Authors of a Lancet research paper have called for more effective measures worldwide to support breastfeeding and an international treaty to end ‘irresponsible’ formula milk marketing and political lobbying.

In their three-paper series, the experts have called for governments and workplaces to recognise the value of breastfeeding and care work, and suggested actions such as extending paid maternity leave duration to align with the six-month WHO recommended duration of exclusive breastfeeding.

The report says that formula milk marketing tactics are exploitative, and regulations need to be urgently strengthened and properly implemented.

According to The Lancet, less than half of infants globally are breastfed, with formula milk sales on the rise despite formula feeding failing to offer the same nutrition, health and development benefits as breastfeeding.

The ‘Lancet 2023 Series on Breastfeeding’ argues that formula milk companies exploit parents’ emotions and manipulate scientific information to generate sales at the expense of the health and rights of families, women and children.

Nigel Rollins, co-author of the series from WHO, said the sale of commercial milk formula is a multi-billion-dollar industry which uses political lobbying alongside a sophisticated and highly effective marketing playbook to turn the care and concern of parents and caregivers into a business opportunity.

“It is time for this to end. Women should be empowered to make choices about infant feeding which are informed by accurate information free from industry influence,” he said.Rafael Perez-Escamilla, series co-author from the Yale School of Public Health, US, said babies are most likely to survive and grow to their full potential when breastfed.

“Breastfeeding promotes brain development, protects infants against malnutrition, infectious diseases and death, while also reducing risks of obesity and chronic diseases in later life. Yet, globally, many women who wish to breastfeed face multiple barriers, including insufficient parental leave and lack of support in healthcare systems and at the workplace, in the context of exploitative marketing tactics of the commercial milk formula industry,” he said.

In a novel analysis, the series describes how profits made by the formula milk industry benefit companies located in high-income countries, while the social, economic and environmental harms are widely distributed and most harmful in low- and middle-income countries.

The review of 153 studies conducted for the series suggests how marketing practices in violation of the Code have continued in nearly 100 countries and in every region of the world since its adoption more than 40 years ago. The World Health Assembly had developed the voluntary International Code of Marketing of Breast-milk Substitutes and subsequent resolutions (the Code) in 1981. The series says voluntary uptake of the Code is not enough and calls for an international legal treaty on the commercial marketing of food products for babies to protect the health and wellbeing of mothers and families.

“However, the powerful influence of the milk formula industry and the marketing of their products in violation of the Code continues, with sales from commercial formula milk having rapidly increased over the past 20 years and now at more than $55 billion a year,” it said.

Experts said that changes are needed society-wide.

“In addition to ending the marketing tactics and industry influence of formula milk companies, broader actions across workplaces, healthcare, governments and communities are needed to more effectively support women who want to breastfeed,” the report says.