Media audit reveals inappropriate promotion of products under the scope of the International Code of Marketing of Breast-milk Substitutes in South-East Asia

Vinje, Kristine Hansen; Phan, Linh Thi Hong; Nguyen, Tuan T; Henjum, Sigrun; Ribe, Lovise Omoijuanfo; Mathisen, Roger

doi:10.1017/s1368980016003591

Cited by 36 publications

(48 citation statements)

References 20 publications

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“…The results of this study are consistent with and advance the knowledge of previous studies related to the Code and the increasing use of breastmilk substitutes worldwide (Baker et al, ; Piwoz & Huffman, ; Vinje et al, ). The types of violations reported by key informants have been described in the literature as damaging to breastfeeding outcomes, namely, interactions with health professionals, cross promotion, and the use of social media channels for product advertisement (Almroth, Arts, Quang, Hoa, & Williams, ; Cheung, ; Coutsoudis, Coovadia, & King, ; Duong et al, ; Liu, Dai, Xie, & Chen, ; Morrow, ; Piwoz & Huffman, ; Pries et al, ; Tang et al, ; Vinje et al, ). The notion of the Code as necessary but insufficient alone is consistent with other studies.…”

Section: Discussionsupporting

confidence: 92%

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The World Health Organization Code and exclusive breastfeeding in China, India, and Vietnam

Robinson¹,

Buccini²,

Curry

et al. 2018

Maternal & Child Nutrition

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Promoting exclusive breastfeeding (EBF) is a highly feasible and cost-effective means of improving child health. Regulating the marketing of breastmilk substitutes is critical to protecting EBF. In 1981, the World Health Assembly adopted the World Health Organization International Code of Marketing of Breastmilk Substitutes (the Code), prohibiting the unethical advertising and promotion of breastmilk substitutes. This comparative study aimed to (a) explore the relationships among Code enforcement and legislation, infant formula sales, and EBF in India, Vietnam, and China; (b) identify best practices for Code operationalization; and (c) identify pathways by which Code implementation may influence EBF. We conducted secondary descriptive analysis of available national-level data and seven high level key informant interviews. Findings indicate that the implementation of the Code is a necessary but insufficient step alone to improve breastfeeding outcomes. Other enabling factors, such as adequate maternity leave, training on breastfeeding for health professionals, health systems strengthening through the Baby Friendly Hospital Initiative, and breastfeeding counselling for mothers, are needed. Several infant formula industry strategies with strong conflict of interest were identified as harmful to EBF. Transitioning breastfeeding programmes from donor-led to government-owned is essential for long-term sustainability of Code implementation and enforcement. We conclude that the relationships among the Code, infant formula sales, and EBF in India, Vietnam, and China are dependent on countries' engagement with implementation strategies and the presence of other enabling factors.

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Section: Discussionsupporting

confidence: 92%

“…Pries et al, 2016;Tang et al, 2014;Vinje et al, 2017). The notion of the Code as necessary but insufficient alone is consistent with other studies.…”

supporting

confidence: 90%

The World Health Organization Code and exclusive breastfeeding in China, India, and Vietnam

Robinson¹,

Buccini²,

Curry

et al. 2018

Maternal & Child Nutrition

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“…Evidence shows that caregivers in many settings struggle to correctly distinguish between similarly branded BMS products (Berry, Jones, & Iverson, ; Cattaneo et al, ), which can lead to inappropriate feeding. The use of similar branding, pictures, and logos on BMS across a wide age range has been described as detrimental to the effectiveness of national restrictions on BMS advertising (Vinje et al, ). Recommendation 5 of the World Health Organization's Guidance on Ending the Inappropriate Promotion of Foods for Infants and Young Children prohibits any strategies to cross promote foods for infants and young child feeding with BMS (World Health Organization, ).…”

Section: Discussionmentioning

confidence: 99%

“…A scan of mass media across Cambodia, also carried out with Indochina Research, found about 20 min of BMS advertising each day across 10 channels with an average estimated advertising expenditure of US$205,536 (Oslo and Ankershus University College of Applied Siences & Alive & Thrive, ). BMS television advertising was common in Indonesia, Myanmar, Thailand, Cambodia, and Vietnam in 2015–2016 (Vinje et al, ), with numerous products advertised and a high frequency of these advertisements. In Indonesia and Thailand, products for young children 12+ months were observed in advertisements, whereas in Myanmar, Cambodia, and Vietnam, they were for young children 24+ months.…”

Section: Discussionmentioning

confidence: 99%

“…Evidence shows that caregivers in many settings struggle to correctly distinguish between similarly branded BMS products (Berry, Jones, & Iverson, 2010;Cattaneo et al, 2015), which can lead to inappropriate feeding. The use of similar branding, pictures, and logos on BMS across a wide age range has been described as detrimental to the effectiveness of national restrictions on BMS advertising (Vinje et al, 2017). Cambodia, and Vietnam in 2015-2016(Vinje et al, 2017, with numerous products advertised and a high frequency of these advertisements.…”

Section: Advertising Of Cpcfmentioning

confidence: 99%

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

Champeny

Kroeun

Diop

et al. 2019

Maternal & Child Nutrition

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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.

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

et al. 2022

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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.

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Media audit reveals inappropriate promotion of products under the scope of the International Code of Marketing of Breast-milk Substitutes in South-East Asia

Cited by 36 publications

References 20 publications

The World Health Organization Code and exclusive breastfeeding in China, India, and Vietnam

The World Health Organization Code and exclusive breastfeeding in China, India, and Vietnam

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

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

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