The DHS Program User Forum
Discussions regarding The DHS Program data and results
Home » DHS-8 Questionnaire Review - Archived » Core questionnaire: Nutrition » Marketing of Breast-milk Substitutes
Marketing of Breast-milk Substitutes [message #16772] Fri, 01 March 2019 13:55 Go to next message
DataDENT is currently offline  DataDENT
Messages: 11
Registered: January 2019
Member
We propose one indicator that would allow countries to quantify the extent to which mothers are exposed to BMS marketing, which can discourage breastfeeding.

1. Exposure to breast-milk substitute (BMS) promotion
Definition: Proportion of mothers exposed to any promotion or advertising for infant formula or other milk targeted for babies

Attached to this post is a completed submission form with full justification for the recommendation.

----------

This recommendation originated in the September 2018 Technical Consultation on Measuring Nutrition in Population-Based Household Surveys and Associated Facility Assessments--a 2-day working meeting convened by the Bill & Melinda Gates Foundation and United States Agency for International Development in collaboration with the World Health Organization (WHO) and United Nations Children's Fund (UNICEF), and coordinated by Data for Decisions to Expand Nutrition Transformation (DataDENT). The consultation included more than 60 technical experts, survey program representatives from DHS, MICS, LSMS and SMART, country data stakeholders, and donors from the nutrition measurement community.

This recommendation was authored by Larry Grummer-Strawn (WHO) and reviewed by Marcus Stahlhofer (WHO), David Clark (WHO), Purnima Menon (Institute for Food Policy Research Institute (IFPRI)), Sunny Kim (IFPRI), Chessa Lutter (RTI), and Monica Kothari (PATH).

This recommendation is endorsed by the WHO-UNICEF Technical Expert Advisory Group on Nutrition Monitoring (TEAM). Out of the 10 sets of recommendations endorsed by TEAM, this recommendation was prioritized as Tier 2 of 3 (high priority data need).

This recommendation is also endorsed by Countdown to 2030, Alive & Thrive, Global Alliance for Improved Nutrition (GAIN), the nutrition team at the Bill & Melinda Gates Foundation, and the Department of International Health at the Johns Hopkins Bloomberg School of Public Health.

[Updated on: Fri, 01 March 2019 14:40]

Report message to a moderator

Re: Marketing of Breast-milk Substitutes [message #16843 is a reply to message #16772] Thu, 07 March 2019 17:04 Go to previous messageGo to next message
Marie Ruel is currently offline  Marie Ruel
Messages: 11
Registered: April 2014
Member
This question is very important and I support the recommendation to add it to the questionnaire.
Re: Marketing of Breast-milk Substitutes [message #16906 is a reply to message #16772] Wed, 13 March 2019 21:43 Go to previous messageGo to next message
SUN Movement MEAL Team
Messages: 9
Registered: March 2019
Member
The SUN MEAL Results Framework seeks to track indicators related to the enabling policy environment for protection, promotion and support of breastfeeding. It would be very useful to the SUN Movement to be able to track the level of exposure of mothers to marketing of BMS in member countries.
Re: Marketing of Breast-milk Substitutes [message #16923 is a reply to message #16772] Thu, 14 March 2019 05:05 Go to previous messageGo to next message
Mauro Brero is currently offline  Mauro Brero
Messages: 12
Registered: March 2019
Member
UNICEF Tanzania Nutrition team concurs with the indicator. This information will be used to strengthen existing advocacy and programmes on regulating promotion and trade of BMS.

UNICEF Tanzania Nutrition team.
Re: Marketing of Breast-milk Substitutes [message #16959 is a reply to message #16923] Thu, 14 March 2019 10:52 Go to previous messageGo to next message
Michele Griswold (ILCA) is currently offline  Michele Griswold (ILCA)
Messages: 1
Registered: March 2019
Member
Thank you for the opportunity to provide comments. The International Lactation Consultant Association (ILCA) is a recognized NGO with the UN ECOSOC and represents more than 5000 skilled lactation providers in 90 countries who work directly with breastfeeding families. ILCA fully supports the inclusion of this important indicator to the DHS survey. This data would be useful in research and advocacy efforts involving support for breastfeeding families worldwide.
Re: Marketing of Breast-milk Substitutes [message #16972 is a reply to message #16772] Thu, 14 March 2019 15:05 Go to previous messageGo to next message
jruelbergeron is currently offline  jruelbergeron
Messages: 8
Registered: March 2019
Member
The Global Financing Facility (GFF) Secretariat endorses the recommendations made in this document (DataDENT).
Re: Marketing of Breast-milk Substitutes [message #16995 is a reply to message #16772] Thu, 14 March 2019 22:55 Go to previous messageGo to next message
Alessandro Iellamo is currently offline  Alessandro Iellamo
Messages: 1
Registered: March 2019
Member
We fully agree with this proposal. It is important we find a practical way to periodically review how invasive marketing and promotion of Code covered products is in each country.

