Infant formula companies use unwitting doctors and…

International regulations and local laws prohibit formula manufacturers from marketing directly to parents. Instead, companies are using the people you trust the most – healthcare workers – to push their products and circumvent regulations…and your nurse might not even know it.

Dr. Chris van Tulleken recently purchased a new knife sharpener. The University College London lecturer didn’t need it, he admits, but he couldn’t ignore the TV commercial.

“He said this new knife sharpener makes knives so sharp that until recently it was illegal for anyone who wasn’t a professional chef to buy one,” he explains. Van Tulleken was speaking at a recent webinar hosted by the British medical journal Friday.

“It wasn’t until the product arrived at my house and started to make my knives much less sharp that I started to wonder,” he continues, his eyes narrowing, “if it was true that chefs needed licenses to buy knife sharpeners”.

The irony did not escape him.

Why marketing to healthcare workers is important

BBC presenter Dr Chris van Tulleken explains why healthcare workers play an influential role in the sale of infant formula despite its risk.

When most of us think of marketing, we may imagine glossy magazines or strident radio ads, but marketing to healthcare workers is different. It can be as small as a free brand pen or free sponsored symposium breakfastand as major research funding, often through corporate-aligned nonprofits.

In 1981, more than 11 dozen countries, including South Africa, adopted the World Health Organization (WHO) international code to stop the aggressive marketing of infant formula which for decades has targeted poor countries and increase in infant and child deaths. The increase in the number of deaths is partly explained by the fact that formula feeding without access to clean water puts babies at increased risk of fatal diarrheal diseases.

South Africa introduced local laws to enforce the code in 2015.

Local code and regulations may prohibit companies from publicly marketing infant formula or speaking directly to parents. Instead, companies are looking to see how they can influence families through the people they trust most for their children’s health: healthcare workers.

Your nurse is just another data point in a marketer’s spreadsheet

“Marketers are really good at understanding Why you buy in the first place,” says Katie Gilbert. Gilbert is the managing director of M&C Saatchi World Services, the social marketing arm of the advertising agency M&C Saatchi Group. Gilbert’s company recently collaborated with the WHO to investigate the marketing of infant formula.

Early in her career, Gilbert had worked on campaigns selling frozen french fries, but even then she knew they weren’t about potatoes.

“People don’t buy frozen potato chips — they buy happy meals where the kids don’t complain because they like what’s on their plate,” she explains. “If you’ve had a stressful day as a mom, a relaxing, peaceful meal is what you’re looking for.”

The reason people buy a product is, in marketing science, one of the five “category entry points” – or the reasons or situations that drive why we buy what we do.

Category entry points come down to “when” consumers buy a product, “where” they buy it, “with whom” they buy it, and “with what” other products they might buy an item.

And healthcare workers, she says, are a valuable entry point into the category because families trust their advice on infant feeding – and because new parents are vulnerable when they encounter them. .

“One of the most vulnerable times for parents is in the hospital after birth,” she says. “Parents are tired and exhausted – first-time parents have never done this before…it’s a really stressful time.”

Gilbert says that if brands can get new parents to associate their infant formulas with reducing that stress, that’s enough to get them hooked. And it’s also a brilliant sales strategy for another reason, she warns:

“If companies can get a mum or dad to use formula for the first two days, it’s much more likely to disrupt the milk supply, making breastfeeding difficult and creating therefore a need for their product.”

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Industry money shapes healthcare, but it’s not always easy to spot

In a network that includes industry-hired PR firms, industry associations, and shadowy, industry-aligned nonprofits, it can be difficult for health organizations to track down funding for the infant formula industry, says midwife Professor Caroline Homer.

In 2018 and writing for the British medical journal, Van Tulleken discovered how infant formula advertising tactics in the form of industry-authored public education materials and sponsorship of physicians who wrote the relevant national guidelines fueled an increase in specialty infant formula prescriptions United Kingdom.

For her story, Van Tulleken contacted doctors in charge of major guidelines who had declared conflicts of interest like these.

All physicians said they agreed that industry can influence healthcare workers. All also said that they themselves had not been influenced.

Van Tulleken reflects on his new knife sharpener: “Even the fact that I study how conflicts of interest affect the behavior of healthcare professionals…didn’t protect me from clever publicity.”

Breastfeeding rates in South Africa remain low, in part because the country lacks policies that support families in breastfeeding, including paid parental leave. New research shows that increasing hunger rates may also deter women from being able to breastfeed exclusively.

Although South African law prohibits companies from offering healthcare workers gifts or even the occasional free breakfast, it is less stringent when it comes to corporate sponsorship of professional health associations — especially in the private sector.

Maverick Citizen reported several instances where formula makers allegedly violated marketing rules. Yet a single national health department official was tasked with monitoring compliance at the end of 2021.

In reality, South Africa relies on a small network of medical professionals to control the marketing of infant formula and conflicts of interest.

An August WHO report recommended that South Africa strengthen law enforcement.

Haroon Saloojee heads the Department of Community Paediatrics at Wits University. He says medical schools in South Africa generally do not teach future healthcare workers the international code or local regulations.

But he says it’s time to start organizing health science students to take on the industry.

In the meantime, Gilbert says, if more healthcare workers understand marketing tactics, they may be better able to avoid conflicts of interest.

“It’s not about restricting the product – any caregiver should have access to it if that’s what they choose,” Gilbert says. “It’s about realizing [among healthcare workers] that you are used as a customer entry point for businesses. » SM/MC