Malaysia faces a double burden of malnutrition that demands urgent policy action.
Nearly one in four Malaysian children under five (24 per cent) is stunted. This accounts for one of the highest rates in Southeast Asia, while obesity and diet-related non-communicable diseases (NCDs) cost the country an estimated RM70 billion annually. These twin crises are not separate problems but symptoms of the same unhealthy food environment.
The Parliamentary Special Select Committee (PSSC) on Women, Children and Community Development has rightly questioned why Malaysia continues to spend billions on sugar subsidies while investing comparatively little in protecting infant and young child nutrition.
Although the proposed targeted milk subsidies may provide short-term financial relief, they do not address the commercial practices that undermine breastfeeding and drive poor nutrition. Subsidising formula without regulating predatory marketing is like pouring water into a leaking bucket.
Malaysia should therefore move beyond voluntary industry compliance and enact legislation that criminalises violations of the national Code of Ethics for the Marketing of Infant Foods.
At the same time, the government must substantially strengthen breastfeeding support. This means expanding the Baby-Friendly Hospital Initiative (BFHI), increasing community lactation services, improving workplace breastfeeding support, ensuring access to certified lactation consultants, and providing structured antenatal breastfeeding education.
Investing in breastfeeding is among the most cost-effective public health interventions available, improving child survival, cognitive development, maternal health, and long-term economic productivity while reducing reliance on commercial breast-milk substitutes.
Breastfeeding is not simply one feeding option. It is the biological norm for human infants. Human milk is a living biological system containing antibodies, immune cells, hormones, enzymes, beneficial microbes, and thousands of bioactive compounds that continuously adapt to an infant’s changing needs.
While infant formula is an essential medical and humanitarian necessity when breastfeeding is not possible, it remains a substitute — not an equivalent — for human milk.
Public policy should therefore recognise breastfeeding as an irreplaceable public health asset deserving legal protection.
The financial burden of formula feeding is also substantial. Exclusively feeding an infant with commercial breast-milk substitutes costs RM600 to RM750 per month. For many B40 households, this can consume 30 to 50 per cent of monthly income.
This creates two harmful consequences. The first is the stunting trap. When finances become strained, some parents dilute formula to make it last longer, reducing calorie and micronutrient intake and increasing the risk of malnutrition, impaired brain development and irreversible stunting.
The second is the NCD time bomb. Formula manufacturers encourage continued brand loyalty through aggressive marketing of growing-up milks (GUMs) for children aged one to three years.
Many of these ultra-processed products contain added sugars such as sucrose, corn syrup solids and maltodextrin. Early exposure to unnecessary sugars shapes children’s taste preferences and increases their lifetime risk of obesity, diabetes, hypertension and cardiovascular disease.
Malaysia’s current safeguards are inadequate because the Code of Ethics for the Marketing of Infant Foods remains voluntary. Without legal penalties, multinational formula companies continue to exploit regulatory loopholes.
One of the most effective tactics is cross-branding. Although direct advertising of infant formula is restricted, companies heavily promote toddler milks using identical brand names, colours, mascots, and packaging across television, social media, pharmacies, supermarkets, and e-commerce platforms.
Parents naturally associate toddler products with infant formula, allowing companies to circumvent advertising restrictions and undermine breastfeeding.
Voluntary compliance has not succeeded. Formula marketing should no longer rely on corporate self-regulation. The Ministry of Health (MOH) and the PSSC should work together to implement the following key reforms.
Transform the voluntary marketing code into enforceable legislation. Manufacturers, distributors, retailers, advertisers and digital platforms that illegally market breast-milk substitutes should face substantial corporate penalties, with criminal liability where appropriate.
Significantly increase investment in breastfeeding support. This includes sustained funding for BFHI implementation, lactation services, workplace breastfeeding facilities, peer counselling, antenatal education by trained lactation consultants, and nationwide public education campaigns.
BFHI compliance should be independently monitored through regular audits, transparent reporting, effective complaint mechanisms and meaningful sanctions. Formula companies should be prohibited from promoting products, distributing samples or engaging with mothers in hospitals and primary healthcare facilities.
Prohibit cross-branding by banning shared branding, colour schemes, mascots and product names across infant formula and toddler milk products, while requiring neutral packaging that prevents indirect promotion.
Monitor and prohibit digital and algorithmic marketing of breast milk substitutes. Consistent with World Health Organization (WHO) recommendations, Malaysia should ban targeted online advertising to pregnant women and parents, influencer marketing, personalised discounts and algorithm-driven promotions.
De-commercialise paediatric health care by prohibiting formula companies from sponsoring paediatric conferences, funding nutrition research, providing gifts to healthcare professionals or distributing samples through healthcare facilities. Clinical nutrition advice must remain independent of commercial influence.
The PSSC’s proposal to redirect public spending towards child nutrition deserves support. However, subsidies alone cannot solve a crisis fuelled by aggressive commercial marketing.
Malaysia will not be able to reduce childhood stunting or reverse its growing NCD burden while allowing commercial interests to undermine breastfeeding.
Protecting children requires recognising breastfeeding as one of humanity’s most effective public health interventions. Because it is biologically irreplaceable, governments have a responsibility to shield mothers from commercial practices that distort infant feeding decisions.
That protection needs to combine legal enforcement with sustained investment in breastfeeding support and accountable implementation of the Baby-Friendly Hospital, workplace and community-based support Initiatives.
The era of voluntary guidelines has passed. Malaysia now needs legislation that places children’s health above corporate profits.
Here, the suggestion to criminalise predatory marketing of breast-milk substitutes should not be interpreted as an unfair intervention on families who need formula. It is a commitment to ensuring that commercial interests do not undermine the healthiest start in life.
Protecting breastfeeding is one of the smartest investments Malaysia can make to reduce stunting, curb NCDs, strengthen human capital and secure the nation’s future.
June Joseph is a health sociologist and Honorary Senior Fellow with the University of Queensland, focusing on breastfeeding, postpartum care, systems accountability, and governance.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
