Remove restrictions on formula advertising! They infantilize women.

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Yesterday I wrote about the ways in which midwives and lactation consultants treat childbearing women like children. Society at large is also guilty of infantilizing women. The paradigmatic example is formula advertising.

Formula advertising restrictions go back to 1981 and the Nestle debacle in Africa. Nestle and other formula companies engaged in the brutally unethical promotion of infant formula powder to women who had access to only contaminated water with which to prepare it. Tens of thousands of infants died as a result.

Though adult women are trusted to determine whether or not to smoke cigarettes or consume alcohol, it is assumed they cannot be trusted to determine whether or not they wish to breastfeed.

The problem was the water and the solution was two fold: mandate truth in advertising about the dangers of preparing formula with contaminated water and increase Africans’ access to clean water. Instead, breastfeeding advocates seized upon this as a way to promote breastfeeding, a tactic they have continued to this day, more than 35 years after the fact.

A central pillar of lactivist efforts has been to restrict formula advertising. The World Health Organization’s Code of Marketing of Breast-milk Substitutes first published in 1981 pulls no punches about what it’s trying to accomplish. Even the title disparages the use of formula.

The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) have for many years emphasized the importance of maintaining the practice of breast-feeding—and of reviving the practice where it is in decline—as a way to improve the health and nutrition of infants and young children. Efforts to promote breast-feeding and to overcome problems that might discourage it are a part of the overall nutrition and maternal and child health programmes of both organizations and are a key element of primary health care as a means of achieving health for all by the year 2000.

To that end:

Manufacturers and distributors of infant formula should ensure that each container as a clear, conspicuous, and easily readable and understandable message printed on it, or on a label which cannot readily become separated from it, in an appropriate language, which includes all the following points: (a) the words “Important Notice” or their equivalent; (b) a statement of the superiority of breast- feeding; (c) a statement that the product should be used only on the advice of a health worker as to the need for its use and the proper method of use; (d) instructions for appropriate preparation, and a warning against the health hazards of inappropriate preparation. Neither the container nor the label should have pictures of infants, nor should they have other pictures or text which may idealize the use of infant formula…

The following guidelines have also been put in place:

No advertising of such products to the public;
No use of baby pictures on packaging to idealize infant formula;
No free samples or gifts to mothers or health workers;
No promotion of such products in health facilities
No contact of mothers by company representatives.

Further refinements have involved banning marketing displays in stores and prohibiting the use of discount coupons to purchase formula as well as prohibiting the use of formula purchases in frequent shopper programs.

The advertising and marketing of infant formula is subject to greater restrictions than cigarette or alcohol advertising, both of which pose far more risk to life and health than formula. The rationale behind restrictions on cigarette and alcohol marketing is to prevent children — who are assumed to be far more impressionable and to lack the analytic powers of adults — from being tempted to use an addictive substance. The restrictions on cigarette and alcohol advertising are NOT designed to prevent adults from accessing either substance.

When it comes to formula marketing, women are assumed to be so limited in intelligence and judgment that they must be treated as children. Though adult women are trusted to determine whether or not to smoke cigarettes or consume alcohol, it is assumed they cannot be trusted to determine whether or not they wish to breastfeed. They must be pressured into it.

Since the promulgation of the WHO Code, we’ve learned a great deal about the fact that the benefits of breastfeeding are far more limited than what we originally thought. With the exception of premature infants, there is no correlation between breastfeeding rates and mortality rates. The only fully documented benefits of breastfeeding for term infants are an 8% reduction in colds and an 8% reduction in episodes of diarrheal illness across the entire population of infants in their first year. Moreover, despite the manipulative language of breastfeeding advocates, there are no “harms” of infant formula and there are real risks (hospital readmission, brain damage, death) to aggressive breastfeeding promotion.

Ironically, there are no restrictions on the marketing of “natural” and “homeopathic” remedies for infants even though they are useless at best and toxic at worst. For example, while draconian restrictions on formula marketing were being enforced, Hyland’s homeopathic teething preparations were implicated in adverse outcomes, including 10 infant deaths. Finally in 2017 the FDA recalled the products because the manufacturer had mislabeled the amounts of belladonna alkaloids they contained.

