A government-funded research team recently investigated whether the packaging of formula milk complies with certain regulations. They undertook the task of inspecting every single formula product on the UK market. Boring, yes, but bear with us, because what transpires is a lesson in absurdity.
The justification for this legislation is that marketing unduly influences parents’ decisions about how to feed their babies. The authors cite two pieces of evidence for this idea. Firstly, they refer to an editorial bewailing the value of the formula industry, especially in developing countries. Secondly, they cite a study of American mothers of older babies, which found that those who fed their babies formula were more likely to ‘endorse marketing claims’. The latter study doesn’t examine whether the endorsement came before or after the use of formula, and it isn’t clear to us why these findings from the US would be relevant here. But wait, it gets better…
In a press release for the new study, one of the authors highlights that the US has an exclusive breastfeeding rate of 19% at six months, compared to 1% in the UK. But the US does not regulate formula marketing or follow the WHO ‘International Code of Marketing of Breast-Milk Substitutes’. Some US doctors give out formula samples. Meanwhile, mothers in the UK say they stop breastfeeding due to pain, latching difficulties and low milk supply. Qualitative studies show women torturing themselves over deciding to stop breastfeeding, even when suffering severe pain. Still, according to these authors, we should apparently be very concerned about formula marketing, because of low breastfeeding rates in the UK.
The authors were concerned about the impact of pictures of toys and baby animals on formula products. How pictures of teddies could compete with the strong arm of public health messaging and trusted healthcare professionals, as women agonise over whether to stop breastfeeding when it is causing them suffering, we cannot imagine.
What else did the authors find? They found 100% compliance with the requirement for every formula packet to have a notice that breastfeeding is superior. Were they pleased? Like hell! No, they concluded that the message was not big or prominent enough! Don’t worry, formula companies, we mothers sympathise a lot here. Because just like us, it seems you can do nothing right.
So, the authors advocate for bigger and more prominent messaging that breastfeeding is superior on every can of formula, apparently to protect us from formula marketing. But in their zeal to protect us, we question whether they have even considered the impact on parents of seeing this messaging multiple times a day, every day, at every feed, especially on those who feel shame and stigma in relation to formula feeding.
The idea that we are unduly influenced by formula marketing is absurd, when so many of us make an unnecessarily stressful decision to stop breastfeeding or to introduce formula. This approach isn’t about helping parents, it is about punishing industry. Whether this will ultimately hurt companies, we don’t know, but it certainly hurts us. We are reminded of Hilda Bastian’s warning from her excellent blog on biases in health sciences:
I think the main thing I learned – very painfully – in 20 years as a health consumer advocate, is that zealots always, always end up hurting patients. Because whatever it is that they are against, is not the same as being for patients, and it will, inevitably, betray us.
Members of IFA and friends wrote a response to the journal, Public Health Nutrition. It has just been published and can be read here. We said loud and clear: anti-industry bias in infant feeding policy, practice and discourse is hurting us.
The study authors had the opportunity to respond to us in the journal. They chose not to.
This blog was adapted from a Twitter thread.