Marketing Malfeasance in the Infant Formula Industry
Infant formula, a scientific innovation designed to save babies’ lives holds responsibility for possibly millions of infant deaths (Schwab, 479). Marketing characterizes infant formula as an icon of modernity, promising health and prosperity. While formula is undeniably beneficial for some infants, companies’ ill intentioned marketing practices unnecessarily jeopardized lives across the world. The business ethics of infant formula marketing provides one example of the catastrophic repercussions of unethical business decisions. Today, regulation exists to monitor the formula industry; however marketing still persists to undermine infant health and a woman’s autonomy for the sake of corporate profit.
Marketing Practices: the 1970’s
By 1970, the vast majority of births occurred in hospitals and 75 percent of babies were fed infant formula from birth (Schwab, 488). These conditions resulted in booming sales for formula companies (488). Nestle, one of the major players in the infant formula industry, began to broaden their outreach beyond hospitals, and entered into new markets across the world. The rapidly industrializing cities of Africa, Asia, and Latin America provided a massive new market for infant formula (489). In 1974, the Oxford Committee on Famine Relief, a British non-governmental relief organization, published The Baby Killers a critical attack on Nestle, exposing Nestlé’s exploitative marketing practices in third world countries.
According to The Baby Killers report, Nestlé’s marking practices influenced impoverished women to abandon breastfeeding, the vernacular method of baby nutrition in favor of bottle-feeding (Krasny). The company encouraged mothers to use formula promising superior health benefits. Furthermore, Nestle sent out company salespersons dressed as nurses in rural Africa to sell door to door and encourage formula use, specifying that undernourished mothers hurt their infants (Schwab, 489). Consequently, mothers in impoverished communities adopted bottle-feeding with infant formula in efforts to “westernize” and modernize (Krasny). Even in the 1970’s research proved that exclusive breastfeeding was indisputably healthier, increasing a child’s chance of survival by six times. With little access to health care information, these women and children spent their limited funds on an unnecessary, expensive product. The effects of bottle-feeding extended beyond financial repercussions to deleterious health effects. Many women over diluted formula to make it last longer. This resulted in contaminated, over diluted formula, causing diarrhea, and hundreds of thousands of babies to die a year (Schwab, 490).
Figure 1: 1974 “The Baby Killer,” a book cover published by London’s War On Want organization (Krasny).
Nestlé’s marketing to vulnerable populations marked a threshold that social activists, health organizations, and the public could no longer ignore (Schwab, 490). As the world looked to regulate the industry, Nestle became a proxy for the whole formula industry.
Formula companies’ improper marketing methods caused a preventable world health crisis (Schwab, 490). Persuading poor, rural mothers outside the medical system to buy formula led to the subsequent international Nestle boycott and lawsuit leaded to regulation formation. Organizations at grassroots, national and international levels worked toward control of formula marketing and active promotion of breastfeeding (491). In 1981, WHO and UNICEF worked with formula companies to develop the International Code of Marketing of Breast Milk Substitutes. This code explained how baby formula should be promoted worldwide (Krasny). The international discussions about the role of formula manufacturers and ways in which hospitals could increase support for breastfeeding resulted in the Baby-Friendly Hospital Initiative, a 1991 codification of practices by the World Health organization (Rosenberg, 290).
While hospitals incorporated these initiatives into routine practices, none of these codes have been solidified with legislation. These codes cannot and do not fully protect mothers from corporate exploitation. Even today, unethical marketing practices continue (Krasny).
Marketing Practices: Today
Today, infant formula manufacturers still violate regulations despite their claimed adherence to the International Code of Marketing of Breast Milk Substitutes (Waterson 127). For example, in West Africa companies still give free samples, donations to health workers, and contravene standards for labeling (113). Additionally, in the United States 90% of hospitals distributed formula sample packs (Merewood, 363). This distribution not only violates the violates the WHO code, but breaches recommendations from the Centers for Disease Control and Prevention, the American College of Obstetricians and Gynecologists, and the Government Accountability Office. These free formula sample packs, known as commercial hospital discharge packs are an efficient and effective marketing method by which formula companies develop customer loyalty on particularly impressionable women. Manufacturers create partnerships and brand loyalty with hospitals and their staff by providing free formula for use in hospitals, support fellowships and conferences, and funds to support supplies (Rosenberg, 290). The formula industry and these “discharge bags” diminished women’s confidence in properly nourishing their newborn through breastfeeding (290).
Commercial hospital discharge packs negatively influence duration and exclusivity of breastfeeding (Rosenberg, 290). Unsurprisingly, in the United states only 66% of women initiate breastfeeding and only 33% exclusively or partially breastfeed for 6 months. These statistics exist because infant formula companies continue to defy regulatory code by marketing within hospitals (290).
Figure 2: percentage of hospitals distributing sample packs by state (Merewood, 363).
Recently, the nation’s top hospitals have been discontinuing the practice of sending mothers home with a hospital discharge pack knowing that this practice makes adopting formula feeding extremely easy; however, the infant formula remains an $11.5 billion- and growing market (Krasny).
Feminist Ethics: Protecting Choice
An analysis of infant formula manufacturers marketing exposes a multitude of ethically dishonorable practices that still proliferate today. A feminist ethics perspective paints a nuanced picture of the industry’s exploitation of women. In the 1970‘s, Nestle, in congruence with the industry, utilized unsavory methods to capitalize on impressionable, impoverished women (Krasny). Nestle, seeking to maximize profit, created a need where none existed, convinced consumers the products were indispensable, and linked their products with desirable and unattainable concepts of health and prosperity (Krasny).
Over 40 years later, the formula industry still actively participates in unethical practices. Today, the formula companies and hospitals maintain a questionably ethical symbiotic relationship (Merewood, 363). This mutually beneficial relationship leads to continued distribution of infant formula sample packs. This distribution prioritizes financial gain over patient care, exploits some women’s fear of inadequacy, and implies the medical endorsement of formula (Rosenberg, 290). Furthermore, this practice indirectly infringes upon a woman’s right to choose what is best for herself and her child (Merewood, 363). While on paper medical establishments adhere to the code, these establishments still distribute and violate the code, implicitly promote formula, and fogging a woman’s clarity and freedom of choice (Rosenberg, 290) (Kedrowski, 118).
Therefore, a feminist ethics approach to infant formula marketing and business ethics focuses on the merit of protecting a woman’s decision (Kedrowski, 118). This women centered approach to breastfeeding rights uncovers how industry and medical establishments discourage breastfeeding. Furthermore, this approach seeks to highlight how women who live within these systems of oppression struggle to make choices about what is best for themselves and their children (Kedrowski, 118). The formula industry and medical institutions must work to support a woman’s autonomy to make educated, unpressured choices. Additionally, in light society must explore how institutionalize structures inhibit women’s capacity to make a real choice in the practical contexts of their lives (Kedrowski, 128). Women should have a right to choose to breastfeed without ill intentioned marking that fogs and influences their choices (Kedrowski, 117).
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