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Milk is part of growing up in many places, but a trade group says the WHO wants to discourage it for toddlers. (Tamara Cralu) Milk is part of growing up in many places, but a trade group says the WHO wants to discourage it for toddlers. (Tamara Cralu)

Milk is part of growing up in many places, but a trade group says the WHO wants to discourage it for toddlers. (Tamara Cralu)

Jon Greenberg
By Jon Greenberg May 20, 2016

Dairy exporters say WHO casts milk as 'an obstacle' to toddler health

The milk industry is upset with the World Health Organization, claiming the international group is pushing a set of marketing guidelines that put their products in a bad light.

In a letter to President Barack Obama on May 9, 2016, the U.S. Dairy Export Council wrote that a WHO proposal "portrays milk and dairy products as an obstacle to a healthy start in life."

Does WHO think that milk and dairy products don’t do a baby’s body good?

Proposed marketing guidelines

At issue are proposed guidelines from the World Health Organization due for a vote at the World Health Assembly in Geneva, Switzerland, at the end of May. The document has been in the works for years and its stated purpose is to end "the inappropriate promotion of foods for infants and young children, with the aim to promote, protect and support breastfeeding, prevent obesity," and generally promote a healthy diet.

Dairy exporters are not against breastfeeding, said Shawna Morris, vice president of trade policy for the U.S. Dairy Export Council.

The problem, Morris said, is that the WHO proposal covers toddlers up to 3 years old. "If we have images of a 1- or 2-year-old drinking milk, is that prohibited?" Morris said. "It seems to us that it would be."

Morris highlighted several troublesome clauses in the WHO document, including this one (emphasis ours):

"Products that function as breast-milk substitutes should not be promoted. A breast-milk substitute should be understood to include any milks (or products that could be used to replace milk, such as fortified soy milk), in either liquid or powdered form, that are specifically marketed for feeding infants and young children up to the age of 3 years (including follow-up formula and growing-up milks).

As the trade groups see it, the proposal would go further.

Yogurt, milk and cheese would fall under this definition, they say, when guidelines from the medical community say that most young children do just fine with these foods.

Charles Taylor, a marketing professor at Villanova University’s School of Business, told us that the dairy industry has a point. He calls the document "draconian."

"At best, the WHO guidelines are a one-sided argument in favor of their strongly held position that breastfeeding is healthier for children without giving the whole position," Taylor said. " At worst, they can be viewed as providing consumers with incomplete information on milk."

How WHO responds

Make no mistake, WHO doesn’t want to see breast-milk substitutes promoted. WHO contends, however, that the dairy industry is reading too much into the proposed marketing rules.

The proposal says you can identify what products would be affected by how they’re pitched to the public. If they are "specifically marketed for feeding infants and young children up to the age of 3 years," then they are a breast-milk substitute.

WHO officials says that excludes milk products such as yogurt, milk and cheese.

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WHO spokeswoman Olivia Lawe-Davies said that "in no way does the guidance discourage the consumption of milk. In fact, WHO recommends milk consumption for older infants and young children who are not being breastfed."

That jibes with current WHO guidelines for non-breastfed children age 2 and under. The guidelines state, "Milk products are rich sources of calcium and several other nutrients. Diets that do not contain animal source foods (meat, poultry, fish or eggs, plus milk products) cannot meet all nutrient needs at this age."

Davies said the new proposal simply adds marketing restrictions for products known as "follow-up formula" and "growing-up milks." Both are similar to infant formula, but the first one is aimed at infants from 6 months to 1 year, and the second is for toddlers up to 3 years.

"Milks marketed for infants and young children are breast-milk substitutes because they de facto displace the intake of breast milk," Davies said. "Milk that is marketed as a general family food is not covered by this recommendation since it is not marketed specifically for feeding of infants and young children."

Reading between the lines

Experts who have studied the language and are aware of both arguments say both the dairy industry and the World Health Organization have a point.

Allyn Taylor has a special expertise in the legal ins and outs of these global health codes. Taylor, a law professor at the University of Washington School of Law, was a senior legal adviser when the WHO crafted its rules on tobacco control. She has had no involvement with the latest guidelines.

