Slide 1

Holding the Formula Industry Accountable Jamie Creason MPH Nutrition Capstone 2014

Slide 2

The Plan -Create a document for CA WIC Assoc. that includes: Current violations of the WHO code UC Davis Human Lactation Center study results -Provide document to CA WIC Association -Collaborate with CA WIC, BMSG, Advocacy Initiative

Slide 3

Benefits of Breast-feeding Protective against: Diabetes Sudden infant death syndrome Childhood leukemia Obesity Asthma Various infections Protective against: Type 2 diabetes Obesity Breast and ovarian cancers InfantMother

Slide 4

Breast-feeding Rates

Slide 5

Factors Influencing the Choice to Breast-feed Choice to BF SocialMediaInstitutional

Slide 6

Strategies to Increase Breast-feeding Hospital support Workplace support Community support, resources Training for all medical providers National campaign to promote breast-feeding Research and surveillance But what about regulating formula marketing?

Slide 7

WHO Code of Marketing of Breast-milk Substitutes Aims: Contribute to provision of safe, adequate nutrition for infants Protection and promotion of breast-feeding Ensuring proper use of breast-milk substitutes when necessary Ratified by more than 100 nations 65 countries adopted regulations and restrictions on marketing based on the code. But NOT the United States

Slide 8

WHO Code of Marketing of Breast-milk Substitutes Formula Companies SHOULD NOT: Advertise to general public Seek contact with pregnant women, mothers

Slide 9

WHO Code of Marketing of Breast-milk Substitutes Formula Companies SHOULD NOT: Promote mixed feeding/supplementation

Slide 10

WHO Code of Marketing of Breast-milk Substitutes Formula Companies SHOULD NOT: Make Nutrition and Health Claims

Slide 11

WHO Code of Marketing of Breast-milk Substitutes Formula Companies SHOULD NOT: Idealize formula Draw similarities with breast-milk Insinuate superiority

Slide 12

WHO Code of Marketing of Breast-milk Substitutes Formula Companies SHOULD NOT: Provide samples, coupons (to consumers or medical providers)

Slide 13

Market share: Infant Formula Oligopoly CompanyStrategyBranded Product Mead JohnsonMedical DetailingEnfamil NestleCompetitive pricing; Consumer marketingGood Start PBM Nutritionals Competitive pricing; Consumer marketing (private label) Walmart/Target Abbott Nutrition Medical Detailing (private label)Similac/Costco

Slide 14

Major Trends in the Formula Industry Growth of Private Label Increasing share of organic product 1 2 Movement to supplemented formula 3 Increase in BF Rates..but Exclusive Rates Remain Low 4

Slide 15

National WIC Association (NWA) 60% of formula market=WIC

Slide 16

How they Increase Profits $3.2B Infant formula market Growth driven by price increases Infant Formula Market Dollar Split by Type of Formula (2002 2011) Dollars ($B)

Slide 17

$ pecialty Products Lutein DHA Probiotics

Slide 18

Exposure to Marketing Consumer SocialMediaMedical

Slide 19

Marketing: Medical Relationships with medical providers Using WIC name Discharge packs

Slide 20

Marketing: Media Public Displays Demos in public Billboards Internet Coupons Advertisements Blogs Forums Expert advice Magazines Advertisements Coupons Television Commercials Smartphones Coupons Trackers Expert advice

Slide 21

Marketing: Media EXAMPLES

Slide 22

Marketing: Social Mommy Parties

Slide 23

UC Davis Human Lactation Center and WIC qualitative research study Perceptions of Infant Formula Additives from Moms Participating in the CA WIC Program (2010-2013) Purpose: Characterize understanding of formula marketing claims Determine impact of infant formula marketing

Slide 24

What Can We Do Align with advocacy groups (IBFAN, LLL, NABA, NWA, USBC) Engage lawmakers Apply pressure on: FDA, FTC, Formula Industry

Slide 25

Thank You! Laurie True for the idea for my capstone Lia Fernald for your guidance My classmates (especially Will, the breast editor around) My mom friends who provided me with anecdotes and wisdom My family and friends for their support