New regulations in Thailand will force baby formula companies to stop advertising, giveaways and discounts for so-called toddler milk, which experts say can contribute to growing obesity and other health problems among the nation’s children.
The action follows a ProPublica investigation that revealed how the U.S. worked to weaken Thailand’s last major attempt to ban formula advertising, in 2017.
Thai health authorities at the time had hoped to end marketing for all formula products as part of their efforts to increase the country’s breastfeeding rate, which was among the lowest in the world. Of particular concern was toddler milk, a type of formula made especially for young children, often pitched with bold and, experts say, unsupported health claims. But formula makers like Mead Johnson asked U.S. trade officials to intervene, setting off a 15-month diplomatic and political pressure campaign that resulted in an exemption for toddler milk ads.
By last year, toddler milk — a processed drink that typically includes powdered milk, vegetable oil and sweeteners — accounted for more than half of all formula sales in Thailand, according to Euromonitor, which tracks sales data.
The U.S. intervention in Thailand was one of roughly two dozen such efforts documented by ProPublica this year as it investigated the federal government’s long-running support for the multibillion-dollar formula industry. In recent years, that advocacy has often centered on opposing local efforts to regulate formula marketing around the globe.
Health officials and activists say such advertising can mislead parents and even prompt mothers to abandon breastfeeding too soon, depriving children of a range of health protections. Mead Johnson did not respond to a request for comment. But the industry has defended its promotion of toddler milk, saying it “can contribute to nutritional intake and potentially fill nutrition gaps for children 12 months and older.”
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In Thailand in 2023, ProPublica observed towering displays of powdered toddler milk boxes lining grocery store shelves beside boxes of baby formula. Companies offered steep discounts for toddler drinks and gave away items such as toys, musical instruments or even small swing sets in exchange for purchases.
“The marketing is quite aggressive,” said Dr. Titiporn Tuangratananon, who worked on the Thai health ministry’s effort to enact the new restrictions.
In 2016 and 2017, U.S. trade officials lambasted Thailand on the floor of the World Trade Organization for proposing restrictions on toddler milk advertising. Officials then said the rules raised questions about whether they were “more trade restrictive than necessary.”
This year, however, the U.S. took a different approach. In a letter to Thai authorities, officials said the U.S. “supports Thailand’s objective to prevent deceptive marketing practices thereby protecting the health and wellbeing of both infants and young children.”
While trade officials asked questions such as which products would be covered and why the new rules would restrict marketing that was not deceptive or inaccurate, they did not echo concerns industry representatives raised about whether the rules were inconsistent with trade treaties, documents obtained by ProPublica show.
In response to questions, a spokesperson for the Office of the U.S. Trade Representative said the agency and others involved in trade policy support regulatory decisions “based on science.”
“Since the start of the Biden Harris Administration, USTR has made no secret our commitment to making sure our trade policy works for people,” spokesperson Angela Perez said in a statement. USTR does not “blindly” advance the will of corporations, the statement said, and has been moving “away from the formerly standard view that too often deemed legitimate regulatory initiatives as trade barriers.”
Before adopting the new rules on toddler formula, the Thai health ministry had a hearing and met with representatives of formula companies, which strongly opposed the changes.
A letter from the industry group the Infant Nutrition Council of America said restrictions on trademarked brands of toddler milk — also known as growing-up milk — could “violate Thailand’s obligations” under a WTO agreement on intellectual property.
“The Ministry’s focus on restricting information about formula and growing up milk products up to 36 months of age overlooks other public health and public policy concerns,” the letter said, citing the challenges faced by working women, the impact of local dietary practices on malnutrition and the importance of milk products for child development.
Another group, the US-ASEAN Business Council, said the changes could violate trade treaties and “deny Thai consumers important information to identify reputable, scientifically-formulated products that are safe and effective.”
The business council declined to comment further. The nutrition council did not respond to questions from ProPublica.
With the new rules, Thailand joins roughly three dozen countries to adopt restrictions on the marketing of formula drinks for children through age 3 or even older — measures the World Health Organization has supported because of concerns about the drinks’ nutrition and potential to disrupt breastfeeding.
The regulations will go into effect in July.