Taylor criticizes the current text as ambiguous, "poorly written" and subject to interpretation. Taylor told us she hopes the wording will be debated at the upcoming World Health Assembly in Geneva. (Perhaps in a way to settle this dispute.)

But even with that, she said to assert that the proposal casts milk as an obstacle goes too far. "That is quite a pejorative claim," Taylor said. "You will not find any words in this document to that effect."

Another law professor, Emily Parento at the McGeorge School of Law in Sacramento, Calif., agreed. The text of the proposal could be more tightly written, she said. But she didn’t see how that flaw gets you to the industry line that WHO is against milk products for toddlers.

"I can’t see the WHO not wanting little kids eating string cheese or having a cup of plain milk," Parento said. "That’s just not there."

A key industry trend

The world of powdered milk mixes has changed a lot since the current breast-milk formula marketing guidelines passed in 1981. Formula makers began targeting older infants and toddlers. A report from a New Zealand business group said the expansion produced a $55 billion a year market.

In a nod to the impact of the 1981 WHO marketing guidelines, the report noted "Infant formula is typically defined as "birth to six months"; the product is then renamed for a range of reasons (primarily to avoid regulation and restrictions on advertising)."

Our ruling

The U.S. Dairy Export Council said a WHO proposal "wrongly portrays milk and dairy products as an obstacle to a healthy start in life."

The proposal clearly is targeting some dairy products, specifically powdered formulations, as ones that work against the benefits that come from maintaining breastfeeding through a child’s early years.

But the dairy industry is making a much broader claim, saying the proposal targets milk and dairy products generally. That’s at best unclear. It’s likely unfounded, experts told us.

The statement contains an element of truth but ignores critical facts that would give a different impression. We rate this claim Mostly False.

Our Sources

U.S. Dairy Export Council, White House Asked to Challenge WHO Proposal Discouraging Dairy for Children up to Age 3, May 9, 2016

U.S. Dairy Export Council, National Milk Producers Federation and International Dairy Foods Association, Letter to President Barack Obama, May 9, 2016

World Health Organization, Guidance on Ending the Inappropriate Promotion of Foods for Infants and Young Children, May 16, 2016

World Health Organization, Guiding principles for feeding non-breastfed children 6-24 months of age, 2005

Agricultural Resource Marketing Center, International Dairy Profile, accessed May 17, 2016

Coriolis, Infant formula value chain, January 2014

ForBaby, Choosing a formula for your baby's stage: 1, 2 or 3?, accessed May 17, 2016

Lancet, Maternal and child undernutrition and overweight in low-income and middle-income countries, Aug. 3, 2013

Maternal and Child Nutrition, Cross-sectional survey shows that follow-up formula and growing-up milks are labelled similarly to infant formula in four low and middle income countries, April 7, 2016

Dairy Reporter, US dairy exporters have ‘huge’ opportunity to tap world market for medical nutrition: USDEC, April 11, 2012

World Health Organization, International Code of Marketing of Breast-milk Substitutes, 1981

Food and Nutrition Bulletin, Childhood dual burden of under- and over-nutrition in low- and middle-income countries: a critical review,  June 2014

Food and Agriculture Organization, Proposed Draft Revision of the Guidelines on Formulated Supplementary Foods for Older Infants and Young Children, September 2010

Interview, Shawna Morris, vice president of trade policy, U.S. Dairy Export Council, May 17, 2016

Interview, Allyn L. Taylor, affiliate professor of law, University of Washington School of Law, May 18, 2016

Email interview, Charles R. "Ray" Taylor, professor of marketing, Villanova University School of Business, May 18, 2016

Email interview, Olivia Lawes Davies, communications officer, World Health Organization, May 17, 2016

Interview, Emily Parento, associate professor of law, McGeorge School of Law, University of the Pacific, May 19, 2016

Email interview, Patti Rundall, policy director, IBFAN Global Advocacy, May 17, 2016

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Dairy exporters say WHO casts milk as 'an obstacle' to toddler health

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