Marketing and infant and young child feeding in rapidly evolving food environments

Zehner, Elizabeth; Champeny, Mary; Huffman, Sandra L.

doi:10.1111/mcn.12810

Cited by 8 publications

(9 citation statements)

References 34 publications

(41 reference statements)

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“…Third, routine exposure to BMS promotion in various channels can undermine breastfeeding and influence social norms in favor of artificial feeding [ 7 , 23 , 49 , 50 , 51 ]. Similar to other studies in the region and globally [ 23 , 32 , 50 , 52 , 53 , 54 ], we found that the BMS industry aggressively markets BMS products to women during pregnancy, at the time of birth, and during the postpartum period both in-person and on social media. The fact that almost 90% of the women brought BMS to the maternity facility at the time of childbirth or purchased it at or near by the facility suggests insufficient self-efficacy and unsupportive social norms related to the sufficiency of breastmilk in the first days of an infant’s life.…”

Section: Discussionsupporting

confidence: 87%

Implementation of the Code of Marketing of Breast-Milk Substitutes in Vietnam: Marketing Practices by the Industry and Perceptions of Caregivers and Health Workers

Nguyen¹,

Tran

Cashin³

et al. 2021

Nutrients

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Background: The promotion of breastmilk substitutes (BMS) is an important barrier to successful breastfeeding. Objective: To examine the enactment and implementation of the Code of Marketing of Breast-Milk Substitutes (the Code) in Vietnam with a focus on marketing practices by the baby food industry and perceptions of caregivers, health workers, and policy makers. Methods: From May to July 2020, we conducted a mixed-method, cross-sectional study including a survey of 268 pregnant women and 726 mothers of infants aged 0–11 months and in-depth interviews with a subset of interviewed women (n = 39), policy makers, media executives, and health workers (n = 31). Results: In the previous 30 days, two mothers (out of 726) participating in the quantitative survey reported that health workers had recommended BMS, at private hospitals in both cases. In-depth interviews with health workers showed that hospitals have internal procedures to prevent the promotion of BMS by health workers. However, companies employed representatives to promote products not covered under the Code (e.g., commercial milk formula for pregnant women) at antenatal care visits and by gaining contact information from women and using this information to promote BMS outside the hospital, often on social media. In the 30 days preceding the survey, one-fifth of pregnant women were exposed to promotions of commercial milk formula for pregnant women and 7.1% to promotions of BMS. Among mothers of infants, 7.3% and 10.7% of respondents with infants aged 0–5 and 6–11 months, respectively, were exposed to some form of BMS promotion in the past 30 days. Around the time of birth, parents commonly brought BMS to maternity facilities (52.5%) or purchased it nearby (35.4%). Conclusions: Although Vietnam has a strong regulatory environment for the protection, promotion, and support of breastfeeding, there are implementation, monitoring, and enforcement gaps. Stronger enforcement of national policies to regulate the presence of BMS industry representatives in health facilities—both public and private—and the promotion of BMS products on digital platforms are needed.

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Section: Discussionsupporting

confidence: 87%

Implementation of the Code of Marketing of Breast-Milk Substitutes in Vietnam: Marketing Practices by the Industry and Perceptions of Caregivers and Health Workers

Nguyen¹,

Tran

Cashin³

et al. 2021

Nutrients

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“…At the country-level, subsidiary and affiliate firms often fail to comply with both national regulations and corporate policies [ 129 ]. Since 1991, IBFAN [ 130 ], and several others [ 39 , 131 , 132 ], have reported extensive Code violations across many countries. These reports are often reviewed and contested by the companies, who consider compliance with local laws and regulations, or their corporate policies only, and not with The Code itself [ 133 ].…”

Section: Resultsmentioning

confidence: 99%

“…None apply to products for children beyond 12 months of age, nor address the issue of crosspromotion (see the later section on marketing strategies) [129]. At the country-level, subsidiary and affiliate firms [39,131,132], have reported extensive Code violations across many countries. These reports are often reviewed and contested by the companies, who consider compliance with local laws and regulations, or their corporate policies only, and not with The Code itself [133].…”

