Harriet Box, spokeswoman for University of the Western Cape

In a significant move to protect public health, academics from the University of the Western Cape (UWC) are heading the fight against exploitative marketing practices, paving the way for a healthier future for all.

A paper just published in the Journal of the Colleges of Medicine of South Africa provides a strong call for South African health professional associations to end sponsorship from commercial milk formula manufacturers.

The authors of this paper represent various health professions, disciplines, universities and organisations in South Africa.

A former UWC lecturer and alumna, as well as academics in public health and health promotion, combined efforts to curb the aggressive promotion of commercial milk formula (CMF).

Despite the well-documented benefits of breastfeeding, the CMF industry continues to expand, driven by pervasive marketing strategies that often target healthcare professionals, creating conflicts of interest (COI).

Professor Renier Coetzee, from UWC's School of Public Health and Deputy President of the Pharmaceutical Society of South Africa (PSSA), highlights the detrimental impact of the CMF industry's influence on health professional associations.

“The commercial determinants of health refer to private sector activities that influence population health, often driven by powerful transnational corporations. These practices are causing illness, environmental harm, and social inequity.”

The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) have issued clear guidance urging healthcare institutions and professional associations to refuse sponsorship from the CMF industry.

“This call aims to protect the integrity of healthcare professionals and ensure that support for pregnant and breastfeeding women, children, and families remains free from commercial influence,” said Prof Coetzee.

“The benefits of breastfeeding are extensive and encompass public health, societal, economic, and environmental advantages. However, the CMF industry continues to grow, employing marketing tactics that actively target trusted health professionals such as doctors, nurses, midwives and dietitians.

“These professionals, who are key sources of advice for parents on infant and young child feeding (IYCF), may be subconsciously influenced by the industry's funding, leading to potential biases in their recommendations.”

Professor Tanya Doherty, Extraordinary Professor at UWC’s School of Public Health and Chief Specialist Scientist at the Health Systems Research Unit of the South African Medical Research Council, describes how recent reports have shed light on the exploitative marketing practices of the CMF industry.

“The WHO has revealed that formula milk companies are increasingly using digital marketing strategies to target new mothers at vulnerable moments. These tactics include personalised social media content, virtual support groups, and paid influencers, which often go unrecognised as advertising. This pervasive marketing undermines breastfeeding by reinforcing myths and eroding women's confidence in their ability to breastfeed successfully.”

Moreover, the industry has been found to subvert global and national regulations designed to prevent such conflicts of interest. Despite guidelines on avoiding COI, the CMF industry's influence persists, highlighting the need for stricter enforcement of these regulations.

In addition to marketing concerns, recent investigations have uncovered unsanitary practices at some of the largest baby formula manufacturing plants.

For instance, workers at an Abbott Laboratories facility reported persistent leaks and contamination issues, which led to a temporary shutdown and a nationwide formula shortage in the USA.

These findings underscore the importance of stringent oversight and regulation in the industry to ensure the safety and quality of infant nutrition products.

UWC academics are among those calling for a concerted effort to address these issues. By raising awareness, said Dr Katie Pereira-Kotze, and advocating for policy changes, they aim to protect the health and well-being of mothers and infants. Their work is a crucial step towards ensuring that healthcare advice remains unbiased and that the benefits of breastfeeding are fully realised.

As the debate over CMF promotion continues, it is clear that the influence of commercial interests on public health must be carefully scrutinised and regulated.

#breastfeeding

UWC academics lead the charge against milk formula promotion