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1.
J Dairy Sci ; 105(8): 6670-6692, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35787324

RESUMO

Milk replacers (MR) for calves usually contain more lactose and less fat than bovine whole milk (WM). There are insufficient data to determine whether these MR formulations are optimal for calves fed at high planes of nutrition. Thus, the effect of 3 MR formulations and a WM powder were evaluated on growth, feeding behavior, and blood metabolites in 96 male Holstein calves fed ad libitum and with 45.5 ± 4.30 kg (mean ± standard deviation) BW at arrival. Calves were blocked based on arrival sequence, and randomly assigned within block to one of the 4 treatments (n = 24 calves/group): a high-fat MR (25.0% fat, dry matter basis; 22.5% protein, 38.6% lactose; 21.3 MJ/kg; HF), a high lactose MR (44.6% lactose, 22.5% protein, 18.0% fat; 19.7 MJ/kg; HL), a high protein MR (26.0% protein, 18.0% fat, 41.5% lactose; 20.0 MJ/kg; HP), and a WM powder (26.0% fat; 24.5% protein, 38.0% lactose; 21.6 MJ/kg; WP). In the first 2 wk after arrival, calves were individually housed and were fed 3.0 L of their respective liquid feed 3 times daily at 135 g/L. They were then moved to group housing and fed ad libitum until d 42 after arrival. Weaning was gradual and took place between d 43 and 70 after arrival; thereafter, calves were fed solids only. Concentrates, chopped straw, and water were available ad libitum throughout the study. Body weight was measured, and blood was collected at arrival and then weekly thereafter from wk 1 to 12. Weight gain and height were greater in HL than WP calves. In the preweaning phase, HL and HP-fed calves consumed more milk than WP, and HL-fed calves consumed more milk than HF calves. In wk 10, starter feed intakes were lower in HF calves than in the other groups. In the preweaning phase, ME intakes were the same for all treatments. This suggests that milk intakes were regulated by the energy density of the milk supplied. The percentage of calves requiring therapeutic interventions related to diarrhea was greater in WP-fed calves (29%) than HF and HL calves (4%), whereas HP (13%) did not differ with other groups. This was coupled with lower blood acid-base, blood gas, and blood sodium in WP than in MR-fed calves. Calves fed HF had greater serum nonesterified fatty acids compared with other groups, and greater serum amyloid A compared with WP and HL calves. Among the serum parameters, insulin-like growth factor-1 and lactate dehydrogenase correlated positively with ME intake and average daily gain. The high lactose and protein intakes in HL and HP calves led to greater insulin-like growth factor-1 concentrations than in WP-fed calves. Although growth differences were limited among MR groups, the metabolic profile largely differed and these differences require further investigation.


Assuntos
Substitutos do Leite , Leite , Ração Animal/análise , Animais , Peso Corporal , Bovinos , Dieta/veterinária , Comportamento Alimentar , Fator de Crescimento Insulin-Like I/metabolismo , Lactose/metabolismo , Masculino , Leite/metabolismo , Nutrientes , Pós , Desmame
2.
Andes Pediatr ; 93(3): 327-335, 2022 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-35857003

RESUMO

INTRODUCTION: In 1981, the WHO and its member countries adopted the International Code of Marketing of Breast- milk Substitutes (CODE) to regulate the marketing of infant feeding products. OBJECTIVE: To eva luate compliance with the CODE in Santiago, identifying the most frequent violations. SUBJECTS AND METHOD: The WHO protocol was applied between June and September 2017 to evaluate the CODE compliance in family health centers (CESFAM) and maternity hospitals (MH) by interviewing 451 mothers and 164 healthcare professionals. In addition, advertising of breastmilk substitutes (BMS) and CODE violations in the media, points of sale (small stores n = 70 and large stores n = 10), and labels of these products were evaluated. RESULTS: In this study, 21% of mothers of newborn infants, 52% of mothers of infants younger than six months, and 71% of mothers of infants older than six months reported receiving instructions on BMS. Exposure to advertising of BMS exceeded 80%, while 4.7% and 2.9% received free samples or discount coupons, respectively. Among healthcare professio nals, 40% from CESFAM and 75% from MH indicated visits from company representatives. Du ring the study period, we found only two television adverts and 59 advertisements on 27 websites. Frequent CODE violations in large stores were offering discounts (70%), special displays (26.5%), and 3,6% promotional gifts. Product label violations were infrequent, however, all labels presented images idealizing product use. CONCLUSIONS: CODE violations are common in Santiago, Chile. The country would benefit from adopting all the CODE's recommendations, improving oversight, and toughening penalties in case of violations.


