TY - JOUR T1 - Babies before business: protecting the integrity of health professionals from institutional conflict of interest JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2022-009640 VL - 7 IS - 8 SP - e009640 AU - Genevieve Ellen Becker AU - Constance Ching AU - Tuan T Nguyen AU - Jennifer Cashin AU - Paul Zambrano AU - Roger Mathisen Y1 - 2022/08/01 UR - http://gh.bmj.com/content/7/8/e009640.abstract N2 - Summary boxThe commercial milk formula industry’s duty to maximise profits conflicts with the health system’s duty to protect health and to support breastfeeding.The marketing tactics and relationships with the commercial milk formula industry including financial or material support, sponsorship of training or research and advertising in journals or at events contribute to conflicts of interest within the health system.Employers of health workers, academic institutions, professional associations and governments all have a duty of care to protect health systems from predatory marketing and to facilitate individual health workers to practice in an ethical manner.National regulatory measures to implement and ensure monitoring of compliance with the International Code of Marketing of Breast-milk Substitutes protect health workers in addition to children and their families.Manufacturers and distributors of commercial milk formula (CMF), or breast milk substitutes (BMS), a US$ 55 billion industry,1 have a duty to their shareholders to maximise sales. Marketing increases CMF sales—but reduces breastfeeding. The health system and those who work within it have a primary obligation to preserve and improve health outcomes. Fulfilling this obligation requires that breastfeeding is protected, supported and promoted. These two interests—maximising CMF sales and protecting, supporting and promoting breastfeeding—directly conflict with each other. Conflicts of interest (COI) arise within practices such as sponsorship and funding that bind companies and health systems together.2 In these situations, professional judgement concerning a primary interest (unequivocal support for breastfeeding) tends to be unduly influenced by a secondary interest (sponsorship by or partnership with industry).3 This conflict is even more evident when CMF marketing targets the health system itself.Infant and young child feeding (IYCF) practices have lifelong effects on the child, the mother, the family, the wider community and on environmental sustainability. As highlighted in the recent report from the World Health Organization (WHO) … ER -