by Ali Weatherford

If a parent is breastfeeding or wanting to breastfeed, they may see a lot of media attention about breastfeeding. On the other hand, if someone is struggling with breastfeeding and is needing to consider using formula, they may start to see a lot of information and ads for formula! We tend to see more marketing about what we are currently most interested in.

Of course web browsers and social media technology are getting smarter, showing us what we want to see. Online retailers know what we’re looking for, and send us little hints and reminders while we’re online so we won’t forget to go back and buy the product. If you don’t know how, or don’t want to turn off these functions, it can seem pretty eerie sometimes. Of course, they’re actually just tracking our online behaviors, but it sure can feel like technology is reading our minds sometimes!

Since the beginning of advertising, marketers and businesses have been working on ways to get their messages to us most effectively. They want us to buy their products and use their services. That makes perfect sense because they have to compete with other companies providing the same product or service.

What DOESN’T make sense is when formula companies compete with HUMAN PHYSIOLOGY to sell a product. Formula companies do have to compete with each other, but their biggest competitors are mothers making their own milk. This is not a competition that they should win. Many think this is not a competition that should be had at all and that it’s called predatory marketing.

Recently, the scientific journal  The Lancet published a series of articles and videos about this topic. For decades, health organizations have been fighting against the marketing of these products. Laws have even been made to protect us from this predatory marketing because it has contributed to a public health crisis.

When formula was first created and proven safe, it did save lives. It was, and still is, medicine that can help babies in certain types of crises. Unfortunately, it went a lot farther than this. The marketing efforts started to tell us that formula was superior to breast milk, and we should buy their products instead of breastfeeding.

Eventually, using formula to feed babies became the norm. Women who decided to breastfeed were thought to be either too poor to afford formula, too ignorant to know better, or somehow dirty or weird.

My mom tells the story of breastfeeding in Nicaragua in 1976. As an educated woman, she understood even then that it was a healthy thing to do, but she was made fun of for it and made to feel like an outsider. The wealthier women there saw breastfeeding as something that only “peasants” or “hippies” did.

This belief persists even today. It might not be explicit, but there is a quiet undercurrent in many communities that guides people’s decisions not to breastfeed. We might still see posters from formula companies in pediatricians offices and hospitals, although that is illegal in many countries. More hospitals in the U.S. are signing on to the “Baby Friendly” initiatives outlined by the World Health Organization’s International Code of Marketing of Breast-Milk Substitutes.

We continue to get free formula samples in the mail or at special events. Coupons are dispersed. Hospitals make exclusive deals with one or the other of the biggest formula manufacturers to dispense their products to patients. While the ads have gotten better and no longer OVERTLY declare that formula is superior to breastmilk, they do normalize the use of formula. And it IS normal! But the argument is that it is MORE normalized than breastfeeding.

Many hospitals still automatically default to giving babies formula if there is even a little bit of mother/baby separation or difficulty breastfeeding. Hospitals given the Baby-Friendly Hospital designation agree to make the shift to making breastfeeding the default. Formula is only offered when absolutely necessary or when requested. It’s more like a medication that has to be prescribed.

In the U.S. today, marketing images depicting breastfeeding are not considered acceptable. Women breastfeeding in public are regularly shamed and removed. Images of babies drinking from bottles, on the other hand, are standard and normal. People feeding their babies from a bottle is allowed everywhere.

But this does not benefit our families and babies. Breast milk is the least risky and most healthful option. Science has proven without a doubt that breast milk has superior health benefits, so shouldn’t that be the focus of marketing efforts? But by whom? No one profits all that much when people just breastfeed.

Of course there are smaller companies selling nursing bras and pads and pillows and lactation support, but they do not have the massive advertising budgets that formula companies have. Widespread marketing efforts in support of breastfeeding won’t come from them. Breast milk does not have a wealthy advocate in the private sector. It falls to non-profit health organizations and governments to do something about it.

There is also a backlash of people who don’t want to be shamed for using formula. That is absolutely correct as well. No one should be shamed for how they choose or need to feed their baby, but it’s ALSO important to disseminate correct information and offer appropriate support. People should clearly understand the benefits of breast milk and receive support to be successful.

