A new study from The Australian National University (ANU) has found a global boom in the sale of infant and baby formula, especially in China and Southeast Asia, raising concerns about the health of millions of mothers and their babies.
Lead researcher Dr Phillip Baker said the study suggested governments around the world needed to do more to control marketing of baby formula and to ensure work policies gave women a choice to breastfeed their children.
Growth in formula sales was most rapid in East Asia, particularly China, Indonesia and Vietnam, where millions of mothers are entering the workforce as the countries industrialise.
"What we are talking about is potentially the largest shift in infant and young child nutrition on record," said Dr Baker, from the RegNet School of Regulation and Global Governance at ANU.
The World Health Organization recommends infants are exclusively breastfed up to six months of age, with ongoing breastfeeding for up to two years of age and beyond, to ensure they get the best start in life.
"Paid employment is a very good thing for families, especially those living on the bread line. The problem is that without paid parental leave or family friendly workplaces breastfeeding can be very difficult or even impossible," Dr Baker said.
"Without supportive workplace policies and regulations in place, formula feeding is often the only choice available to parents in many countries.
"Competition among companies selling formula is also reaching fever pitch. We estimate that the industry's global marketing spend exceeded $US4.48 billion in 2014, a figure comparable with the World Health Organization's annual budget.
"The decision to breast feed or formula feed should be an informed choice made in dialogue with a health professional, not by the marketing of a formula company."
The research examined the growth in formula sales worldwide. It found sales grew by 41 per cent from 5.5 kilograms to 7.8 kilograms per infant/child between 2008 and 2013, a figure predicted to increase to 10.8 kilograms by 2018.
This global sales boom applies not only to infant formula for infants aged up 0-6 months but also to follow-up formulas for children aged 7-12 months and toddlers aged 13-36 months, which can displace ongoing breastfeeding.
Dr Baker said formula-fed children experience poorer health and developmental outcomes than breastfed children, with increased risks of pneumonia, diarrhoea, obesity and type-2 diabetes, ear infections and asthma.
"Marketing by these companies powerfully shapes what parents consider best for their babies by portraying formula as a symbol of modernity, as comparable or superior to breast-milk and formula feeding," Dr Baker said.
Dr Baker said he hoped that this study would encourage debate and discussion about the need for stronger regulation of the marketing of these products."
"Ultimately the health of mums and kids is at risk and governments need to do more," he said.
The research has been published in the Public Health Nutrition journal.