Thursday, December 15, 2011

Formula Companies Dare to Compare Imitations to the Real Thing

This post is about advertising, marketing and deception.  We as educators, public health professionals, moms, citizens, consumers, tax payers, etc.  have to demand honesty in advertising--especially from the formula companies.  These companies use inferior ingredients, cut corners in production, and then lie about its value, causing customers to flock to the registers with complete peace of mind.  As consumers, we question the quality of what we purchase and we want what we pay for...then there's formula...

I made some tongue-in-cheek posters last week.  I am a very visual learner, so I created a visual.  I was attempting to show the stark difference between formula and breastmilk in a vivid, humorous way, but the humor was lost on some.

My posters showed the stark contrast between artificial infant milk and breastmilk.  The superiority of breastmilk is not a new concept, but rather a well-documented, well-established, scientific fact. The two are NOT created equal.  In fact, by law, every can of formula must explain that breastmilk is superior to the product contained therein.  One is a man-made, synthetic recipe; the other a natural, organic species-specific food.  Just like vitamin C tablets are not as potent or healthy as natural vitamin C from real fruit consumed; formula (artificial breast milk) is not as healthy as natural, species-specific breastmilk.

Most of the people who viewed the photos I posted gave it a "thumbs up" and some re-posted. Facebook is pretty good at tracking where posts travel via shares and the subsequent comments.  It was the dialogue that surfaced on some of my friends' pages that truly concerned me.  I realized for the first time how successful the formula companies are at not only dominating the infant feeding market, but also controlling the critics that may voice any opposition.  They conjure up feelings of guilt, anger, fear, disappointment and frustration--not for their product or marketers--but at those who may want to point out that their product is did they accomplish that?

One irate commentator "shouted" obscenities and cursed the person who made the poster...strong, emotional response--was this response to the false advertising and implied similarities of formula and breastmilk?  No, as far as I could tell, the reader took offense at what she perceived the message insinuated...that she was a "bad" mother. Nothing could be further from the truth.  I even prefaced the ad with the following remarks
"Just a visual reminder that no matter how the formula companies try to package it, formula and breastmilk are NOT created equal...another thought on the deceptive advertising of formula...(not-and never will be-an attack on those who use it...)"

If a mom gives her infant formula to ensure survival she is definitely a good mom!  There are many legitimate reasons to use or supplement with formula (adoptive moms, foster moms, dads with custody, moms on certain medications...all rely on the nutrition adequacy of artificial infant milk), but still the reader saw:  formula=bad mom; breastmilk=good mom; and I was absolutely, positively judging them!  When a company can cause formula-using moms to take things personally they have achieve a great accomplishment. These companies have undoubtedly succeeded in attaching feelings to facts and substitute perception for reality.

Then there was responses from colleagues in the lactation field.  A couple stated that although they know the risks of formula feeding, they anticipated that people might be offended and riddled with guilt if they were to share my photo on their wall.  Now, this is where the formula companies really hit the jackpot.  Not only do they promote their product, but they also have successfully silenced the opposition.  Really?!  Professionals can't share that there are risks to formula-feeding without retaliation?  Are we free to share risks of not using a car seat or feeding infants honey, egg whites and peanut butter?  What if parents want to give these foods to their children?  Does that mean I am prohibited to share the information for fear of causing guilt? Of course not, but these other safety and feeding recommendations do not elicit the same emotional response the formula warnings do.

It appears as though formula companies have even found a way to convince breastfeeding advocates to keep silent about opinions and concerns.  Even as I write this, I have a bit of fear and trepidation about how this blog will be received.  Will people understand that I want to educate, and that my heart is in helping moms regardless of what their feeding choice is?  Will readers understand I am campaigning for honesty in advertising, or will I fall victim to the scandal that all opposition is insensitive and cruel?  I really am at a loss for how to change perception.  I hope others will help me turn the tide of perception by sharing this post.

