Formula advertisements in Malta should be banned

[ 0 ] 07/09/2014 |

Update 46 - page 10

I am sure most of you have read the recent article ‘Fearne seeking agreement to ban advertising of breast milk substitutes‘ on Times of Malta. As a result, there have been lots of discussions privately and in Facebook groups, either supporting or rejecting the idea.

My personal point of view is that yes, of course, it should be banned. What they suggest is to ban the advertisement, the marketers attempt to manipulate mums to turn into their product. The formula is still going to be there for the ones who need it, and the doctors, midwives, breastfeeding consultants are all there and perfectly equipped to give such information when and if needed. Formula is a food substitute for babies, when the natural source, breast milk, is not available, and/or when the family as a whole makes an informed choice to use formula. Adverts do not help to make informed choices. Their purpose is to sell something to someone. Formula is not a product to promote for public consumption.

With the kind permission of two mums, Becky Gauci Maistre* and Rebecca Buttigieg, I am re-posting here some of their well researched responses that appeared in Facebook groups, in regards to this subject. They are worth your attention.

Rebecca Buttigieg

The Government is not conducting a campaign to shame formula-feeding mothers. They are just bring Malta up to speed with the rest of the world, or at least with the other 84 countries who have adopted at least some of the provisions of the International Code of Marketing of Breast-milk Substitutes into their legislation.

International Code of Marketing of Breast-milk Substitutes

Although babies can grow and thrive just fine on formula (mine did!), breastmilk is better for many reasons. This law does not have anything to do with mothers who can’t breastfeed, or even with mothers who know the benefits of breastmilk but choose to give formula (for example, going back to work where pumping is not supported). Instead this law is aimed at mothers who, through marketing, think that formula is just as good as breastmilk and therefore don’t prioritise their own breastfeeding, or mothers who may even think that formula is *better* than breastmilk and switch their babies over.

The formula market is worth BILLIONS of dollars world-wide, and formula companies invest a lot of money in marketing it, including giving gifts, free samples or promotional items to paediatricians and other healthcare workers to encourage them to promote formula to their patients. Banning the marketing of formula for infants is meant to protect breastfeeding mothers from these aggressive campaigns. Of course the companies don’t give up that easily…

In England, it is illegal to advertise breast-milk substitutes for babies under 6 months. That’s why the formula comes as “Type 1” for under 6 months and “Type 2” for over 6 months – the companies create a Type 2 for over 6 months (which is only very slightly different to Type 1) so they can get around the law and still advertise formula. If you read British baby magazines, they’re full of formula adverts but it’s all for follow-on milk for over 6 months, or else they run adverts featuring the name of the formula, and showing pregnant women or infants, but advertise “helpful guides to feeding”, and since they’re not actually advertising formula, they get away with it. In the USA they don’t have this law against advertising for infants, and so the formula brands usually offer just one type of formula from birth to 12 months.

As a mother who wanted to breastfeed but was medically unable to, I felt a lot of shame about giving my baby formula. This is wrong, no mother should feel shame about feeding her baby and I agree that people who set out to shame formula-feeding mothers should stop. But this law has nothing to do with that, it exists simply to protect breastfeeding mothers from clever marketing, and therefore I think it is a good thing.

Becky Gauci-Maistre

-Rebecca Buttigieg your post is spot on.

I’d also like to point out that this article is quite misleading. I attended the seminar and It covered so much more than the headline would have you believe. The audience brought up many issues including the lack of support, the enormous amount of misinformation there is, and the lack of understanding. Very new places that target families are not breastfeeding friendly and the breastfeeding policy is going to make them be aware of their obligations to mothers and families.

At no point was banning formula or restricting it suggested. Milk banks (donated breastmilk, as is done in numerous industrialised countries) was also brought up as an alternative for mothers who wish to breastfeed, can’t but prefer the benefits of breastmilk over formula.

All mothers need to be 100% supported if their choices, but making sure the right information is out there is crucial. Making sure birth and post partum workers are all providing the same advice is also crucial. There is no way one can make a truly informed choice from advertising, and that is why the code is in place and why Malta needs to join the majority of the rest of the world in enforcing it.

On this note, I once again wish to emphasise the following: the largest number of mothers who choose not to breastfeed are not actually doing so out of real choice. The lack of support- be it at birth, early post partum, at home, by family, by friends, by media, by cafes, etc- is the real reason why mothers give up. Where medical issues are the reason, it is a different story and we need to make sure that the right information (as opposed to the “cover my ass”) is given at all times. Whichever the case, 100% support MUST be given at all times, no matter what!

