Marketing of commercial milk formula: a system to capture parents, communities, science, and policy

Elsevier, The Lancet, Volume 401, Issue 10375, 11–17 February 2023, Pages 486-502
Prof Nigel Rollins MD, Ellen Piwoz ScD, Phillip Baker PhD, Gillian Kingston PhD, Kopano Matlwa Mabaso PhD, Prof David McCoy DrPH, Paulo Augusto Ribeiro Neves PhD, Prof Rafael Pérez-Escamilla PhD, Prof Linda Richter PhD, Prof Katheryn Russ PhD, Prof Gita Sen PhD, Cecília Tomori PhD, Prof Cesar G Victora MD, Paul Zambrano MD, Prof Gerard Hastings PhD, 2023 Lancet Breastfeeding Series Group

Despite proven benefits, less than half of infants and young children globally are breastfed in accordance with the recommendations of WHO. In comparison, commercial milk formula (CMF) sales have increased to about US$55 billion annually, with more infants and young children receiving formula products than ever. This Series paper describes the CMF marketing playbook and its influence on families, health professionals, science, and policy processes, drawing on national survey data, company reports, case studies, methodical scoping reviews, and two multicountry research studies. We report how CMF sales are driven by multifaceted, well resourced marketing strategies that portray CMF products, with little or no supporting evidence, as solutions to common infant health and developmental challenges in ways that systematically undermine breastfeeding. Digital platforms substantially extend the reach and influence of marketing while circumventing the International Code of Marketing of Breast-milk Substitutes. Creating an enabling policy environment for breastfeeding that is free from commercial influence requires greater political commitment, financial investment, CMF industry transparency, and sustained advocacy. A framework convention on the commercial marketing of food products for infants and children is needed to end CMF marketing.