Is Formula Marketing a Problem?

I am a nursing mom. Over four years and two kids I have experienced many benefits of breastfeeding first-hand. Nursing my babies has been a very positive thing for me, on the whole. Because of that experience I believe in the value of breastfeeding. And because I believe in the value of breastfeeding I’m generally opposed to formula marketing as it exists today. Logic dictates that if we want to support something, we shouldn’t promote the alternative.

But the other day as I was recycling yet another brochure from a formula company I thought about my own history. When Hannah was born and she wouldn’t nurse they sent us home from the hospital with a couple of cans of formula, and we bought some of our own. Within two days she was nursing and we didn’t use the remaining 80% of our formula supply. If you really want to breastfeed, will you just disregard the ads? I know that I did, for sure. Does formula marketing really convince people to stop breastfeeding?

So I decided to do some research, to see what information there was, if any. Is formula marketing effective? Are people who are inundated with promotional materials and free samples more likely to use formula?

Here are some results that I found:

  • Women who were given formula company produced infant feeding information during prenatal visits were more likely to cease breastfeeding before discharge from hospital as well as before 2 weeks postpartum.
  • Giving women research based discharge packs that support breastfeeding instead of formula company sponsored packs resulted in higher breastfeeding rates, as well as delayed the introduction of solids.
  • The US Government Accountability Office found that in 7 of 11 studies it reviewed, breastfeeding rates were lower amongst mothers who received formula discharge packs from the hospital.
  • In the US women who receive free formula through WIC are much less likely to breastfeed.
  • Health care authorities and governments believe that formula marketing has a negative impact on breastfeeding.
  • When women were given commercial hospital discharge packs from hospitals, at every stage exclusive breastfeeding was reduced compared to women who received non-commercial packs or no packs at all.

The evidence certainly suggests that formula marketing practices have a negative impact on breastfeeding, while research-based information has a positive impact. It just sort of makes sense because the purpose of marketing is to convince people to use your product. Formula companies are no different than anyone else on this front. They are trying to sell us something.

Of course, it’s our choice whether or not we want to use formula. If you have used it yourself I am not judging you. I think the problem is when it’s not really your choice. In a perfect world every mother would be satisfied with her breastfeeding experience, whatever it looks like. We aren’t living in a perfect world, though. In real life we are bombarded with conflicting information and we encounter problems we didn’t expect. The result is that many moms are not satisfied with their breastfeeding experience at all.

I think that the only possible solution is good breastfeeding support and information at all stages of maternity and infant care. We need to be there to help moms who want to breastfeed but can’t. We need to make sure that we’re not giving out conflicting information or leaving distraught mothers with no one to turn to. We also need to support moms and not make them feel guilty for their choices.

Based on the research and plain common sense unsolicited formula marketing may interfere with breastfeeding. Handing out free formula or promotional materials to all mothers ‘just in case’ sends the message that many moms probably can’t breastfeed. Sponsorship of medical conferences by formula marketers, posters in doctors’ offices, and samples distributed in the hospital lend a medical stamp to that message. And it’s a message that is just not helpful if we want to mothers to receive good breastfeeding information and support.

I know now that I was able to breastfeed Hannah. There was a while there where I didn’t think I could. I don’t believe I’m the only mom who’s felt alone and overwhelmed and didn’t think she could do it. Thankfully I had excellent support from my midwives, who came to my home to help me. If the only information on infant feeding I had was a brochure from a formula company I’m not sure I would have succeeded. And that’s why I think formula marketing is a problem, because it doesn’t contribute to empowering women to make the choices that are best for them. Whatever those choices may be.

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  1. Amber, how do you come up with such interesting posts? I have lots to say, but let me boil it down to comment size in the (European) morning!

  2. I wish formula marketing was tamed down rather than pushed on every mother every chance they get.

  3. This is a critical issue for me. I believe that the twin causes of breastfeeding failure are formula marketing and poor medical leadership/advice.

    It infuriates me that the formula companies continue to contravene the international code on marketing of breast-milk substitutes and those contraventions have a direct impact on women’s ability to feed their babies.

    It’s an OUTRAGE.

