ILactation Sept 2016 - Bever - Handouts-4

Formulamarketingintheinformationage:amovingtarget
I am co-owner of the Arizona Breastfeeding

Center
For teaching purposes, this presentation

contains images that are not in compliance
with the International Code of Marketing of
Breastmilk Substitutes (The WHO Code) and
does not constitute an endorsement.
I am not a Code expert
I am passionate about supporting moms and

babies
July 2006
Baby Friendly
Hospital
S
San
Diego,
Di
CA
CA
Jeremy Babendure 2006

2016JennieBeverBabendurePhDIBCLC
ForindividualuseofiLactation'sBreastfeeding:passionandbiologyparticipantsonly
Jennie Bever Babendure 2016
N Bag
No
B
12 4
12.4
Breastfeed Bag
O equivalents
Oz
i l t off FFormula
l
Coupon Value
Coupon Bag
4.2
Formula Bag
81.4
0
50
100
Source: Radha Sadacharan, Xena Grossman, Stephanie

Matlak, and Anne Merewood. Hospital Discharge Bags and
Breastfeeding at 6 Months: Data from the Infant Feeding Practices
Study II. J Hum Lact February 2014 30: 73-79.
Not a single Ad.
I didnt join Facebook until 2008
+?
Ads
10
15
20
25
Arizona Breastfeeding Center 2015
The Code covers the marketing of:

Infant formulas
Items that replace breastmilk including water,
juice, teas, homemade formulas
Food directly marketed for babies younger than
6 months.
Feeding bottles and their nipples (teats)

Used with permission from Norma Escobar
The Code requires:

No advertising
i i
off products to the public
i
No free samples
No promotion of products in health care
facilities including free or low-cost formula

No company representatives advise families
No gifts or samples to health care workers
No idealizing artificial feeding
Information on artificial feeding should explain
benefits of breastfeeding as well as the costs
and hazards associated with artificial feeding
Never
made
Law
No penalty for
noncompliance
Used with permission from Norma Escobar
How much infant

formula
marketing does 1
US mother
receive?
Source: Nina mala by Arturo J. Paniagua . This work is licensed under a Creative Commons
Attribution-ShareAlike 2.0 Generic License.
AZSciTech Festival 2011
Inclusion Criteria:
Where was the

marketing
g coming
g
from?
How much marketing

was being sent?
When was the

marketing being sent?
Received from 5
weeks of pregnancyp g
y
1 year postpartum
What was the

marketing telling new
parents?
Timeframe:
2/2011-10/2012
Print, email or
samples
Considerations:
Changed providers (OB to a
OB/CNM) at 14 weeks
Changed providers again
(OB/CNM to freestanding
birth center/CNM) at 30
weeks
Baby born in a freestanding
birth center
*May have reduced the
amount of marketing
received from Healthcare
Providers
Healthcare
Providers
Direct Mail
B b R
Baby
Registries
i ti
Email
Not an endorsement!
Not an endorsement!
Similac:4 bottles(8oz)
Enfamil:1 can powder
(makes 52oz)
Not an endorsement!
Not an endorsement!
Not an endorsement!
Not an endorsement!
Not an endorsement!
Not an endorsement!
Not an endorsement!
Not an endorsement!
Not an endorsement!
10
Not an endorsement!
Not an endorsement!
Not an endorsement!
Not an endorsement!
11
Pediatric Visit: 4 months
Not an endorsement!
Enfamil
Formula Ads
Formula Feeding Info (pgs)
6
Associated Brands
14
9
Coupons for Other Items
Fluid Formula (# bottles)
Branded Swag
Magazines
30
Breastfeeding Info (pgs)
Pediatric Visit: 4 months
Similac
28
Pediatric Careplan
Powder (cans)
Coupons for Formula 0
12
Babies R US Registry
Coupon Value
Ads
$10
BuyBuy Baby Registry
$3
36
14
13
Not an endorsement!
Not an endorsement!
Formula (#pkgs) 4488
Coupons ($)
$96
Ads (#)
Mailings (#)
$41
112
$81
54
133
15 713
Not an endorsement!
50
100
From Similac
150
From Enfamil
200
250
300
From Babies R Us
14
Not an endorsement!
15
Not an endorsement!
Not an endorsement!
Not an endorsement!
16
Not an endorsement!
Not an endorsement!
600
500
400
Similac
Enfamil
300
Formula
Total
200
100
0
Number of Mentions
17
Advertisements
influence social norms
Oz equivalents of
Formula
Coupon Value
Ads
0
HealthCare
Providers
Baby Registry
Direct Mail
Email
200
400
600
800
1000
Ads
Coupon
p
Value
Oz equivalents
of Formula
72
18
60
50
299
567
13
218
0
0
624
0
--or the shared

understanding of
behavior within a social
group
by illustrating that the
behavior is common and
accepted in the
population.
Source: Piwoz EG, Huffman SL. The Impact of Marketing of
Breastmilk Substitutes on WHO Recommened Breastfeeding
Practices.Food Nutr Bull. 2015 Dec;36(4):373-86.
Expectant
parents
spend avg.
$4,294
preparing
p
p
g
for baby
USA 2011
Source: Anita Frazier. Expectant Moms Spend Thousands, with
most spending happening after baby is born. Marketing
to Women. Vol XXIV Nov 2011.
18
USA: Average couple

spends $14,000 on baby
products within the
babys first year (2004)
90
Diapers
59
89
Infant Clothing
Global sale of infant

formula $40 Billion (2013)
53
61
58
Formula/Baby Food
Source:s Cole, Sharon. Market Focus: Expectant Mothers. Target

