Conflicts of interest are harming maternal and child health : time for scientific journals to end relationships with manufacturers of breast-milk substitutes

Abstract

► Forty years after the World Health Assembly adopted the International Code of Marketing of Breast-milk Substitutes, inappropriate marketing of breast-milk substitutes persists and puts infants and young chil- dren at risk of malnutrition, illness and death. ► The formula industry is large and powerful and has used various ‘medical marketing’ strategies to influ- ence scientists and health professionals as to the purported benefit of breast-milk substitutes. ► The examples provided in this commentary show how a manufacturer is using a leading scientific journal to market breast-milk substitutes through paid advertisements and advertisement features. ► By receiving funding from breast-milk substitute manufacturers, journals create a conflict of interest, whereby the publisher and readers of the journal may favour corporations consciously or unconsciously in ways that undermine scientific integrity, editorial in- dependence and clinical judgement. ► Conflicts of interest have previously been identified in infant and young child nutrition science and in journal advertising policies and have been criticised by public health experts, yet the practice continues. ► All scientific journals and publishers should stop ac- cepting funding from manufacturers and distributors of breast-milk substitutes, in accordance with global public health guidance. Public health must come be- fore profit.