By Naomi Bromberg Bar-Yam, PhD
Each year, World Breastfeeding Week is an opportunity to consider what we need for breastfeeding to thrive. The 2026 theme, “Breastfeeding for a Sustainable Start in Life: Strengthen What Works,” invites us to focus on what we have learned from decades of breastfeeding advocacy.
We know many things that work:
- Skilled lactation care;
- Paid leave and keeping mothers and babies together;
- Supportive health care practices and workplaces;
- Access to human milk for vulnerable infants;
- Accurate information, time, resources, to support families’ feeding decisions.
We also know that individual support is important but not enough.
Breastfeeding decisions occur within health care systems, workplaces, families, communities, economies, and cultures. Public policy determines whether parents have paid time to care for a new baby. Hospital practices influence how breastfeeding begins. Workplace policies affect whether breastfeeding can continue successfully. Marketing shapes what families and health professionals learn and believe about infant feeding.
Commercial interests influence all of these environments.
An Anniversary of an Event that Worked
Next year marks the 50th anniversary of the Nestlé boycott, an important chapter in the history of breastfeeding advocacy and global public health. The boycott began in 1977 in response to the harmful marketing of infant formula, particularly in low- and middle-income countries. Marketing through health care systems, including free samples, undermined breastfeeding and often created dependence on products that families could not safely use or consistently afford.
But the boycott was about more than one company or one product. It raised a larger question: What responsibility do corporations have when their business practices affect health?
Advocates organized across countries, documented marketing practices, built international networks, and pressed corporations and governments to act. In 1981, the World Health Assembly adopted the International Code of Marketing of Breast-milk Substitutes, establishing international standards to protect infant feeding decisions from inappropriate commercial influence.
The Code did not end inappropriate marketing, and the boycott did not eliminate the many structural barriers to breastfeeding.
But the movement has changed what is possible. It demonstrated that corporate practices affecting health could be documented, measured, challenged, regulated, and monitored. It helped create international advocacy networks and new expectations of accountability. And it contributed to a broader understanding that, beyond educating families, protecting breastfeeding requires changing systems.
From the Boycott to the Commercial Determinants of Health
Nearly fifty years later, the questions raised by the boycott remain.
The ways companies reach families and health professionals have evolved. Marketing now travels through social media, influencers, sponsored content, targeted advertising, online parenting communities, and corporate-funded education and research. Many of these did not exist when the boycott and the Code were developed.
And the problem extends far beyond infant feeding. Researchers and public health leaders use the term commercial determinants of health to describe the ways that commercial actors, products, practices, and economic systems influence health. We see these forces in tobacco, ultra-processed foods, opioids, fossil fuels, and corporate involvement in research, professional organizations, public health institutions, and policy.
The industries and products differ, but the underlying questions are similar:
- Who shapes the environments in which people make health decisions?
- Who benefits?
- How should conflicts of interest be managed?
- What systems are needed to protect public health when commercial interests and the health of communities do not align?
Strengthening What Works
The history of breastfeeding advocacy suggests some of the strategies that work: collective action; independent monitoring; transparency; strong public institutions; international cooperation; and a willingness to ask difficult questions, repeatedly, about power and accountability.
The ways of organizing, monitoring, and demanding accountability developed during the boycott remain relevant today.
During World Breastfeeding Week we celebrate breastfeeding and the people who support it. We also remember that breastfeeding does not succeed or fail because of individual mothers alone. The environments we build matter. The institutions we create matter. The commercial forces we permit to shape health decisions matter.
As we strengthen what works, we learn from how earlier generations of advocates created change and consider how the next generation can build on that work.
Coming Soon: Boycott at 50
In 2027, the Nestlé boycott will mark its 50th anniversary.
Over the coming year, Massachusetts Breastfeeding Coalition will publish a series exploring the boycott and its continuing significance for breastfeeding and public health.
The boycott began with infant feeding. Its legacy reaches far beyond it.
Naomi Bromberg Bar-Yam, PhD, has been working in maternal and child health for over 35 years as an educator, researcher, advocate, and writer. In addition to serving on the board of Massachusetts Breastfeeding Coalition, she is past president of the Human Milk Banking Association of North America (HMBANA) and is the founding director emerita of Mothers’ Milk Bank Northeast, which provides safe donor milk to hospitals and families throughout the northeastern US. Learn more about her on her LactSpeak profile.
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