Five Things Infant Formula Companies Don’t Want You to Know

Infant formula sales have nearly doubled over the past 20 years creating a multibillion-dollar global industry that generates an estimated $55 billion in revenue annually.

At the same time, the World Health Organization reports that less than half of all infants globally are exclusively breastfeeding despite important health benefits that have been extensively documented by leading health organizations such as the American Pediatric Association, the CDC, and the USDA.

Now, experts like Professor Rafael Pérez-Escamilla from the Yale School of Public Health are pushing back, exposing what they believe are aggressive and predatory marketing tactics by formula companies that are driving a global increase in formula consumption at the potential expense of infant and maternal well-being.

A leading authority on breastfeeding and early childhood nutrition, Pérez-Escamilla and other researchers say formula companies routinely distort their products’ health benefits and present other misleading information in their advertising in an attempt to convince parents commercial milk formula is as good, if not better, for babies as breastfeeding,

In recognition of National Breastfeeding Month and World Breastfeeding Week, which begins today (Aug. 1, 2024), Pérez-Escamilla recently discussed five key, science-based facts that formula milk companies may not want people to know.

(Editor’s note: This article discusses formula use and breastfeeding. The authors acknowledge that breastfeeding or chestfeeding is a personal decision and may not be an option for some parents who rely on commercial formula for infant nutrition.)

Here is what Pérez-Escamilla had to say:

When a mother and child are breastfeeding, they also engage in a rich biological conversation. These benefits from breastfeeding are not limited solely to the infant.

Mothers’ bodies alter the composition of their milk to meet the needs of their babies in the environment where they are growing and the developmental stage of the infant, like adding more antibody-producing cells to fight pathogens and changing the content based on the child’s age. Breastmilk is a form of “personalized medicine” that helps protect babies from sudden infant death syndrome and ear and respiratory infections early in life. It also can help to prevent obesity and diabetes later on, and it has been shown to improve a child’s cognitive development.

In addition, research has shown that lactation helps to reduce the risk of breast and ovarian cancer in breastfeeding women, as well as Type-2 Diabetes and cardiovascular diseases.

Since formula companies cannot tailor their products to each individual baby’s needs, parents and their children miss out on the constellation of breastmilk’s benefits.

“Breastmilk is a strongly bioactive fluid food,” Pérez-Escamilla said. “In addition to essential nutrients, it has thousands of immunoprotective substances, hormones, oligosaccharides, and live bacteria, among others, that work in synchrony to promote the child’s health, growth and development.”

Intermittent sleep, loud and persistent crying, and other unsettled behaviors are all normal for growing infants.

Still, fussiness can worry parents into thinking that they are not producing sufficient or adequate breastmilk. Formula companies capitalize on these anxieties through advertisements promoting artificial milk as a sleep enhancer and highlighting its alleged anti-colic properties. These messages can undermine a woman’s self-confidence in her ability to breastfeed.

It’s an exploitative marketing tactic that makes claims that are largely baseless, Pérez-Escamilla said. These kinds of advertisements, which focus on tranquility and peace of mind, may end up pushing mothers away from breastfeeding and toward formula when that’s not what they wanted to do.

“Formula companies spend about $3 billion dollars per year marketing their products,” he said. “That is more than the World Health Organization's annual combined budget for universal health coverage and population health promotion. This is why we are calling for global regulation of the commercial milk formulas industry.”

Anxiety over normal behaviors, combined with baseless health claims in formula advertisements, can lead parents to want to supplement, and not fully replace, their breastmilk with formula.

A recent report, The Lancet series on Breastfeeding 2023, which Pérez-Escamilla led and co-authored, indicates that nearly half of mothers cite self-perceived insufficient milk production as being a factor in their decision to introduce formula to their child. This in turn reduces suckling frequency, disrupting the whole breastfeeding process.

“The vast majority of women can successfully breastfeed when provided with adequate counseling and support, adequate maternity benefits, and protection against predatory marketing from formula companies,” Pérez-Escamilla said. “The growth and development of all babies should be monitored by their pediatricians to ensure mothers of the adequacy of their breastmilk supply or take action when necessary.”

Health care providers need to be much better trained on how to counsel mothers about normal infant behaviors and should give them adequate science-based resources to make an informed choice about feeding their children, Pérez-Escamilla added.

Contrary to what milk formula companies advertise, toddler milks are unnecessary, as infants can continue breastfeeding until they are at least two years old or can transition into regular animal milk at one year of age. Toddler milks are expensive, ultra-processed with added sugars, and are not recommended by the World Health Organization and the American Academy of Pediatrics.

Women have a right to choose how to feed their infants, and their decision should be respected above everything else, Pérez-Escamilla said. And if women choose not to breastfeed, or cannot breastfeed, then babies should drink formula until they are one year old. Pasteurized cow’s milk can replace formula after that milestone.

For children who do not tolerate cow’s milk, then parents have other options to explore with a qualified health provider, he said.

Formula companies often capitalize on political, social, and economic obstacles to steer women away from breastfeeding for as long as they would like — or even from breastfeeding at all.

A lack of breastfeeding opportunities can set back global health, stunting child development, and keeping mothers themselves from benefiting from breastfeeding, Pérez-Escamilla said.

To counter this dynamic, Pérez-Escamilla and other child nutrition and development experts are calling on governments across the world to implement policies that are more breastfeeding-friendly and empowering for women – such as requiring more breastfeeding accommodations in the workplace, improving maternity benefits, and increasing resources for quality breastfeeding counseling at the community level. This is in addition to the urgent need to implement robust regulatory processes to prevent exploitative marketing from commercial milk formula companies.

“In August, we are using this month to acknowledge, facilitate, and celebrate breastfeeding around the world,” Pérez-Escamilla said.