  4. Maybe the mindset is different here than it is in the states? Because, everyone I know was PRESSURED to breastfeed, and was socially scorned if not able to (or chosing not to). So though I am a FIRM believer in all the benefits and conveniences that go with breastfeeding (who could be better equipped to optimally nourish a human infant than it’s human mother?! NOT a cow nor a soyplant I think!), I have to respect the mother’s choice and limitations and be thankful there is an acceptable alternative. Unfortunately my mom did not nurse me or my sister (we were poor, so you think she would have)and she did not buy formula — somehow I survived on vitamin drops and sweetened canned milk!!!!!!

    I think the marketing of formula preys on the under-educated. And there is the painful first time struggle to succeed and make the “right” choices and it feels much much harder than it should! Even with my stupidly huge milk supply, no one told me how HARD it was going to be to learn how to get a good latch, to keep a good latch and to feel secure that they actually were getting enough! With a bottle, you can measure it, you can read the nutritional label, you can let your husband take a turn!

    I had a friend thats milk didn’t come in and she was devistated that she couldn’t nurse, and another friend who’s baby did not thrive on her milk and she felt completely hopeless as her baby lost weight. These women were lucky that there were options. Then there is my sister, she tried to nurse, but by the end of 6 weeks she felt so much resentment towards her babies for being a “milk machine” that she turned to formula just to love her babies properly (so she bonded with them BETTER without the breast– I don’t get it but it’s what worked for her).

    It is an OUTRAGE how they market and push for these SUBSTITUTION products, but it is a necessary product for a lot of moms and babies.

  5. very interesting amber – i had not heard of those statisicts before-
    I thought i read that In canada all formula ads have to state that breastfeedng is best.. or something to that tune?
    I was shocked at how much formula marketing I encounterd not birthing in a hospital ( i figures that would be another benefit of homebirthing)
    Every time a can arrived I would spend days trying to figure out WHO gave them my name? do they watch people goiong in and out of the midwives office?
    it is very interesting and it makes you think hey-

  6. The midwife run hospital program I delivered both girls at was pro breastfeeding. All us moms knew this going into having our babies their. We were told well in advance that there would no formula supplied and no bottles or nipples available. If we chose to bottle feed, it would be up to us to supply everyting. Thankfully, lactatiion consultants were on hand as were the midwives and wonderful nurses. It was a blessing to be surrounded by so many people who cared and were supportive. It was even better to know that they didn’t judge me when Emma dropped weight dramatically and had to be brought back into the hospital for a short stay. They encouraged me to keep breastfeeding and pumping and they also knew when to step in and supplement Emma for her own health.

    Before I became pregnant as well as during my pregnancy I always had a fantasy of being the ‘perfect’ mother. I had images of me breastfeeding my children and being their sole nurishment. It was a dream for me though. It wasn’t my reality.

    I can’t say that I ever looked at formula advertising before I had children. I was reading up on breast pumps. But, when faced with my reality, my education focus changed to looking into the best formula options that was out their for the most important person in my life.

    I wish I had of been able to breast feed my children. I long to have had that bond with my babies. I wish no mother had to feel the pain and rejection I did and absolute failure as a mother when I couldn’t sustain or nourish my children. But, there are lots of moms out there who feel like me every day, and we aren’t uneducated, or duped by mass marketing. We are just the same as the breastfeeding moms out there…just doing the best we can with what we have.

  7. Like *pol commented earlier, I also was surrounded by tremendous pressure to breastfeed, rather than the opposite. Boobs and babies were willing, so it worked out for me, but it doesn’t for many and I’m glad there’s an alternative to death or malnutrition. Our hospital sent us home with both a formula sample and a book titled “The New Mother’s Guide to Breastfeeding,” which I need feverishly page through in the middle of the night while I was still trying to get the hang of things.

    The formula container was great, because our nurse pointed out that if the baby is with someone other than me during an emergency, he has to be able to eat. We put a spare bottle and the container in the car, like she advised.

    As the boys got older, mobile, and less interested in sitting still to nurse, we did switch to formula, but they’re now into sushi (even the baby!) so thank god we’re done washing bottles too.

    You have very thought-provoking posts, Amber!

  8. I’ve been thinking about this, and I actaully question whether mothers who use formula in our society do so as a result of marketing pressure. I tend to believe that they do it for choice. My US mother-in-law 43 years ago (at the time when formula was not only marketed, but marketed as nutritionally BETTER than breast milk) chose not to breasfeed because she wanted “her body back”. I’m not implying that all USmothers want their “body back”, but nowadays there’s such a wealth of information available that I must conclude that formula is a choice based on whatever personal reason. And, as you point out, nowadays breasfeeding is pushed even in the case of premature babies, when they can’t nurse, and even when they are in NICU (my youngest child was transferred to a NICU at a different hospital from where I had my emergency Csection, and the one request that the staff at NICU made was that I start expressing milk immediately, and have it delivered to them for freezing and keeping). PS this is not what I intended to write last night, and still very long. As Lady M above wrote, this is a great thought provoking post, thanks.

