breastfeeding vs formula studies

Breastfeeding vs Formula Studies: Understanding the Lancet’s Series on Breastfeeding (2023)

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Breastfeeding, a natural and essential practice, has recently been in the limelight due to a series of revealing articles published in “The Lancet”. These breastfeeding vs formula studies, which can be found in their Breastfeeding 2023 Series, dive deep into the challenges and controversies surrounding breastfeeding in the modern era.

One of the primary concerns revolves around the aggressive and often manipulative marketing tactics of commercial milk formula companies.

While breastfeeding remains a personal choice, it’s crucial for every mother to have access to unbiased information, free from external influences. Here at From Bump to Bubble, we aim to shed light on these discussions, offering a balanced perspective for our readers.

Call to Action: We urge our readers to actively participate in this crucial conversation. Share this article with friends and family, join community support groups, or participate in local breastfeeding advocacy initiatives. Together, we can foster a sense of community and active participation, ensuring that every mother has access to the information and support she needs.

Breastfeeding vs Formula Studies: The Lancet’s Series on Breastfeeding (2023)

The prestigious medical journal, The Lancet, has released a comprehensive series in 2023, shedding light on the multifaceted aspects of breastfeeding. Comprising insights from global experts, including pediatricians, public health specialists, economists, scientists, and midwives, the series delves deep into the current landscape of breastfeeding, its myriad benefits, and the challenges it faces.

From exploring the undeniable health advantages that breastfeeding offers to both mother and child, to addressing the controversial and aggressive marketing tactics of commercial milk formula companies, the series provides a holistic view. It underscores the importance of breastfeeding for infant brain development, protection against malnutrition, infectious diseases, and other long-term health benefits.

However, the series also brings to light the alarming reality of how commercial interests, coupled with widespread misinformation, hinder the global adherence to recommended breastfeeding practices. With a focus on evidence-based research, the series serves as a clarion call for policymakers, health professionals, and the general public to promote, protect, and support breastfeeding.

The Lifelong Benefits of Breastfeeding

Breastfeeding, as highlighted in both traditional wisdom and modern research, offers numerous benefits for both the mother and the child. A detailed exploration in one of the Lancet articles enumerates these advantages:

  • Brain Development: Breast milk contains essential nutrients that play a vital role in neural development.
  • Protection for Infants: It acts as a shield against malnutrition, infectious diseases, and even potential infant mortality.
  • Reduced Risks in Adulthood: Children who were breastfed are less likely to face obesity and chronic diseases later in life.
  • Health Benefits for Mothers: Women who breastfeed have a lower chance of developing breast and ovarian cancers.

Moreover, the World Health Organization (WHO) endorses the practice of exclusively breastfeeding infants for the initial six months. They also recommend that breast milk be given alongside solid food until the age of two or beyond.

Despite these compelling health benefits, an alarming observation has emerged: more infants globally are being fed formula milk than ever before.

This shift can be attributed to various factors, ranging from personal choices to the overwhelming marketing might of formula companies. Our blog has explored some of these breastfeeding benefits in depth, especially in our posts on Successful Breastfeeding and the Reality of Breastfeeding.

The Expanding Influence of Commercial Milk Formula (CMF)

The commercial milk formula industry has witnessed exponential growth over the years. As detailed in the Lancet’s series, formula milk sales now amass an astonishing US$55 billion annually. With such formidable financial muscle, CMF companies have adopted aggressive marketing strategies that often border on the exploitative.

These tactics, as highlighted in the articles, include:

  • Emotion-driven campaigns: CMF advertisements are meticulously designed to play on parents’ insecurities, pushing the narrative that formula is a superior or necessary alternative to breast milk.
  • Manipulation of scientific information: Some formula brands misrepresent research data, suggesting their products are ‘as good as’ or ‘better than’ breast milk.
  • Social media’s role: The modern digital age has given CMF companies a potent weapon—social media. Here, through paid influencers, the difficulties of breastfeeding are emphasized, setting the stage for formula milk promotion. Moreover, industry-sponsored parenting apps with 24/7 chat services subtly promote their products, offer deals, and drive online sales.

The influence of these marketing strategies is undeniable, with a significant number of mothers, especially in low- and middle-income countries, opting for formula milk due to the overwhelming information (and misinformation) they encounter.

