Guest post: “Formula companies in Southeast Asia have changed their advertising tactics during the coronavirus outbreak”

[BojanaMumsnet]

Multinational baby formula companies, such as Nestlé and Danone, are using social media to market to consumers in Southeast Asia in ways that raise serious concerns that they may violate World Health Organization (WHO) guidelines.

The companies have changed their advertising tactics during the coronavirus outbreak and are also using mothers to create online marketing material.

I started reporting on this issue after WHO said that social media advertising was a “cause of growing concern” when it came to formula.

WHO introduced an international ethical code for formula marketing in 1981, after Nestlé’s advertising practices in developing countries attracted international attention and made it subject to a boycott campaign. A 2016 resolution clarified that “growing-up milks” for children under the age of 36 months fall under the code’s scope.

The WHO code prohibits formula marketing to the public, but its guidelines are not legally binding. While 70 per cent of WHO member states have enacted some legal measures against formula marketing, only 25 countries have adopted legislation that substantially aligns with the code.

There is no suggestion that either company has broken any Indonesian laws, but public health experts have expressed concerns that their actions go against the spirit of the WHO code.

During the ongoing pandemic, Nestlé's Indonesian formula brand, Dancow, ran ads featuring straplines such as “Bunda, Lindungi Si Buah Hati” (“Mother, protect your sweetheart!”) next to images of children drinking formula. The company has also used its hashtag #DancowLindungi (#DancowProtects) frequently on its posts since March 2020.

The code bars companies from seeking direct or indirect contact with pregnant women and mothers, but, during the pandemic, Dancow has hosted webinars discussing infant nutrition and live-streamed an event called ParentFest, billed as an online festival to support mothers “learning from home.”

Danone’s SGM brand has done something similar during lockdown, encouraging consumers to post questions to health experts on Facebook. Contrary to the code, Danone advertised its customer careline on Facebook and urged mothers to call if they had questions about their child’s growth and development.

WHO states that companies should not market any formula product for children under the age of three. But Nestlé’s recent Facebook ads in Indonesia show products for children aged one and above. Nestlé said that all of its communications comply with Indonesian law, “where advertisement of products for children above one year old is allowed.”

Indonesian breastfeeding advocate, Nia Umar, told me that companies promote freely. She believes it’s violating the code, “but it’s not against the law. They know the gap. And since the gap is very big and very wide, they use it to promote unethically.”

The companies have also used mothers to create online marketing material. In 2014, Danone’s SGM band launched its “mombassador” scheme. Each year, young women are encouraged to become brand ambassadors. Judged in part on their social media presence, successful applicants are encouraged to host parenting events, some at government-run health centres, and publish posts promoting SGM online.

Women who have taken part in the programme told us that they were offered classes on nutrition and child development, editing photos, and writing social media content. Danone said that the initiative was purely informational and did not promote any baby formula products.

Danone claims to have more than 400 mombassadors across Indonesia. The company does not cover the cost of transportation to participants’ classes and does not pay the mothers directly for their branded social media posts.

“I am only a middle-school graduate,” said one mother. “The most important thing is knowledge, right? For me, paying for transportation [to classes] is not really a big deal. Going to school, you have to pay tuition. The [mombassador] programme is free and useful.”

David Clark, a nutrition specialist at Unicef, told me the women were being “manipulated.”

“There is no doubt in my mind that mommy bloggers and brand ambassadors are involved in a form of promotion that is prohibited by the Code,” he said.

Health experts say that aggressive advertising can cause mothers to move to formula unnecessarily. WHO recommends that, where possible, babies are exclusively breastfed for the first six months and receive continued breastfeeding up to the age of two and beyond.

In response to our investigation, Nestlé said, “The WHO code and subsequent WHA (World Health Assembly) resolutions are recommendations for member states to translate into local legislation. This is why we apply WHO recommendations as implemented in law by member states.”

Both Nestlé and Danone told the Bureau that they take any allegation of non-compliance seriously and have robust systems to encourage people to report any concerns around marketing practices.

Some experts predict that, without adequate legislation and enforcement, formula companies will continue to flout WHO guidelines. “They’re in this business to make money and to sell products,” David Clark told me. “But we have to have a regulatory framework in place that stops them from exploiting and manipulating the public.”

