Underhanded marketing?

Today I received an email from an Eumom partner asking if I’d like to complete a survey on “Being a mum” to be in with the chance to win flights. The survey I completed wasn’t about motherhood at all though, unless you consider the primary focus of your child’s babyhood to be how soon you start formula feeding them and which formula you will choose.

I completed my postgrad in technical communication, and an important part of that course was the focus on information gathering. We learned that the way a question is asked may bias the answer. For example, if you ask a series of questions about someone’s awareness of a school shooting, and then follow up with a question about whether or not guns should be banned, you’re far more like to have people say yes they should than if you start with a series of questions about personal freedoms and gun ownership.

The way you phrase a question may also imply that you are imparting truths rather than testing the participants knowledge. As I worked my way through this formula feeding survey, I kept thinking about that and wondering in whose interest this survey may be. I should have guessed that the questions weren’t going to be well formed when one of the opening questions establishing demographics asked me about my children’s ages and failed to give me an option for more than one child, unless I was currently pregnant.

Next up, what feeding regime did I follow with my last baby prior to introducing solids? Exclusive formula milk, exclusive breast milk, initially breastfeeding followed by formula feeding, or breastfeeding with formula “top ups”. Ignoring the fact that there’s no option for initially formula feeding and then switching to breastfeeding (and why would there be – no one ever seems to tell women that that’s an option in the early weeks), the wording of the final option irked me. Why “top ups”? Why not combination feeding? I’m sure there are those reading this right now who are thinking “get a grip Lisa, you know what they mean?” but if you learn more about the insidious practices of formula companies as they attempt to grow their markets (start with The Politics of Breastfeeding by Gabrielle Palmer), you’d understand why I think language is important. Why else do we spend so much time listening to messages about “the benefits of breastfeeding” as opposed to “the risks of formula feeding”, and “breast is best” as opposed to “breastfeeding is normal”? Those marketing formula know well that language is important. Hence my problem with this wording. Top ups implies breastmilk isn’t enough and has to be topped up.

Next question. “At what point did you introduce your baby to formula milk?” See what I mean about language?

The phrasing of this question indicates that the assumption is that of course you introduced your baby to formula milk. Some mothers don’t, you know. (The option to indicate that you didn’t introduce formula milk is available if you scroll down the screen. Clearly an afterthought though because technically it is not a direct answer for the original question.)

The next question is a doozy. It asks how knowledgeable I am about the relative benefits of breastfeeding and formula milk to my baby. Are there benefits of formula milk to my baby relative to the benefits of breastmilk? What are they hoping I’ll say here? I don’t really understand what they are asking.

Then there are several questions about what sources of information I accessed to find out more about breastfeeding and formula feeding, from various medical professionals, to online support boards, to friends and family, and advertising. I assume this is so that the next set of advertising can be tailored to target mothers more closely. I hope I’m wrong.

Then we’re on to brand recognition. Is my ability to name brands of artificial baby milk integral to “being a mum”, which let’s not forget is the supposed subject matter for this survey?

This is quickly followed by questions about my formula purchasing habits – which formulas have I used, which would I use, and which would I not consider. So far, so typical for a marketing survey.

But then we got to the section that made my blood boil.  Why would you consider switching to formula milk? Is this the bit that attempts to determine which popular breastfeeding or formula feeding myth you are most susceptible to?

I think the reason this question annoyed me so much was because it reinforces the common misperceptions about breastmilk and formula milk. Remember this survey is aimed at pregnant women as well as women who already have children. By offering these as potential reasons for switching, the survey is (inadvertently?) validating those reasons. Starting with the hungry baby. Would you switch to formula milk if you had a hungry baby? Lots of people do. There’s a perception that formula milk is more filling and more calorific. This is only true if by more filling you mean more difficult to digest. Because from a calorie point of view, breastmilk averages more calories per ounce (source: kellymom). Who knew?

What about mastitis or other health concerns? This is another problematic one. Lots of people report being advised to switch to formula milk by their health professional if they develop mastitis. Even though the appropriate treatment for mastitis is antibiotics and feeding through it. (Source: NHS)

The list goes on. If breastfeeding is too painful… Because there are no breastfeeding facilities available… Because I’m too embarrassed to breastfeed… Because breastfeeding takes too much time… If I’m too busy with other children…

Let’s just take those last two which perpetuate the myth that formula feeding somehow saves time. But last I checked making bottles, washing bottles, and feeding a baby those bottles takes plenty of time. It all goes back to a general misunderstanding about breastfeeding. For many people their only experience of breastfeeding occurs in the early newborn weeks, when feeding can indeed take a long time. But that’s because the effort required to breastfeed is front-loaded. You put time in in the first two months to save time later on. At five months old, as my daughter is now, feeds are generally short (she averages less than five minutes a feed), and I certainly have a lot more time to spare than I would if I was formula feeding. I know this for certain because I formula fed my son from seven months. I was that soldier boiling kettles, washing bottles, and mixing powder.

So now I have a question. If you’re a newly pregnant woman taking that survey, what is your impression of breastfeeding after taking the time to consider all of those reasons for switching? It’s hard to know why you’d bother with it in the first place considering all those negatives.

Almost 90% of the survey done now and it’s on to assessing your opinion on statements about feeding. One jumped out at me. “Combining breastfeeding and formula milk in the first six months is the healthiest option for the baby.” There’s no alternative statement to balance it out and say “Exclusive breastfeeding for the first six months is the healthiest option for the baby and is recommended by the WHO and the HSE.” Again, I’m thinking of my college days and all we learned about designing questions to elicit certain responses.

Almost done now, and the next question is about the importance of certain factors in deciding to switch brands of formula. Digestibility, baby needs a special formula, price, closer to breastmilk… The closer to breastmilk one really got to me. Ugh, the power of advertising. Back in 2007, Aptamil was ordered to removed that false and misleading claim from its packaging. But do a quick search today, seven years later, on any new parent forum for “closer to breastmilk” and you’ll find someone advocating Aptamil because it is “closest to breastmilk”. (Source: The Caroline Walker Trust)

Finally a question asking for my opinion on what areas relating to breastfeeding it is not acceptable for a formula company to involve itself through supporting or sponsoring. As you can probably guess, I had a bit to say in my response here about how it is never acceptable. The WHO has set out a code for the marketing of breast milk substitutes. Article 5.1 of this code clearly states “There shall be no advertising or other form of promotion to the general public of products within the scope of this Code.” (Source: WHO)

And one final question to finish the whole thing off: “How acceptable do you feel it is in Ireland for mothers to breast feed their babies in public?” No comment.

So where does that leave us? Well, the fact remains that I have no idea who the client is for this survey. It could well be a breastfeeding support body attempting to analyse the effectiveness of formula marketing strategies. But the likelihood is that it is marketing on behalf of a formula company. After all, it takes money to conduct marketing research, and because they don’t have a product to sell, most breastfeeding support agencies are sadly lacking in money. So I’m left wondering what insights are being gained by this survey on “Being a mum” and who is benefiting from it? Will the answers given here be used to drive breastfeeding rates down further and grow the market for formula milk? And why the need for such underhandedness with the misleading title for the survey?

One thing’s for sure. Now I’m the one with lots of questions. But the biggest one of all on my mind is “Will this do harm?”