Misinformation and formula milk donations are threatening breastfeeding during COVID-19

COVID-19 has had a catastrophic impact on the nutrition of children in South Asia.  

Lockdowns hit families’ livelihoods and food supply chains hard — causing the quality and quantity of children’s diets to reduce. Life-saving health and nutrition services were closed. Those that did remain open saw huge drops in visits, as families sheltered from the virus at home.  

This perfect storm could leave 3.9 million more children in South Asia dangerously malnourished and at risk of death this year. The largest increase of any region in the world. 

In such circumstances, it’s even more important that mothers breastfeed their babies. Breast milk is a baby's ‘first vaccine'. It provides protection against life-threatening illnesses, and also promotes healthy growth and boosts brain development.  

Babies should begin breastfeeding immediately after birth, be exclusively breastfed for the first six months, and continue breastfeeding until at least two years.  

Breast milk is so important to babies’ health that UNICEF and the World Health Organization urge women to breastfeed if they have COVID-19 — as the benefits of breast milk far outweigh the risks of infection to the baby. 

However, research recently commissioned by UNICEF in five countries across South Asia found that less than 25% of people interviewed understood it’s safe to continue breastfeeding if a mother has symptoms of COVID-19. 

UNICEF is deeply concerned that confusion, misinformation and inappropriate donations of formula milk are stopping mothers from breastfeeding — further jeopardizing the health of South Asia’s children. 

The public health messages on physical distancing, combined with a lack of access to correct information and counselling on breastfeeding and misinformation on social media is leaving mothers anxious and confused. 

UNICEF is especially concerned about narratives circulating on social media that promote formula milk as a safer alternative to breastfeeding.  

Formula should always be a last resort for families. Formula milk is difficult to prepare safely and there is also a risk of babies becoming sick from unclean bottles and dirty water.  It is inferior to breastmilk in nutrition content and is costly, so parents often dilute it too much to make it last longer. 

However, social media messages promoting formula milk claim differently. In some cases, influencers on social media deliver marketing messages that undermine women’s confidence to breastfeed.  

Such content taps into parents’ anxieties and emotions. It can quickly go viral and be readily believed as fact.

Mothers who have confirmed or suspected COVID-19 can breastfeed safely by: 

• Washing their hands frequently with soap, for at least twenty seconds, especially before touching their babies.  

• Wearing a facemask. 

• Regularly cleaning and disinfecting any surfaces.  

• Sneezing or coughing into a tissue. After, they should immediately dispose of the tissue and wash their hands with soap and clean water.  

If a mother feels too unwell to breastfeed, there are a few options: 

• She can express milk that she, or someone else, can then feed to the baby with a clean cup and spoon.  

• Another breastfeeding woman can breastfeed the baby. 

• She can seek advice and support from a health worker.  

Learn more about breastfeeding during COVID-19 here. 

The International Code of Marketing of Breast-milk Substitutes and subsequent World Health Assembly resolutions ban all forms of breast milk substitute promotion. 

But inappropriate donations of formula milk to families during COVID-19 are also endangering children’s health. These donations sometimes come from well meaning, but misguided, individuals. However, there are cases of companies donating or distributing formula milk either directly or through other organizations such as NGOs — a further violation of the international code meant to protect families and children.  

Once a mother reduces or stops breastfeeding, her milk production can decline quickly, even after just one pack of formula. This can make it very difficult to resume breastfeeding —  putting women and their babies at risk of becoming permanently reliant on expensive formula milk.  

The situation will only get worse unless action is taken now to protect families. Governments must act to stop donations and distributions of breast milk substitutes and legislation needs to be revised to prevent misleading marketing.  

UNICEF is working with governments and partners across the region to find innovative ways to promote breastfeeding and counter the harmful impacts of misinformation. In India, health workers have been harnessing WhatsApp to reach families with videos and audio messages on breastfeeding practices during lockdown —  helping them to feel empowered and supported to make the best choices for their children's health.