Assuntos
Substitutos do Leite , Leite Humano , Publicidade , Chile , Feminino , Humanos , Lactente , Recém-Nascido , Marketing , Gravidez
4.
Rev Saude Publica ; 56: 70, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-35894407

RESUMO

OBJECTIVE: To analyze the receipt of sponsorships from breast-milk substitute companies by health professionals in scientific events. METHODS: Multicenter study (Multi-NBCAL) performed from November 2018 to November 2019 in six cities in different Brazilian regions. In 26 public and private hospitals, pediatricians, nutritionists, speech therapists, and a hospital manager were interviewed using a structured questionnaire. Descriptive analyses were carried out regarding the health professionals' knowledge about the Norma Brasileira de Comercialização de Alimentos para Lactentes e Crianças de Primeira Infância, Bicos, Chupetas e Mamadeiras (NBCAL - Brazilian Code of Marketing of Infant and Toddlers Food and Childcare-related Products), companies sponsoring scientific events, and material or financial sponsorships received, according to profession. RESULTS: We interviewed 217 health professionals, mainly pediatricians (48.8%). Slightly more than half of the professionals (54.4%) knew NBCAL, most from Baby-friendly Hospitals. Most health professionals (85.7%) attended scientific events in the last two years, more than half of them (54.3%) sponsored by breast-milk substitute companies, especially Nestlé (85.1%) and Danone (65.3%). These professionals received sponsorships in the events, such as office supplies (49.5%), meals or invitations to parties (29.9%), promotional gifts (21.6%), payment of the conference registration fee (6.2%) or ticket to the conference (2.1%). CONCLUSION: The infant food industries violate NBCAL by harassing health professionals in scientific conferences, offering diverse material and financial sponsorships.


Assuntos
Alimentos Infantis , Substitutos do Leite , Brasil , Aleitamento Materno , Feminino , Indústria Alimentícia , Humanos , Lactente , Marketing
5.
J Hum Lact ; 38(3): 386-391, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35684948

RESUMO

Leah Margulies was Director of the Infant Formula Program at the Interfaith Center on Corporate Responsibility in NYC from 1975 to 1985. She is a founder of the International Nestlé Boycott, Corporate Accountability (formerly INFACT), and one of the founders of the International Baby Food Action Network (IBFAN). She was hired at UNICEF in 1982 to set up the legal office for implementation of the International Code of Marketing Breast-Milk Substitutes, as part of the Baby Friendly Hospital Initiative. Previously, she was legal advisor to the Environment Unit of the United Nations Centre on Transnational Corporations. From 2006 to 2016, she was Project Director of LawHelpNY at the NYC Bar Association. Currently, she works for a legal non-profit, representing low-income Brooklynites, defending them against eviction. She is a lawyer, a second Wave Feminist, and a member of Veteran Feminists of America. She is also a musician and founding member of a pioneering women's rock band that played at the first national women's march for abortion rights in Washington, DC, 1972.


