The U.S. infant formula industry: is direct-to-consumer advertising unethical or inevitable?

Throughout their history, U.S. based infant formula companies have promoted their products as though they required a prescription. This form of marketing is called "ethical" promotion, which focuses on gaining a physician to parent recommendation for a brand of infant formula. Until Nestle's entry into the U.S. infant formula market in 1988, there was little direct-to-consumer promotion of infant formula. This article provides a background on the history of infant formula practices in the United States and then focuses on a descriptive model to explain how mothers' make their infant formula selection. Finally, we offer suggestions for the "ethical" marketers of infant formula.