What other company can get the loyal consumers on board and silent the opposition? Formula is a taboo subject to discuss in any circle. It has a protective barrier around it and is off-limits when it comes to criticism.  How did they ever achieve this marketing phenomenon?

I am also a bit perplexed and maybe even in awe at how the big formula companies have succeeded in promoting their imitations as "close to the real thing." No one believes that artificial infant milk is as good as breastmilk, but the nation accepts that it is "close enough."  I have to congratulate the conglomerates for their marketing genius and their ability to control perception.

I often stand in front of a group I am teaching and take a side step to my left and boldly announce, "I am now one step closer to China." Of course, I am no where near China, but one step closer.  Recently, I created this poster to convey the same message:

Here's another way for me to put this in perspective.  If a young couple walked into a jewelry store, while window shopping for an engagement ring, and a savvy salesman produced the sugar-coated ring pop with the description that it is "closer to a diamond than ever before," the customers would be outraged, insulted and storm out of the shop (of course the guy may still nonchalantly ask, "how much for the beautiful topaz").  The point is, we are wise to manipulation--especially from salespeople. The candy sentiment may be beautiful, shiny, slide nicely onto the ring finger, but it is not the same as a diamond--and how dare a jeweler insinuate that it is!

Would honesty be appreciated?  Absolutely...the same salesman could have said, "I have this replica that could serve the purpose of a symbol during the nuptials.  It isn't a diamond.  It is made of hard sugar, but you can use it as a stand in."  Then the couple could make an informed decision.  Most would prefer the diamond, but no one but they know all the circumstances.  Maybe a diamond is not an option.  Perhaps the bride has adverse reactions to metal and the plastic alternative is perfect!  They can confidently select the confectionery token without any guilt.  Content with their choice, they are still happy for those who can buy diamonds and understand that diamonds are superior, they do not try to argue the incredible investment that ring pops are and become outraged when anyone suggests that diamonds are superior. It would be ludicrous.

Take the next scenario.  A customer steps onto a used car lot.  Just the location puts people on the defensive by anticipating lies or stretching of the truth.  I'm not saying it's right or even warranted, just a matter of  car lot facts. The car salesman approaches the on-looker with a beauty to sale.  It has four wheels, a new paint job, will get you where you need to go and is "just as good as" the Lamborghini parked adjacent.  Really, who are you kidding?!  Consumer Reports are out and the little, plastic toy does not beat the sports car in any category (well, except MPG--which could actually be a good selling point in this gas war).  The real kicker comes with the sticker price...the dwarfed vehicle is actually priced higher.  The salesman blames inflation and the premium parts that have been used in construction.  Once again, no sale.  We are not going to be duped by a smooth talker.  We are going to look under the hood, kick the tires, and we may in all actuality purchase the little car...not because it is better--or even as good as--the hot rod, but because we need transportation and it is a viable option, but not because we "bought the lie."

Now, let me attempt to share the how these same analogies are used in formula promotion. The impracticable, ridiculous sales tactics mentioned above are laughable, but when marketing experts use them to promote formula, they now miraculously work!  The company passes off an inferior product as the real thing.  Customers are promised that it is "closer than ever to breastmilk."

How can they make these unsubstantiated claims?  Professionals working in the advertising world will attest that these phrases can be legally used if even the color is closer to breastmilk than it was previously.  The American Academy of Pediatrics, World Health Organization, UNICEF and the Department of Public Health all try to expose the deceptive marketing to no avail. These companies seem to be untouchable--even with facts.

Not only are established organizations' warnings rejected, friends and family attempt to share the truth about formula and the "Ring Pop crowd" embraces a mob mentality.  All of the sudden well-meaning friends are labeled "Breastfeeding Nazis" or "Lactivists."  Why is the truth so threatening?  Why would sharing the truth be interpreted as "making formula-feeding moms feel guilty"?

