Prevalence, duration, and content of television advertisements for breast milk substitutes and commercially produced complementary foods in Phnom Penh, Cambodia and Dakar, Senegal

Abstract

Promotion of breast milk substitutes (BMS) and inappropriate marketing of commercially produced complementary foods (CPCF), including through television, can negatively influence infant and young child feeding. The World Health Organization International Code of Marketing of Breast‐milk Substitutes and subsequent relevant World Health Assembly (WHA) resolutions prohibit such advertising and require manufacturers and distributors to comply with its provisions; however, such regulations at national level may vary. Advertisements require Ministry of Health approval in Cambodia but are not regulated in Senegal. Television stations were monitored for 13 months in Phnom Penh and for 3 months in Dakar to assess advertisements for BMS and CPCF. Ten television channels (out of 16) in Phnom Penh and four (out of 20) in Dakar aired advertisements for BMS. Three and five channels, respectively, aired advertisements for CPCF. All BMS advertised in Phnom Penh were for children over 1 year of age. BMS products for children 6+ months of age and 1+ years of age were advertised in Dakar. Average air time for BMS advertisements was 189.5 min per month in Phnom Penh and 29.7 min in Dakar. Air time for CPCF advertisements averaged 3.2 min per month and 13.6 min, respectively. Fewer than half of BMS advertisements and three quarters of CPCF advertisements explicitly stated an age of use for products. Nutrition and health claims were common across BMS advertisements. This study illustrates the need to adopt, regulate, monitor, and enforce legislation prohibiting BMS promotion, as well as to implement regulations to prevent inappropriate promotion of CPCF.

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

“…In Champeny, Pries, et al (), mothers were interviewed about their use of BMS prior to discharge after delivery in Phnom Penh and Kathmandu Valley maternal health facilities. In both sites, over half of infants were fed BMS while in the health facility.…”

Pilot implementation of a monitoring and enforcement system for the International Code of Marketing of Breast‐milk Substitutes in Cambodia

“…A 2014 survey found 86% of mothers of children less than 24 months old had observed commercial promotions for BMS and 19% observed BMS product logos on health facility equipment (Pries et al, ). Reviews of television advertisements airing in Cambodia indicate increasing BMS promotions: approximately 3 hours per month of BMS advertisement time on television in 2013–2014, growing to 20 hours per month of advertisement time in 2015–2016 (Alive & Thrive, ; Champeny et al, ). Commercial promotions of BMS products contribute to suboptimal breastfeeding practices (Piwoz & Huffman, ; Rollins et al, ).…”

Commercial growing up milks: usage frequency and associated child and demographic factors across four Asia Pacific countries

“…The Asian rates of GUM feeding parallel the IF feeding in Asian countries 24 with breastmilk substitute sales increasing across the region 23 . The packaging and labelling of GUMs has been shown to be similar across product ranges, including IFs, FUFs and GUMs, leading to confusion among consumers regarding the difference between products 6,7,8 . This has the potential for consumers to misguidedly assume that the following formula is the required next step in child feeding.…”

“…The rising demand for GUMs is being driven by growth in the Asia Pacific region, particularly China, Indonesia, Vietnam and Thailand 2,5 . The lack of regulation for GUM content or advertising has allowed commercial milk companies to promote their GUM products and cross‐promote IFs and FUFs, which are more regulated 6,7,8 . The increasing wealth of Asian countries, along with open markets, growing populations, often limited food legislation and nutrition transition, provides market opportunities for multinational food companies promoting ultra‐processed foods 1 .…”

“…The lack of regulations for the marketing of GUMs, and their subsequent worldwide promotion, is likely to be leading to an increased use of these products and cross‐promotion to similarly packaged IFs, raising concerns about their impact on the health of children 6,8 . Furthermore, the expansion and promotion of product lines targeting older children, teenagers, adults and older adults in countries with relatively strong regulations relating to the marketing of breast milk substitutes allows cross‐promotion to indirectly promote products ‘protected’ under the regulations.…”