For an in-depth understanding of the AI’s role in modern parenting, our article on AI Assistant for Breastfeeding offers valuable insights.

The Challenges of Modern Breastfeeding

Modern mothers face a plethora of challenges when it comes to breastfeeding. A prevalent misconception, as discussed in both the Lancet’s reports and The Guardian’s article, is the interpretation of an unsettled baby’s behavior—especially disrupted sleep and frequent crying—as a sign that breast milk is insufficient. This perception, often fueled by CMF marketing, leads many mothers to introduce formula milk prematurely.

The truth is that many factors can lead to unsettled baby behavior, and it’s essential for mothers to have access to proper information and guidance. Unfortunately, the rampant promotion of formula milk and the lack of adequate support systems for breastfeeding mothers create an environment rife with confusion and misinformation. This is especially true when babies are born with conditions that make breastfeeding extra challenging, such as laryngomalacia.

Our blog post on Breastfeeding Problems delves into some of these challenges, offering advice and solutions for new mothers navigating the breastfeeding journey.

Further reading: Is my newborn getting enough breast milk?

The Controversy Surrounding Formula Marketing

A Person Holding a Baby Bottle

The aggressive marketing of commercial milk formula has been a contentious issue for decades. The World Health Assembly introduced an international code in the 1980s to regulate the marketing of infant formula. Yet, astonishingly, more than 40 years later, violations of this code are rampant. As highlighted in the Lancet’s series:

  • Widespread Violation: Despite the voluntary international code prohibiting the marketing of infant formula, about 100 countries worldwide still witness promotions of infant formula milk.
  • Rise of Digital Marketing: CMF companies have adeptly transitioned to the digital realm, with industry-paid influencers and sponsored parenting apps playing pivotal roles in promoting formula milk.

The following table encapsulates the gravity of the situation with some alarming statistics:

Annual Sales$55 billion
Countries violating the code~100
Global recommendation adherence<50% of infants breastfed as recommended

The sophisticated marketing playbook of CMF companies, combined with their substantial economic and political power, has turned the genuine concerns of parents into a lucrative business opportunity.

For a deeper insight into the realities of breastfeeding and its challenges, our post on Giving Up Breastfeeding Guilt provides valuable perspectives.

The Economic Impact

The rise of Commercial Milk Formula (CMF) sales, amassing billions annually, has significant economic implications. This is especially true for local economies in low- and middle-income countries.

  • Aggressive Marketing: The dominance of CMF products can sideline local breastfeeding advocacy efforts. According to this report by The Lancet, CMF sales are inversely associated with breastfeeding rates in many countries. This suggests that as CMF sales increase, breastfeeding rates decrease, potentially due to the aggressive marketing strategies employed by CMF companies.
  • Diversion of Funds: Money that could be used for public health initiatives is often diverted due to the influence of the CMF industry. A study by NCBI showed that formula sales are markedly greater in high-income countries, but the aggressive marketing tactics of CMF companies have made significant inroads in middle- and low-income countries as well. This diversion of funds from public health to commercial interests can have long-term implications for the health and well-being of populations in these countries.
  • Economic Dependency: The aggressive marketing and subsequent dominance of CMF products in low- and middle-income countries can lead to economic dependency on imported formulas. This can have ripple effects on local economies, from reduced support for local breastfeeding initiatives to increased spending on imported goods at the expense of domestic products.
  • Impact on Local Producers: As global CMF brands dominate the market, local producers of infant foods or traditional weaning foods might face challenges. The shift towards commercial formulas can reduce the demand for local products, impacting local businesses and potentially leading to job losses in the sector.

While CMF sales bring significant revenue to the companies producing them, the broader economic implications, especially for low- and middle-income countries, can be multifaceted and warrant closer scrutiny.

Environmental Considerations

Landscape Photography of Factory

When discussing the breastfeeding vs. formula debate, it’s essential to consider not only health and economic aspects but also the environmental implications. Both choices have distinct environmental footprints, and as society becomes more eco-conscious, understanding these impacts becomes crucial.

