An exploration of pregnant women and mothers’ attitudes, perceptions and experiences of formula feeding and formula marketing, and the factors that influence decision-making about infant feeding in South Africa

BMC Public Health

Silondile Luthuli¹  Christiane Horwood¹  Lyn Haskins¹  Gillian Kingston²  Catherine Pereira-Kotze³  Tanya Doherty⁴  Gilbert Tshitaudzi⁵  Sithembile Dlamini-Nqeketo⁶ 

[1]Centre for Rural Health, University of KwaZulu-Natal, Durban, South Africa

[2]M&C Saatchi World Services, London, UK

[3]King’s Business School, Kings’ College London, London, UK

[4]School of Public Health, University of the Western Cape, Cape Town, South Africa

[5]School of Public Health, University of the Western Cape, Cape Town, South Africa

[6]Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa

[7]UNICEF, Pretoria, South Africa

[8]World Health Organization, Pretoria, South Africa

关键词: Formula feeding;    International code of marketing of breast-milk substitutes;    Marketing;    Infant feeding practices;    Breast-milk substitutes;    Child health;    Global health;    South Africa;   

DOI  :  10.1186/s12889-022-12784-y

来源: Springer

【 摘 要 】

BackgroundDespite strong evidence showing the lifelong benefits of breastfeeding for mothers and children, global breastfeeding practices remain poor. The International Code of Marketing of Breastmilk Substitutes is an internationally agreed code of practice, adopted by the World Health Assembly in 1981, to regulate promotion of commercial formula, and is supported by legislation in many countries. However, marketing of formula remains widespread and contributes to mother’s decisions to formula feed. We present South African data from a multi-country, mixed-methods study exploring women’s decision-making about infant feeding and how this was influenced by exposure to formula marketing.MethodsUsing a consumer-based marketing approach, focus group discussions (FGDs) were conducted with pregnant women and mothers of children aged between 0 and 18 months in two urban sites in South Africa. Participants were purposively selected according to their child’s age, infant feeding practices and socioeconomic status. Ten FGDs were conducted during February 2020 with a total of 69 participants. Thematic analysis was used to analyse the data with NVivo v.12 software.ResultsDespite being encouraged by health professionals to breastfeed and intending to do so, many mothers chose to give formula in the early weeks and months of their child’s life. Mothers reported breastfeeding challenges as the most frequent reason for initiating infant formula, stating that family members and health professionals recommended formula to solve these challenges. Although participants described few advertisements for infant formula, advertisements for ‘growing-up’ formulas for older children were widespread and promoted brand recognition. Mothers experienced other marketing approaches including attractive packaging and shop displays of infant formula, and obtained information from social media and online mothers’ groups, which influenced their choice of formula brand. Mothers reported strong brand loyalty derived from previous experiences and recommendations. Health professionals frequently recommended formula, including recommending specific formula brands and specialist formulas.ConclusionGlobal formula companies use multifaceted marketing methods to promote a strong narrative portraying formula feeding as a positive lifestyle choice. Positive, coordinated efforts are required to counter pro-formula messaging and change the narrative to support breastfeeding as an aspirational choice. In particular, health professionals must stop supporting the formula industry.

【 授权许可】

CC BY