Here's a confession, just because I feel like readers may think I cannot relate.  I formula-fed my first child.  Not exclusively, I breastfed when it was convenient. Do I feel guilty when I hear how certain risks are increased with formula-feeding.  No, absolutely not.  I was convinced that formula and breastmilk were equal.  My nurse gave my son formula...she was older, "wiser" and had more children than I, so I deferred feeding to the lady Nightingale.  Now, I am upset that no one shared the truth with me. No one said the manufacturers cut corners, use inferior ingredients and market their product in order to please the share holders because it is a commodity that people heavily invest in...that would have been helpful.  I also put my son on his belly to sleep--another sign of the times.  I would do things differently now.  A lot of us would.

I have friends, family and clients that have had to use formula to feed their infants.  They do not feel guilty either.  It is a matter of fact.  They almost all would have preferred breastmilk, but it wasn't an option.  They knew the facts, were informed and also admit that scientists and other experts are correct in stating that breastmilk is the best choice. They are not part of the crowd that takes remarks personally.

Remember, by law every formula company has to confirm that breastmilk is superior to formula.  They have to print it right on the packaging labels, but do we get angry at the formula companies for this atrocious declaration? No, we direct our anger at a friend, family member or random individual that posts something on Facebook.  Wow, how do they do it?

Why have my ads elicited such emotional responses from some people?  Once again, I think it is part of the marketing.  

Please indulge me as I share another personal analogy of artificial food.  TPN  (Total parenteral nutrition) keeps getting improved is "closer than ever to nutritious food."  My dad had to be on it to get nutrients that he couldn't get by eating food, we appreciated the medical advance, but wouldn't have chosen it as our first choice, we knew food was was just a matter of fact that we would need to use it to replace food to sustain life...we didn't feel guilty for using the TPN, or offended when professionals explained there were risks to using TPN as a food alternative, I understood it was lifesaving, but I was also happy for the rest of my family that could eat whole one ever tried to convince us that TPN was equal to whole food...doctors and nutritionists were very transparent. Why is formula any different?

These are some final remarks and observations that I believe help the formula companies perpetuate a feeling of guilt when someone mentions the formula vs. breastmilk topic.  Moms feel guilty. That is a fact. Formula companies know this and they take advantage of moms during a vulnerable time in their lives...they play on a temporary weakness.  Moms assume the "fight or flight mode" and fight off a perceived attack...guns are cocked and everyone is ready for a fight...we will defend ourselves at all costs...good meaning friends must also be aware of this delicate time in a mother's life and assume a protective role as we educate.  That may seem like an oxymoron, but it is possible and preferred. 

How else can we combat the advertising moguls?  We must figure out a way to remove feelings from formula.  Just like readers had to try to remove feelings from fact as this article was being read.  It's difficult because perception is reality.

So what can we say about formula?  The truth.   formula was created to sustain life by trying to replicate breastmilk, much like TPN is used, but that does not make it the same as and truth can go along way, and everyone deserves to be informed...

Sometimes there is no choice, but given a choice, it only makes sense...

I hope this doesn't come across as segmented.  I have a lot of thoughts and this blog has taken way too much time to compose, but I have been cautious and rewritten it a few times.  I will just have to submit it to the public after I make a final note to my lactivist friends: we must be extremely cautions to never confirm what the formula companies try to insinuate: that guilt and fear, depression and anger should be directed at lactation consultants.  If we make clients defensive, we are promoting the formula companies agenda.  We must be honest, sincere, gentle, supportive and loving (in fact, maybe even a little more than we naturally are).

Hope this provided some food for thought...
Christy Jo Hendricks, IBCLC, RLC, CD(DONA), CAPPA CLE Faculty

Hope you can join me for a lactation training in the future...together we can make a difference


  1. Thank you Christy, This is great!!

  2. I agree whole-heartedly and am sorry you have been attacked. I wish those who have been so soundly duped could feel the same rage towards the profit-mongering formula companies. When I was on a mission trip last summer in Honduras, a tv was on in a restaurant where our group was eating and a formula ad came on featuring a doctor (or at least someone dressed in a labcoat with a stethoscope dangling from his neck) recommending the formula and touting the added DHA as good for baby's brain development. It was shocking as an American to see such an ad, but I was truly enraged that apparently this is the rule and not at all exceptional in the third world. SHAME on them. Babies are dying because of just such deceptive advertising practices. Babies are dying all over the world....where's the outrage over that???

