The characteristics of formula milk marketing on health system: a qualitative study from Beijing and Jinan in China
Abstract Background Breastmilk is widely regarded as the healthiest choice for both infants and mothers due to its numerous advantages over formula, such as higher concentrations of essential nutrients and antibodies, easier digestion, and superior taste. The World Health Organization International...
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2024-11-01
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| Online Access: | https://doi.org/10.1186/s12889-024-20298-y |
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| author | Yinghang Wang Hanxiyue Zhang Suying Chang Ge Yang Wen Wang Xinyi Lv Zhi Lin Shuyi Zhang Angela Y. Xiao Anuradha Narayan Kun Tang |
| author_facet | Yinghang Wang Hanxiyue Zhang Suying Chang Ge Yang Wen Wang Xinyi Lv Zhi Lin Shuyi Zhang Angela Y. Xiao Anuradha Narayan Kun Tang |
| author_sort | Yinghang Wang |
| collection | DOAJ |
| description | Abstract Background Breastmilk is widely regarded as the healthiest choice for both infants and mothers due to its numerous advantages over formula, such as higher concentrations of essential nutrients and antibodies, easier digestion, and superior taste. The World Health Organization International Code of Marketing of Breast-milk Substitutes was adopted over 40 years ago to mitigate the effects of infant formula marketing on a woman’s decision to breastfeed. Yet, the commercial formula milk industry has continued to market their products aggressively and through an increasing variety of social media channels. This study examines the impact of formula milk marketing on specific components of the health system to understand how systems that are built to support and sustain breastfeeding may have been captured and repurposed by industry practices. Methods As part of A Multi-country Study of Early Infant Feeding Decisions, this qualitative study was conducted in two representative cities in China, Beijing and Jinan, in 2020. The participants were recruited through convenience sampling and snowballing sampling methods. Data were collected through 40 in-depth interviews and 10 focus group discussions with health professionals, pregnant women, and formula milk marketing executives. A thematic analytical method was used to analyze the main themes and sub-themes that detail the characteristics of formula milk marketing and its impact on the health system in China. Results Our results identified the most common practices used by the formula milk industry to reach health workers as well as mothers and their families through health systems. Such practices include (1) provider/facility-based marketing to sponsor academic activities (e.g., seminars, conferences, and research projects) and promote specialized infant formula that targets health care providers and facilities, which influence the health consultations and recommendations provided by health professionals to mothers and families; and (2) receiver-based marketing that targets Chinese women and increases marketing exposure through lectures provided by maternity schools at health facilities during the antenatal period and health promotion activities organized by formula milk companies outside of facilities during the postnatal care period. Conclusions Formula milk marketing aims to influence the practices and services within the health system in China, both directly through health professionals and facilities, and also indirectly by targeting mothers. These marketing strategies have impacted the perceptions of providers on formula milk, and strategies targeting consumers have aimed to further influence and undermine mothers’ intentions to continue breastfeeding. Stricter regulation of industry marketing practices is needed to create a supportive environment for mothers to breastfeed. |
| format | Article |
| id | doaj-art-bd3c7584ca7e4ca796ccb2e9a8af35af |
| institution | DOAJ |
| issn | 1471-2458 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj-art-bd3c7584ca7e4ca796ccb2e9a8af35af2025-08-20T02:49:19ZengBMCBMC Public Health1471-24582024-11-0124111010.1186/s12889-024-20298-yThe characteristics of formula milk marketing on health system: a qualitative study from Beijing and Jinan in ChinaYinghang Wang0Hanxiyue Zhang1Suying Chang2Ge Yang3Wen Wang4Xinyi Lv5Zhi Lin6Shuyi Zhang7Angela Y. Xiao8Anuradha Narayan9Kun Tang10Vanke School of Public Health, Tsinghua UniversityVanke School of Public Health, Tsinghua UniversityUnited Nations Children’s Fund Office for ChinaDivision of Neonatology and Center for Newborn Care, Guangzhou Women and Children’s Medical CenterInstitute for Social and Economic Research, University of EssexNational Research Institute for Family PlanningPeking University Cancer Hospital & InstituteCapital Institute of PediatricsVanke School of Public Health, Tsinghua UniversityUnited Nations Children’s Fund Office for ChinaVanke School of Public Health, Tsinghua UniversityAbstract Background Breastmilk is widely regarded as the healthiest choice for both infants and mothers due to its numerous advantages over formula, such as higher concentrations of essential nutrients and antibodies, easier digestion, and superior taste. The World Health Organization International Code of Marketing of Breast-milk Substitutes was adopted over 40 years ago to mitigate the effects of infant formula marketing on a woman’s decision to breastfeed. Yet, the commercial formula milk industry has continued to market their products aggressively and through an increasing variety of social media channels. This study examines the impact of formula milk marketing on specific components of the health system to understand how systems that are built to support and sustain breastfeeding may have been captured and repurposed by industry practices. Methods As part of A Multi-country Study of Early Infant Feeding Decisions, this qualitative study was conducted in two representative cities in China, Beijing and Jinan, in 2020. The participants were recruited through convenience sampling and snowballing sampling methods. Data were collected through 40 in-depth interviews and 10 focus group discussions with health professionals, pregnant women, and formula milk marketing executives. A thematic analytical method was used to analyze the main themes and sub-themes that detail the characteristics of formula milk marketing and its impact on the health system in China. Results Our results identified the most common practices used by the formula milk industry to reach health workers as well as mothers and their families through health systems. Such practices include (1) provider/facility-based marketing to sponsor academic activities (e.g., seminars, conferences, and research projects) and promote specialized infant formula that targets health care providers and facilities, which influence the health consultations and recommendations provided by health professionals to mothers and families; and (2) receiver-based marketing that targets Chinese women and increases marketing exposure through lectures provided by maternity schools at health facilities during the antenatal period and health promotion activities organized by formula milk companies outside of facilities during the postnatal care period. Conclusions Formula milk marketing aims to influence the practices and services within the health system in China, both directly through health professionals and facilities, and also indirectly by targeting mothers. These marketing strategies have impacted the perceptions of providers on formula milk, and strategies targeting consumers have aimed to further influence and undermine mothers’ intentions to continue breastfeeding. Stricter regulation of industry marketing practices is needed to create a supportive environment for mothers to breastfeed.https://doi.org/10.1186/s12889-024-20298-yBreastfeedingInfant formulaBreastfeeding practiceHealth claimsBreast milk substitute |
| spellingShingle | Yinghang Wang Hanxiyue Zhang Suying Chang Ge Yang Wen Wang Xinyi Lv Zhi Lin Shuyi Zhang Angela Y. Xiao Anuradha Narayan Kun Tang The characteristics of formula milk marketing on health system: a qualitative study from Beijing and Jinan in China BMC Public Health Breastfeeding Infant formula Breastfeeding practice Health claims Breast milk substitute |
| title | The characteristics of formula milk marketing on health system: a qualitative study from Beijing and Jinan in China |
| title_full | The characteristics of formula milk marketing on health system: a qualitative study from Beijing and Jinan in China |
| title_fullStr | The characteristics of formula milk marketing on health system: a qualitative study from Beijing and Jinan in China |
| title_full_unstemmed | The characteristics of formula milk marketing on health system: a qualitative study from Beijing and Jinan in China |
| title_short | The characteristics of formula milk marketing on health system: a qualitative study from Beijing and Jinan in China |
| title_sort | characteristics of formula milk marketing on health system a qualitative study from beijing and jinan in china |
| topic | Breastfeeding Infant formula Breastfeeding practice Health claims Breast milk substitute |
| url | https://doi.org/10.1186/s12889-024-20298-y |
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