Is unimpeded marketing for breast milk substitutes responsible for the decline in breastfeeding in the Philippines? An exploratory survey and focus group analysis

Sobel, Howard; Iellamo, Alessandro; Raya, René R.; Padilla, A; Olivé, Jean-Marc; Nyunt-U, Soe

doi:10.1016/j.socscimed.2011.08.029

Cited by 71 publications

(95 citation statements)

References 17 publications

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“…3 A larger percentage of Asians in the military are Filipino compared to in the civilian population [28] and this is also the case in our data. While we can only speculate, recent research has shown that infant formula lobbying in the Philippines has been linked to lowered breastfeeding rates among Filipino women [29].…”

Section: Dependent Variablesmentioning

confidence: 84%

Do Black–White Racial Disparities in Breastfeeding Persist in the Military Community?

Lundquist

Barfield³

et al. 2014

Matern Child Health J

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We conduct a comparative analysis of breastfeeding behavior between military and civilian-affiliated mothers. Our focus is on African American mothers among whom breastfeeding rates are lowest. The military context may mitigate conditions associated with low breastfeeding prevalence by (a) providing stable employment and educational opportunities to populations who face an otherwise poor labor market and (b) providing universal healthcare that includes breastfeeding consultation. Using pregnancy risk assessment monitoring system (PRAMS) data for which we received special permission from each state to flag military affiliation, we analyze civilians and military affiliate in breastfeeding initiation using logistic regression and breastfeeding duration using Cox proportional hazard analysis. We find that breastfeeding is more prevalent among all women in the military setting and that the blackwhite gap in breastfeeding duration common among civilians is significantly reduced among military affiliates. Breastfeeding is a crucial component of maternal and child health and eliminating racial disparities in its prevalence is a public health priority. This study is the first to identify the military as an important institutional context that deserves closer examination to glean potential policy implications for civilian society.

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Section: Dependent Variablesmentioning

confidence: 84%

Do Black–White Racial Disparities in Breastfeeding Persist in the Military Community?

Lundquist

Barfield³

et al. 2014

Matern Child Health J

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“…Mendoza (16) noted that breast-milk substitute promotional materials have detrimental effects on breast-feeding. Another study by Sobel et al (17) found that mothers who have seen breast-milk substitute promotions are less likely to breast-feed over a longer period.…”

Section: Discussionmentioning

confidence: 99%

Violations of the International Code of Marketing of Breast-milk Substitutes: Indonesia context

Hidayana¹,

Februhartanty

Parady

2016

Public Health Nutr.

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Objectives: To measure compliance with the International Code of Marketing of Breast-milk Substitutes ('the Code') in Indonesia. Design: The study was a cross-sectional survey using the Interagency Group on Breastfeeding Monitoring protocol. Setting: Public and private health facilities in six provinces on Java island in Indonesia. Subjects: A total of 874 women (382 pregnant women and 492 breast-feeding mothers of infants below 6 months) and seventy-seven health workers were recruited from eighteen participating health facilities. The study also analysed a total of forty-four labels of breast-milk substitute products, twenty-seven television commercials for growing-up milk (for children >12 months) of nine brands and thirty-four print advertisements of fourteen brands. Results: The study found that 20 % of the women had received advice and information on the use of breast-milk substitutes and 72 % had seen promotional materials for breast-milk substitutes. About 15 % reported receiving free samples and 16 % received gifts. Nearly a quarter of the health workers confirmed receiving visits from representatives of breast-milk substitute companies. Two health workers reported having received gifts from the companies. The most common labelling violations found were statements or visuals that discouraged breastfeeding and the absence of mention about the consideration of local climate in the expiration date. Conclusions: Violations of the Code by health workers, breast-milk substitute companies and their representatives were found in all provinces studied. A regular monitoring system should be in place to ensure improved compliance with and enforcement of the Code.

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“…In our study we observed that even when participants knew about formula costs, the idea that giving formula gives you a higher social status persists, resulting in people thinking that you are wealthy if you will try to use formula. In other studies (54,55) it has also been noted that even when women are lowincome, the ones who provide formula do not think that the monetary cost is important.…”

Section: Status/costmentioning

confidence: 98%

‘Life does not make it easy to breast-feed’: using the socio-ecological framework to determine social breast-feeding obstacles in a low-income population in Tijuana, Mexico

Bueno-Gutierrez

Chantry

2015

Public Health Nutr.

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Objective: Breast-feeding rates reflect sociodemographic discrepancies. In Mexico, exclusive breast-feeding under 6 months of age has deteriorated among the poor, rural and indigenous populations from 1999 to 2012. Our objective of the present study was to identify the main social obstacles to breast-feeding in a low-income population in Tijuana, Mexico. Design: Qualitative study using a socio-ecological framework for data collection. Setting: Low-income communities in Tijuana, Mexico. Subjects: Mothers (n 66), fathers (n 11), grandparents (n 27) and key informants (n 25). Results: One hundred and twenty-nine individuals participated in the study: six focus groups (n 53) and fifty-one interviews among mothers, fathers and grandparents; and twenty-five interviews among key informants. Seven social themes were identified: (i) embarrassment to breast-feed in public; (ii) migrant experience; (iii) women's role in society; (iv) association of formula with higher social status; (v) marketing by the infant food industry; (vi) perception of a nonbreast-feeding culture; and (vii) lack of breast-feeding social programmes. Conclusions: Socio-structural factors influence infant feeding practices in lowincome communities in Tijuana. We hypothesize that messages emphasizing Mexican traditions along with modern healthy practices could help to re-establish and normalize a breast-feeding culture in this population. The target audience for these messages should not be limited to mothers but also include family, healthcare providers, the work environment and society as a whole. Keywords Breast-feedingObstacles Low income Socio-ecological framework Breast-feeding practices have improved in the last decades in most of Latin America (1)(2)(3) . Exclusive breast-feeding (EBF) under 6 months of age has increased greatly in Brazil, Colombia and Peru. However in other countries, such as Mexico and the Dominican Republic, prevalence of EBF under 6 months of age has decreased (3,4) . Despite improvements, only in five of nineteen Latin American countries with nationally representative data on trends in EBF over a 10-20 year period do >50 % of mothers exclusively breast-fed babies under 6 months of age (1) . Table 1 depicts rates of EBF under 6 months from Latin America including Tijuana.In the last decades, changes in breast-feeding prevalence in Latin America have shown less improvement in population subgroups whose children are most at risk for mortality and increased morbidity from not being breast-fed, such as poorly educated women with little access to health care (5,6) . In Mexico, EBF under 6 months deteriorated among the poor (33·5 % to 16·6 %), rural (32·7 % to 18·5 %) and indigenous (46 % to 27·5 %) populations from 1999 to 2012 (7,8) . Breast-feeding rates in Mexico are one of the lowest of Latin America with 14·4 % of EBF under 6 months of age (1) . Particularly in North Mexico, there is a lower prevalence of EBF under 6 months of age (10·6 %) than the national average in 2012 (4,9) . There are no data with EBF rates in...

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Is unimpeded marketing for breast milk substitutes responsible for the decline in breastfeeding in the Philippines? An exploratory survey and focus group analysis

Cited by 71 publications

References 17 publications

Do Black–White Racial Disparities in Breastfeeding Persist in the Military Community?

Do Black–White Racial Disparities in Breastfeeding Persist in the Military Community?

Violations of the International Code of Marketing of Breast-milk Substitutes: Indonesia context

‘Life does not make it easy to breast-feed’: using the socio-ecological framework to determine social breast-feeding obstacles in a low-income population in Tijuana, Mexico

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