Restricting Infant Formula Marketing in Australia
Industry engagement with healthcare workers
Are stronger restrictions on engagement with healthcare workers required?
The WHO Code outlines recommendations on limiting the marketing of breastmilk substitutes to health professionals and in healthcare facilities. It also urges health professionals to encourage and protect breastfeeding, and states that healthcare professionals and representatives should not promote or advertise breastmilk substitutes.
Similarly, the former MAIF Agreement outlined restrictions on the use of healthcare facilities to promote, advertise and distribute materials provided by infant formula manufacturers. Both the WHO Code and former MAIF Agreement outline that healthcare professionals should not receive financial or material inducements to promote infant formula, or free samples of products.
Both the WHO Code and the former MAIF Agreement do however permit industry representatives to engage with healthcare workers on the basis they provide factual and scientific information regarding their products. Healthcare professionals are permitted to provide factual information to parents and the public about breastmilk substitutes under both policies.
Please refer to pages 16 - 17 of the Discussion Paper for more detail.
Data on Industry engagement with healthcare workers
Health professionals are influential in feeding decisions. Healthcare professionals have been observed to engage with manufacturers or their representatives in several countries, with many perceiving no conflict of interest (Topothai et al., 2024). Although not directly relevant to the Australian context, a study of Indonesian mothers showed that those who used breastmilk substitutes were nearly twice as likely to have received a recommendation to feed breastmilk substitutes from inside the health system (Green et al., 2021). Parents have also been observed to be less willing to switch infant formula brands if the products were recommended by health professionals (Huang et al., 2013).
Data from OzFITS 2021 showed the main reason for exclusive breastfeeding cessation for infants under one month of age was exposure to breastmilk substitutes while in hospital (Netting et al., 2022). Infant formula companies have been observed promoting products through health systems by sponsoring meetings and webinars, providing free gifts, and providing free infant formula samples (Piwoz and Huffman, 2015; Mota-Castillo et al., 2023). Topothai et al. (2024) showed breastmilk substitute marketing was commonly conducted through healthcare facilities.
Data regarding marketing by breastmilk substitute companies in Australian health care facilities and to health professionals is limited, however a recent study of documents on professional ethics for 19 medical, nursing, midwifery and lactation professional associations in Australia found minimal requirements around marketing of breastmilk substitutes (Hull, Iellamo & Smith, 2025).
Anecdotal reports of industry sponsored attendance at conferences and professional development opportunities are common. This may be due to differing perceptions of ‘financial or material inducements’, or due to such sponsorships not being explicitly linked to a requirement to promote specific products per the wording of the former MAIF Agreement. This presents an opportunity to clarify these provisions through the development of new mandatory controls on infant formula marketing.