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Global Health Leaders Call for End to Formula Company Sponsorship

Letter to The Lancet highlights ‘aggressive marketing’ by manufacturers of commercial milk formula

International Lactation Consultant Association® (ILCA®) partnered with five global and regional healthcare professional associations (HCPAs), including midwives, neonatal nurses, breastfeeding medicine specialists, and paediatricians to draft a letter that was published in The Lancet on 9 March that calls for an end to sponsorship by companies which manufacture commercial milk formula. This call to action comes in recognition of the harm such sponsorship causes to the health of infants and their mothers worldwide.

The letter, of which ILCA Board President Iona Macnab, BA(Hons), LLB, IBCLC, served as corresponding author of, points out that in 2016, the World Health Assembly (WHA) had passed a Resolution and the World Health Organisation (WHO) had issued guidance stating that HCPAs should not allow such companies to sponsor meetings of health professionals and scientific meetings, on the grounds that such events are marketing activities which create a conflict of interest among health professionals. The authors state that “Sponsorship of educational events influences many activities, including research and prescribing behaviour, even when healthcare professionals do not recognise this influence.”

Macnab and others say, “we pledge to support and assist our member associations to end sponsorship from companies that market breastmilk substitutes through training, advocacy for policy development and implementation, information dissemination, and monitoring.”

The letter follows many recommendations from WHA, WHO, UNICEF and other global organisations over the years in an attempt to control the marketing by commercial milk formula companies, which make false claims about the benefit of artificial feeding over breastfeeding. The health benefits of breastfeeding in all countries are well proven and current marketing practices are damaging to the health of infants by making it appear that formula fed infants are as healthy as breastfed babies – which is demonstrably false.

The new initiative being taken by global health leaders in this Lancet letter is supported by WHO and will be followed by further actions by the leaders (none of whose organisations accept formula company sponsorship) to bring their experience to bear on associations which still take such funding and are exposed to conflict of interest as a result.

About the issue: Marketing to parents and health professionals by commercial milk formula companies (also known as manufacturers of breastmilk substitutes) has been a major problem in global health for decades, and led to the launch of the International Code of Marketing of Breastmilk Substitutes (the Code) in 1981 which established minimum requirements for regulation of marketing of commercial milk formula, later expanded by subsequent WHA resolutions. Unfortunately there have been many violations of the Code by companies over the which was described fully in a recent Lancet series in 2023. Commercial milk formula company sponsorship of educational meetings for paediatric societies and other healthcare professional associations has become the norm, with a 2019 WHO survey finding that 60% of 114 paediatric associations received such sponsorship.

Letters published in the Correspondence section represent the views of the authors and not necessarily the views of The Lancet journals. Letters to the Editor are not normally externally peer reviewed. 

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