Today, countries that ban the advertising or promotion of infant formula, such as Brazil, tend to have higher rates of breastfeeding than those that don’t, like the United States. Still, even countries that adopted the WHO code into law don’t always crack down on formula manufacturers that break it.
Though 130 countries restricted advertising in the wake of the WHO code’s passage, a study in 2010 documented 500 violations of the code in 46 countries. One billboard in Laos, for example, showed a child happily eating “Bear Brand Formula Milk.” “This type of widespread marketing results in mothers’ recognizing certain brands and believing their children will be healthier with formula,” wrote the pediatrician June Pauline Brady in the Archives of Disease in Childhood in 2012.
In 2004, the U.S. Department of Health and Human Services tried to do the opposite: to advertise breastfeeding. Health officials were going to release ads showing some of the health issues—in the form of insulin syringes and inhalers—that they claimed babies who aren’t breastfed are more likely to face, according to a Washington Post story from the time. But the infant-formula industry hired lobbyists to appeal to the department, and the ads were toned down to feature happier pictures of ice cream and flowers. The new campaign, in the end, did nothing to boost breastfeeding rates.
Two years later, Massachusetts went further, becoming the first state to ban gift bags filled with infant formula in maternity wards. But the decision, crafted by the state’s Department of Public Health, was reversed by then-Governor Mitt Romney. The following month, Bristol-Myers Squibb, which makes formula, announced it would build a plant in Massachusetts. (“The decision to build our facility in Devens did not involve any consideration of our Mead Johnson business,” said a Bristol Myers Squibb spokesperson, referencing a former subsidiary.)
As recently as February of this year, a report by the group Changing Markets Foundation found that Nestle pitched its baby formulas as “closest to,” “inspired by,” and “following the example of” human breast milk, The Guardian reported. In some cases, the company contradicted itself, promoting Brazilian formula as being free of sucrose “for baby’s good health” while tucking sucrose into its South African formula. (A Nestle spokesperson told me, “The Changing Markets Foundation report on infant formula raises some important points. We engaged with CMF in a dialogue to clarify these points. We hope to collectively address the critically important challenge of ensuring access to the right nutrition for infants.”)
A few weeks later, an investigation by The Guardian and Save the Children found that infant-formula makers were offering health workers in the Philippines “free trips to lavish conferences, meals, tickets to shows and the cinema and even gambling chips, earning their loyalty,” in violation of the country’s laws. The investigation found:
TV advertising campaigns for follow-on milk by brands such as Bonna—which portray the “Bonna kid” as one who is smarter and succeeds in life—convinced them, they said, that bottle feeding is not only as good for the baby’s health as breast milk but will bolster their IQ and future prospects. Store displays of formula were splashed with claims such as “clinically proven to give the IQ + EQ advantage.”
The reporters spoke with one woman who could only afford to give her baby half-bottles of the formula. The girl’s stomach, they wrote, was visibly swollen from malnutrition.