Digital ads for breast-milk substitutes are now one of the most popular and effective marketing strategies – negatively impacting breastfeeding practices, according to a new report published Friday by the World Health Organization. 

The report, ‘Scope and impact of digital marketing strategies for promoting breastmilk substitutes’, found that digital marketing of infant formulas has increased sales in every country studied. It is thus fueling the steady growth of the breast milk industry, now valued at $52 billion – and increasingly threatening healthy breastfeeding in the early months of life. 

In some countries reviewed, more than 80% of women who reported seeing breast-milk substitutes (BMS) advertisements were now seeing the content online.

This demonstrates the power of digital technologies, as they offer advertisers new marketing tools that are powerfully persuasive, extremely cost effective and often not easily recognizable as BMS promotions.

“We have a huge threat on breastfeeding. Digital marketing is really going to make things difficult for us on breastfeeding, and therefore is a huge challenge to the health of mothers and the health of babies,” said Lawrence Grummer-Strawn, WHO Unit Head of Food and Nutrition Action in Health Systems, during a launch of the report.

“The reach of digital marketing is so great that, in many countries, it is inescapable… It is therefore not surprising that digital marketing has become the dominant form of BMS promotion,” reads the report. 

Ample evidence shows that exclusive and continued breastfeeding in the first months of life are key to health for children, women and communities.  But far too few children are breastfed as recommended.  And despite the World Health Assembly’s adoption of the International code of marketing of breast-milk substitutes (“the Code”) in 1981 – digital advertising is increasingly undermining the will of women to breast feed.  

The report includes findings from several studies including: a multi-country study of mothers’ and health professionals’ experience with digital marketing; individual country reports of BMS promotions; and an analysis of legal measures that have been taken to implement the Code to date.  Studies captured digital interactions that referenced infant feeding in 11 languages that originated from 17 countries, which together account for 61% of the global population and span all six WHO regions. 

The report further confirms findings aired at the World Health Assembly in 2020, that breast mild substitutes were making new inroads into households in the global South,  including through new and more effective modes of digital marketing.

Breast-milk substitute sales boosted through online social media 

In one of the reviews, women in seven countries – Bangladesh, China, Mexico, Morocco, United Kingdom, and Vietnam, who recorded BMS promotions in marketing diaries over a single week reported seeing advertisements for formula on social media and e-commerce sites.

In Indonesia and Vietnam, the most frequently identified sources of advertising for BMS products were the Internet and Facebook. In Thailand, Facebook was the most commonly reported source of BMS marketing, with most of these advertisements (58%) originating from company/brand websites, followed by the companies’ Facebook accounts. 

Exploiting women’s most vulnerable moments to sell formula

The Facebook promotions include targeted advertising about infant formulas, follow-on formula and toddler formula, virtual support groups known as baby clubs hosted by BMS brands, BMS branded apps and social media influencers promoting BMS products. 

“The precision with which digital marketing platforms can identify users by their characteristics, their traits, their spending patterns, and their likeness to other users is quite uncanny,” remarked Nina Chad, an expert in WHO’s Department of Nutrition and Food Safety.   

“When women share information about pregnancy with family and friends online or purchase maternity clothing, search for a health provider, or join an online support group, they’re often identified as targets for advertising for baby related products and brands, including BMS.” 

“This technology enables advertisers to exploit their most vulnerable moments, disguise their marketing content as information or advice and enlist people women respect most to influence their infant feeding choices,” the report adds.  

Only one in five countries prohibits online marketing of infant formulas  

Digital marketing techniques described in the report present challenges for regulation with fewer than one in five countries (19%) explicitly prohibiting the promotion of BMS. 

These technologies enable advertisers to evade scrutiny from enforcement agencies by delivering BMS promotions to personal accounts without ever publishing them publicly. 

However, it is difficult to hold manufacturers and distributors of the products accountable as their promotions are generated by virtual support groups that consist of the general public and mothers, as well as social media influencers, who are not directly employed or contracted by these companies.  

Additionally, product promotions more frequently target the mothers of infants 6-12 months old, as compared to newborns. This practice, known as line extension or cross promotion, is used to circumvent regulation that prohibits the promotion of infant formula products suitable for infants up to 6 or 12 months of age.  

The report advises new approaches to implementing the Code and potentially even new and updated strategies to monitor and enforce its regulations in order to protect both mother and infants from the harms of digital marketing. 

“We need to have greater regulation of the platforms themselves. We can’t put all of this on the shoulders of those who want to be advertising. It’s also among those who are actually carrying out the advertising who are making this targeting possible and who are hiding the information that is needed for monitoring and enforcement,” said Grummer-Strawn. 

Image Credits: Flickr, WHO.