LLL Today #4 – World Breastfeeding Conference

The International Baby Food Action Network (IBFAN), of which La Leche League has been a partner since its creation, works to protect babies, breastfed or not, from the aggressive marketing of breastmilk substitute manufacturers.

Every four years, IBFAN brings together partners and researchers for its World Breastfeeding Conference. In March 2023, I had the opportunity to represent La Leche League International in Cairo, Egypt, for the 4th edition of this important conference. I would like to share with you, parents, Leaders and friends of La Leche League, a few points that I think are important to remember.

We need to fight to enforce the International Code of Marketing of Breastmilk Substitutes

The International Code of Marketing of Breastmilk Substitutes (the Code) was accepted in 1981 by the World Health Assembly and ratified by many countries. Yet, despite its importance, this Code is not sufficiently implemented in national laws. The power of industrial lobbies, the lack of interest of legislators in infant nutrition, and sometimes even corruption were highlighted during the conference as obstacles to strong policies to implement the Code in the world.  

Without strong enforcement laws, commercial milk formula (CMF) manufacturers continue to flood families (and health professionals!) with misleading advertisements, incentive promotions, parenting clubs, etc., all at the expense of public health. The latest WHO and UNICEF reports are formal: Code violations are a real scourge [1]. It is urgent that citizens mobilize: get informed, and talk to your LLL Leader or IBFAN for more information.

All parents are victims of abusive marketing

Commercial milk formula is not a product like any other, and Code enforcement is crucial for non-breastfed babies. Without the huge marketing expenditures made by CMF producers, formula would be much more affordable for families who need it. The Code is not intended to prohibit the sale of formula at all, but to ensure informed access to healthy choices unbiased by commercial interests.

Marketing plays on parents’ fears

Many breastfeeding relationships could be protected if parents were not so exposed to the messages of CMF producers. The fear of lack of milk, the fear that breast milk is not “good enough”, and fears that crying, gas, colics or regurgitation of the infant are pathological are conveyed in “new mother clubs”, on social media, in newsletters, in retail stores, etc. Of course, for each problem, manufacturers offer a specific product as a solution! It is misleading to pretend that a substitute product is the only solution! [2]

For each concern or problem with breastfeeding, there are answers and many suggestions for solutions that can be provided by the health system. Support by organizations such as La Leche League is an important link in this health network. If you have any doubts, questions, or concerns, La Leche League has nothing to sell, but it is there for you.

A feigned pro-breastfeeding image

In many parts of the world, the CMF manufacturers have been building relationships with mothers since pregnancy. They have even developed powdered milks for pregnant women! These ultra-processed products, often with high levels of added sugars, are supposed to provide the nutritional supplements necessary for the health of the mother and (her unborn child [3]. The companies use slogans and campaigns [4] to create a pro-breastfeeding image that almost makes us forget that their primary goal is to make profits. The only way to increase their profits is precisely to decrease breastfeeding rates and change traditional local eating habits.

Many studies show that the influence of marketing on consumers is real [5]. Marketing influences not only parents, but also healthcare professionals [6]. For healthcare providers, this marketing takes the form of scholarships and study trips, gifts of equipment, sponsored conferences and congresses, etc. The medical sector should be ethically blameless, but unfortunately, conflicts of interest are common in many professions.

The conference lasted three extremely full days. Five hundred people attended daily. Nearly 80 speakers offered information on many other topics besides the Code. For more information, feel free to contact me.

Photo: La Leche League at the 4th World Breastfeeding Conference: From left to right, Stefanie Rosin (LLL Germany), Amina Hanifia (LLL Egypt), Charlotte Codron (LLL Turkey and LLLI International Code and Conflicts of Interest Committee)

[1] How the marketing of formula milk influences our decision on infant feeding. Geneva: World Health Organization; 2022
Scope and impact of digital marketing strategies for promoting breast-milk substitutes. Geneva: World Health Organization; 2022

[2] Chris van Tulleken. “Trojan Formula: How companies use normal infant behavior as a marketing tool.” For more information, read van Tulleken C. Overdiagnosis and industry influence: how cow’s milk protein allergy is extending the reach of infant formula manufacturers BMJ 2018; 363 :k5056 doi:10.1136/bmj.k5056

[3] Constance Ching. “Beliefs and norms associated with the use of Ultra-Processed Commercial Milk Formulas for Pregnant Women in Vietnam.” Based on Nguyen TT, Cashin J, Ching C, Baker P, Tran HT, Weissman A, Nguyen TT, Mathisen R. Beliefs and Norms Associated with the Use of Ultra-Processed Commercial Milk Formulas for Pregnant Women in Vietnam. Nutrients. 2021 Nov 19;13(11):4143. doi: 10.3390/nu13114143. PMID: 34836398; PMCID: PMC8621914.

[4] Patti Rundall et Elisabeth Sterken. “The business of malnutrition – How corporations use the humanitarian image.”

[5] The Lancet Series on Breastfeeding, February 2023.

[6] Laurence Grummer-Strawn. “Sponsorship of healthcare professional associations, why this is a problem, and what the Code says about it.”

Charlotte Codron, LLL Leader in Turkey, Member of the LLLI International Code and Conflicts of Interest Committee, lllturkiye@gmail.com