Formula manufacturers continue to defy international regulations and target health centers to market their products, according to a WHO study on the marketing of infant formula and its impact on breastfeeding.
This practice is particularly prevalent in developing countries such as Nigeria and the South, where television marketing is less popular and where formula companies target health workers.
At Ipakodo Health Centre, Ikorodu, Lagos, Nigeria, SciDev.Net meets a nurse who takes care of pregnant women and young 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 to the press, says SciDev.Net.
The WHO report, a multi-country study published in February, notes that healthcare 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 formula manufacturers was extremely common in public and private health care settings.”
“The formula brand representatives are targeting different types of healthcare professionals – including pediatricians, nurses, dieticians and hospital administrators – with a range of incentives, including research funding, commissions on sales, ambassador roles, merchandise and gifts
and all paid promotional travel expenses.”
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 it has posters and pamphlets 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, the WHO report revealed.
Omolayo Adetutu, a mother who attended Ipakodo Primary Health Care Center, said SciDev.Net that “people come to us to market products, and we seek advice from caregivers”, but adds that doctors and nurses emphasize exclusive breastfeeding.
According to the WHO multi-country report, 51% of 8,528 pregnant and postnatal women said they had been exposed to the marketing of infant formula in 2021.
While the International Code of 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 outcomes.
According to experts, breastfeeding reduces the likelihood of childhood infections, including diarrhea, pneumonia and premature death. It also reduces the risk of depression in mothers.
Nearly 600,000 children die each year from lack of breast milk, according to a 2019 study published in Health policy and planning shows.
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 scaling up breastfeeding and nutrition interventions for children and their mothers to enhance human capital development and economic outcomes in the whole world. »
According to nutritionists, better education can help health workers and parents make breastfeeding decisions that will best promote a baby’s health.
WHO and UNICEF have developed training courses for health workers to provide skilled support to breastfeeding 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-term illnesses and diseases, including Sudden Infant Death Syndrome.”
Goodness Anyanwu, a nutritionist with the Federal Ministry of Health in Nigeria, saysSciDev.Net there are feeding alternatives for women who cannot breastfeed – this may be due to maternal health risks or issues 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. .