Assuntos
Aleitamento Materno , Substitutos do Leite , Feminino , Humanos , Lactente , Fórmulas Infantis , Marketing , Gravidez , Nações Unidas
6.
J Hum Lact ; 38(3): 383, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35684982
7.
J Dairy Sci ; 105(8): 7011-7022, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35691749

RESUMO

Colostrum stimulates gastrointestinal development. Similar to colostrum, transition milk (TM; the first few milkings after colostrum) contains elevated nutrient levels and bioactive components not found in milk replacer (MR), albeit at lower levels than the first colostrum. We hypothesized that feeding neonatal calves TM, compared with MR, for 4 d following colostrum at birth would further stimulate intestinal development. Holstein bull calves were fed 2.8 L of colostrum within 20 min of birth, allocated to 1 of 11 blocks based on birth date and body weight (BW), randomly assigned to MR (n = 12) or TM (n = 11) treatments within block, and fed treatments 3 times per day. Milk from milkings 2, 3, and 4 (TM) of cows milked 2 times daily was pooled by milking number and fed at 1.89 L per feeding; milking 2 was fed at feedings 2 through 5, milking 3 at feedings 6 through 8, and milking 4 at feedings 9 through 12. TM was not pasteurized and contained 17% solids, 5% fat, 7% protein, 4% lactose, and 20 g of IgG per liter on average, whereas MR (as fed) contained 15% solids, 4% protein, 3% fat, 6% carbohydrate, and no IgG. Refusals were similar, so calves fed TM consumed 1.0 Mcal of metabolizable energy per day more than those fed MR. On the morning of d 5, calves were injected i.v. with 5 mg of bromodeoxyuridine per kg of BW and slaughtered 130 min later; then, intestinal sections were excised. Feeding TM, instead of MR, doubled villus length, villus width, villus to crypt ratio, and mucosal length in all intestinal sections, increased submucosal thickness 70% in the proximal and mid jejunum, and tended to increase submucosal thickness in duodenum and ileum. Mucosal surface area was also increased in both the ileum and mid jejunum when feeding TM by 19 and 36%, respectively. Treatment did not alter crypt depth. Bromodeoxyuridine labeling was increased 50% by TM compared with MR in the cells along the epithelium of the crypts and within the villi of all sections, indicating that TM increased cell proliferation compared with MR. Calves fed TM gained more BW than calves fed MR and had improved cough, fecal, nose, and ear scores. We conclude that feeding TM for 4 d following an initial feeding of colostrum stimulates villus, mucosal, and submucosal development in all sections of the small intestine in the first few days of life and improves health and growth.


Assuntos
Substitutos do Leite , Leite , Ração Animal/análise , Animais , Animais Recém-Nascidos , Peso Corporal , Bromodesoxiuridina , Bovinos , Colostro/metabolismo , Dieta/veterinária , Feminino , Masculino , Leite/metabolismo , Gravidez , Desmame
8.
J Dairy Sci ; 105(8): 6710-6723, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35717332

RESUMO

The objectives of this study were to examine the effects of pelleted starter diets differing in starch and neutral detergent fiber (NDF) content when fed differing levels of milk replacer (MR) on nutrient digestibility, whole gastrointestinal tract fermentation, pH, and inflammatory markers in dairy calves around weaning. Calves were randomly assigned to 1 of 4 dietary treatments (n = 12 per treatment) in a 2 × 2 factorial design based on daily MR allowance and amount of starch in pelleted starter (SPS): 0.691 kg of MR per day [dry matter (DM) basis] with starter containing low or high starch (12.0% and 35.6% starch on DM basis, respectively), and 1.382 kg of MR per day (DM) with starter containing low or high starch. All calves were housed in individual pens with straw bedding until wk 5 when bedding was covered. Calves were fed MR twice daily (0700 and 1700 h) containing 24.5% crude protein (DM) and 19.8% fat (DM), and had access to pelleted starter (increased by 50 g/d if there were no refusals before weaning and then 200 g/d during and after weaning) and water starting on d 1. Calves arrived between 1 and 3 d of age and were enrolled into an 8-wk study, with calves undergoing step-down weaning during wk 7. Starting on d 35, an indwelling pH logger was inserted orally to monitor rumen pH until calves were dissected at the end of the study in wk 8. Higher SPS calves showed an increase in rumen pH magnitude (1.46 ± 0.07) compared with low SPS calves (1.16 ± 0.07), a decrease in rumen pH in wk 8 (high SPS: 5.37 ± 0.12; low SPS: 5.57 ± 0.12), and a decrease in haptoglobin in wk 8 (high SPS: 0.24 ± 0.06 g/L; low SPS: 0.49 ± 0.06 g/L). The majority of differences came from increased starter intake in general, which suggests that with completely pelleted starters the differences in starch and NDF do not elicit drastic changes in fermentation, subsequent end products, and any resulting inflammation in calves around weaning.


