Informed choice or guessing game? Understanding caregivers’ perceptions and use of infant formula labelling

Abstract

ObjectiveAlthough breast-feeding is the recommended way to feed an infant, a safe and nutritious substitute for breast milk is needed for infants who are not breast-fed. Labelling information on infant formula (IF) products aims to enable caregivers (who have already made the decision to use IF) to make informed product choices. Yet, there is limited data on how caregivers understand and use the information provided on IF packaging. The present study aimed to increase understanding of caregivers’ interpretation and use of the following label elements on IF products: the nutrition information statement; the ingredients list; and statements around nutrition content and health claims.DesignQualitative data were obtained from twenty-one focus group discussions. To enable comparison of findings by education level and ethnicity, focus group participants were homogeneous with respect to educational attainment (Australian groups) or ethnic background (New Zealand groups).SettingFocus groups were conducted in metropolitan and regional areas of Australia and New Zealand.ParticipantsCaregivers (n 136) of formula-fed infants.ResultsFramework analysis revealed that caregivers commonly experience difficulties when using labelling information, particularly when trying to identify and understand key differences between products. Moreover, comparing products can be a complex task regardless of education level and ethnicity.ConclusionsFurther research is required to determine the most effective strategies for meeting information needs of caregivers and allowing easier identification and understanding of product differences. This is especially important given that the vast range of IF products across large price ranges in the market adds to the complexity of purchase decisions.

The idealisation of bottle feeding: content analysis of feeding bottles and teats packages in Uruguay

“…The packages of feeding bottles and teats are an important marketing tool and may be regarded as a relevant source of information for caregivers, as previously reported for infant formula (32) . In this context, the present study analysed the information displayed on the packages of feeding bottles and teats, commercialised in Montevideo (Uruguay).…”

“…Almost all caregivers need to rely on bottle feeding at some point to conciliate their personal life with children's feeding (10) . In such situations, the characteristics of feeding bottles and teats are expected to influence the feeding experience (32) . The instructions included on the packages of feeding bottles and teats should encourage appropriate feeding practices.…”

The Nutritional Profile and On-Pack Marketing of Toddler-Specific Food Products Launched in Australia between 1996 and 2020

“…A key aspect of the food system is on-pack marketing, which influences consumer purchases of UP and discretionary foods [ 16 , 17 , 18 , 19 , 20 , 21 ]. Consumers are often confused by claims and are potentially being misled by on-pack claims into thinking foods are healthier than they really are [ 22 , 23 , 24 ]. While it is known that the food system has evolved over time, it is unclear how the nutrition profile and on-pack marketing of toddler foods has changed as a part of this.…”

The Idealization of Infant Formula: A Longitudinal Analysis of Labels in Uruguay

“…This agrees with previous studies identifying these cues as one of the main violations of the IC in different countries across the globe (Ergin et al, 2013; Funduluka et al, 2018; Hernández-Cordero et al, 2019; Parrilla-Rodríguez & Gorrín-Peralta, 2008; Pomeranz et al, 2018). Visual and textual marketing cues on the labels of infant formula have the potential to largely influence caregivers’ infant feeding decisions, as extensively reported for food and beverages (Ares et al, 2022), and for infant formula in particular (Malek et al, 2019; Salem, 2019). These types of references may lead caregivers to believe that infant formulas are necessary for infants’ growth and development, when in fact their indiscriminate use has several risks and is not recommended (Zong et al, 2021).…”

“…It explicitly prohibits the inclusion of text or images that idealize the use of infant formula. These visual and textual elements can undermine efforts to promote breastfeeding by creating the belief that infant formula is superior or equivalent to breastfeeding, motivating caregivers to choose formula over human milk (Malek et al, 2019; Salem, 2019).…”