  3. love your comparisons lol - great point throughout the blog!

  4. This is excellent. Thanks so much for taking the time to put your thoughts down. I feel like I've read just about every angle on this topic, ad nauseum, and you succeeded in putting a whole new spin on it and bringing up some new food for thought.

  5. Thank you all for the awesome comments. I know it was a lengthy read, but I had to do the topic justice and thoroughly explain my platform. Hope you will share with others...we need this message to resonate around the world.

  6. Love the analogies!

    Tho the clock one is kinda weak... Having come from a family of watch and clock makers hehehe... that pocketwatch is a fine timepiece, comparable to big ben

    May I suggest using a sundial perhaps? or a sandglass?

    Otherwise I think this is an amazing campaign!!! Love the 'closer to the moon' the most!

  7. Great idea to use a sundial! I did make sure not to use an expensive pocket watch...I even tried a cheap, plastic watch, but it was too long to fit in the area...a sundial is perfect!!

  8. While I agree with the information herein, I really wish that you would acknowledge that another good reason for using formula are women whose bodies either (a) don't produce enough for their child's needs, or (b)cannot make breast feeding work. I tried so hard with both of my children - lactation specialists (please note the plural), pumping, everything that was suggested or that I could find via my own research. I supplemented with formula with both of them and eventually had to go with formula only as my body simply didn't do what it is biologically supposed to do. It was heartbreaking for me, but I am grateful that I had an alternative. I believe that the work you do it wonderful and am not trying to take anything away from your message, but please remember that there ARE women out there who do the best they can and their bodies don't cooperate.

  9. The reason people react that way is because thats how it reads. if breast milk is superior to formula, as everyone in america is well aware, then by implication a mother who uses formula must be a bad mom, barring some extreme condition. and then any adult who was breast fed has a bad mom. Of course that is going to elicit strong defensive emotions. It has nothing to do with formula advertising.

  10. Well said!! I totally agree and this is coming from someone who had to supplement with formula due to low supply issues as O. Sebastian said. Something missing from this dialog (which I only found out about recently) is donor milk. Finding someone to donate pumped milk, or a milk bank, is a way to give human milk to your baby when you are unable. Granted it can be expensive and most women don't even know about it. I think the more we talk about it, the more normalized it could become and then maybe cost and availability will be less of an issue.

  11. Great point about the milk banks. For that very reason, I formed a breastfeeding coalition with a few friends and our first order is to get a milk depot in our local hospital. Moms and babies deserve the best. I have quite a few moms that have insufficient mammary tissue, PCOS, have had a mastectomy--and the list goes on...I see high risk and complicated issues, so even though the percentage of these breastfeeding issues is low, I may see more than average. I help these moms and babies and they understand supplementation and their choices...they know they are good moms and have my full support. Sometimes just having a friend at this time is all a mom one has to feel bad or guilty if they can't have their first choice, but there is something wrong if they aren't given a choice because they have believed all the propaganda that has been thrown at them...I truly appreciate the dialogue here. I will be writing about milk banks and exposing more advertising gimmicks in the future. I am grateful the message is being distributed!

  12. Thank you for the great post! I am unable to breastfeed (suspected IGT), but we have used donor milk successfully for over a year now because of every reason you discuss! I want the real thing for my baby :) because ALL babies deserve the perfect food for them. Formula feeding is not ideal, no matter how much guilt or how many angry, defensive comments some people post, simply, they cannot change the facts.