Assuntos
Substitutos do Leite , Leite , Ração Animal/análise , Animais , Peso Corporal , Bovinos , Dieta/veterinária , Fibras na Dieta/metabolismo , Fermentação , Trato Gastrointestinal/metabolismo , Concentração de Íons de Hidrogênio , Leite/metabolismo , Nutrientes/metabolismo , Rúmen/metabolismo , Amido/metabolismo , Desmame
10.
J Food Sci ; 87(5): 1999-2008, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35368090

RESUMO

Recently, plant-based milk substitutes, as an emerging industry, are receiving more attention. Despite that, these dairy alternatives have not been adequately studied for their functional properties. Thus, the current research was devoted to study the satiety potential through in vitro secretion of cholecystokinin (CCK) and glucagon-like peptide-1 (GLP-1), and the antioxidant capacity of these dairy alternatives after in vitro digestion. The enteroendocrine cell line, STC-1, was used to measure satiety hormones release (CCK and GLP-1) by enzyme-linked immunoassay (ELISA). Also, total phenolic and flavonoid contents and antioxidant capacity (using oxygen radical absorbance capacity [ORAC], ferric reducing antioxidant power [FRAP], and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid [ABTS] assays) were measured before and after in vitro digestion. The results demonstrated that CCK secretion was significantly (p < 0.05) higher for cow's milk (350.64 pg ml-1 ) as compared to plant-based milk substitutes. Among the plant-based milk substitutes, tiger nut milk showed the highest CCK stimulant (228.96 pg ml-1 ), followed by hazelnut milk (220.04 pg ml-1 ). Concerning GLP-1 release, the data exhibited that spelt milk was the food with the highest induction of GLP-1 hormone secretion, followed by cow's milk (910.17 and 876.59 pg ml-1 , respectively), but without any significant differences between them. total phenolic content (TPC) values strongly increased after in vitro digestion, cow's milk and soymilk being the samples with the highest TPC values after in vitro digestion (165.76 and 153.71 mg GAE/100 ml, respectively). In line with TPC values, soymilk had the highest ORAC, ABTS, and FRAP values after in vitro digestion (25.41, 8.17, and 2.51 µmol TE/ml, respectively). Thus, these dairy alternatives could be an adequate substitute for cow's milk, according to its satiety and antioxidant capacity. PRACTICAL APPLICATION: The first study deals with the efficacy of plant-based milk substitutes as satiating foods. Spelt milk was the highest stimulant for GLP-1 secretion. Tiger nut milk showed the highest CCK stimulant, followed by hazelnut milk. TPC and total antioxidant capacity increased after digestion.


Assuntos
Colecistocinina , Substitutos do Leite , Animais , Antioxidantes/análise , Bovinos , Colecistocinina/metabolismo , Digestão , Feminino , Peptídeo 1 Semelhante ao Glucagon/metabolismo , Fenóis/análise , Plantas/metabolismo
11.
BMJ Open ; 12(4): e055872, 2022 04 12.
Artigo em Inglês | MEDLINE | ID: mdl-35414555