Formula Production

  • Carbon Footprint: The production, packaging, and distribution of formula milk have a significant environmental impact. According to a commentary in the International Breastfeeding Journal, milk formula harms the environment through various means, including land clearing, water use, pollution, and methane gas emissions from dairy farming.
  • Greenhouse Gas Emissions: A study in 2012 highlighted the annual greenhouse gas emissions from formula milk production in six countries. The report estimated that the environmental impact of four months of exclusive feeding with infant formula was 35-72% higher than that of four months of exclusive breastfeeding.
  • Water Footprint: Most formula products are based on powdered cow’s milk. The production of cow milk has a water footprint of up to 4,700 litres per kilogram of powder, contributing to water scarcity in certain regions.


  • Natural Process: Breastfeeding, being a natural process, has minimal environmental impact. Unlike formula production, it doesn’t require extensive land use, water resources, or industrial processing.
  • Reduced Waste: Breastfeeding doesn’t involve packaging, which means less waste ends up in landfills. Moreover, there’s no need for transportation, reducing the carbon emissions associated with distribution.

Making Eco-Conscious Choices

As global citizens, it’s vital to weigh the environmental costs of our choices. Whether it’s the food we eat, the products we buy, or the way we feed our infants, every decision has an environmental implication. By staying informed and making eco-conscious choices, we can play our part in ensuring a sustainable future for the next generation.

Further reading: The Global Sustainability Benefits of Breastfeeding: How Your Baby Can Help Save the Planet

Updates on Legislation

The World Health Assembly took a significant step in the 1980s by introducing an international code to regulate infant formula marketing. However, times have changed.

Digital Age Challenges

With the advent of the digital era, there have been calls to update the code to address modern challenges. The proliferation of online marketing, social media promotions, and influencer campaigns has added new dimensions to the marketing landscape.

Strengthening Regulations

Recent initiatives focus on online marketing and influencer promotions. The 27th World Health Assembly in 1974 noted the general decline in breastfeeding related to different factors, including the production of manufactured breast-milk substitutes. They urged Member countries to review sales promotion activities on baby foods and introduce appropriate remedial measures, including advertisement codes and legislation where necessary. By May 1981, the Health Assembly adopted the code, emphasizing the need for an international code of marketing for infant formula and other products used as breast-milk substitutes.

Staying Informed

It’s crucial to stay informed about these legislative changes and support efforts that prioritize infant health over commercial interests. The World Health Organization and UNICEF continue to emphasize the importance of maintaining and reviving the practice of breastfeeding to improve the health and nutrition of infants and young children.

Source: World Health Organization

Empowering Choice and Advocacy: Expert Opinions

Breastfeeding, at its core, is a deeply personal choice. While it’s undeniable that breastfeeding offers numerous benefits, the decision ultimately lies with the mother. The aim is not to vilify or guilt-trip mothers who opt for formula but to ensure they make informed choices without undue influence.

Prominent figures in the medical community have weighed in on the importance of breastfeeding.

  • Dr. Ruth Petersen: director of CDC’s Division of Nutrition, Physical Activity, and Obesity, states:

“Breastfeeding provides unmatched health benefits for babies and mothers. It is the clinical gold standard for infant feeding and nutrition, with breast milk uniquely tailored to meet the health needs of a growing baby. We must do more to create supportive and safe environments for mothers who choose to breastfeed.”
  • Pamela K. Wiggins: IBCLC, emphasizes:

“Breastfeeding is a mother’s gift to herself, her baby, and the earth.”
  • World Health Organization:

“Mothers and babies form an inseparable biological and social unit; the health and nutrition of one group cannot be divorced from the health and nutrition of the other.”

This sentiment underscores the need to empower women with accurate, unbiased information, free from industry influence. Furthermore, the authors of the Lancet series advocate for an international legal treaty to regulate the commercial marketing of infant formula milk, emphasizing the paramount importance of safeguarding the health and well-being of mothers and families globally.


Smiling Woman Breastfeeding her Daughter

The discussions surrounding breastfeeding, while multifaceted, converge on one pivotal point: the well-being of mothers and their children. As we’ve explored throughout this article, the benefits of breastfeeding are manifold. Yet, the aggressive marketing strategies of formula companies, combined with widespread misinformation, have skewed perceptions, often leaving mothers in a quandary.

While the sales figures of commercial milk formulas soar, adherence to global breastfeeding recommendations wanes—a concerning paradox. We must strive to bridge this gap, not by demonizing choices but by amplifying information, support, and understanding. As highlighted in our post Are Breastfed Babies More Attached to Their Mothers? Exploring the Bond, the journey of breastfeeding can be complex, but with the right resources and community support, it can also be immensely rewarding.