Marketing Magazine. June 1, 2004.
http://www.targetmarketingmag.com/article/market-focusexpectant-mothers-28713/all/ accessed 4/20/16
50
100
Source: Anita Frazier. Expectant Moms Spend Thousands, with

most spending happening after baby is born. Marketing
to Women. Vol XXIV Nov 2011.
Holla-Bhar R, Iellamo A, Gupta A, Smith JP, Dadhich JP. Investing in

breastfeeding the world breastfeeding costing
initiative. International Breastfeeding Journal. 2015;10:8.
doi:10.1186/s13006-015-0032-y.
Mothers who did not

receive formula
containing discharge
bags 58% more likely
to exclusively
breastfeed at 6 mo.
Source: Feldman-Winter L, Grossman X, Palaniappan A,

et al. Removal of industry-sponsored formula sample
packs from the hospital: does it make a difference?
J Hum Lact. 2012;28(3):380-388.
Purchased in past 6
months
Expect to Purchase
in next 6 Months
My numbers are likely

an underestimate of
the total amount of
marketing most US
mothers receive
I switched to a
midwifery practice at
10 weeks, then to a
practice associated
with a free standing
birth center at 30
weeks
19
Not an endorsement!
Used with permission from Unlatched Not an endorsement!
Used with permission from Unlatched
Not an endorsement!
Not an endorsement!
20
Advertisers
continue
Marketing methods
toshifting
add
rapidly
more
Advertisers
continue
to add
online
ads
more online ads to
theirto
marketing
their
efforts
marketing
efforts
Not an endorsement!
Not an endorsement!
Not an endorsement!
21
Not an endorsement!
Used with the permission of Jodine Chase and Ted Greiner
Not an endorsement!
Not an endorsement!
22
Not an endorsement!
Parents are being HEAVILY marketed to

by the infant formula industry,
industry with
incredible sophistication
~$4-6
$4 6 Billion spent worldwide each year
to market infant formula
~$2.3 Million? spent on breastfeeding

promotion (2005)
Food Nutr Bull. 2015 Dec;36(4):373-86. doi: 10.1177/0379572115602174. Epub 2015 Aug 27.
The Impact of Marketing of Breast-Milk Substitutes on WHO-Recommended Breastfeeding Practices.
Piwoz EG1, Huffman SL2.
23
Companies can reach their target

audience with more precision, for less $$
Not an endorsement!
Used with permission from Unlatched
24
How to Report Code

Violations:
USA: Marsha Walker, National Alliance
for Breastfeeding Advocacy at

marshalact@aol.com.
JJodine
di
Ch
Chase
Rachelle Lesteshen (Unlatched)
Norma Escobar
WORLDWIDE: International Baby Food
Action
A
ti
Network
N t
k (IBFAN) att
www.ibfan.org/code_watch_form.
#WHOCode
Friends of the WHO
Code on Facebook
25

ILactation Sept 2016 - Bever - Handouts-4

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Formulamarketingintheinformationage:amovingtarget

I am co-owner of the Arizona Breastfeeding

For teaching purposes, this presentation

I am not a Code expert

I am passionate about supporting moms and

Jeremy Babendure 2006

Jennie Bever Babendure 2016

Source: Radha Sadacharan, Xena Grossman, Stephanie

Not a single Ad.

I didnt join Facebook until 2008

Jennie Bever Babendure 2016

Jennie Bever Babendure 2016

Jennie Bever Babendure 2016

Jennie Bever Babendure 2016

Jennie Bever Babendure 2016

Arizona Breastfeeding Center 2015

The Code covers the marketing of:

juice, teas, homemade formulas

Food directly marketed for babies younger than

Feeding bottles and their nipples (teats)

The Code requires:

facilities including free or low-cost formula

Used with permission from Norma Escobar

Jennie Bever Babendure 2016

How much infant

AZSciTech Festival 2011

Arizona Breastfeeding Center 2015

Where was the

How much marketing

When was the

What was the

Arizona Breastfeeding Center 2015

Arizona Breastfeeding Center 2015

Jennie Bever Babendure 2015

Arizona Breastfeeding Center 2015

Jennie Bever Babendure 2015

Arizona Breastfeeding Center 2015

Jennie Bever Babendure 2015

Jennie Bever Babendure 2015

Jennie Bever Babendure 2015

Pediatric Visit: 4 months

Coupons for Other Items

Fluid Formula (# bottles)

Breastfeeding Info (pgs)

Pediatric Visit: 4 months

Coupons for Formula 0

Jennie Bever Babendure 2016

Jennie Bever Babendure 2016

BuyBuy Baby Registry

Jennie Bever Babendure 2016

Formula (#pkgs) 4488

Jennie Bever Babendure 2015

Jennie Bever Babendure 2016

--or the shared

Jeremy Babendure 2006

USA: Average couple

Global sale of infant

Source:s Cole, Sharon. Market Focus: Expectant Mothers. Target

Source: Anita Frazier. Expectant Moms Spend Thousands, with

Holla-Bhar R, Iellamo A, Gupta A, Smith JP, Dadhich JP. Investing in

Mothers who did not

Source: Feldman-Winter L, Grossman X, Palaniappan A,

My numbers are likely

Arizona Breastfeeding Center 2015