RESUMO

OBJECTIVE: To understand the views of public and private sector health professionals on commercial milk formula, to describe their exposure to companies that market commercial milk formula within their workplaces and to describe their awareness of South African (SA) regulations. DESIGN: A qualitative study consisting of semistructured interviews. SETTING: The study was conducted in Cape Town and Johannesburg, SA. PARTICIPANTS: Forty health professionals who had regular contact with pregnant or postnatal women were interviewed between February 2020 and February 2021. RESULTS: Analysis of the interviews revealed six themes. Health professionals in the private sector reported frequent contact with industry representatives with over two-thirds reporting exposure to industry representatives to present products, provide training or sponsor educational activities. Participants held strong opinions regarding the equivalency of breastfeeding to commercial milk formula citing information from industry representatives and product packaging. Health professionals were very knowledgeable on so-called formulas for special medical purposes and these were valued as solutions to infant feeding challenges. Of the 40 health professionals interviewed, less than half (19) had ever heard of the SA regulation related to marketing of breast milk substitutes (R991). CONCLUSIONS: This study demonstrates clearly that health professionals, particularly in the private sector, are exposed to and promote the use of commercial milk formula among SA women. The findings of this study should be used to catalyse policy responses, social movements, consumer and professional association action to strengthen monitoring and enforcement of the Code regulations in order to protect breastfeeding and support the optimal health and well-being of the population.


Assuntos
Substitutos do Leite , Leite , Animais , Aleitamento Materno , Feminino , Humanos , Lactente , Marketing , Gravidez , África do Sul
12.
Matern Child Nutr ; 18 Suppl 3: e13368, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35489107

RESUMO

The introduction of fluids other than breast milk during the first few days of life or later neonatal period has been identified as a risk factor for suboptimal breastfeeding (BF) outcomes in numerous studies using varying study designs. However, the relationship between early introduction of fluids other than breast milk and BF outcomes has not been systematically assessed using only prospective studies that can establish temporality, which is critical for determining whether observed associations are causal. We conducted a systematic review and meta-analysis of prospective studies to assess if there is a difference in BF outcomes as a result of the introduction of: (a) milk-based prelacteals, (b) water-based prelacteals and (c) breast milk substitutes (BMS) between 4 days and 4 weeks postpartum. We searched PubMed, Lilacs, Web of Science and other repositories for original research investigating the relationship between early introduction of prelacteals and/or BMS and BF outcomes. Forty-eight studies met the inclusion criteria for the systematic review. Of the 39 prelacteal feeding studies, 27 had the prerequisite statistical information for inclusion in the meta-analysis. Findings from the meta-analysis showed a relationship between prelacteals and exclusive BF cessation (RR 1.44; 1.29-1.60) and any BF cessation (2.23; 1.63-3.06) among infants under 6 months old. Nine studies focusing on the introduction of BMS during the neonatal period identified this practice as a statistically significant risk factor for a shorter BF duration. Effective interventions are needed to prevent the introduction of unnecessary milk-based prelacteals and BMS during the perinatal and neonatal periods to improve BF outcomes.


Assuntos
Aleitamento Materno , Substitutos do Leite , Feminino , Humanos , Lactente , Recém-Nascido , Leite Humano , Gravidez , Estudos Prospectivos , Fatores de Tempo
13.
Matern Child Nutr ; 18 Suppl 3: e13358, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35438250

