Breastfeeding seminars

Africa: Commercialization of infant formula disrupts breastfeeding goals

Lagos – Formula companies continue to defy international regulations and target health centers to market their products, says WHO study on formula marketing and its impact on breastfeeding programming.

This practice is particularly prevalent in developing countries such as Nigeria and the South, where television marketing is less popular and formula companies target health workers.

At Ipakodo Health Center, Ikorodu, Lagos, Nigeria, SciDev.Net meets a nurse who cares for pregnant women and new mothers. She is one of many health workers who have witnessed the marketing ploys of infant formula manufacturers.

“It’s not news that they come, they get approval from the primary health care board. Sometimes they come to help fund some of our programs but ultimately it’s to market their product,” said the nurse, who requested anonymity because she does not have the authority to speak with the press, tells SciDev.Net.

The WHO report, a multi-country study published in February, notes that health workers in eight countries surveyed said they had been approached by representatives of infant formula companies.

“Health professionals in Morocco, Nigeria and Vietnam reported that contact with infant formula manufacturers was extremely common in public and private health facilities.”

“Formula brand reps target different types of healthcare professionals – including pediatricians, nurses, dietitians and hospital administrators – with a range of incentives, including funding for to researchcommissions on sales, ambassador roles, merchandise and gifts, and all expenses paid for promotional travel. »

The Ikorodu nurse admits this is the reality, but adds that the health center where she works prioritizes exclusive breastfeeding for six months and makes sure they have posters and leaflets on exclusive breastfeeding.

The targeting of health workers and infant formula marketing centers has direct consequences on breastfeeding rates.

In Nigeria, about 45% of postpartum women received a recommendation from a health professional to feed their infants with formula, according to WHO report revealed.

Omolayo Adetutu, a mother who attended the Ipakodo Primary Care Center, told SciDev.Net that “people come to market products to us and we seek advice from health workers,” but adds that doctors and nurses emphasize exclusive breastfeeding.

According to the WHO multi-country report51% of 8,528 pregnant and postnatal women reported being exposed to infant formula marketing in 2021.

While the International Coded Marketing of Breastmilk Substitutes – a WHO public health agreement implemented in 1981 – exists to regulate the marketing of infant formula, companies continue to ignore this code.

Formula Marketing Strategies

In its report, the WHO condemned what it called widespread marketing by formula manufacturers. He described the marketing strategies as “invasive” and breaking “international standards” to influence parents’ decisions on how to feed their babies.

The report found that women were much more likely to choose formula feeding after being exposed to the marketing of breastmilk substitutes because the marketing messages contained misconceptions about breastfeeding.

According to the report, the messages included claims that their products almost resemble breast milk and that formula should be the first food, especially for babies born by caesarean section, babies of HIV-infected mothers and babies whose mothers have insufficient milk production. In turn, health workers recommend these formulas to mothers based on this information.

“Usually we give this (formula) to make sure the baby is not hungry. When the mother is getting stronger, we encourage her to breastfeed and not to continue with the formula. I have to say that we rigorously preach baby-friendly,” the Lagos nurse said.

“These mothers even feed the baby paps [maize porridge] because many have low levels of education and income, which puts babies at risk,” said another nurse from the Federal Medical Center in Owerri, Imo State, Nigeria, who also asked to remain anonymous.

“This is the point where we recommend formula milk, recommending alternative feeding is the last resort, if we don’t mothers will continue to feed the baby what they see fit,” she adds .

Cost of not breastfeeding

Evidence has shown that breastfeeding within the first hour of birth and exclusive breastfeeding for the first six months of an infant’s life are known to improve survival and health results.

Breastfeeding reduces the risk of childhood infections, including diarrhea, pneumonia and premature death, experts say. It also reduces the risk of depression in mothers.

Nearly 600,000 children die each year from lack of breast milk, a 2019 study published in programs on health policy and planning.

Map showing the prevalence of breastfeeding in Nigeria.

The researchers used a tool they called “the cost of not breastfeeding” to analyze the human and economic consequences of not breastfeeding at national, regional and global levels.

“Breastfeeding was attributed to 595,379 child deaths from diarrhea (38%) and pneumonia (62%) each year,” the study adds. “An estimated 974,956 cases of childhood obesity each year have been attributed to not breastfeeding as recommended.”

About two-thirds of these infectious disease cases occurred in South Asia and sub-Saharan Africa, with 84% in lower-middle-income and low-income countries.

Researchers said optimal breastfeeding also has the potential to prevent 98,243 additional maternal deaths from cancer and type II diabetes each year.

“The total annual global economic losses [to lack of breastfeeding] are estimated between $257 billion and $341 billion, or between 0.37% and 0.70% of global gross national income,” the study found.

The costs of not breastfeeding are significant and should compel policy makers and donors to invest in breastfeeding development and nutrition interventions for children and their mothers to enhance human capital development and economic outcomes around the world.

Potential Solutions

Better education can help health workers and parents make breastfeeding decisions that will best support baby’s health, nutritionists say. WHO and UNICEF have developed training Classes health workers to provide skilled support to nursing mothers and help them overcome problems.

“We have prenatal and postnatal conferences, and exclusive breastfeeding is our main topic,” says the nurse from Ikorodu. “We encourage mothers to make sure they eat well, so they can produce milk, and we let them know that breast milk contains everything the baby needs for the first six months of pregnancy. life and may help protect babies against certain long-lasting illnesses and diseases including Sudden Infant Death Syndrome.”

Goodness Anyanwu, a nutritionist at the Federal Ministry of Health in Nigeria, tells SciDev.Net that there are feeding alternatives for women who cannot breastfeed – this may be due to maternal health risks or problems such as inverted nipples.

“Breastmilk banks exist for mothers who cannot breastfeed. We are trying to explore that at the Federal Ministry of Health where a woman can go to donate breastmilk for cases like this,” she says, adding that discussions are continuing.

Anyanwu says hormone-induced lactation – where hormones like estrogen or progesterone are given to mimic the effects of pregnancy – can also be explored, while healthy parents who can breastfeed can also be considered. .

This story was produced as part of Dataphyte’s 2022 Media Fellowship.