Influencer’s infant formula ad sparks debate about ‘combo feeding’

Posts also highlighted how abortion bans impact people experiencing miscarriage.

This past week, an Instagram post from a social media influencer advertising infant formula generated the largest spike in online conversation about reproductive health, with some comments questioning whether formula is healthy for infants. Other posts discussed how abortion bans impact health care for people experiencing miscarriage and shared unfounded concerns about the safety of over-the-counter birth control pills.

In light of these conversations, public health communicators may share information about breastfeeding—sometimes called chestfeeding—and formula feeding, explain how abortions and miscarriages use the same medications and procedures, and circulate information about over-the-counter birth control pills and their safety.

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What’s trending nationally in reproductive health conversation:

On October 16, a social media influencer with nearly 800,000 Instagram followers shared a post about her participation in an advertising campaign for an infant formula brand. In the post, she explained that she had been exclusively breastfeeding her infant but needed to begin “combo feeding” with breast milk and formula when her doctor expressed concern about her milk supply and she also had to return to work. She stated that the campaign “is my wholehearted endorsement of a parent’s right to feed their baby however the eff they choose.” Her post received approximately 96,500 likes and 1,000 comments as of October 22, with many comments claiming that infants should not be fed formula or should only be fed formula as a last resort. One read, “‘Going back to work’ is never a valid excuse to start forcing your baby to eat something that is not naturally and uniquely made for them.” Another read, “If your doctor had concerns about a baby gaining weight the doctor should advise the woman see a lactation consultant…This ad is unethical and further degrades public health.” However, many comments came to the influencer’s defense and shared their own positive experiences with using formula. One stated, “Formula is a valid option and I just don’t understand this vitriolic hatred of formula. It’s a lifesaver for some people-leave it alone!”

On October 14, an X user shared a post that read, “If I say, ‘My wife had an incomplete miscarriage, & was refused the abortion care she needed’ & your response is, ‘Miscarriage has nothing to do with abortion!’ You’re an idiot.” The post received approximately 1.3 million views, 41,000 likes, 5,400 reposts, and 1,000 comments as of October 22. Comments debated the similarities between miscarriage and abortion, with some arguing that miscarriage has “nothing to do with abortion.” Others correctly stated that in fact the same medications and procedures are used for both abortions and to treat people experiencing miscarriage; however, since exceptions to abortion bans are often vague, patients experiencing a miscarriage may be denied these necessary and sometimes lifesaving medical interventions due to legal concerns.

On October 21, the Biden administration proposed a change to the Affordable Care Act that would require insurance companies to cover over-the-counter birth control pills and other contraceptives—including emergency contraceptive Plan B—at no cost. If finalized, the change will go into effect next year. Several news outlets covered the announcement, and those articles were shared across multiple social media platforms. A Facebook post from NBC about the proposal received approximately 300 reactions, 20 reposts, and 350 comments as of October 22. Some comments celebrated the news, while others expressed unfounded concerns about the safety of over-the-counter birth control pills.

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Recommendations for public health professionals

Each week, the Infodemiology.com team will provide messaging recommendations in response to some of the trending narratives outlined above. These helpful tips can be used when creating content, updating web and FAQ pages, and developing strategy for messaging about reproductive health. 

Conversations about breastfeeding provide an opportunity to recirculate information about the benefits of breastfeeding. Messaging may emphasize that breast milk provides the most nutrition for babies and that exclusively breastfeeding is recommended for the first six months of a baby’s life. However, supplementing with infant formula is recommended when exclusively breastfeeding is not possible or when babies are not receiving enough nutrients from breast milk.

Communicators may also share information about increasing milk supply; pumping and storing breast milk; safe donor breast milk; preparing and using formula; and local lactation consultants, including WIC Designated Breastfeeding Experts for WIC-enrolled parents. Sharing the National Women’s Health and Breastfeeding Helpline (800-994-9662) is recommended. Communicators may also want to outline the mental health challenges that breastfeeding parents may face and recirculate information about local mental health resources. 

In light of ongoing confusion about how abortion bans impact miscarriage treatment, messaging may explain that the same medications and procedures used for abortions are sometimes used to treat people experiencing incomplete miscarriage. While some states with abortion bans have exceptions in cases when the health or life of the pregnant person is in danger, abortion bans may delay lifesaving care. Ensuring that materials outlining local abortion laws are up to date is recommended, particularly for public health departments, community organizations, and other partners in states with changing restrictions. In November, 10 states will vote on ballot measures about abortion access, so communicators should be prepared for additional questions after Election Day.

In response to safety concerns about over-the-counter birth control pills, messaging may explain that Opill, the first and only FDA-approved over-the-counter birth control pill, is safe for most people who could become pregnant. It is not recommended for people who previously had or currently have breast cancer or for people who are using another type of birth control pill, implant, patch, injection, vaginal ring, or IUD. Messaging may emphasize that no form of birth control is 100 percent effective, so birth control pills work best when they are consistently used in combination with safer sex barriers, like condoms, which also protect against sexually transmitted infections. Explaining that Opill is available at most pharmacies and online is recommended.