RESUMO

Scaling up effective interventions, policies and programmes can improve breastfeeding (BF) outcomes. Furthermore, considerable interest exists in learning from relatively recent successful efforts that can inform further scaling up, with appropriate adaptations, across countries. The purpose of this four-country case studies analysis was to examine why and how improvements in BF practices occurred across four contrasting countries; Burkina Faso, the Philippines, Mexico and the United States of America. Literature reviews and key informant interviews were conducted to document BF trends over time, in addition to why and how BF protection, promotion and support policies and programmes were implemented at a national level. A qualitative thematic analysis was conducted. The 'Breastfeeding Gear Model' and RE-AIM (Reach; Effectiveness; Adoption; Implementation; and Maintenance) frameworks were used to understand and map the factors facilitating or hindering the scale up of the national programmes and corresponding improvements in BF practices. Each of the studied countries had different processes and timing to implement and scale up programmes to promote, protect and support breastfeeding. However, in all four countries, evidence-based advocacy, multisectoral political will, financing, research and evaluation, and coordination were key to fostering an enabling environment for BF. Furthermore, in all countries, lack of adequate maternity protection and the aggressive marketing of the breast-milk substitutes industry remains a strong source of negative feedback loops that are undermining investments in BF programmes. Country-specific best practices included innovative legislative measures (Philippines), monitoring and evaluation systems (United States of America), engagement of civil society (Mexico) and behavior change communication BF promotion (Burkina Faso) initiatives. There is an urgent need to improve maternity protection and to strongly enforce the WHO Code of Marketing of Breast-Milk Substitutes.


Assuntos
Aleitamento Materno , Substitutos do Leite , Feminino , Promoção da Saúde , Serviços de Saúde , Humanos , Marketing , Leite Humano , Gravidez
15.
Matern Child Nutr ; 18 Suppl 3: e13335, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35313063

RESUMO

The influence of marketing on infant and young child feeding and health is well recognized, and an International Code was adopted by the World Health Assembly (WHA) in 1981 to reduce inappropriate marketing and protect breastfeeding. Yet the marketing and influencing continue. This scoping review systematically examined the published research evidence on the nature and extent of exposure to International Code violations from 1981 to August 2021. We used several search strategies involving multi-language databases, organization websites, citation tracking, and expert consultation, to find research items meeting our inclusion criteria. We evaluated 657 items and retained 153 studies from at least 95 countries in the review. The majority of the studies (n = 113) documenting exposure to inappropriate marketing were published since 2010. Studies reported a broad range of marketing violations targeting mothers and families, health workers, and the general public. Marketing via digital platforms and brand extension has become more frequent. The evidence shows the use of misleading and inaccurate labeling and health and nutrition claims in breach of the Code. Our review confirms that violations of the Code have not ceased and calls for renewed attention from the WHA and national governments to protect the health of children and their mothers.


Assuntos
Substitutos do Leite , Aleitamento Materno , Criança , Feminino , Saúde Global , Humanos , Lactente , Marketing , Mães
16.
Matern Child Nutr ; 18 Suppl 3: e13351, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35313083

RESUMO

The International Code of Marketing of Breast-milk Substitutes (BMS) instituted to protect breastfeeding against unethical marketing, has been adopted by many countries, including Bangladesh. Despite national adoption, evidence suggests violations occur and inadequate BMS Code implementation is an issue. The study aimed to assess violations of the International BMS Code and the national 'Breast-milk Substitutes, Infant Foods, Commercially Manufactured Complementary Foods and the Accessories Thereof (Regulation of Marketing) Act, 2013' of Bangladesh in commercial settings (retail outlets and media) in Bangladesh, for different types of milk, bottles, and teats using a standardized Network for Global Monitoring and Support for Implementation of the Code and Subsequent relevant World Health Assembly Resolutions (NetCode) protocol. This cross-sectional quantitative study was conducted in Bangladesh from January to September 2018 in Dhaka, Chattogram, and Sylhet cities. Descriptive statistics were reported and χ2 tests were conducted to assess differences between categorical variables of interest. Data were analysed using SPSS version 20. In retail outlets, there were higher proportion of violations observed in Dhaka than in Sylhet and Chattogram (p < 0.001). Significantly greater proportion of violations in product labels occurred among products sold without local distributors compared to others (p < 0.05); violations were higher among "other milk" for children aged 0 to <36 months compared to formulas and growing-up milk (p < 0.05). Among media channels, internet clips had significantly higher proportions of violations compared to television, radio and newspaper (p < 0.001). BMS Code violations were prevalent in product labels and promotion of products through retail outlets. The study findings highlight the need for specific multisectoral strategies for better enforcement of BMS Code and points to the need for periodic assessment of Code violations.


