‘Babies before bottom lines’ – WHO and Unicef slam unethical baby formula marketing in SA

29 Apr 2025

The World Health Organization and the United Nations Children’s Fund say action is needed to address the ‘predatory and pervasive’ digital marketing practices of some baby formula companies.

The World Health Organization (WHO) and the United Nations Children’s Fund (Unicef) have launched a campaign, “Babies Before Bottom Lines”, calling out what they say is false and unethical baby formula advertising in South Africa.

The manifesto for the campaign, released on Tuesday, highlighted the “predatory and pervasive” practices of some formula companies that allegedly use unregulated digital marketing spaces and targeted messages to manipulate vulnerable parents.

“It’s about just how insidious this [marketing] is, that you don’t even recognise that it’s an ad … Take an example of a mother who wakes up in the middle of the night and her baby’s crying, and she says, why is my baby crying so much? … They’re doing this as a Google search, to just see what others are saying out there, and she starts getting answers coming in that she doesn’t recognise are coming from industry,” said Dr Laurence Grummer-Strawn, who leads the WHO’s work on infant and young child feeding.

“They might be directly on an industry site. They might be filtered through an influencer, filtered through the discussion groups out there for moms … And so those messages about how you need to supplement your baby come up right away. The mother thinks she’s getting good advice from a bunch of other mothers, when in fact, it’s being driven by commercial interests.”

In some cases, formula milk companies present incomplete scientific evidence or infer unsupported health outcomes for their products, alleges Shenaaz El-Halabi, the WHO’s country representative in South Africa.

These “pseudo-scientific health claims” can discourage mothers from breastfeeding. This is problematic, says the WHO and Unicef, as breastmilk remains the “most complete and healthiest” milk for babies.

“In addition, widespread evidence exists that women have internalised doubts about the quality and quantity of their breastmilk, mirroring the themes and messaging of formula milk marketing campaigns,” said the WHO and Unicef.

Promoting parent education

As part of the campaign, the two organisations are working with “parenting influencers” to draw attention to the risks around baby formula marketing, to push South African caregivers and civil society groups to advocate for stricter advertising regulations.

“We’re hoping that civil society and the general population of mothers would be reaching out to their parliamentarians and government representatives, particularly in the ministry of health, ministries of industry, asking them to update the legislation,” Grummer-Strawn told Daily Maverick.

“South Africa has had pretty decent legislation on the marketing of breast milk substitutes, but it largely ignores this whole new context of digital [spaces] and so things fall between the cracks … In principle, the things that the companies are doing ought to be against the law already, but when it comes to actually enforcing that, because it’s not recognised as an ad, because no one knows how to pick it up in monitoring systems, it goes into a legal complication.”

South Africa’s Regulations relating to foodstuffs for infants and young children set out the rules on the marketing of infant formula, including labelling requirements, restrictions on product promotion and guidelines for health personnel.

The regulations prohibit promotional practices for infant formula through “direct or indirect contact between company personnel and members of the public”, including via the internet, television and radio, telephone or internet helplines, and mother and baby clubs.

Daily Maverick asked the National Department of Health about the WHO/Unicef campaign and the concerns about the regulation of formula marketing practices in the digital space, but had not received a response at the time of publishing.

Global fight

Grummer-Strawn noted that the problems with digital marketing for baby formula were not unique to South Africa, adding that the WHO and Unicef had plans to expand the “Babies Before Bottom Lines” campaign to other countries.

“We estimate about 30 countries have at least mentioned something about digital environments within their laws … but even those, oftentimes, don’t really get into what tactics are being used … And so there’s a real concern that there aren’t many great examples of capturing all the regulations that are needed … in the digital space,” he said.

Read more: WHO/Unicef report reveals how companies violate global standards in the marketing of formula milk to parents

It’s not the first time the WHO and Unicef have drawn attention to unethical practices in the baby formula industry. In 2022, they released a multicountry study on the impact of marketing of breastmilk substitutes on infant feeding decisions and practices. The report covered eight countries, including South Africa.

It found that just over half (51%) of the mothers and pregnant women surveyed were targeted by formula-milk marketing, despite the existence of the WHO’s International Code of Marketing of Breast-milk Substitutes, which aims to protect parents from aggressive marketing practices used by the baby-food industry. DM

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South Africa

Promoting parent education

Global fight