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MAIF Agreement in Australia - ACCYPN's Submission April 2026Date:
Restricting Infant Formula Marketing in Australia – Submission
The Australian College of Children and Young People’s Nurses (ACCYPN) is the only national nursing professional organisation that has children and young people as its core focus. Through direct membership, the ACCYPN forms an influential professional body acting on behalf of children, young people, families and the nurses who care for them. ACCYPN recognises children and young people's nursing as speciality nursing practice and advocates for the speciality irrespective of the setting in which children and young people are cared for. Vision The ACCYPN will promote excellence in health care for children and young people in the context of their family and the community. Mission The ACCYPN will advocate for and facilitate the continuing development of speciality nursing practices to meet the unique needs of children and young people. The ACCYPN welcomes the opportunity to contribute to this review of the MAIF agreement strategy moving forwards. The College would welcome any further opportunities to contribute to various issues that are related to the health and wellbeing of children, young people and their families in the future. Please contact us on secretary@accypn.org.au The ACCYPN strongly supports Option 3 (Australian Government legislation aligned with the scope of the former MAIF Agreement, plus controls on retailer and/or toddler milk marketing) as the most effective path to safeguard breastfeeding and boost exclusive breastfeeding rates in Australia. We advocate for expanding the scope of the legislation to include mandatory controls and to increase the protected age to three years, thereby aligning more closely with the World Health Organisation (WHO) Code on Infant Feeding. This approach is advantageous as it ensures that all infant formula companies are engaging in ethical marketing practices – provided that the regulations are stringent enough to ensure that practices remain ethical. Through good regulation of marketing practices, consumers are able to make an informed choice based on accurate, reliable information. Additionally, it includes regulation/guidance on the marketing of infant formulas, which are an unnecessary addition to the toddler's diet. Furthermore, the College urges the government to examine other commercially marketed feeding options for toddlers, such as food pouches, bottles, and related equipment. Specifically, food pouches, which are advertised for infants over four months, require clearer labelling regarding the percentage of sugar and sodium content in relation to daily dietary requirements.
The evidence unequivocally shows that breastfeeding offers superior long-term health and wellbeing benefits for children, their mothers, and their families. A commitment to these issues will ultimately be reflected in improved population health outcomes, through a reduced risk of chronic health issues, consequently lessening the burden on future health budgets. Importantly, a balance between accessibility and appropriate use is fundamental and needs to be acknowledged and considered when developing regulations relating to infant feeding and formula marketing. We want all families that want to or need to use infant formulas to have good, unbiased information so they are able to make an informed choice on how to feed their child correctly and safely. Our position statement, "Promoting, Protecting and Supporting Optimal Nutrition in the Early Years," which outlines the supporting evidence, is attached for your reference. https://www.accypn.org.au/client_images/3915234.pdf The College strongly feels that the perception of child health needs to be elevated to national importance and as a strategy to influence and protect the Australian population's long-term health. There is clear evidence of the long-lasting effects on the health and wellbeing of children and their families when breastfeeding is successful. Money, time and effort need to be put into this area of preventative health to enhance the population's health and wellbeing in the long-term. The College is aware of the pressure for women to breastfeed (from themselves or those around them) and the distress and feelings that may be associated with the inability to do so. The aim of this legislation is to control how companies and retailers present, market and influence the use of breastmilk substitute feeds and to not make this choice more stressful for the families that have to use them. The College is also aware of the complexities of feeding infants, especially those with feeding difficulties, or those who may need to be formula fed or for expressed breastmilk to be fortified. The legislation must be implemented in a considerate way so it does not have a negative impact on the families that need to use infant formula.