May I also add please as the phone didn’t let me carry on.

For the mothers who choose to formula feed and have zero interest in breastfeeding: if you made your choice and you are confident in your choice, nothing anybody says should make you feel inadequate or guilty. Guilt is only really likely to come in if there may be some doubt, and if you do have a smidgen of doubt, seek out those who can guide you and support you appropriately. Seek out the right information. No one should make you feel bad for a choice you made for your family, especially if that is an informed choice. Equally, please don’t blame us, the birth workers, for wanting to get certain information and support out there. Please remember we are working tirelessly for, and with, mothers to provide the best possible support system and knowledge base we possibly can. Our campaigns are not there to belittle you or impose guilt because we see things differently. Our campaigns are there to provide education and support to those who want it. And just like you ignore other adverts or campaigns that don’t apply to you, you are equally welcome to ignore anything we put out there that does not apply to you. None of these campaigns are aimed to hurt those with different beliefs or choices. Never! It really is that simple, I promise.

-According to the WHO (World Health Organization) policy, there should be no advertising of milk substitutes for children under 6 months. Same with advertising of bottles and bottle teat. Malta has been in breach of this code for many many years. In October Mater Dei will likely be certified a baby-friendly hospital. So Malta as a whole needs to move in line with the rest of Europe and the WHO.

The seminar and policy itself covers much more than this. I was there. I assure you this is one very small snippet. Plus formula should be given according to baby’s needs not according to the perks the doctor is receiving.

You can never make an informed choice from an advert, sorry. Only a doctor or midwife can guide you on which formula suits your child best, and if these people are being swayed by samples and benefits, then it may change the advice they give. You need to see the bigger picture.

And yes, if an exhausted mother is in a shop and sees a poster of a perfectly groomed mum bottle feeding a baby, clever advertising might be enough to make her consider that option “just this once”. Aside from the “just this once” becoming one frequent, research clearly shows that just one bottle of formula make a baby’s stomach much more acidic and it can take days to return to the ideal alkaline level. All formula led babies have higher acidity levels than breastfed. That is a researched fact. The repercussions of this are still being researched.

– No one Is taking away your right to be informed. They are taking away misleading advertising. It’s as simple as that.

– And to assume anyone who promotes breastfeeding has never had children or problems breastfeeding, is exceptionally unfair to mothers like myself who went through hell, serious hell. And whose daughter is suffering health problems as a direct result of being given formula by midwives in the first 3 days of her life. So please, instead of pointing fingers, realise that 99% of people who work with pregnant and new mothers and their families, genuinely want to help these families get the best possible start. We all work very hard, whether government workers or private, so that mothers get more help, more options, more autonomy. And we all are working hard so that these workers all provide consistent information across the board. There is a long way to go, but accusations like that are extremely unfair!

– I believe every mother feeds with love of needs to do what works best for them. But one thing that really annoys me is misinformation. Saying that there is no difference between breastfed or formula fed babies is incorrect. It does not mean you love the baby less. U does not mean you bonded less. It just means that a baby’s digestive system is not equipped to take artificial milk products and research is repeatedly showing that the gut of a formula fed baby is more acidic, that the child might be more prone to allergies and may suffer from conditions like ibs In the future. This is all being researched now as up until a few years ago, formula companies had no studies done on the health benefits or otherwise of their products. So now we need to wait and see.

However, formula is there to help when breast milk is not available for ANY reason. And a fed baby is always better than a starving one. After all, animals breastfeed other babies of their own kind, and even sometimes of other species. And in most cases those babies survive.

– Anna Maria 100% agree. And it was brought up as criticism today too. Much much more needs to be done. It is a recognized fact that the largest number of mothers who stop breastfeeding straight after leaving hospital are those who either did not get help or who got conflicting advice.

– We need to go one step further back. We need to reduce the ridiculous amount of unnecessary inductions, interventions and c-sections first. We need to give mothers and babies that “golden hour” which is so crucial for them both. We need to stop separating preemies from parents. It has to start from the bottom. And Marianne Theuma made an excellent speech about it.

– The breastfeeding policy has zero to do with who is the good or bad mother. A good mother feeds her baby in the best way possible for her. What we are saying is that if mothers are given more help, more rights, more options and more of the right information and support, they may have more success at breastfeeding, and those who might normally have completely declined might give it a try. They may still decide it is not for them, but at least the choice they made was with the right knowledge, not misguided by advertising.