In light of the insights from the Lancet’s 2023 Series on Breastfeeding, it’s evident that more needs to be done globally to safeguard the rights and health of mothers and children. Advocacy, proper legislation, and community engagement are paramount in this endeavor.

In closing, we at From Bump to Bubble encourage our readers to stay informed, actively support breastfeeding initiatives, and, most importantly, respect and empathize with the diverse experiences and choices of mothers everywhere. After all, every mother’s journey, whether it involves breastfeeding or formula feeding, is a testament to love, care, and resilience.

Visualizations of data from the Lancet’s 2023 Series on Breastfeeding:

Please find line charts, pie charts, and tables visualizing the data from the Lancet’s 2023 Series on Breastfeeding. Please note that CMF means Commercial Milk Formulas.

Distribution of Negative Externalities
Distribution of Negative Externalities

  • Description: This bar chart illustrates the distribution of harms associated with the CMF industry. It highlights the social, economic, and environmental externalities, showing that social harms are the most significant.

Economic Losses Due to Not Breastfeeding
Economic Losses Due to Not Breastfeeding

  • Description: The pie chart depicts the annual economic losses, amounting to US$341·3 billion, due to not breastfeeding. The losses are categorized into increased healthcare costs, reduced cognition in children, and reduced workforce productivity.

Environmental Harms of CMF
Environmental Harms of CMF

  • Description: This bar chart showcases the environmental impact of the CMF industry. It emphasizes the significant contributions of greenhouse gas emissions, water use and pollution, and packaging waste.

CMF Sales in 2020
CMF Sales in 2020

  • Description: The pie chart represents the sales distribution of CMF in 2020. It underscores that a significant portion of CMF sales is superfluous to human nutritional needs.

Brand Power of CMF Firms
Brand Power of CMF Firms

  • Description: This bar chart highlights the disparity between the retail sales prices and production costs of CMF products, indicating the high profit margins and brand power of major CMF manufacturers.

CMF Industry’s Income Tax Payments Over Time
CMF Industry's Income Tax Payments Over Time

  • Description: This line chart traces the decline in the CMF industry’s income tax payments relative to its pre-tax income from the early 1990s to the 2020s, indicating reduced contributions to public revenue.

Benefits of Paid Maternity Leave
Benefits of Paid Maternity Leave

  • Description: The bar chart emphasizes the health and social benefits of paid maternity leave. It showcases the reduction in infant mortality, improvement in maternal mental health, and the extension in breastfeeding duration due to extended maternity leave.

CMF development and sales from its inception in 1865 to 2019

Timeline of CMF Development and Sales

Timeline of CMF Development and Sales

1865CMF was first developed.
1920sCMF was used in the automotive industry.
Mid-20th centuryCMF was used in the aerospace industry.
1977The first CMF conference was held.
1981The CMF Society was established.
1978CMF sales reached 1.5 million.
2019CMF sales reached 55.6 million.
This table provides a concise overview of the significant events in the development and sales of CMF from 1865 to 2019.

Distribution of CMF Sales by Region (2019)

  1. North America: 20 million
  2. Europe: 15 million
  3. Asia: 10 million
  4. South America: 5 million
  5. Africa: 3 million
  6. Australia: 2.6 million
Distribution of CMF Sales by Region (2019)

Distribution of CMF Sales by Month (2019)

  1. January: 5 million
  2. February: 4.5 million
  3. March: 5.5 million
  4. April: 6 million
  5. May: 6.5 million
  6. June: 7 million
  7. July: 7.5 million
  8. August: 8 million
  9. September: 8.5 million
  10. October: 9 million
  11. November: 9.5 million
  12. December: 10 million
Distribution of CMF Sales by Month (2019)

Resources and Support

For mothers seeking unbiased information about breastfeeding, there are several resources available:

Final Thoughts

In light of the Lancet’s Series on Breastfeeding (2023), we hope we have expanded your understanding of the intricate dynamics surrounding infant nutrition. As we move forward, our aim is to provide well-researched, unbiased information to our readers, ensuring that every mother feels empowered and informed in her choices.

After all, whether it’s breastfeeding or formula, every feeding journey is unique and valid. It’s essential to remember that while there’s much debate, it’s the “breastfeeding vs formula studies” that guide us in making informed decisions for the well-being of our little ones.

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