The World Health Organization has long advised countries to ban baby formula marketing, given its potential to mislead parents and harm some of society’s most vulnerable members. For those reasons, among others, at least 144 countries have followed suit. The United States is not one of them.
In fact, the U.S. has led a decadeslong global campaign to thwart such efforts, advancing the interests of multinational formula companies at the expense of public health, according to a ProPublica investigation. Notably, this advocacy has not only hindered local attempts to stop formula marketing, but it has also undermined the work of U.S. foreign aid and health officials, who have long considered breastfeeding “one of the highest returns on investment of any development activity,” especially in the Global South.
While this meddling has rarely broken into public view, ProPublica’s reporting found the scope of U.S. interference is far greater than previously understood. We mapped interventions in at least 17 jurisdictions, including Thailand, where lawmakers exempted “toddler milk” from their latest marketing ban over public health warnings. The reporting, which took place over a year and spanned three continents, represents the fullest public accounting of the U.S.’s trade actions around formula to date.
The topic is timely, given the rise of dubious formula products like toddler milk, which the American Academy of Pediatrics has called “unnecessary and potentially harmful to young children.” Some brands have hefty doses of sweeteners and sodium, which public health officials say contributes to rising obesity rates. Nevertheless, formula makers market these products with unsupported claims of improved brain and eye health. The advertising pushes are particularly pronounced in the Global South, where developing economies have, in the words of one formula executive, given rise to “dual-income families that can afford more expensive, premium nutrition products.”
We wanted to explain to readers how U.S. trade campaigns have cleared the path for these products — and how their advertising has misled parents. This was not easy. Stories about bureaucracy tend to be technical and can alienate readers. So we focused on one party — the Office of the U.S. Trade Representative — and made the story visual, using internal documents to show how the trade office weakened a key formula resolution. The interactive feature offers a rare peek at U.S. policymaking, allowing readers to scroll through an annotated copy of the resolution, in which trade officials battled with health experts.
Then, to illustrate how these interventions play out on the ground, we visited one of the world’s largest markets for formula, Thailand, which watered down its marketing ban under U.S. pressure. There, we met a family directly impacted by the outcome. Influenced by unregulated marketing, they fed their sons toddler milk. By the time their youngest was 3, he weighed nearly 66 pounds — as much as an average 9-year-old. Photos were integral to the storytelling, showing not only the health impacts of unregulated marketing but also the sea of products parents encounter in supermarkets.