Think about that: the US government believes that mothers are adults capable of judging dangers of alternative infant remedies, some of which are toxic, but so incapable of judging the “dangers” of formula that they must be protected from formula marketing as if they were children.

Women are either capable of making safety decisions or they are not. If they are capable of determining whether or not to consume cigarettes or alcohol then they are capable of determining whether or not to breastfeed or use formula. There should be no special restrictions on formula advertising or marketing. To allow them, or worse to promote them, is to demean women.

  • rational thinker

    What i find revolting is how some grocery stores have all baby formula locked up by customer service so you are made to feel guilty when you but it.

  • HailieJade

    “It is assumed they cannot be trusted to determine whether or not they wish to breastfeed. They must be pressured into it.” Not just pressured, TRICKED into it. That’s literally what they’re trying to do with those ridiculous restrictions- trick women into thinking formula doesn’t exist, and that breastfeeding is literally the only way to feed a baby. And assuming we’re so stupid we’ll fall for it!

  • space_upstairs

    I think the ideal restrictions would be to include information about safe preparation and warnings about unsafe preparation (bad water, inadequate formula-to-water ratio, poor storage), about slightly increased risks of infections in term babies compared to properly stored breast milk, and more seriously increased risks of infection in highly premature babies compared to properly stored breast milk. This is the stuff that’s most relevant to why these codes were created in the first place. Banning discounts is problematic because it just punishes poor people, and “medical reasons only” is probably not justified except maybe in the case of micro-preemies. The “glorifying images and text” thing seems like a bit of a gray area, as it can get into what people don’t like about advertising in general. (Is it ethical, for instance, to include those health claims with the “quack Miranda warning” on supplements at all?) Discussions of superiority of breastfeeding should probably be limited to the mention of the relative infection risks mentioned above, and *maybe* a soft, non-moralized statement like “Preference for use of breastmilk may provide general health benefits” because people might object to ignoring the bulk of the research, no matter how questionable most of its quality is.

    • Outstanding comment. Dodgy claims that “X formula will make your kid smarter!” shouldn’t be allowed–just as dodgy claims that “Breastmilk will make your kid smarter” shouldn’t be allowed. Informative and accurate advertising should certainly be allowed.

      • Allie

        Ha! For a second I was thinking “who the hell is Dodgy?” I must have been formula fed… bit slow on the uptake : )

    • EmbraceYourInnerCrone

      What general health benefits? Increased risks of what infections? That makes it sound like formula itself gives you baby a risk of infection?

      • space_upstairs

        As shaky as the science may be, I don’t think it would be ethical for formula companies to outright ignore what the bulk of it says, which is that formula use is *correlated with* an increased risk of colds and gastrointestinal infections, and the latter most especially in premature infants (which doesn’t prove, of course, that formula causes them). They also shouldn’t necessarily ignore the fact that some of the science *suggests* (but may be too weak to prove) that breastfed babies may have general health benefits including avoidance of overweight and short-term cognitive benefits, although this may not be as well established as the infection thing. However, “breastmilk is the ideal infant food” or whatever they currently have to say on formula ads is probably going too far, as it is too generalized and statement.

        • swbarnes2

          Formula feeding is also correlated with a mother’s full employment status, but I don’t think that makes it ethically required to say so.

          “This product may do this or that” is what homeopathic products can advertise.

          • space_upstairs

            Well, I think there’s a bit more science (though maybe not much better science) supporting the notion that formula may increase risks of colds and GI infections compared to breast milk than that homeopathic remedies can actually work. So I think there should be some mention at least of that. Maybe not as much of the “general health benefits” associated with breast milk as the science is weaker on that topic, and in particular to what extent the real cause might be the socioeconomic and marital status of the parents.

  • Zornorph

    I’ve a question; is any of this mandated by law? What would happen if Similac put out a package without the ‘breast is best’ mantra? Would stores all of a sudden stop carrying it? Or would it just collapse the whole thing like a house of cards like when Stan Lee put out Amazing Spider-Man #96 without the comics code.

    • seenthelight

      Yeah, it’d be interesting to see it brought up in court. Sadly, I doubt it’s worth it to any formula company to try, because the lactivist world would explode with bad PR over it, and the general public tends to side with “natural.”