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December is an advertiser's dream but who stops to reflect on how marketing affects our health? Consider the impact of the pictures of adorable, thriving babies looking down at us beckoningly from the supermarket infant formula section. There are choices for every maternal anxiety: formulas for newborns; young infants; older infants; the lactose-intolerant and those with gastro-oesophageal reflux disease.1 The marketing gurus offer ‘casein-dominant’ or ‘whey-dominant’ proteins, iron fortification or even special supplements such as ‘omega-3 acids’, ‘omega-6 acids’, ‘probiotics’ or ‘prebiotics’. How did the human race survive before these designer formulas?
Perhaps the World Health Organization (WHO) should patent breast milk and advocate it as a new formula. Imagine the sales pitch:
NEW MIRACLE FORMULA
Halve the risk of Sudden Infant Death Syndrome.6
Exclusive use for more than 4 months adds more than 4 points to your child's IQ.10
But wait... there's more: 22% reduction in breast cancer.11
Special unlimited offer: free instant delivery of pre-warmed sterilized milk wherever you are, anywhere in the world, any time of the day or night!
Despite these advantages only 35% of infants worldwide are exclusively breastfed to 4 months,12 let alone the current recommendation of 6 months.13 This is a dismal result. There are many reasons for this including maternal,14 infant and societal factors not all of which are modifiable. Some mothers are aware of the benefits but choose not to breastfeed—as is their right. Our task as an international community is to identify and remove impediments to breastfeeding for mothers considering their options. Recent media cases demonstrate we are failing. A Canadian woman has been threatened with detention under terrorism laws for refusing to stop breastfeeding during a flight,15 and an Australian parliamentarian has been ejected from the House for breastfeeding under archaic standing orders prohibiting ‘aliens’ in the chamber!16
It is the choice of every mother and family whether or not to breastfeed their baby. However, to make informed decisions, we need information not misinformation. As direct marketing is restricted, companies sponsor the healthcare industry, provide gifts for new mothers and produce educational posters for early childhood centres and pharmacies. Individuals can assist by notifying the relevant national body when manufacturers breach the WHO code regulating the marketing of breast-milk substitutes.17 Health professionals should ensure they provide mothers with up-to-date information on the benefit of breastfeeding. Governments can play their part by expanding the effective UNICEF Baby Friendly Hospital Initiative.12
These simple measures are important as breastfeeding could save billions in health care costs,18 spare the environment from unnecessary water and agricultural land usage and provide effective family planning acceptable to all religions. However, the most compelling argument for exclusive breastfeeding remains the potential to prevent 1.5 million infant deaths every year in both developed and developing nations.13
Conflict of Interest This article was not sponsored by formula manufacturers.