New editorial: Infant Formula Marketing: Lessons From Recent Litigation
This new editorial was published in the Journal of Clinical and Experimental Allergy on 23 September and is written by Dr Bob Boyle and Gerard Hastings. It examines a series of US legal cases in 2024, 2025 and 2026 involving infant formula manufacturers and their marketing. It highlights the tension that exists between the formula industry's desire to maximise infant formula sales and profits, and society's desire to optimise the health and well-being of our most vulnerable members. It shows the central role of misleading marketing practices and the conflicts of interest that arise when formula companies sponsor healthcare professional associations, conferences and training, whether allergy related, or otherwise.
The first case covered is a class action case involving Gerber (formerly owned by Nestlé), in which plaintiffs alleged that the company ‘engaged in a pattern of false, deceptive, and unfair business practices through advertising and marketing representations’. Specifically, Gerber falsely marketed a partially hydrolysed formula as the "first and only formula that reduces the risk that infants will develop allergies." The company denied the allegations, but the case raises wider questions about how allergy-related claims have been used to market infant formula. Evidence underpinning the allergy-prevention claims on hydrolysed formula is weak, based on poor-quality evidence, retracted or fraudulent research and incomplete reporting of trial findings. The claims have been pushed through industry-funded educational activities aimed at healthcare professionals, highlighting how formula industry funded healthcare professional education has the potential to over-emphasise unreliable scientific findings.
Another case involved a lawsuit against Abbott Laboratories concerning necrotising enterocolitis (NEC), a serious bowel disease affecting mainly premature infants and low-birth weight infants. A Missouri jury awarded substantial damages after finding that warnings about NEC risks associated with their preterm formula products were inadequate. While pre-term formulas represent a small market segment with relatively low volume sales, industry documents reveal the value placed on marketing of these products to secure future sales of other branded products - the ‘First bottle fed’ approach (as the figure below illustrates). It is important for health workers supporting families with infant feeding to be aware of this approach given the increasing promotion of early, sustained cow's milk formula (or amino-acid formula) for preventing cow's milk allergy. This new concept is not supported by clinical trial evidence.
A key allegation in the Abbott case is that health risks were not communicated effectively. The editorial highlights similar concerns about the lack of communication that appears to exist around the potential health harms of almost all of the allergy specialist formulas which contain non-lactose free/added sugars (sucrose, fructose and glucose syrups) as well as maltodextrins, linked to dental caries and early-onset obesity. Recommendations for sugary plant-based drinks in the case of allergy (or for other reasons) are also concerning where associated risks are not communicated.
The profound health consequences of allegedly misleading formula marketing in these cases supports the ongoing relevance of the World Health Organization recommendation that ‘sponsorship of healthcare professional and scientific meetings by companies selling foods for infants and young children should not be allowed’.
Key learning points include:
Allergy initiatives which promote early, sustained formula use may have been influenced by formula company marketing objectives related to brand loyalty.
Healthcare professionals should consider health risks associated with formula products which they recommend, as well as any potential health benefits.
Healthcare professionals should avoid industry-funded education [just one example below].
Healthcare professional organisations that accept funding from formula companies may inadvertently become channels for marketing messages which can harm babies and young children.