  9. I think that the sad fact is, as someone mentioned above, that the marketing is aimed at the under-educated. If you break it down socio-economically the lower the socio-economic status, the more likely they are to formula feed. I think this has to do with support and education. I also know some women who seem well educated but who know nothing about breastfeeding. One asked, after less than 24 hours giving birth, if she should go to formula because her milk hadn’t come in yet. She didn’t know it takes 3 – 4 days. I also think that because of the lack of exposure to resources a LOT of women have trouble getting the latch right and therefore stop because they’re struggling with pain/discomfort and just generally feeling like a failure.

    I heard this morning on the news that less than 40% of new mothers around the world breastfeed which is shockingly low and I think goes to show how formula marketing is doing its job!

  10. This is really interesting. With my first, I was determined to breastfeed and absolutely frustrated that I “couldn’t get it right”. No matter what I had read before he was born, it just wasn’t the same as having a real live baby squirming around and crying because he was hungry. Luckily, the hospital we were in (one with a maternity ward mostly staffed by midwives) had several lactation consultants on staff who where also available to moms for the first three months after the baby was born. They came to my room as much as I needed until we learned to latch on properly. I think this really helped us to have a successful nursing relationship. I went on to nurse him for almost two years. I also think that the fact that my mom nursed me, my grandmother nursed her, and in my family, I had seen women nursing and pumping, made breastfeeding very normal to me.

  11. I could really write a HUGE comment about my breastfeeding experiences… I am a very happy breastfeeding mom, but I also give my son formula as we wean. He’s over a year now, and weaning himself slowly.

    The hospital where I gave birth to my son actively encouraged breastfeeding, but also showed us how to make formula. An informed parent is a parent who can make a good decision for their situation, was their idea.

    My husband asked me if I wanted to supplement, about two weeks after I began my breastfeeding journey. he was worried, I was sore and tired, and he wanted what was best for both me and our son (ie: sleep, enough food to eat, me being able to put a shirt on and function).

    Sometimes I think this has a lot to do with it. When you are exhausted, it hurts, the baby is screaming, you reach for that formula just to have a break, to regain temporary sanity.

    But… I’m stubborn 😉 I said no. And I am glad I did.

  12. There is such a backlash at this point with people saying “Oh, everyone is pressuring moms to breastfeed.” Well, OK. Maybe that’s not such a bad thing.

    Yes, there is a lot of push to breastfeed, but the minute there is any trouble, everyone rushes to say “try formula.” I was breastfeeding my THIRD child. THIRD. I knew what I was doing. And the minute she had jaundice? They pushed me to give formula. You probably remember my posts on this last October. Pissed me off to no end. And you know what? Formula would have made NO difference in the jaundice.

  13. Wow! Thanks for this excellent post! I don’t have much to add but I’m off to Twet this for you. It’s just so good!

  14. Merewyn Janson says:

    In Australia the marketing and promoting of formula is policed somewhat. You cannot advertise formula in magazines or the television (however they can market over 1 milks). It is also prohibited for women to receive free samples when in hospital or visiting the health nurse. It is called the APMAIF agreement and consumers can make complaints against companies that disregard the agreement.
    We do have a great initiation rate of breastfeeding here about 84% – however that is significantly different by 6 months – about 34% (i think). I think that the advertising of infant formulas is wrong and should be banned. In other places you need a script to get formula…

  15. “And that’s why I think formula marketing is a problem, because it doesn’t contribute to empowering women to make the choices that are best for them. Whatever those choices may be.”

    This is so awesome and insightful. I totally agree. I am more in favour of a push to support breastfeeding than a ban on formula. I have low supply challenges and by the time I added up all costs of drugs, pumps, etc. for my first baby, it actually worked out to more than formula would have. That is so wrong! If a woman needs to pump, it should be covered by OHIP and ditto for other aspects of breastfeeding. I think the answer is in breastfeeding support being more out there than worrying about the formula stuff.

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