August is National Breastfeeding Month

The American Academy of Pediatrics, World Health Organization (WHO) and UNICEF all recommend that infants be breastfed exclusively for the first six months of life.

Yet, according to WHO, fewer than half are.

Part of the problem, say breastfeeding advocates like Mirine Richey, a USF College of Public Health DrPH student, is the robust and sometimes misleading advertising of breast-milk substitutes to new moms.

It’s been estimated that the marketing tactics inflate the expected use of infant formula, part of which was the driver for the shortages in the U.S. in 2022.

In an effort to stem the problem and encourage more breastfeeding, WHO developed the International Code of Marketing Breast-milk Substitutes in 1981. The code established international policies and regulations regarding the advertising of formula, bottles and other breast-milk substitute products.

But those policies are often ignored or violated.

In June, Richey took part in the first Global Congress on the Implementation of the International Code of Marketing Breast-milk Substitutes held in Geneva, Switzerland.

The Congress

During the three-day congress, delegates from 130 countries met to share knowledge and strategies to end what WHO calls the “unethical” marketing of breast-milk substitutes. Some of that “unethical” marketing, said Richey, includes formula companies using paid social media “influencers” to promote the use of their products.

“The meeting was intended to address implementation challenges for those countries, such as the U.S., where the code does not even have partial implementation,” said Richey, a certified lactation consultant who works at Florida State University in a research faculty position. “During the 2022 U.S. infant formula crisis, I gave several presentations and talks on the lack of oversight in the U.S. and the barriers to breastfeeding. I submitted a statement to WHO when they issued their call for a congress meeting. The call was looking for academics, policymakers and public health leaders from each UN member country. I applied as an academic, as the majority of my doctoral research and work centers around breastfeeding and policy.”

Working to Curb False Advertising

After listening to reports of the latest research and international perspectives, Richey and the other delegates were divided into regional groups and tasked with developing ways to overcome code implementation barriers.

The congress, said Richey, had its highs and lows. For example, without a U.S. government representative at the gathering, policy changes were not able to move forward.

“The infant formula lobby is incredibly powerful in our country, and it will take bipartisan political and public health leadership to move the needle,” Richey commented. “We are behind many of our contemporaries in this realm.”

But there is some good news.

The five U.S. delegates at the congress work for a variety of academic and nongovernmental organizations and remain dedicated to participation, Richey said. They’ve also formed a small but determined workgroup.

“I am truly inspired to overcome implementation barriers to breastfeeding health policy,” she said. “While most countries have only adopted some of the guidelines, WHO wants to encourage full implementation, and I can see promise in a move to adopt some of the key elements in the U.S., such as enforcing safe and truthful marketing and restricting direct consumer marketing.”

Story by Donna Campisano, USF College of Public Health