  13. I agree whole-heartedly with your comments and comparisons. I continue to address these issues daily in my practice as an LC. When I am sturggling with the power of the formula companies and the injustices done as they violate the WHO Code around the globe, I find comfort in thinking about the long battles that were similarly waged against cigarette companies in the past decades. While these battles took many years, public perception has now changed and I am hopeful that we will see issues around infant feeding follow in the same way in time. (and similarly, those who initially opposed smoking as a health risk were seen as radical and even crazy!)

  14. Do we think adoptive mothers are less of a woman or mother b/c her body didn't cooperate in becoming pregnant or delivering a baby? Of course not! Most people would understand choosing to adopt if the mother has struggled through the physical challenges of trying to bear a baby and been unsuccessful in reaching her goal.

    It can be a bit more challenging to accept the mother who attempts breastfeeding and is failed by her body only b/c there are far many more women who probably could breastfeed but choose not to but use the excuse of "I couldn't make enough milk" or "My baby didn't take the breast" If someone's body truly doesn't cooperate then of course we understand the choice to formula feed but that is the exception rather than the rule.

    Would we be so understanding and happy for the adoptive mother if choosing adoption were commonly done b/c it was perceived as "easier" or b/c women didn't want to give birth b/c of body image reasons or other reasons most of us would deem ridiculous.

    It's sad but true that the few who have genuine struggles with breastfeeding are often painted with the same brush as those who choose bottle feeding b/c they can't be bothered to breastfeed for a host of lame reasons that are of course promoted by the formula companies in many clever and subtle ways.

    I think not knowing if the reason a mother does not breastfeed is genuinely due to an unfixable problem or or just a lame excuse is at the heart of the issue as to why mothers feel they are being judged if they don't breastfeed. It's just too common not to breastfeed for reasons that would be easily addressed or that are purely selfish.

    If you didn't breastfeed for legitimate reasons beyond your control then you should not include yourself in with the group who is just not breastfeeding b/c of their own preferences. However a mother who doesn't breastfeed for personal preferences will not likely say I didn't breastfeed b/c I was more concerned with my own comfort and body image than I was the health of my baby! OR I was to lazy to learn anything about breastfeeding, OR I was tired and wanted to send the baby to the nursery in the hospital so I could rest. OR I want to use....(insert illegal drug).

    Sorry I'm sure I will get critisized but it's what I see everyday. Women giving up the gift of breastfeeding for lame reasons! BTW, I have an adopted granddaughter who's mom worked very hard to breastfeed her. If every woman could live her life for just one minute they would understand the gift they are throwing away.

    My comments are definitely not aimed at the women who have struggled with genuine breastfeeding problems. My heart goes out to you. No one would ever accuse an adoptive mother of 'not trying hard enough' But with breastfeeding it's a different story.

  15. You have written what I have often thought. Thank you. Be strong, be brave, culture change takes many generations!
    Lisa Paladino CNM IBCLC

  16. I appreciate your thoughts! I am currently still breastfeeding my 12mo old. I did go through a period of a few weeks around 5-6months where I supplemented with formula because I was on antibiotics. I didn't know about milk-banks at the time, but am now a part of a group in IN for donor milk. I would love to see more information about ingredients in formula that we should avoid. Maybe a comparison of a few formulas. Also, maybe top 2-3 formulas if supplementing becomes necessary for a breastfeeding mom - ie) short term antibiotics or illness preventing breastfeeding - mine was so sudden, I did not have enough time to pump and freeze milk to last 21 days of antibiotics.
    I don't want to encourage formula as a first option, but occasionally it is needed. My sister in law is adopting and she asked me about formula, but since I breastfeed, I had no idea what to suggest to her .