The question is a tested question, has it has been used in several major national, regional and global assessments


regards
Re: Marketing of Breast-milk Substitutes [message #17032 is a reply to message #16772] Fri, 15 March 2019 07:38 Go to previous messageGo to next message
Rolf Klemm is currently offline  Rolf Klemm
Messages: 7
Registered: March 2019
Member
HKI wishes to endorse the Marketing of breast-milk substitutes recommendations for inclusion in DHS-8 (2018-2023). These recommendations were coordinated by DataDENT, authored by Larry Grummer-Strawn (WHO), and endorsed by TEAM, Countdown to 2020, Alive & Thrive, GAIN, the nutrition team at the Bill & Melinda Gates Foundation and Johns Hopkins Bloomberg School of Public Health.
A new question is needed because the International Code of Marketing of Breast-milk Substitutes, adopted by nearly all DHS countries, prohibits the promotion of infant formula and other breast-milk substitutes. Such promotion is well documented to reduce breastfeeding. Nonetheless, data show that exposure to promotion is widespread. Recent studies conducted by HKI in Cambodia, Nepal, Tanzania, Senegal and Indonesia document mothers' reported exposure to commercial promotions for breastmilk substitutes and show rates vary considerably in different countries (Feeley et al., 2016; Helen Keller International & Ministry of Health, 2018a, 2018b; Alissa M Pries, Huffman, Adhikary, et al., 2016; Alissa M Pries, Huffman, Mengkheang, et al., 2016a, 2016b; Vitta et al., 2016).

Adding the proposed marketing of breastmilk substitutes questions will provide information relevant to efforts to increase exclusive breastfeeding, one of the global nutrition targets endorsed by the World Health Assembly. The data from the new questions will be used to provide evidence for the need to strengthen countries' Code legislation and monitoring/enforcement of their national laws that protect breastfeeding. It will also be used by programs to tailor breastfeeding messages to counteract inappropriate marketing of infant formula and other breast-milk substitutes.

References:
Feeley, A. B., Ndeye Coly, A., Sy Gueye, N. Y., Diop, E. I., Pries, A. M., Champeny, M., ... Huffman, S. L. (2016). Promotion and consumption of commercially produced foods among children: situation analysis in an urban setting in Senegal. Maternal & Child Nutrition, 12 Suppl 2, 6476. https://doi.org/10.1111/mcn.12304

Helen Keller International, & Ministry of Health. (2018). Breastfeeding practices and consumption of breastmilk substitutes among children under 36 months in Bandung City. Jakarta, Indonesia: Helen Keller International.

Pries, A. M., Huffman, S. L., Adhikary, I., Upreti, S. R., Dhungel, S., Champeny, M., & Zehner, E. (2016). High consumption of commercial food products among children less than 24 months of age and product promotion in Kathmandu Valley, Nepal. Maternal and Child Nutrition, 12. https://doi.org/10.1111/mcn.12267

Pries, A. M., Huffman, S. L., Mengkheang, K., Kroeun, H., Champeny, M., Roberts, M., & Zehner, E. (2016). Pervasive promotion of breastmilk substitutes in Phnom Penh, Cambodia, and high usage by mothers for infant and young child feeding. Maternal & Child Nutrition, 12 Suppl 2, 3851. https://doi.org/10.1111/mcn.12271