I always think of the example of footwear. My feet have been flat since birth, and I have a genetic condition that causes issues with my joints. I wore beautiful but less healthy shoes for way too many years, and I’m paying for it now. The vast majority of the footwear advertising shows beautiful people wearing beautiful shoes. I wanted to look like the pictures. If I had heard a different message from the beginning, I may have made different choices. If “healthy” shoes had been the predominant image, I might have chosen to go that route without fear of judgment for wearing ugly shoes or “old lady shoes”. Because of my particular condition, the pretty shoes were not the best option for me. I’d have more functional feet and ankles now if I had made different choices. OR I may have chosen to wear the pretty shoes because I wanted to appear taller and get those benefits. Or maybe I needed some extra height so my pants wouldn’t drag on the ground. Maybe someone else can make those choices without consequence, or maybe the benefits of wearing those shoes somehow outweigh the downsides. The point is that I would have had ALL the information, and the freedom to make my choice without fear of judgment.

The predatory marketing of formula does not allow choices. They deceptively leave out information and include biased messaging to increase their profit. This is the part that is under heavy fire and investigation. This misinformation is especially harmful in communities where using formula can actually be dangerous. There are places in the world without safe water to mix into formula and bottled water is expensive or hard to get. There are countries without easy access to vaccines and medicine where breastfeeding can provide life saving immune benefits to those babies.

There are communities experiencing extreme poverty where breastfeeding is especially critical.
When these babies get formula, it is often watered down to save money or supplemented with unhealthy but cheaper options. When this happens, those babies suffer with developmental hurdles and health consequences caused by malnutrition. These families are not doing this intentionally. They do this fully believing that formula is the best option. They have accepted the message of the advertising.

Unfortunately, people on BOTH sides of the argument have the issue of feeling shamed and judged. If you feed your baby formula, some people will judge you. If you breastfeed your baby, some people will judge you.

It’s important for the breastfeeding advocates to assume that anyone using formula needs to use formula. The reasons don’t matter, it’s not for anyone else to notice or judge. It’s also important to recognize formula as medicine, assume that’s what it’s for, and appreciate those benefits.

Even the most highly educated Lactation Consultant breastfeeding activists sometimes need to offer a prescription for formula because there is nothing more they can do to help. Formula use does not need advocacy, but formula users do often need advocacy and support because there are some who behave in judgmental and malicious ways. That is very unfortunate and needs to change. I argue that breastfeeding advocacy can happen most effectively without tearing people down for using formula.

It’s also important for those using formula not to react to breastfeeding advocacy with defensiveness. Doing this can cause harm as well. People who use formula should expect to be treated with respect, but breastfeeding advocacy is very rarely an attack on the parents who are using formula. The problem is with the systems and businesses that are selling and marketing the products.

It’s unfortunate when defensiveness causes people to attack breastfeeding advocates or publicly downplay the importance of breast milk. This doesn’t serve the most people. It can, however, further the work of predatory marketing and massive for-profit infant feeding corporations.

Breastfeeding vs formula is one of those controversial topics that doesn’t have a simple answer. The indisputable truth is that breast milk carries important individual and public health benefits that should be advertised as loudly and clearly and non-judgmentally as possible. This is not so that anyone can profit from it. It’s just a public service announcement.

Formula is too expensive, unavailable, or even unsafe for many people in the world, and it does not offer equal health benefits to breast milk. Formula is a for-profit invention that does have a lot of value for the health of certain babies, but should NEVER be advertised as the gold-standard for feeding or as an equal replacement for breast milk. Unfortunately that is what has been happening for far too long and to the detriment of many children and families.

We need to speak out against predatory marketing tactics and start sending a different message. Because breastfeeding is not a product or service that makes money and it’s often not an easy path to choose, we need advocates in the medical community, in the public health sector, and in our communities to help normalize, support, and uplift those who are attempting it.

If you are struggling with breastfeeding or need to talk with someone about a decision to breastfeed, please contact us for an online or in-person appointment.

Our articles are not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment.

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