You can read our full investigation here.

Rosa Furneaux will respond to some comments and questions in this discussion next week.

[AnneLovesGilbert]

And this is why “fed is best” is so stupid. Formula is fine if you can afford to buy it and have access to clean water and are able to sanitise bottles and other equipment. It’s outright dangerous if you can’t, and it’s evil to manipulate worried women and recommend they use it instead of the free, sterile, convenient alternative which actually produces antibodies.

[RosaFurneauxTBIJ]

Hi all, Rosa from the Bureau of Investigative Journalism here. Thanks for your comments — I’m looking forward to responding.

The way formula marketing interferes with what we might call “free choice” is a thorny issue. The WHO Code was established in response to the marketing practices many of you have mentioned, which led to the Nestlé boycott in the 1970s. With regard to the present position of mothers in Indonesia, I’d highlight a 2016 study which found that more than 70 per cent of pregnant women and new mothers in Java had seen promotional materials for breast-milk substitutes. The authors noted that women who recall such marketing are more likely to use formula than those who do not.

WHO recommends that, where possible, babies are exclusively breastfed for the first six months and receive continued breastfeeding up to the age of two and beyond. But recent government data showed that just 38 per cent of Indonesian mothers exclusively breastfed their baby from birth to six months, and the percentage of children under six months who were never breastfed increased four percentage points between 2013 and 2017.

As a growing market, Indonesia and wider Southeast Asia is particularly attractive to the formula industry. It’s perhaps unsurprising, then, that we’re seeing these kinds of “aggressive” marketing practices take root.

[RosaFurneauxTBIJ]

[quote Spam88]@ChristmasKitties I don't get that from it at all.

The "protect your baby" stuff is REALLY not okay.

I hadn't realised that WHO says formula for under 3s shouldn't be advertised. Very interesting that the U.K. doesn't follow that![/quote]
@Spam88 — correct, follow-on milks for children up to the age of three are covered by the WHO Code. In fact, the World Health Assembly passed a resolution in 2016 to clarify this, stating that “‘follow-up formula’ and ‘growing-up milks’ fall under the scope of the Code and should not be promoted.”

But there is a difference between what the WHO Code says and what countries have put into law. The Code is not legally binding, so in Indonesia (for example) companies are able to market follow-on milks. As the Indonesian breastfeeding expert Nia Umar said in my story, companies know the gap between the Code and the law.

[RosaFurneauxTBIJ]

@Dinocan

Thanks, interesting post. Will read the article. I have also read that formula companies were capitalising on the Covid pandemic by suggesting that mothers shouldn’t breastfeed because of risk of infecting their babies with Covid. This is an issue that really upsets me and leads to so many extra deaths and illness for babies. Unfortunately people seem to think it’s a problem that was left in the 80s.

@Dinocan — yes, globally there have been reports of mothers being separated from their newborn babies due to fears that they may pass on the virus.

Luckily the Covid-19 virus has not, to date, been detected in breastmilk, nor have there been any confirmed cases of virus transmission through breastmilk or breastfeeding.

The World Health Organization recently released guidelines that recommend mothers and babies be kept together, and that breastfeeding or feeding with expressed breastmilk continues — even if the mother is suspected or confirmed to have the virus. To mitigate any risk, WHO recommends mothers wear a mask while feeding and wash their hand thoroughly and frequently.

[RosaFurneauxTBIJ]

@greenshopberwick

Just to say there has been a global campaign against Nestle's malpractice with formula milk promotiom since the mid (?) seventies. This is nothing new. Unfortunately, Nestle seem invulnerable. They, Danone and others are simply too big, too global to ever be held to account. All anyone can do is just stop buying their products - and they own lots and lots of 'brands'.

@greenshopberwick — I agree that this problem really does seem intractable. Thankfully, there are organisations working to hold companies to account for potentially harmful marketing practices.

The International Baby Food Action Network (IBFAN) is a global network working in more than 160 countries to stop misleading marketing by the baby formula industry. In the UK, Baby Milk Action monitors formula advertising and attends UN meetings to counter industry lobbying. They encourage consumers to report instances of unethical marketing that may constitute WHO Code violations. You can find out more about getting involved here.