Vitta, B. S., Benjamin, M., Pries, A. M., Champeny, M., Zehner, E., & Huffman, S. L. (2016). Infant and young child feeding practices among children under 2 years of age and maternal exposure to infant and young child feeding messages and promotions in Dar es Salaam, Tanzania. Maternal & Child Nutrition, 12 Suppl 2, 7790. https://doi.org/10.1111/mcn.12292
Re: Marketing of Breast-milk Substitutes [message #17036 is a reply to message #17032] Fri, 15 March 2019 07:49 Go to previous messageGo to next message
aperry is currently offline  aperry
Messages: 9
Registered: March 2019
Member
The DFID Nutrition Policy team supports the proposal to include this indicator - improving data on the marketing of BMS is an important step to protect and enable safe infant feeding - particularly given how much of a problem this is in many of the countries where we operate.
Re: Marketing of Breast-milk Substitutes [message #17040 is a reply to message #16772] Fri, 15 March 2019 08:03 Go to previous messageGo to next message
Marie Ruel is currently offline  Marie Ruel
Messages: 11
Registered: April 2014
Member
I fully endorse adding this indicator. The information is urgently needed at population level.
Re: Marketing of Breast-milk Substitutes [message #17078 is a reply to message #16772] Fri, 15 March 2019 11:02 Go to previous messageGo to next message
Amal Omer-Salim is currently offline  Amal Omer-Salim
Messages: 1
Registered: March 2019
Member
The World Alliance for Breastfeeding Action (WABA) fully supports the adoption of this indicator. WABA is very concerned about the rampant and aggressive marketing and promotion of infant formula and other breastmilk substitutes globally. The effects of these practices affect women's confidence in breastfeeding and undermine breastfeeding rates. The inclusion of this indicator will provide information about the prevalence of these negative practices and give direction to the types of interventions required to curb them, for example, the full implementation, monitoring, and enforcement of legislation to effect the International Code of Marketing of Breastmilk Substitutes and the relevant WHA resolutions.
Re: Marketing of Breast-milk Substitutes [message #17165 is a reply to message #16772] Fri, 15 March 2019 15:23 Go to previous messageGo to next message
1000 Days is currently offline  1000 Days
Messages: 10
Registered: March 2019
Member
1,000 Days is the leading non-profit organization working in the U.S. and around the world to improve nutrition and ensure women and children have the healthiest first 1,000 days.
1,000 Days is supportive of this recommendation because without this indicator, there is a lack of understanding on how mothers receive information about breastmilk substitutes. Enforcement of the International Code of Breast Milk Substitutes is critical to improving breastfeeding rates around the world. Better understanding how product promotion and marketing is happening with caregivers and mothers can help advocates better explain the threat to policymakers and protect mothers from aggressive marketing practices.
Re: Marketing of Breast-milk Substitutes [message #17308 is a reply to message #17165] Fri, 15 March 2019 17:23 Go to previous messageGo to next message
SafelyFed Canada is currently offline  SafelyFed Canada
Messages: 2
Registered: March 2019
Member
SafelyFed Canada is a national Canadian not-for-profit organization with the aim of improving the preparedness and response to the nutrition needs of infants and young children in emergencies. SafelyFed Canada supports the addition of this indicator to measure the proportion of target populations who have been exposed to breastmilk substitute marketing. This indicator will help to measure effectiveness of regulatory controls to protect consumers from inappropriate marketing. In the emergency setting specifically, it will assist in the assessment of the information needs of populations affected by disaster, particularly where heavy BMS marketing counter-messages public health recommendations to parents.
Re: Marketing of Breast-milk Substitutes [message #17318 is a reply to message #17308] Fri, 15 March 2019 17:32 Go to previous messageGo to next message
ktripp is currently offline  ktripp
Messages: 6
Registered: March 2019
Member
Abt Associates wishes to endorse the Marketing of breast-milk substitutes recommendations for inclusion in DHS-8
Re: Marketing of Breast-milk Substitutes [message #17324 is a reply to message #16772] Fri, 15 March 2019 17:40 Go to previous messageGo to next message
Erin Milner is currently offline  Erin Milner
Messages: 9
Registered: February 2019
Member
USAID agrees that data on this will be informative for monitoring adherence to country policies related to the International Code of Marketing of Breast-milk Substitutes.
Re: Marketing of Breast-milk Substitutes [message #17406 is a reply to message #16772] Fri, 15 March 2019 22:44 Go to previous messageGo to next message
manita3 is currently offline  manita3
Messages: 1
Registered: March 2019
Member
I support the recommendation.
Re: Marketing of Breast-milk Substitutes [message #17412 is a reply to message #17406] Fri, 15 March 2019 23:17 Go to previous messageGo to next message
Judy Canahuati is currently offline  Judy Canahuati
Messages: 9
Registered: March 2019
Member
La Leche League International supports the questions on the marketing of breastmilk substitutes.
Re: Marketing of Breast-milk Substitutes [message #17425 is a reply to message #16772] Fri, 15 March 2019 23:56 Go to previous message
Olutayo
Messages: 12
Registered: March 2019
Member
Marketing of breast milk substitutes is a source of intense international debate between industry and public health experts. There are laws restricting such marketing in many countries. It would be quite useful to have information about how effective laws, advocacy and other actions are and this information currently does not exist. I support the inclusion of this indicator in the DHS.
Previous Topic: Support for Breastfeeding at Health Facilities - BFHI Monitoring
Next Topic: Physical activity among adolescents and women
Goto Forum:
  


Current Time: Thu Jun 4 11:08:05 Eastern Daylight Time 2020