Formula like gold dust, and shortage will only get worse

Showing growing concern over shortages of the baby product—an issue that has been reported extensively across the world in recent weeks—Hong Kong’s authorities has been taking strong action to prevent the smuggling. 

Under the latest measures, the accused face a maximum penalty of two years in prison and a HK$500,000 fine if convicted.

For many, this crisis ably illustrates the elevated sense of fear the Chinese have over the quality and safety of milk formula on sale in the country. The well-documented melamine case of 2008, as well as numerous others since, continues to haunt current and prospective mothers, so the demand for the seemingly safe brands from overseas has been turning powder into gold dust.

However, what seems to have gone unnoticed as supermarkets across the region find themselves cleared out of formula stocks, is that the use of milk powder has also been growing while breastfeeding has dwindled. This, it seems, is the real issue.

Formula fear is perfectly natural, not least when local suppliers have behaved so appallingly in the past, but this alone cannot explain the incredible demand at present. What really makes the difference is the speed with which mothers are willing to open a can of formula. 

Like much of the region, China has a developing middle-class and sees baby milk as a product with aspirational appeal. Breast milk might be indisputably better for a baby’s health, but formula is seen as a product with status that is used by the wealthy. While women with means are most likely to begin with breastfeeding before moving on to formula, those from poorer households scour for powder in the belief they are investing in their child’s health.

However, they would be wrong. When babies receive colostrum—the mother's first milk—within an hour of birth, it kickstarts the child's immune system, making them three times more likely to survive. Babies in developing countries breastfed for six months have been found to be up to 15 times less likely to die from diseases like pneumonia and diarrhoea.

According to a recent report by Save the Children, global breastfeeding rates are on the rise, whereas the proportion of breastfeeding mothers in Asia has actually fallen from 45% in 2006 to 29% last year. This equates to a huge number of formula cans in the world’s most populous continent.

In Indonesia, the number of mothers who would breastfeed their children fell by 10 percentage points to 32% in the decade to 2007; in the Philippines—a country with a fast-growing middle-class—only 17% of mothers now feed their babies on the breast.

The scale of this drop cannot be attributed to the rise of the Asian middle-class and its aspirations alone—valid though it might be. 

Worth US$25bn, the formula industry has been known to market aggressively—some say misleadingly, with unfounded claims. During the 1970s, a global campaign accused companies of using every trick in the book to dupe Asians into opting for milk powder, with one well-known ruse being to dress up formula sales reps as nurses.

A global boycott of Nestle—the biggest player in the baby food market—was launched in 1977 to end contentious marketing of infant milk formula, especially to poor women. In 1981, the public backlash to this approach prompted the WHO to recommend an international code of standards, parts of which are now law in over 100 countries.

However, Save the Children has reported that the formula industry might have adopted new strategies along the lines of those of the 1970s. For instance, the charity found companies offering incentives to healthcare workers in Indonesia to promote milk powder to new mothers. These included cash and even trips to Mecca.

While in China, the site of this crazed grab for supplies, it discovered that a quarter of mothers had been given free gifts from a number of formula companies, and 40% had received samples.

So as we see ever more stories about food safety in China and the SAR’s empty shelves, it is worth considering that this is not just a homegrown problem for China. And while middle-class aspiration accounts for a great deal of the country’s successes and worries, its role in this milk formula crisis is limited.

What is particularly worrying, though, is that soon the Chinese will only be one group out of many from developing nations desperately hunting for their formula fix if breastfeeding rates continue to fall. Hong Kong is only the tip of the iceberg.

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