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A woman kisses her baby as they wait for a nationwide simultaneous breast-feeding at suburban Paranaque city south of Manila, Philippines Wednesday May 2, 2007. The event was part of a campaign to counter advertising claims that artificial baby foods are better than breast milk.Bullit Marquez

Advertisements for infant formula can dramatically reduce breastfeeding rates, according to new research that is stirring the debate over the ethics of formula promotion.

The subject has been a heated topic in Canada and around the world for decades, with members of the medical community and other health experts saying it is responsible for serious declines in breastfeeding.

The new study, led by the World Health Organization and published in the journal Social Science and Medicine, examined whether formula advertisements in the Philippines was responsible for that country's drop in breastfeeding rates.

Researchers found that about 60 per cent of women surveyed recalled seeing a formula ad, making them twice as likely to bottle feed their babies as mothers who didn't see ads.

Rates of exclusive breastfeeding of babies up to four months of age dropped to 40 per cent in 2008 from about 47 per cent in 1998, according to the WHO.

In developed countries, the bottle versus breast debate hinges on the objections many critics have to formula companies promoting their products and giving away free samples in hospitals, as exclusive breastfeeding for the first six months of a baby's life is considered ideal.

In developing nations, the issue is much more serious. Bottle feeding in those countries has been linked to higher rates of infant deaths and other health problems because the water that is used to mix with formula can be contaminated, and many mothers may mix less than their babies need to make supplies last longer.

Despite this, formula manufacturers fight for the right to advertise in low-income countries. In 2007, when the Philippines tried to limit formula advertising, several companies selling formula took the issue to court. The court ruled against a ban on baby formula advertisements but clamped down on potentially misleading health claims and increased regulation of such ads.

Should formula advertisements be banned in the developing world, or even countries such as Canada?