Holding the Formula Industry
Accountable
Jamie Creason
MPH Nutrition Capstone 2014
The Plan
-Create a document for CA WIC Assoc. that includes:
▪ Current violations of the WHO code
▪ UC Davis Human Lactation Center study results
-Provide document to CA WIC Association
-Collaborate with CA WIC, BMSG, Advocacy Initiative
Benefits of Breast-feeding
Infant
Mother
Protective against:
Protective against:
▪
▪
▪
▪
▪
▪
Diabetes
▪ Type 2 diabetes
Sudden infant death syndrome
▪ Obesity
Childhood leukemia
Obesity
Asthma
Various infections
▪ Breast and ovarian cancers
Breast-feeding Rates
Factors Influencing the Choice to Breast-feed
Media
Institutional
Social
Choice
to BF
Strategies to Increase Breast-feeding
▪ Hospital support
▪ Workplace support
▪ Community support, resources
▪ Training for all medical providers
▪ National campaign to promote breast-feeding
▪ Research and surveillance
……But what about regulating formula marketing?
WHO Code of Marketing
of Breast-milk Substitutes
Aims:
▪ Contribute to provision of safe, adequate
nutrition for infants
▪ Protection and promotion of breast-feeding
▪ Ensuring proper use of breast-milk substitutes
when necessary
Ratified by more than 100 nations
65 countries adopted regulations and restrictions on marketing based on the code.
But NOT the United States
WHO Code of Marketing
of Breast-milk Substitutes
Formula Companies
SHOULD NOT:
▪ Advertise to general public
▪ Seek contact with pregnant women, mothers
WHO Code of Marketing
of Breast-milk Substitutes
Formula Companies
SHOULD NOT:
▪ Promote mixed
feeding/supplementation
WHO Code of Marketing
of Breast-milk Substitutes
Formula Companies
SHOULD NOT:
▪ Make Nutrition and Health Claims
WHO Code of Marketing
of Breast-milk Substitutes
Formula Companies
SHOULD NOT:
▪ Idealize formula
▪ Draw similarities with breast-milk
▪ Insinuate superiority
WHO Code of Marketing
of Breast-milk Substitutes
Formula Companies SHOULD
NOT:
▪ Provide samples, coupons
▪ (to consumers or medical providers)
Market share: Infant Formula Oligopoly
Company
Strategy
Mead Johnson Medical Detailing
Branded Product
Enfamil
Nestle
Competitive pricing; Consumer marketing
Good Start
PBM
Nutritionals
Competitive pricing; Consumer marketing
(private label)
Walmart/Target
Medical Detailing (private label)
Similac/Costco
Abbott
Nutrition
Major Trends in the Formula Industry
1
Growth of Private
Label
2
Increasing share of
organic product
3
Movement to
supplemented formula
4
Increase in BF Rates..but
Exclusive Rates Remain Low
National WIC Association (NWA)
▪ 60% of formula market=WIC
How they Increase Profits
▪ $3.2B Infant formula market
▪ Growth driven by price increases
4
3
Dollars ($B)
2
1
0
Infant Formula Market Dollar Split by Type of Formula (2002 – 2011)
$pecialty Products
▪ Lutein
▪ DHA
▪ Probiotics
Exposure to Marketing
Media
Medical
Social
Consumer
Marketing: Medical
▪ Relationships with medical providers
▪ Using WIC name
▪ Discharge packs
Marketing: Media
Magazines
Public Displays
• Advertisements
• Coupons
• Demos in public
• Billboards
Television
Internet
• Commercials
•
•
•
•
•
Smartphones
• Coupons
• Trackers
• “Expert” advice
Coupons
Advertisements
Blogs
Forums
“Expert” advice
Marketing: Media
EXAMPLES
Marketing: Social
“Mommy Parties”
UC Davis Human Lactation Center and WIC
qualitative research study
Perceptions of Infant Formula Additives from Moms
Participating in the CA WIC Program (2010-2013)
▪ Purpose:
Characterize understanding of formula marketing claims
Determine impact of infant formula marketing
What Can We Do
▪ Align with advocacy groups
(IBFAN, LLL, NABA, NWA, USBC)
▪ Engage lawmakers
▪ Apply pressure on:
FDA, FTC, Formula Industry
Thank You!
▪ Laurie True for the idea for my capstone
▪ Lia Fernald for your guidance
▪ My classmates (especially Will, the breast editor
around)
▪ My mom friends who provided me with anecdotes
and wisdom
▪ My family and friends for their support