Abstract

BackgroundThe global milk formula market has ‘boomed’ in recent decades, raising serious concerns for breastfeeding, and child and maternal health. Despite these developments, few studies have investigated the global expansion of the baby food industry, nor the market and political practices corporations have used to grow and sustain their markets. In this paper, our aim is to understand the strategies used by the baby food industry to shape ‘first-foods systems’ across its diverse markets, and in doing so, drive milk formula consumption on a global scale. We used a theoretically guided synthesis review method, which integrated diverse qualitative and quantitative data sources.ResultsGlobal milk formula sales grew from ~US$1.5 billion in 1978 to US$55.6 billion in 2019. This remarkable expansion has occurred along two main historical axes. First, the widening geographical reach of the baby food industry and its marketing practices, both globally and within countries, as corporations have pursued new growth opportunities, especially in the Global South. Second, the broadening of product ranges beyond infant formula, to include an array of follow-up, toddler and specialized formulas for a wider range of age groups and conditions, thereby widening the scope of mother-child populations subject to commodification. Sophisticated marketing techniques have been used to grow and sustain milk formula consumption, including marketing through health systems, mass-media and digital advertising, and novel product innovations backed by corporate science. To enable and sustain this marketing, the industry has engaged in diverse political practices to foster favourable policy, regulatory and knowledge environments. This has included lobbying international and national policy-makers, generating and deploying favourable science, leveraging global trade rules and adopting corporate policies to counter regulatory action by governments.ConclusionThe baby food industry uses integrated market and political strategies to shape first-foods systems in ways that drive and sustain milk formula market expansion, on a global scale. Such practices are a major impediment to global implementation of the International Code of Marketing of Breastmilk Substitutes, and other policy actions to protect, promote and support breastfeeding. New modalities of public health action are needed to negate the political practices of the industry in particular, and ultimately to constrain corporate power over the mother-child breastfeeding dyad.

Highlights

  • The global milk formula market has ‘boomed’ in recent decades, raising serious concerns for breastfeeding, and child and maternal health

  • New modalities of public health action are needed to negate the political practices of the industry in particular, and to constrain corporate power over the mother-child breastfeeding dyad

  • The rise of big formula and the material foundations of its power we describe the evolution of the baby food industry, and in doing so, describe the material assets and resources the corporations have accrued, as milk formula markets have expanded worldwide

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Summary

Introduction

The global milk formula market has ‘boomed’ in recent decades, raising serious concerns for breastfeeding, and child and maternal health Despite these developments, few studies have investigated the global expansion of the baby food industry, nor the market and political practices corporations have used to grow and sustain their markets. Our aim is to understand the strategies used by the baby food industry to shape ‘first-foods systems’ across its diverse markets, and in doing so, drive milk formula consumption on a global scale. As the biological ‘first-food’ for human children, breastmilk is safe to consume, nutritionally optimised to the child’s evolving developmental needs, and protects against infection [5, 6] It is literally ‘packaged with love’ given breastfeeding fosters mother-child bonding, and reduces stress for both [7]. Optimal development and health, the World Health Organization (WHO) recommends infants initiate breastfeeding in the first hour of life, are exclusively breastfed for 6 months, and thereafter receive nutritious and safe complementary foods, while breastfeeding continues for up to 2 years of age or beyond [10]

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