Funding received from breastmilk substitute manufacturers and policy positions of national maternity care provider associations: an online cross-sectional review

OBJECTIVES: Maternity care providers play an essential role in supporting women to breast feed. It is critical that their professional associations limit influence from breastmilk substitute (BMS) manufacturers. Aims of this study were (i) to examine whether maternity care provider associations had policy or positions statements addressing BMS marketing and (ii) to explore the type of funding received by these associations. DESIGN: An online cross-sectional review. SETTING: National or regional maternity provider professional associations in Australia, New Zealand, the USA, Canada and the UK. PARTICIPANTS: Twenty-eight maternity care provider (obstetricians, midwives, nurses and others involved in perinatal care) professional association websites. INTERVENTIONS: Websites were examined from November 2019 to October 2020. PRIMARY AND SECONDARY OUTCOME MEASURES: Evidence of BMS industry funding and policy or position statements addressing acceptance of funding from industries such as BMS. RESULTS: Policies addressing the BMS industry were found for 14 associations (50%). UK-based associations (5/5, 100%) and perinatal associations (4/6, 67%) were most likely to have a policy. Six associations (6/28, 21%) received some form of BMS financial support. The highest rates of BMS support were seen in the form of event advertising (5/28, 18%); closely followed by event sponsorship (4/28, 14%). At a provider level, obstetric associations had the highest rates of BMS support (2/4, 50%). At a country level, US-based associations were most likely to receive BMS support (3/7, 43%). CONCLUSIONS: BMS industry financial support was received by one-fifth of maternity care provider associations. Half of these associations had policies addressing BMS marketing. BMS industry support can create conflicts of interest that can threaten efforts to support, protect and promote breast feeding. Healthcare provider associations should avoid BMS funding and at a minimum have policy or position statements addressing BMS marketing.