A local expert says there is an urgent need to strengthen lactation education and knowledge of breastfeeding benefits, suggesting health science students could be used to act as “targets of change” to counter the aggressive marketing by formula milk companies, who use health professionals to push their products by offering sales commission and all-expenses-paid promotional trips.
Dr Haroon Salojee, Professor of Community Paediatrics at the University of Witwatersrand (Wits), says that expanding lactation education and training would not only provide mothers with the necessary knowledge but also healthcare professionals, seen as the most trusted sources of education on infant feeding and nutrition, reports Health-e News.
Two-pronged approach
“First, we need to strengthen lactation education and training. Second, we need to use medical health science students’ advocacy to combat the industry’s influence on their education,” he said.
Salojee added that faculties also needed attention, while those professionals already in clinical practice “also need education opportunities”.
The professor was speaking at last week’s WHO Webinar series: the problem with the formula milk industry.
Breast is best
A study earlier this year by the WHO and UNICEF found that formula milk brand representatives target various health professionals – paediatricians, nurses, dieticians and hospital administrators – with incentives like research, sales commissions, merchandise and all-expenses-paid promotional trips.
“These specialists have personal access to pregnant women and parents of young children, who often turn to them for evidence-based and impartial advice. Aware of this, formula milk companies seek to influence these professionals’ understanding of breastfeeding by convincing them of the need for formula. The professionals act as a perfect channel for marketing,” the study stated.
“There is a lack of standardisation currently across guiding frameworks, course content, and strategies. The evidence that we have is limited and of low quality. However, training resulted in small but significant improvements in breastfeeding knowledge, attitude towards breastfeeding and demonstrations,” said Saloojee, adding that online learning platforms were also recommended.
“These would be effective for under-and-post graduate students in evidence-based lactation support and care. The curriculum can include theory, skills and assessment components developed by the WHO academy and individual university paediatrics academies.”
Separating marketing from support
Dr Nigel Rollins, from WHO’s Department of Maternal, Newborn, Child and Adolescent Health and Ageing, said health professionals must separate marketing from the support they provide to women as they are two separate issues: over the past 15 years, there had been an increase in the number of infants on formula milk.
“The problem is the industry’s marketing practice and not the availability of formula products in supermarkets or women's choices. Marketing of formula products is unquestionably a significant part of the story. These approaches can influence our understanding and views and wholly interrupt our patients and the industry knows this,” he said.
“As health professionals, we all know that infant feeding is important. Essential to systems biology influences are lifelong health risks, mortality and development and impact on maternal health. There is high-quality evidence that breastfeeding gives infants and children the best health outcomes, in all settings. Breastfeeding is not only for low-or-middle income countries.”
The WHO and UNICEF recommend that children be exclusively breastfed for the first six months of life.
WHO Webinar series: the problem with the formula milk industry (Open access)
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Breastfeeding improves cognitive skills for children of poorer mothers – UK study
Breastfeeding rates in SA increased but still short of global targets
WHO studies: Europe’s problems with breastfeeding and child obesity
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Royal College of Paediatrics slammed over baby milk producer link