Marketing of infant formula in breach of international standards, report finds

WHO/Unicef research cites misleading messages that claim breast milk is inadequate

Formula milk marketing practices, which target parents and pregnant women, are in breach of international standards, according to a new report.

More than half of parents and pregnant women surveyed for the World Health Organisation (WHO) and Unicef report said they had been targeted by formula milk companies. The report, which surveyed 8,500 parents and 300 health workers in cities in eight countries, found that 84 per cent of women in the UK and 97 per cent of women in China had been exposed to formula milk promotion. Ireland is one of the biggest producers of formula milk in the world.

Examples of misleading marketing messages included how breast milk was inadequate for infant nutrition and that ingredients in formula milk were proven to improve child development or immunity. Both these messages violate the International Code of Marketing of Breastmilk Substitutes, which was passed by the World Health Assembly in 1981 to protect mothers from aggressive marketing practices by the baby food industry.

"This report shows very clearly that formula milk marketing remains unacceptably pervasive, misleading and aggressive," said Dr Tedros Adhanom Ghebreyesus, WHO director-general, following the publication of the report entitled "How Marketing of Formula Milk Influences our Decisions on Infant Feeding".


The report found that formula milk marketing strategies included sponsoring advice networks and helplines and giving free gifts to health workers. More than a third of women surveyed said a health worker had recommended a specific brand of formula to them.


The WHO recommends that babies are exclusively breastfed for the first six months and continue to be breastfed for up to two years and beyond. In Ireland, about six per cent of babies are exclusively breastfed for six months, while the global average of babies exclusively breastfed for six months is 44 per cent.

"False and misleading messages about formula feeding are a substantial barrier to breastfeeding, which we know is best for babies and mothers," said Unicef executive director Catherine Russell.

According to EU food law, infant formula cannot be advertised for babies up to 12 months, however, a loophole in the legislation allows so-called follow-on formula – for babies from six months onward – to be promoted. The WHO code states that breast-milk substitutes shouldn’t be advertised or marketed for babies and toddlers up to 36 months.

Commenting on the WHO/Unicef report, Dr Liz O’Sullivan, lecturer in nutrition at the Technological University of Dublin and member of Baby Feeding Law Group Ireland said that women in Ireland are also targeted by formula milk companies. “Although Ireland wasn’t one of the countries studied in this research, we face many similar challenges to those experienced by families in other countries. For example, baby clubs being run by the formula industry and the excessive marketing and promotion of products for infants over the age of six months are common in Ireland,” said Dr O’Sullivan.

“To truly implement the WHO code, we need to prevent the marketing and promotion of all breast-milk substitutes for infants and children up to 36 months,” she added.

Health claims

The Food Safety Authority of Ireland (FSAI), which is responsible for enforcing and monitoring EU food law (but not the WHO code), audits the marketing materials and labels of infant formula products each year.

"According to EU food law, companies are not allowed to make health claims about infant formula, compare breast milk and infant formula or imply bottle feeding is equivalent or superior to breastfeeding, but the rules are not as strict for follow-on formula which allows companies to advertise to a certain degree," said Nuala Collins, public health nutrition and safety manager at the FSAI.

The HSE has recently implemented a policy to ensure that health workers take active measures to eliminate the advertising of breast-milk substitutes within the HSE. A spokesperson said that it supports the WHO code in wanting to ensure that all parents have factual, unbiased information when it comes to their child nutrition by eliminating the inappropriate marketing of breast-milk substitutes within the HSE.

Sylvia Thompson

Sylvia Thompson

Sylvia Thompson, a contributor to The Irish Times, writes about health, heritage and the environment