Influence of Commercial Milk Formula Marketing - Strategies and Problem

Introduction

Although the benefits of human milk and breastfeeding are widely known, infants and young children being breastfed, according to WHO (World Health Organization) recommendations, remain below 50 percent of the global proportion. On the other hand, marketing and sales of commercial milk formula (CMF) have increased tremendously in recent years, with more and more babies and young children receiving formula feeds compared to earlier decades.

The World Health Assembly in 1981 constituted several guidelines as a public health agreement for breast-milk substitutes (any food or milk substance being marketed as a partial or full replacement for mother's milk). Unfortunately, however, some CMF marketing practices have become exploitative in defiance of the authorized code. In addition, today's digital media amplify the impact of commercial milk formula marketing.

A clear orientation is needed based on scientific evidence to rationalize the use of commercial milk formula without eclipsing the practice of breastfeeding. This understanding also prevents falling prey to unethical marketing practices of commercial milk formula products.

What Is Commercial Milk Formula?

Commercial milk formula (CMF) refers to artificially processed milk substitutes or products for infants (babies of age from 0 up to 12 months) and young children (from 12 to 36 months) made from a wide range of edible substances such as animal milk, soybean, and vegetable oils and are promoted as a suitable replacement (partial or total) for human milk in the infants and young children's diet. Currently, there are various types of commercial milk formula products that are marketed. Some of them are listed below:

• Specialized Milks or Comfort Milks - Include commercial milk formula (CMF) products that are promoted for special medical conditions such as lactose intolerance and allergy to human milk where breastfeeding is contraindicated.

• Infant Formula - Usually recommended for infants of 0 to 6 months old but is marketed for older babies, also commonly referred to as stage 1 formula.

• Stage 2 Formula - Recommended for infants aged 6 to 12 months, but is also marketed for older babies and is widely known as the follow-on formula.

• Stage 3 Formula - Generally used for young children from 12 to 24 months but is marketed for younger and older children as toddler formula.

• Growing-up Milk Formula - Usually contains modified animal milk-based and animal milk substitute-based components that shares the specific brand identity with the identical infant formula product and is promoted as suitable for use as a partial or total replacement for breast milk in the diet of a child for children of age three years and above.

What Are the Marketing Strategies of Commercial Milk Formula?

Formula milk companies manufacture, promote, market, and sell commercial milk formula (CMF) products. These companies get authorized and undergo periodic quality assurance of the products by regulatory bodies.

The World Health Assembly (WHA) of the WHO has formulated strict resolutions on commercial milk formula marketing. However, recent research shows that most marketing techniques, such as inappropriate advertising and promotions to the general public, violate the WHA Code.

Some of the currently practiced marketing strategies include -

• These companies use the misinterpretations of the caregivers on the infant's behavior to favor and introduce commercial milk formula products.

• The products are marketed widely as comfort milk substitutes that target infants' uncooperative behaviors like poor sleep, fussiness, and unusual hungry cues.

• The CMF marketing companies tend to represent private sector modalities where the public health concept is compromised, masking the unfavorable determinants of commercial milk formula.

• The most successful marketing tactics include huge capital investments for advertising commercial milk formula (CMF) products through numerous media platforms such as TV, radio, commercials, magazines, online platforms, and social media.

• Another attractive marketing strategy of commercial milk formulas is to highlight the presence of artificially added and ultra-processed nutrients such as fortified iron and docosahexaenoic acid (DHA) in CMF products. Parents and caregivers prefer such products based on the information available that these components promote the child's growth and development.

• CMF marketing also uses aids from scientists and health professionals to effectively enhance confidence in using these products.

• CMF marketing identifies and capitalizes on the inadequate information and shortcomings in various public health policies and food regulations.

• Conflicting and insufficient recommendations from healthcare providers on the optimal duration of breastfeeding and the appropriate age to start complementary foods need to be clarified for parents and caregivers, resulting in preferring commercial milk formula products.

• Marketing companies use ambiguity among parents in interpreting public healthcare guidelines and how they receive information from healthcare professionals.

• Even during a pandemic like COVID-19, these CMF companies actively use parents' fears and anxiety to enhance the sales of commercial milk formulas.

How Does Commercial Milk Formula Marketing Influence?

Commercial milk formula marketing influences families, the scientific community, health and wellness professionals, policymakers, national survey reports, clinical trials, case studies, and research studies.

Some of its impact on the global population is as follows -

• Currently employed commercial milk formula marketing undermines the complete access to relevant information essential to support the reliable feeding of babies and toddlers.

• It becomes a potential barrier to following required breastfeeding methods and contributes to a reduced proportion of global breastfeeding practices.

• CMF marketing influences normative and sensitive beliefs, existing values, and business approaches to establish favorable environments for CMF sales.

• The marketing of commercial milk formula has negatively altered the whole feeding ecosystem for its unrequired use in the initial three years of the baby's life.

• CMF marketing significantly influences parents' and caregivers' decisions on the feeding practices of infants.

• The added nutritional components in commercial milk formula for toddlers affect their taste patterns and considerably contribute to unhealthy and unwanted taste preferences in later childhood.

What Are the Problems Associated With Current Commercial Milk Formula Marketing?

Global organizations like the World Health Organization's International Code of Marketing Breast-milk Substitutes firmly recommend that commercial milk formula manufacturers prohibit marketing practices that downregulate and discourage breastfeeding initiation and continuous practice. However, in reality, overall commercial milk formula marketing results in a negative impact on breastfeeding.

Research studies on commercial milk formula marketing tactics and strategies result in the following problematic consequences such as:

• Promotion of commercial milk formula, particularly infant formula, discourages breastfeeding initiation, resulting in reduced duration of exclusive breastfeeding the newborns.

• Promoting CMF formula products containing special nutrients and fortified formulas is unnecessary for most babies and toddlers. They are only needed when breastfeeding does not meet the child's nutritional demands.

• Huge advertising costs and employing ultra-processing techniques increase the monetary value of commercial milk formula products, making them more expensive than recommended foods such as regular infant formula or plain milk. As a result, such products become unaffordable by low-income groups or incur heavy financial imbalance in their families.

• Also, supplementing unwanted or excessive nutrients can harm infant and young children's diets.

• Commercial milk formula advertising claims and associated marketing strategies mislead parents and caregivers about optimally essential products and feeding practices of infants and toddlers.

• CMF marketing disrupts accessing genuine impartial information on child feeding practices, which is a violation of fundamental human rights affirmed by the UN Convention regarding the child's rights (CRC).

• The CRC emphasizes children's right to health. It has legal obligations to ensure that all fractions of society, especially parents, receive unbiased information and have adequate access to basic knowledge about the health and nutrition of children.

• Currently, commercial milk formula marketing is powered by generous budgets and deliberately misuses scientific evidence leading to the over-consumption of commercial milk formula products and discouraging breastfeeding.

• It also undermines women's confidence and cynically exploits parents' curiosity and instinct to do the best for their babies and children.

Conclusion

Commercial milk formula products do contribute to the growth and development of children. However, they should be marketed as complementary nutritional supplements to mothers' milk as exclusive breastfeeding is essential for the first six months of neonates' life. Potential interventions, effective policy-making, and strict regulatory solutions are needed to ensure that CMF marketing does not overshadow existing recommendations and practices of breastfeeding.