Assuntos
Substitutos do Leite , Bangladesh , Aleitamento Materno , Criança , Estudos Transversais , Feminino , Humanos , Lactente , Alimentos Infantis , Marketing
17.
PLoS One ; 17(3): e0265012, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35271643

RESUMO

South Africa has one of the lowest breastfeeding rates on the African continent. Globally, just 44% of infants are breastfed soon after birth, and 40% of those less than six months old are exclusively breastfed. To improve infant nutrition by 2025, the United Nations established targets to eliminate malnutrition and increase exclusive breastfeeding (EBF) rates to at least 50%. Despite the WHO Code regulations endorsed by the World Health Assembly since 1981, breaches continue to be prevalent due to a combination of weak implementation, monitoring and enforcement in low-to-middle income countries. Over the years, infant formula sales in LMICs (including South Africa) have skyrocketed contributing to excess infant morbidity and mortality. To that end, the specific aims of this study was to gain an understanding of priority actions and strategies necessary to improve breastfeeding outcomes in South Africa in the context of the HIV pandemic. The team used a qualitative study design based on a semi-structured interview guide. The guide consisted of eight open-ended questions addressing the WHO HIV-related infant feeding guidelines, the WHO International Code of Marketing of Breastmilk Substitutes, political will, and advocacy. Of the 24 individuals contacted, 19 responded and 15 agreed to participate. The Breastfeeding Gear Model guided the thematic analysis. The three main themes identified were 1) WHO guidelines on HIV and infant feeding, 2) Improving exclusive breastfeeding, and 3) Advocacy. Key informants identified issues that need to be addressed to improve breastfeeding outcomes in South Africa. Strong political will is a key ingredient to harness the resources (human, financial) needed to implement, monitor, and act against Code violators. South Africa and other countries with similar challenges should consider using the WHOs Network for Global Monitoring and Support for Implementation of the International Code of Marketing of Breast-milk Substitutes and Subsequent relevant World Health Assembly Resolutions (NetCode) methodology.


Assuntos
Infecções por HIV , Substitutos do Leite , Aleitamento Materno , Feminino , Humanos , Lactente , Fórmulas Infantis , África do Sul/epidemiologia
20.
Matern Child Nutr ; 18(2): e13332, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35213768

RESUMO

China has the largest and fastest-growing breast milk substitutes (BMSs) market and a disproportionately low exclusive breastfeeding rate. Many BMS manufacturers have established Chinese e-commerce stores. This marketing is of concern as it is likely to undermine breastfeeding. This study aimed to identify: (1) the marketing themes and strategies used to promote BMSs on the Chinese BMSs e-commerce websites; (2) if and how digital BMSs marketing may deviate from the World Health Organization Code of Marketing of Breast Milk Substitutes (the Code) recommendations. Content analysis was conducted on the flagship websites of 10 BMSs companies on the Chinese e-commerce platform "TMall" in July 2019. The main landing page (n = 10) of the flagship TMall website and the product description page (n = 113) of all individual formulas (Stages 1-3) within each company's TMall website were examined. The content was analysed and coded using an iterative thematic analysis approach. Emphasis on Premiumization and Science & Nutrition was the most commonly used marketing approaches. A total of 27.4% of the product description pages sampled used images of infants (<12 months), 33.6% made favourable comparisons of BMSs to breast milk, and only 34.5% included probreastfeeding statements. Marketing strategies were often inconsistent with the Code, and companies used "creative" ways to target mothers, often circumventing the Code recommendations. Unsubstantiated information was commonplace and of concern, because the e-commerce platform provided easy opportunities for bulk purchases. National regulatory actions are urgently needed to monitor online BMS marketing and the undermining of breastfeeding in China.


Assuntos
Substitutos do Leite , Aleitamento Materno , China , Comércio , Feminino , Humanos , Lactente , Marketing/métodos , Leite Humano
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