Digital Marketing of Breast-Milk Substitutes: a Systematic Scoping Review

Abstract

Purpose of Review Globally, too few children are breastfed as recommended. Commercial promotion of breast-milk substitutes (BMS) is one factor undermining breastfeeding globally. Although the International Code of Marketing of BMS prohibits all forms of marketing, promotion has been observed in digital environments. We aimed to understand the scope and impact of digital marketing for the promotion of BMS. Recent Findings BMS are promoted strategically and in an integrated fashion across multiple digital channels (social media, manufacturer websites, online retailers, blogs, mobile apps and digital streaming services). Traditional marketing strategies like gifts, discounts and coupons are also disseminated digitally. Data mining, real-time direct-to-consumer advertising and partnering with peer-group social media influencers are additional avenues. Exposure to digital marketing is common. Research on the impact of digital marketing is scarce, but its negative impact on breastfeeding intention and initiation has been documented. Case reports from marketing industry press corroborate academic evidence by highlighting the benefits of digital marketing to BMS companies in recruiting new users and increasing sales. Summary To protect and promote breastfeeding, coordinated global action and strengthened national measures will be needed to implement, monitor and enforce the International Code in a digital context. Further action could include voluntary restrictions on BMS marketing by social media platforms and greater use of government-led data and health privacy regulation.

Violations of the International Code of Marketing of Breast-milk Substitutes: a multi-country analysis

“…This review also reported an increase in marketing through digital platforms and brand extensions. Digital marketing of BMS is not only common, but particularly challenging to measure [26]. As with all digital marketing, messages about specific products can be tailored to individual consumers through multiple globally used platforms.…”

Regulation of baby food marketing in Thailand: a NetCode analysis

“…By contrast, the most common violation of the Thai Act was BMS marketing to mothers, and IF product marketing was the most common violation of the Act. Recently, a review of the scope and impact of digital marketing of BMS has proposed new national and international initiatives to address this type of marketing (47) . This issue is being reviewed by WHO, to develop new guidance on restricting digital marketing (48) .…”

Methodologies for Monitoring the Digital Marketing of Foods and Beverages Aimed at Infants, Children, and Adolescents (ICA): A Scoping Review

“…The urgent call for a monitoring system for BMS and FBHFSS marketing on digital environments is given by the marketing techniques’ ability to increase consumer demand and consumption, with the corresponding risk for adequate feeding practices (e.g., breastfeeding or intake of healthy foods and beverages) [ 72 , 73 ], health consequences, and economic loss [ 74 , 75 , 76 ]. This marketing influence on purchasing decisions has also been described for tobacco and alcohol [ 77 , 78 ].…”

“…Most of the studies ( n = 13) focused on monitoring the marketing of FBHFSS targeted toward adolescents. The latter finding is of relevance, considering the influence of BMS marketing on infant feeding practices and the number of WHO Member States that have not yet adopted legal measures to implement at least some of the Code’s provisions [ 73 ]. Of the 144 member states, 28.5% (41 countries) are moderately aligned with the Code, and 22.2% (32 countries) are substantially aligned [ 11 ].…”