  17. Dear Sir/Madam

    We are group of volunteers consists of Law attorneys, gynecology, neonatologists, pediatrics, family physicians, nurses and social workers, form Lahore Pakistan, worried about maternal and infant mortality rate in Pakistan because United Nations Children's Fund (UNICEF) has notified that the biggest challenge for Pakistan, right now, is the high infant mortality rate, as 500 children die every day before reaching to their first birthday.
    One of the reasons for this high mortality rate is improper nutrition. To reduce this high mortality rate we are interested in starting Human milk Bank to save our infants by providing proper natural food to the premature infants.
    We have contacted local hospitals they are ready to work with and support us. We have started working in this respect and have arranged some Milk donors. We also got support from medical community as well as civil society.
    We need guidance in planning features and structure for establishing Milk Bank. Can you please give us some information and guidance in this regard?
    Have a Great Day and thanking in advance for your help and cooperation.

    Best Wishes

    Ejaz Ahmad Malik
    Advocate High Courts
    M-9 First Floor, Khan Arcade,
    Fardous Market, Gulberg
    Lahore, Pakistan.
    Phone: 00924235944515
    Cell: 00923074485300

  18. This comment has been removed by the author.

  19. You really just need to take those silly posters you made and toss them. They have nothing to do with formula vs breastmilk. Of course, OF COURSE, formula feeding parents are going to feel attacked. Do you live under a freaking rock? Consider the mothers out there are absolutely bombarded by the "BREAST IS ALWAYS ALWAYS ALWAYS BEST" messages and then, for whatever reason, cannot breastfeed or realize that because of one reason or another breastfeeding is absolutely not going to work out. Your ridiculous posters will cause more guilt and hurt with some mothers than you have ever imagined. Maybe you did formula feed your baby but that doesn't mean formula was not a heart breaking, last resort choice that another young mother struggles with daily. I read stories from mothers all the time that had no other choice but to formula feed. It's not always a light hearted decision or a decision made with confidence. And donor milk is not an option for every mother. Your posters are silly. They are ridiculous. They have absolutely nothing to do with formula vs breast milk. You are taking an issue that is extremely serious and gut wrenching to so many mothers and trying to make it funny and cute. It's not. If you are so smart how about educating yourself on the many, many reasons some mothers choose to formula feed or need to make that choice. Use your time to educate the public about mothers who have sexual abuse in their past and breastfeeding or pumping would be so emotionally painful it's something they cannot even consider. Think about the mothers who deal with bipolar disorder and it's in the best interest of their babies and their older children to have a mother on medication that's not safe for breastfeeding. Consider the mother with chronic pain who needs daily meds to get by and must formula fed her baby from birth. You made mention of cases where people may need to formula feed but obviously it was mentioned in passing and you really don't "get it". You need to consider the mothers who want to breastfeed and struggled so hard to do so and it just didn't work out. The mothers who have cried many tears over how to feed their baby. Consider those situations and so many others. Most of all consider the feelings of other people. Also, consider the fact that everyone with common sense knows that breast milk is the best choice in a perfect world. We get it! I don't know what rock you're living under but "the breast is best" message is all over the place. What we need is for you people to tone down your "breast is always best" message and start educating the world about other issues that women go through and start supporting ALL women out there. Formula is not going to go away EVER. Formula will never be as good as breast milk, we get it, but it has come a long way and it is a good and safe option when needed. And your silly posters are doing more harm than good. How are your posters helping the guilt ridden mother struggling with severe PPD, low supply and having to switch to formula?? It's not. Your posters are making you look like a genius to the "breast is best" crowd and boosting the ego of the mother who was able to breastfeed for three years but it's tearing a hole in the heart of a young formula feeding mother out there. I hope you're happy.

  20. I disagree Just Me. If someone says yes, I know bm is best, shut up already, fair enough but I often hear people say it doesn't matter whether you give your child bm or formula and when that is the pervasive message in out society then we still have work to

  21. do. I think those heartbroken mothers who couldn't breastfeed would want to know that others are being educated so they don't go through the same, Ihope so.

    1. Congratulations to those who can do bf. Instead of discouraging those who cannot do breastfeeding, why not help them? For some, formula milk are life savers for their babies when bm is not produced. There some health issues as well that may have caused the inability to lactate. Others have breast infection which lead them to use formula milk.