aspect of the code qualifies as “bullying.”  The author refers to it as “[t]he latest strike in the war against moms who don’t want to breastfeed.”

China_Infant_formula_milk_powder20093111150175                           food can

Let me explain something.  There is almost no advertising for breastfeeding.  There is no product placement, there are not free goody bags from the breastfeeding fairy, there are no samples delivered to your door.  If a baby needs formula, parents know where to find it.  They don’t need cute pictures or slick ads to be able to pick up a can of formula and follow the directions for its preparation.  All formula sold in the United States has to meet safety and health standards.  The advertised additives that many name brands throw in are, in the words of pediatrician David Paige, “chemical soup.”  Touting the benefits of these additives through advertising doesn’t help anyone but those profiting from the sale of brand-name formulas.

I do agree that the bullet “All information on artificial feeding, including the labels, should explain the benefits of breastfeeding, and the costs and hazards associated with artificial feeding” is controversial.  Certainly if a woman wanted to breastfeed and then saw “risks” touted on her baby’s best alternative food, it could cause unwarranted guilt.  That’s wrong.

Everyone thinks of him or herself as a rational being who is somehow immune from the influences of advertising.  Each of those people is delusional.  Consumers actually have more trust in advertising now than ever.  Jean Kilbourne has some great work on the ways advertising influences us all.  I once argued at a presentation on food advertising that teaching children media literacy skills could help combat ads, and the presenters laughed.  They said that as adults who studied food advertising for a living, watching ads for Dairy Queen Blizzards still made them all want to run out and buy one immediately. Which of the two cans pictured above would you buy? Why would formula corporations spend 8 billion dollars if that investment had no return?

There is no reason for formula to be marketed at all.  If people need it, they need it–they shouln’t need to be persuaded.  The message should be out that formula is the safest alternative to breastmilk, and families should be taught to prepare and feed formula safely.  Past that, what’s to market?  All formula marketing has the potential to discourage breastfeeding.  We should stop it.

We do not need to fight for the right of formula companies to make a profit.  The only people who should win in the infant feeding debate are parents and their babies.