– I am an emergency c-section mum, the details of which I don’t want to discuss here. It was traumatic enough do me to be diagnosed with PTSD. I also run a support group for birth trauma mums. There is a lot of research into the dangers of c-section and other unnecessary interventions. They should only be used in cases where the situation makes it 100% necessary. That is all I have to say on this matter or in this conversation. Goodnight all.

Rebecca Buttigieg

Sarah and Olivia in fact the regulation of advertising of junk food targeted at children is one of the “priority areas for action” of the Government’s “Healthy Weight For Life” strategy. I found a cope of the strategy written in 2012, if anyone is interested you can download it here:

This is a quote: “To regulate audiovisual advertising, such as advertising of unhealthy foods especially that directed at children. ”

The measure being proposed right now regarding the advertising of formula, is also mentioned as a point in the plan.

“To update existing legislation to bring it in line with the International Code of Breast Milk Substitutes (WHO, 1981) and subsequent WHO resolutions.”

So there is actually a comprehensive plan, and it is being implemented bit by bit. There are also several measures mentioned to support breastfeeding mothers. None of them are concrete measures regarding educating the general public about breastfeeding, or making it easier to breastfeed while out and about, but at least it does mention that breastfeeding education will be included in PSED classes in school, and the final point is “To promote the establishment of a breast-feeding
friendly environment within our society.”.

I also came across two more interesting documents. One is guidelines for setting up a breastfeeding room in (1) the workplace and (2) the community. This link automatically downloads the document.

And the second document I found is the National Breastfeeding Policy, updated for 2014. There is a section about trying to promote positive perception in the general public, and an interesting section mentioning extending legislation to help working breastfeeding mothers be able to continue doing so (nothing concrete but at least it is mentioned!)

My responses in regards to the subject which was brought up, on how to normalize breastfeeding in public so we can still keep on going out like normal persons during the lactation period

-I think things might be a little bit easier if we also stop feeling ashamed to breastfeed in public. If we accept that our boobs at this stage are just like a bottle of milk, bearing nothing sexual, we won’t feel bad to go out with our friends and our little ones and breastfeed when needed. What I do is the following: if my little one is hungry, wherever I might be,on a bench, cafe, restaurant etc, I will breastfeed, and I just avoid looking around so that I don’t see people’s reactions. So far noone has ever come to me to say something bad. On the contrary, the few times I heard a comment, it was a positive one.

-Becky Gauci-Maistre, milk banks should ideally be an option. Back in the days, when formula was not invented yet, this is how babies grew up. Neighbor lactating mothers would breastfeed the little ones that their mum wasn’t able to. At least this is what used to happen in Greece, my home country, and I assume it must have been the norm in many more countries. The next alternative was milk straight from the cow, donkey, goat. When I asked an older relative how did they manage to do that, since these were hard times with WW2, civil war, famine etc, and why would they risk their health by breastfeeding more than one, she told me that the kids, no matter to whom they belonged, were the priority back then. Giving a mama’s milk to a baby that doesn’t belong to her is the second best option when that is available.

-I think a good starting point is for breastfeeding mums to start breastfeeding without feeling ashamed in front of their parents and parents-in-laws. If this is done, then both the older generations get acquainted with it, and educated from within their own family that it is ‘OK’ and normal, and the mum overcomes the feeling of shame. If you can breastfeed in front of your father and father-in-law would you mind about a complete stranger? This can be an effective way for the message to be passed-on to many people within the society.


*Becky Gauci-Maistre had a traumatic birth experience with her first baby. She embarked on a journey of knowledge and discovery, determined to help others avoid such an introduction to parenthood. Following a healing and empowering journey with her second child, Becky quit her PhD studies in Identity Management and decided to start training as a childbirth educator and post-partum doula instead. She also co-founded the Better Birth Coalition, which is now a member of The Positive Birth Movement. She is the local chapter leader for Momma Trauma’s Sacred Circle – an international peer-to-peer group set up to assist mothers who have experienced a traumatic birth experience. She is currently beginning to get her ante- and post-natal services of the ground under the umbrella name Tree of Life. She is particularly focused on assisting mothers who have had traumatic birth experiences, require information on birth after traumatic birth, be it natural or repeat cesarean, and raising awareness on how to have positive birth experiences. For more information, you can contact and for birth trauma support.


Category: Guest posts

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