The resurgent influence of big formula

In May, word spread from the World Health Assembly of remarkable developments around an apparently non-controversial World Health Organization resolution to support breastfeeding. The Trump administration had opposed the motion and threatened the proposer country, Ecuador, with a suspension of trade and military support.1 Ultimately, the motion was proposed by Russia and accepted by the assembly, but the behaviour of the US caused ripples of surprise and concern throughout the global public health community.

Increased lobbying from infant formula manufacturers may underlie the US’s new hard line approach.2 The formula industry is anticipated to turn over about $70bn (£55bn; €61bn) next year,3 and $60m has been spent lobbying the US government alone in the last decade.4 The formula industry has other links to US power—one of the companies tasked with separating children from immigrant parents at the US-Mexico border shares two board members with a formula company.56

The 2016 Lancet Breastfeeding Series estimated that over 820 000 babies’ lives could be saved annually worldwide by increased breastfeeding rates.7 Mothers benefit …