Violations of the International Code of Marketing of Breast‐milk Substitutes in Mexico

Abstract

This study estimated the prevalence of violations of the International Code of Marketing of Breast-milk Substitutes (BMS) and subsequent resolutions of the World Health Assembly (Code) at health facilities, points of sale (POS), and on BMS labelling and media in Mexico. We carried out a cross-sectional survey among 693 mothers with children aged less than 24 months and 48 health providers at public and private health facilities in two states of Mexico. Observational assessment at 20 POS and the health facilities was conducted as well as an analysis of labels on BMS products for sale. Women attending public and private health facilities reported receiving free BMS samples in the previous 6 months (11.1%), and about 80% reported seeing BMS promotion in the mass media. Health providers reported contact with BMS manufacturer representatives in the previous 6 months (15.5%), and only 41.6% of the health providers had knowledge of the Code. BMS promotions were identified at nearly all POS. Analysis of 190 BMS labels showed that 30% included pictures/text idealizing the use of BMS, and all labels incorporated health and nutrition claims. Violations of the Code are prevalent within the health services, POS, and labelling of BMS products. The high percentage of health providers with no knowledge of the Code calls for action at national level to better disseminate and comply with the Code. A transparent, free from commercial influence, and continual monitoring system for Code compliance is needed, including a follow-up component on sanctions for contraventions of the Code.

Barriers and facilitators to breastfeeding during the immediate and one month postpartum periods, among Mexican women: a mixed methods approach

“…Public and private hospitals from rural and urban communities in the States of Chihuahua and Puebla, Mexico. Detailed criteria for State selection, are explained elsewhere [ 13 ]. Briefly, states were selected as a follow-up of a 2016 study about violations of the Code [ 13 ].…”

“…However, the regulatory framework to pressure the mass media and the infant formula industry was only recently established [ 12 ], and healthcare centers face difficulties to comply with BMS marketing ethics and regulations. A recent study provided evidence of violations to the Code in Mexico [ 13 ].…”

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

“…In 1981, the World Health Assembly adopted the International Code of Marketing of Breast‐milk Substitutes, which proscribes the promotion of BMS, as well as other food and beverage products when marketed or otherwise represented to be suitable as a partial or total replacement of breastmilk. However, these provisions have been inconsistently implemented and enforced (Mcfadden, Kenney‐muir, Whitford, & Renfrew, ; Robinson, Buccini, Curry, & Perez‐Escamilla, ; WHO, ), leaving caregivers exposed to commercial marketing for BMS through many promotional avenues and indicating a need for more robust monitoring systems (Hernández‐Cordero et al, ). Recent analysis suggests that full implementation of the Code is necessary but not sufficient to significantly improve breastfeeding outcomes in the absence of other enabling factors (Robinson et al, ).…”

Association Between Breastfeeding and Child Stunting in Mexico

“…improve the training of healthcare providers to increase the quality of services provided for mothers and their children; enable food systems to provide healthy and innocuous foods; and improve or provide safe WASH systems where not yet available [10,12,20,29,31,40,45,46]. Pre-and post-natal efforts should also focus on households with moderate to severe food insecurity and in families with a higher number of children aged <5 years.…”