WHO, UNICEF and the Lancet call for better regulation of the breastmilk substitute industry to protect child health

Last week, the WHO-UNICEF-Lancet Commission released their report: “A Future for the World’s Children”i . The report highlights how the health of children now and in the future, and our ability to make progress towards the Sustainable Development Goals, depends on overcoming two new challenges: the climate emergency and “predatory commercial exploitation”; including by the breastmilk substitute industry.

The Commission calls for early investment in children’s health, education and development in order to leverage lifelong, intergenerational, and economic benefits. They stress that good health and nutrition in the prenatal period and early years lay the foundation for a healthy life course, highlighting that “breastfeeding provides personalised medicine to the newborn—a potent tool for improving health, if we can overcome the poor support for breastfeeding mothers and regulate the inappropriate promotion of formula milk by a $70 billion industry”.

A key message is that all Governments have a duty of care and protection across all Sectors, including those necessary to ensure good nutrition and food security for all. And we are reminded that the rights and entitlements of children are enshrined within the UN Convention on the Rights of the Child (CRC) ratified by all countries, except the USA.

Critically, whilst acknowledging the role business plays in wealth and job creation, the Commission highlights concern that the commercial sector’s profit motive poses huge threats to child health; e.g. “inappropriate use of breastmilk substitutes is associated with lowered intelligence, obesity, and increased risk of diabetes and other non-communicable diseases, collectively accounting for an estimated loss of $302 billion”. Their view is that “industry self-regulation does not work, and the existing global frameworks are not sufficient”; and while they call for efforts to reinforce the International Code of Marketing of Breastmilk Substitutes, they also imply that there are serious limitations associated with it not being a legally binding instrument.

Consequently, they call for a far stronger and more comprehensive approach to regulation; as follows: “We propose adding an Optional Protocol to the CRC regarding commercial marketing and targeting of children, which would require national governments to prohibit or regulate the types of products that should not be marketed to or for children (including sugary beverages, unhealthy foods, alcohol, tobacco, e-cigarettes, gambling products, and breastmilk substitutes)…”.

The BFLG endorses this proposal, which would ensure tighter regulation of the breastmilk substitute industry, in line with the Code. Greater legal protection for breastfeeding is urgently needed in the UK, alongside ongoing promotion and improved support.

i https://www.thelancet.com/commissions/future-child

Helena Little