‘Insidious campaign’: experts flag high baby formula sales despite ‘breast being best’

SA has one of the lowest rates of exclusive breastfeeding for infants on the continent though babies who are exclusively breastfed are 14 times more likely to survive to six months than those who are fed formula.

In World Breastfeeding Week, dietitians and advocates of the practice say they are concerned that formula feeding is widely accepted in SA, despite a significant financial strain in low-income households and lacking the same health benefits as exclusive breastfeeding.

“At a rate of less than 32% in 2016, it is unlikely that the country can meet the World Health Organisation’s global target of a 70% exclusive breastfeeding rate by 2030. In line with international codes, the country has regulations in place to protect breastfeeding and to limit the formidable marketing powers of infant formula producers,” they say.

Breast milk is the natural, sustainable food for the healthy development of babies and young children and provides for all the nutritional needs of an infant up to six months of age while also conveying immune-boosting antibodies from mother to child. 

According the UN International Children’s Emergency Fund, babies who are exclusively breastfed are 14 times more likely to survive to six months of age than those who are fed formula. Breastfeeding can provide protection against many childhood illnesses such as diarrhoea, allergies and middle ear infections.

There’s still a pervasive, false view that when it comes to infant health and development, breastfeeding and infant formula are somehow equal, which they are most definitely not. It is uncontested that scientific evidence shows that ‘breast is best’.

—  Maria van der Merwe, president of the Association for Dietetics in SA

Maria van der Merwe, president of the Association for Dietetics in SA, said: “We are battling the legacy of the once-unfettered marketing, including free giveaways of infant formula not just to new mothers but also to the health professionals engaging with them. 

“There’s still a pervasive, false view that when it comes to infant health and development, breastfeeding and infant formula are somehow equal, which they are most definitely not. It is uncontested that scientific evidence shows that 'breast is best'. 

“We need a whole-society approach and multilevel advocacy if we are to create a pro-breastfeeding culture in SA that supports higher rates of exclusive breastfeeding, and longer breastfeeding durations once complementary foods have been offered.”

Dr Chantell Witten, from the DST/NRF Centre of Excellence for Food Security at the University of the Western Cape, said research had shown “we are not effective enough at attenuating the aggressive influence and interference of the formula industry”.

“They are involved in the training and continuous development of health professionals, sponsoring conferences and putting promotional speakers forward at events. They are reaching mothers through social media channels and gathering their data,” she said.

Witten said marketing tactics are used to present breastfeeding as arduous, to undermine mothers’ confidence in their abilities to produce milk, raising insecurities about their bodies and their parenting skills. 

“There’s an insidious campaign flying under the radar, grooming mothers to formula feed. So much of this is playing out in under-regulated digital spaces, and this demands a greater whole-society awareness that breast is best, so that you have citizen advocates standing up to support breastfeeding moms.”

Daddy Matthews, a registered dietitian, says while the correct regulations and policies are in place to protect breastfeeding, enforcement is weak. 

“There are inadequate resources, both human and financial, for monitoring and evaluating, and then a lack of serious fines or prosecutions for those who are out of line.

“We are seeing marketeers shift promotions to social media channels where they are cross-promotional. The powerful infant formula industry is taking advantage of loopholes and resorts to legal threats if confronted.

“It is an ongoing concern that in a low-to-middle income country such as SA, infant formula sales are skyrocketing, which contributes to excess infant morbidity and mortality,” he said.

Van der Merwe believes it is important to not only focus on the regulatory side, but to also actively strengthen support to mothers. 

“We will benefit from a whole-society approach where breastfeeding is normalised and supported.

“Having a breastfeeding mom frowned upon when she feeds her infant in public, or not having comfortable facilities for infant care in public spaces, are barriers to breastfeeding.

“Taking a practical approach to supporting SA moms in more effective ways will help to increase breastfeeding rates for the benefit of our newest generation,” she said.