Globalization, first-foods systems transformations and corporate power: a synthesis of literature and data on the market and political practices of the transnational baby food industry

Abstract

Background 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. 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. Results Global 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. Conclusion The 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.

Breastfeeding, first-food systems and corporate power: a case study on the market and political practices of the transnational baby food industry and public health resistance in the Philippines

“…To sustain high levels of milk formula sales in the Philippines, the baby food industry has since the mid-1980s, more aggressively promoted products for older infants and young children, which are now a major feature of the country’s first-food system [ 4 ]. This is a strategy adopted by the industry worldwide to ‘widen the scope’ of its market, as regulations have tightened on the marketing of infant formulas [ 14 ].…”

“…First, describing the scope and setting of the case study; second, collecting data from documentary sources and key informant interviews; and finally, synthesising results. To help develop initial concepts, guide our data collection and organize the results, we were guided by a theoretical framework (outlined in Text S1), which we developed in earlier studies on first-food systems and corporate power [ 12 , 14 ]. We did not place constraints on the time-period under study, but allowed for an emerging understanding of events.…”

“…Growth in CMF consumption is occurring mainly in industrialising middle-income countries, home to the world’s largest populations, indicating an unprecedented change in infant and young child diets [ 13 ]. It is also occurring in the context of continuing economic globalization, including rapid growth in the size, transnational reach and consolidation of the baby food industry, with the majority of sales accruing to just a small number of ‘Big Formula’ corporations [ 14 ]. Despite these developments, surprisingly few studies have investigated what market and political strategies the baby food industry has used to expand, sustain and protect its CMF markets worldwide, with some exceptions [ 15 – 18 ].…”

What You Don’t Know About the Codex Can Hurt You: How Trade Policy Trumps Global Health Governance in Infant and Young Child Nutrition

“…Baker et al describe the scale of financing behind private-sector groups working to influence standard-setting and trade policy. 68 Third, CAC documentation of committee proceedings could be more detailed and transparent. All records that we draw from have the advantage of being publicly available, but it would be helpful for public understanding and future research if the CAC provided more transparent records of both the committee meetings and email or other written deliberations during the proceedings of Electronic Working Groups.…”

Evidence of Violations of the International Code of Marketing of Breast-Milk Substitutes since the Adoption by the World Health Assembly in 1981: A Systematic Scoping Review Protocol

“…This marketing includes promotion to the general public, health workers and mothers directly and via media [9][10][11][12][13][14], donations of free and low-cost supplies of BMS and equipment to health services [8] and in emergency situations [15,16], gifts to health workers and to mothers [17][18][19][20], and unsubstantiated health claims [21][22][23][24], among other activities. The highly profitable marketing utilises highly effective strategies to influence the "first food system" to undermine breastfeeding, unduly influence the policy frameworks that protect breastfeeding from commercial influence, and ultimately influence the attitudes and practices of parents, caregivers, healthcare workers, even policymakers [25]. The COVID-19 pandemic was shown to be another platform and opportunity for harmful marketing of BMS and the undermining of breastfeeding [26].…”