Today, 4 April 2017, the National Legislative Assembly will deliberate on Thailand’s first ever “Control of Marketing of Infant and Young Child Food Act.” Recognizing that breastmilk is the single best source of nutrition for infants and young children, the Act helps regulate extensive and often misleading industry marketing of breastmilk substitutes.
This deliberation will be a historic moment for Thailand: it’s an opportunity to pass the first legislation of its kind to bring us in line with both global recommendations, and to join many of our neighboring countries in the ASEAN region in adopting such regulations.
But why is this Act so important for Thailand? The answer is simple: researches show that marketing of formulas for infants and young children influence their families’ feeding choices. And that’s a problem, because doctors and scientists worldwide agree that optimal breastfeeding is one of the single best ways to save lives, protect the health of infants and young children and ensure they thrive.
Based on extensive worldwide evidence, the World Health Organization infant and young child feeding recommendations are that breastfeeding should start within the first hour after birth; infants should be exclusively breastfed for the first six months of life; and breastfeeding should continue up to two years or beyond, together with adequate and safe complementary foods.
Just last year, international medical journal The Lancet compiled the latest global evidence and found that optimal breastfeeding alone could prevent more than 800,000 infant deaths each year. It contributes to higher IQs (3 points on average), improved school performance and higher incomes.
Here in Thailand, we know the costs of not breastfeeding well. Research by Alive & Thrive and UNICEF quantified the “Cost of Not Breastfeeding in Thailand” in an economic analysis of the profound toll it takes on both Thai lives and our economy.[i]
Every year, the Thai healthcare system can save up to $7.65 million (263 million baht) by eliminating diarrhea and pneumonia due to inadequate breastfeeding. Improved cognitive development associated with improved breastfeeding can generate an additional $192.6 million (6.6 billion baht). And for Thai families, the savings are substantial: the same study found that 25 percent of an average worker’s earnings goes towards paying for formula.
Yet too many mothers and fathers are facing challenges in providing their child with optimal breastfeeding. As of the 2016 Multiple Indicator Cluster Survey, only 40 percent of infants in Thailand were breastfed within the first hour of birth. Only 23 percent of infants below six months are exclusively breastfed for the first six months, one of the lowest rates in the region. And only 16 percent continue to be breastfed by two years.
As a result, many of our children are at risk of the irreversible effects of poor nutrition on growth, development, and productivity, simply because they weren’t breastfed in the earliest days of life.
It’s our job to make breastfeeding both the right choice and the easy choice. But when breastmilk substitutes are often marketed as equal to or superior to breastmilk in nutritional value, it sends the wrong and misleading message to families. When formula companies market their products in healthcare settings, it undermines the role of healthcare providers in delivering fact-based support to mothers. That’s why the World Health Assembly has also called on all nations to end industry sponsorships of medical associations, to ensure that health care professionals provide guidance based on global recommendations and not industry influence.
The breastmilk substitute industry will undoubtedly oppose this Act. Sales of breastmilk substitutes are expected to increase globally from US$45 billion to US$71 billion by 2019. It’s estimated that Thailand accounts for 2 percent of the 2014 market, or about 26.3 billion THB. This is expected to grow to 32 billion THB by 2019.
And it’s true: when breastfeeding rates increase, the revenue of breastmilk formula companies decrease. These products bring enormous profit to companies. That’s why they advertise them in misleading ways that imply they help children become taller, stronger, and smarter than breastmilk can.
The only ones to gain from these marketing practices are companies, not families and not our nation. We should be choosing the clear economic benefits of breastfeeding for Thailand—the increased worker productivity, earnings and gross national income—instead of the economic benefits for companies.
Thailand has one of the lowest exclusive breastfeeding rates in the region, and we are one of the few countries in the region with no law to protect against marketing of breastmilk substitutes. It’s time we changed that.
To protect mothers and families and promote breastfeeding in Thailand, we must bring our policies and laws in line with World Health Organization global recommendations, including extending the ban on marketing of breastmilk substitutes to all milk products for children up to 36 months of age and beyond.
By putting our children’s health at the heart of our decision-making we will be healthier and stronger, as individuals and as a nation, for generations to come.
(Dr. Siraporn Sawasdivorn is the Secretary General of the Thai Breastfeeding Center Foundation; Thomas Davin is the Representative of UNICEF Thailand and Roger Mathisen is the Program Director of Alive & Thrive)