Section: Vietnam Preventing the Expanded Scope Of Marketing Regulationsmentioning

confidence: 99%

Globalization, first-foods systems transformations and corporate power: a synthesis of literature and data on the market and political practices of the transnational baby food industry

et al. 2021

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Background The global milk formula market has ‘boomed’ in recent decades, raising serious concerns for breastfeeding, and child and maternal health. Despite these developments, few studies have investigated the global expansion of the baby food industry, nor the market and political practices corporations have used to grow and sustain their markets. In this paper, our aim is to understand the strategies used by the baby food industry to shape ‘first-foods systems’ across its diverse markets, and in doing so, drive milk formula consumption on a global scale. We used a theoretically guided synthesis review method, which integrated diverse qualitative and quantitative data sources. Results Global milk formula sales grew from ~US$1.5 billion in 1978 to US$55.6 billion in 2019. This remarkable expansion has occurred along two main historical axes. First, the widening geographical reach of the baby food industry and its marketing practices, both globally and within countries, as corporations have pursued new growth opportunities, especially in the Global South. Second, the broadening of product ranges beyond infant formula, to include an array of follow-up, toddler and specialized formulas for a wider range of age groups and conditions, thereby widening the scope of mother-child populations subject to commodification. Sophisticated marketing techniques have been used to grow and sustain milk formula consumption, including marketing through health systems, mass-media and digital advertising, and novel product innovations backed by corporate science. To enable and sustain this marketing, the industry has engaged in diverse political practices to foster favourable policy, regulatory and knowledge environments. This has included lobbying international and national policy-makers, generating and deploying favourable science, leveraging global trade rules and adopting corporate policies to counter regulatory action by governments. Conclusion The baby food industry uses integrated market and political strategies to shape first-foods systems in ways that drive and sustain milk formula market expansion, on a global scale. Such practices are a major impediment to global implementation of the International Code of Marketing of Breastmilk Substitutes, and other policy actions to protect, promote and support breastfeeding. New modalities of public health action are needed to negate the political practices of the industry in particular, and ultimately to constrain corporate power over the mother-child breastfeeding dyad.

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“…Over the last decade, there has been substantial growth in the processed foods market in South-East Asia, including commercially produced complementary foods (CPCF), which have gained popularity due to their convenience and aggressive promotion (6)(7)(8) . Total sales of CPCF in the Philippines in 2020 were over US$ 30 million, having grown 10 % between 2015 and 2020 (9) .…”

mentioning

confidence: 99%

Nutrient profiles of commercially produced complementary foods available in Cambodia, Indonesia and the Philippines

Bassetti

Zehner

Mayhew

et al. 2022

Public Health Nutr.

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Objective: To assess the nutritional suitability of commercially produced complementary foods (CPCF) marketed in three South-East Asian contexts. Design: Based on label information declared on the products, nutrient composition and content of CPCF were assessed against the WHO Europe nutrient profile model (NPM). The proportion of CPCF that would require a ‘high sugar’ warning was also determined. Setting: Khsach Kandal district, Cambodia; Bandung City, Indonesia; and National Capital Region, Philippines Participants: CPCF products purchased in Cambodia (n=68) and Philippines (n=211) in 2020, and Indonesia (n=211) in 2017. Results: Only 4.4% of products in Cambodia, 10.0% of products in Indonesia, and 37.0% of products in the Philippines fully complied with relevant WHO Europe NPM nutrient composition requirements. Sixteen percent of CPCF in Cambodia, 27.0% in Indonesia, and 58.8% in the Philippines contained total sugar content levels that would require a ‘high sugar’ warning. Conclusions: Most of the analyzed CPCF were not nutritionally suitable to be promoted for older infants and young children based on their nutrient profiles, with many containing high levels of sugar and sodium. Therefore, it is crucial to introduce new policies, regulations and standards to limit the promotion of inappropriate CPCF in the South-East Asia region.

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Marketing and infant and young child feeding in rapidly evolving food environments

Cited by 8 publications

References 34 publications

Implementation of the Code of Marketing of Breast-Milk Substitutes in Vietnam: Marketing Practices by the Industry and Perceptions of Caregivers and Health Workers

Implementation of the Code of Marketing of Breast-Milk Substitutes in Vietnam: Marketing Practices by the Industry and Perceptions of Caregivers and Health Workers

Globalization, first-foods systems transformations and corporate power: a synthesis of literature and data on the market and political practices of the transnational baby food industry

Nutrient profiles of commercially produced complementary foods available in Cambodia, Indonesia and the Philippines

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