Effect of baby food marketing exposure on infant and young child feeding regimes in Bangkok, Thailand

Self Cite

Breast milk substitute (BMS) marketing harms breastfeeding and public health. To control BMS marketing, the Member States of the World Health Organization is called upon to adopt all provisions of the International Code of Marketing of Breastmilk Substitutes (the Code) into national law. In 2017, Thailand adopted many provisions of the Code through the Control of Marketing Promotion of Infant and Young Child Food Act B.E. 2560 (the Act), including the establishment of a compliance monitoring system and enforcement mechanisms. Nevertheless, recent research showed widespread violations. This study aims to assess gaps in the monitoring system and the Act's enforcement in its first three years of operation. This qualitative research study employed in-depth interviews between April and June 2020 with 34 key informants (KIs) from the Thai government, academia and civil society organisations. KIs identified gaps in six areas that could be mitigated to increase compliance with the Act. These gaps are unclear provisions on coverage of the Act; communications with retailers and the public; lack of strong direction and processes; inadequate budget allocations; skilled and confident human resources; and external factors which facilitate BMS marketing. Recommendations may be relevant for other countries and include revising and clarifying the Act, developing targeted communication strategies; providing clear monitoring direction including through setting key performance indicators related to the Act; and providing sufficient budget and training for authorised and support officers. Strengthening the health system and workplace support for breastfeeding and social marketing would also help address wider structural factors.

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Regulating the marketing of foods for infants and young children: Lessons from assessment of gaps in monitoring and enforcement in Thailand

Cetthakrikul

Banwell

Kelly

et al. 2023

Self Cite

“…These findings regarding caregivers' strong consideration of product healthiness and the influence of nutrient/health claims on CPCF purchase is supported by considerable literature on how health/nutrient claims can create a 'health halo' for consumers. Such 'health haloes' can result in overestimation of product healthfulness, enabling their overconsumption (Chandon & Wansink, 2007;Jurkenbeck et al, 2022). Findings from a range of other (both HIC/LMIC) settings have also found CPCF to often be fed due to perceptions of healthiness (Dearlove et al, 2021;Maslin & Venter, 2017;Wrottesley et al, 2021) and is concerning given that most CPCF products in Southeast Asia have been nutrient profiled as nutritionally unsuitable for promotion for older infants and young children.…”

Section: Discussionmentioning

confidence: 99%

“…CPCF consumption is highly prevalent in many LMIC contexts, replacing and often exceeding the consumption of homemade foods in some populations (Kavle et al, 2015 ; Maslin & Venter, 2017 ). Several studies in LMICs of Africa and Asia suggest that the purchase of CPCF is associated with higher socioeconomic status, with poorer families unable to afford such products (Abeshu et al, 2016 ; Cetthakrikul et al, 2022 ; Tampah‐Naah et al, 2019 ). However the converse has also been found—for example in Phnom Penh, Cambodia (Pries et al, 2017 )—highlighting the complexity and context‐specific nature of CPCF use.…”

Section: Introductionmentioning

confidence: 99%

Health first, convenience second: Caregiver perspectives of commercially produced complementary foods in five Southeast Asian capital cities

Walls,

Pries,

Chotivichien

et al. 2023

Caregivers in low‐ and middle‐income countries increasingly feed commercially produced complementary foods (CPCF) to older infants and young children—shaped by factors including industry promotion. The dynamics of CPCF consumption and caregiver knowledge, attitudes and behaviours regarding complementary feeding practices are poorly understood in these settings. We examined how caregiver knowledge/attitudes/behaviours about CPCF shape the feeding of older infants and young children in the capital cities of five countries in Southeast Asia (Bangkok, Hanoi, Jakarta, Kuala Lumpur, Manila). An online, web‐based, cross‐sectional panel survey was conducted among mothers of a child aged 6−23 months. One hundred participants were included in each of the five capital cities. Questionnaires were undertaken in the official language of each city. Data were analysed in Stata (version 17.0), using χ2 tests to examine difference between variables of interest. All mothers purchased CPCF for their youngest child aged 6−23 months at the time of survey. CPCF were commonly fed to children at least once per day, and in many of the five cities at most or every feeding. While factors such as convenience and affordability influenced CPCF purchase, mothers primarily purchased CPCF for nutritional reasons. The most common source of feeding information was health care professionals, followed by social media. CPCF are ubiquitous in the diets of older infants and young children of educated middle–upper socioeconomic status mothers in capital cities of Southeast Asia, with perceived healthiness a key driver in selecting CPCF. A strong governmental regulatory response to industry marketing/promotion will be critical to addressing CPCF appropriateness, including health and nutritional claim use.

“…With an increase in mobile phone use and internet access, there is an opportunity to potentially improve dietary quality in resource‐poor settings (Flax et al, 2022 ). At the same time, mass media can increase exposure to messaging related to commercial milk formula and other commercial complementary foods with low nutrient density in violation of WHO breastfeeding and complementary feeding guidelines (Cetthakrikul et al, 2022 ). Thus, it is important that strategies to use media to promote proper infant and young child feeding practices encompass the examination of a broad set of opportunities that are aligned with WHO guidelines.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with diet diversity among infants and young children in the Eastern and Southern Africa region

Kang

Heidkamp

Mako‐Mushaninga³

et al. 2023

This study explores common factors associated with not meeting minimum dietary diversity (MDD) among 27,072 children aged 6-23 months in Eastern and Southern Africa using data from nine Demographic and Health Surveys from 2013 to 2016.MDD was defined as consumption of more than or equals to five of eight food groups including breast milk in the past 24 h. Equity gaps were calculated as the difference in MDD prevalence between the top and bottom wealth quintiles.Logistic regression was conducted to identify common factors for not meeting MDD at the household, maternal and child levels across two or more countries to inform regional policies to improve children's diets. Kenya had the highest MDD wealth equity gap (40.4 pts), and South Africa had the smallest (14.4 pts). Equity gaps for flesh foods or eggs (up to 39.8 pp) were larger than for grain or legumes (up to 20 pp). Common risk factors for not reaching MDD included younger child age (6-11 months) (n = 9 countries), no formal maternal occupation (n = 6), not receiving vitamin-A supplementation (n = 3), younger maternal age (n = 3), lower maternal education (n = 3), no media (n = 3) or newspaper (n = 3) exposure, lower household wealth quintile (n = 3), use of nonefficient cooking fuel (n = 2), longer time to get to the water source (n = 2), not listening to the radio (n = 2) and higher birth order (n = 2). Priorities for improving MDD in the region include introducing diverse foods at a young age from 6 months with early nutrition counselling, promoting higher maternal education, increasing food purchasing power and ensuring the support of younger mothers.