Questions & Feedback 1. Impacts of marketing on perceptions and behaviours Infant feeding decisions are complex and influenced by health literacy, social determinants of health, financial insecurity, and individual family circumstances. While some families are unable to exclusively breastfeed and require access to infant formula, marketing practices play a significant role in shaping perceptions and behaviours related to infant feeding. Regulation must therefore balance accessibility for families who require formula with the need to prevent inappropriate or misleading promotion that undermines breastfeeding as the norm. Potential benefits of regulated marketing (Pros) Appropriately regulated marketing may support families who cannot exclusively breastfeed by ensuring continued accessibility to necessary products. Ethical regulation across all companies may also help maintain a competitive market, potentially keeping costs as low as possible. Where marketing is strictly regulated to ensure information is accurate, reliable, and unbiased, families are better positioned to make informed decisions without exposure to misleading or emotive messaging. Negative impacts of current marketing practices (Cons) Mainstream infant formula marketing often normalises formula use in place of breastfeeding, particularly when promoted as a convenient or equivalent option. This is especially concerning in the first six months of life, when exclusive breastfeeding provides clear health benefits. Infant formula manufacturers currently dominate infant feeding promotion, while messaging that actively supports breastfeeding remains limited outside health professional advice. The use of scientific-sounding and biased claims exaggerates formula benefits, contributes to misinformation, and undermines parental confidence—particularly among families with lower health literacy. Additionally, targeted marketing towards lower socioeconomic and vulnerable populations contributes to higher formula uptake and widening health inequities. Recommendations
2. Infant formula marketing prevalence Marketing of infant formula and related products remains widespread across digital, print, and retail environments, contributing to confusion around infant feeding and undermining efforts to promote exclusive breastfeeding for the first six months of life. In addition to overt advertising, marketing strategies that imply formula can be added to breastfeeding as a routine or benign supplement require specific consideration, as they risk normalising early formula introduction and weakening public health targets focused on exclusive breastfeeding. Further information should be gathered to better understand how and why families initiate the use of formula, including the influence of marketing messages, perceived convenience, and exposure to free samples or promotions. This evidence is essential to inform regulatory approaches that are both proportionate and effective, particularly where marketing frames formula as a routine supplement to breastfeeding rather than a substitute used when required. Current practices, which include free formula samples available online or in maternity packs, the proliferation of stage 2 and 3 formulas, and the ease of retail access, continue to contribute to misinformation and complexity in infant feeding decisions. Recommendations
3. Limitations of MAIF The voluntary nature of the current MAIF Agreement significantly limits its effectiveness in regulating infant formula marketing. The infant formula industry is highly profitable, and existing penalties for non-compliance are insufficient to deter unethical marketing. Ongoing breaches—including within professional and conference settings—highlight the inadequacy of self-regulation. There is no robust or systematic mechanism for monitoring compliance across companies and retailers. Reliance on complaints places the burden on individuals and results in delayed or inconsistent responses. Existing monitoring frameworks have also failed to keep pace with contemporary marketing practices, including digital, algorithm-driven, and AI-enabled advertising. These limitations undermine public health objectives and necessitate enforceable regulation.
4. Industry engagement with health care workers Engagement between infant formula companies and health care workers requires careful regulation to prevent conflicts of interest. Engagement should be limited to medically necessary formulas used in specific clinical circumstances. Industry sponsorship may be beneficial where it supports education relevant to clinical practice; however, sponsorship should be restricted to education related to medically indicated formulas and limited to experienced or advanced practice health care professionals capable of critically evaluating such engagement. Concerns remain regarding the promotion of breastmilk substitute formulas through scientific-sounding claims. Further research and education are required to support evidence-based guidance in complex clinical contexts, including bottle feeding and otitis media, and feeding modalities for infants and children with cleft lip and/or palate or other maxillofacial conditions. To strengthen oversight, data should be collected on the frequency and nature of industry engagement with health facilities, including visits, distribution of sponsored materials, and provision of samples to maternity units, special care nurseries, NICU, PICU, and paediatric wards.
5. Objectives of government action and rationale for intervention Government action is required to correct structural imbalances between commercial promotion and public health priorities in infant feeding. The ACCYPN suggests the following objectives of government action: Objective 1: Protect and promote breastfeeding as the normative method of infant feeding Intervention: Enforce regulation limiting marketing that undermines exclusive breastfeeding.
Objective 2: Limit inappropriate commercial influence Intervention: Replace voluntary agreements with mandatory legislation regulating marketing across all platforms. Objective 3: Ensure informed choice for families who require formula Intervention: Regulate formula information to ensure it is factual and non-promotional. Objective 4: Strengthen health workforce capability Intervention: Improve education and regulate industry engagement. Objective 5: Address environmental impacts Intervention: Incorporate sustainability considerations into regulation.
6. Policy options To address the limitations of the current MAIF Agreement and achieve the stated objectives of government action, the ACCYPN proposes the following policy options. Policy options include:
7. Implementation Considerations Implementation requires coordinated governance, robust monitoring, workforce support, clear communication, and equity-focused delivery. A designated independent regulator should oversee compliance across retail, digital, and health care environments. Monitoring systems should support enforcement, evaluation, and policy refinement. Communication strategies must minimise stigma for families who require formula while reinforcing breastfeeding as the norm. Equity considerations and environmental impacts should be embedded throughout implementation.
8. Next Steps
Thank you for the opportunity to contribute to this work. Jacquie Burton, RN, RM, PGD - Paeds Chairperson On behalf of the ACCYPN Board and Membership
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