Conflicts of interest are harming maternal and child health: time for scientific journals to end relationships with manufacturers of breast-milk substitutes

The promotion and support of breastfeeding globally is thwarted by the USD $57 billion (and growing) formula industry that engages in overt and covert advertising and promotion as well as extensive political activity to foster policy environments conducive to market growth.1 This includes health professional financing and engagement through courses, e-learning platforms, sponsorship of conferences and health professional associations2 and advertising in medical/health journals. These contribute to the overuse of specialised formulas3 and inappropriate dissemination of health and nutrition claims.4 Such ‘medical marketing’ reduces breastfeeding initiation, exclusivity, and duration, irrespective of country context.5 It also creates a subtle, unconscious bias and conflict of interest, whereby journal publishers may consciously, or unconsciously, favour corporations in ways that undermine scientific integrity and editorial independence—even perceived conflicts of interest may tarnish the reputation of scientists, organisations or corporations. Such conflicts have plagued infant and young child nutrition science for decades