Formula and infant food manufacturers urged to implement WHO marketing recommendations

Despite the World Health Assembly (WHA) adopting ‘The International Code of Marketing of Breast-milk Substitutes’ 40 years ago and passing 18 associated resolutions since (collectively referred to as ‘The Code’), the BMS/CF Marketing Index 2021 found none of the companies it assessed fully abides by The Code’s recommendations; and most fall well short.

The nine companies assessed are: Abbott, China Feihe Limited, China Mengniu Dairy Company Limited, Danone, Inner Mongolia Yili Industrial Group, The KraftHeinz Company, Koninklijke FrieslandCampina, Nestlé S.A. and Reckitt. In 2019, these companies accounted for global sales in the baby food segment of nearly $38bn and 52% of the market, combined.

“Even before the Covid-19 pandemic, there was resounding evidence that increasing breastfeeding rates around the world to near universal levels could prevent 823,000 deaths in children younger than five years old each year,”​ said Inge Kauer, executive director of ATNI.

“The pandemic has underlined the importance of breastfeeding in providing babies with natural immunity to Covid-19, as well as many other communicable and non-communicable diseases over their lifetimes.”​

The ATNI said marketing of breast-milk substitutes has been shown by extensive independent research to be one of the factors that undermines women’s choice to breastfeed. It added brands must play their part by marketing their products responsibly and in line with The Code, so women can make informed decisions about how to feed their children. It is particularly important that companies make this commitment because, so far, only 31 countries have a legal framework that substantially implements The Code.

“We are making two calls based on the results of our Index,”​ Kauer said.

“One is for governments to do more to curtail the inappropriate marketing of breast-milk substitutes and promotion of foods for infants and young children. Those governments that have not yet done so must urgently embed The Code fully into law, to create a level-playing field for all companies, and not just those we have assessed. The second call is to baby food companies themselves. They have a clear opportunity to demonstrate their commitment to mothers’ and babies’ health by closing the substantial gaps between The Code and their current marketing policies and practices. They need to act quickly if they are to contribute to realizing the WHO nutrition targets by 2025 and Sustainable Development Goals by 2030.”​

“The findings of this report again illustrate that the world’s largest baby food manufacturers fall well short of complying with global health policy, despite having had 40 years to do so,”​ said Laurence Grummer-Strawn, unit head in the Department of Nutrition and Food Safety at the World Health Organization.

“These companies claim that they support breastfeeding, but in reality, their policies and practices continue to ignore The Code that exists to protect breastfeeding. The progress documented in the report is good news, but also demonstrates significant gaps that must urgently be addressed. It is time for all baby food companies to demonstrate a commitment to improving the health of babies and young children the world over by aligning their actions to The Code.” ​

The BMS/CF Marketing Index 2021 is the only independent assessment of the extent to which the world’s biggest makers of formulas and foods for infants and young children market their products in line with The Code. It scores and ranks companies based on their policies, internal systems and disclosure of information, as well as ‘on-the-ground’ assessments of their marketing practices.

While the scores indicate some improvement since 2018, the report said all companies still have a lot to do to align their marketing practices with The Code in order not to undermine breastfeeding and to give babies and young children the best start in life.

Results

Danone retained first place with a score of 68%, up from its 2018 score of 46%.

Nestlé, the market leader in sales value, retained its second place with a score of 57% – also a substantial improvement on its score of 45% in 2018.

KraftHeinz achieved the greatest improvement, ranking third, with a score of 38% compared to in 2018 when it didn’t score at all.

Reckitt (previously RB) substantially improved its BMS Marketing policies, which led to a big jump in its score from 10% in 2018 to 32% in 2021 and climbing one place to fourth in the ranking.

While some of the companies’ policies align to some extent to The Code, most make significant exclusions in relation to certain products and markets. For example, the policies of six companies that ATNI was able to assess all exclude growing-up milks and complementary foods from their scope. No company applies The Code’s recommendations in full, globally.

The ATNI added none of the six companies that make foods for infants and young children have extended their policies to incorporate guidance on ending inappropriate marketing of these products, to bring those policies into line with guidance published by the WHO in 2016 and endorsed by the WHA of that year when passing Resolution 69.9.

In spite of the ATNI saying all companies still have a lot to do, Danone said the ranking reflects its approach to ethical marketing of breast milk substitutes based on its far-reaching and industry-leading policies to protect and promote breastfeeding.

The French headquartered company said it is the first company to prohibit the promotion of breast milk substitutes for children aged 0-6 months anywhere in the world, even where it is still permitted by local law.

“We welcome ATNI’s assessment as we strongly believe that external monitoring raises the compliance and integrity of marketing practices of individual companies, and ultimately, the entire industry,’’​ said Jean Marc Magnaudet, president Danone Specialized Nutrition.