Article Text

Digital marketing of formula and baby food negatively influences breast feeding and complementary feeding: a cross-sectional study and video recording of parental exposure in Mexico
  1. Mishel Unar-Munguía1,
  2. Andrea Santos-Guzmán1,
  3. Pedro Javier Mota-Castillo1,
  4. Marena Ceballos-Rasgado2,
  5. Lizbeth Tolentino-Mayo1,
  6. Matthias Sachse Aguilera3,
  7. Fernanda Cobo Armijo3,
  8. Simón Barquera1,
  9. Anabelle Bonvecchio1
  1. 1 Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
  2. 2 Centre for Global Development, University of Central Lancashire, Preston, UK
  3. 3 United Nations International Children’s Emergency Fund, UNICEF, Mexico, Mexico
  1. Correspondence to Mishel Unar-Munguía; munar{at}


Background There is little evidence of the association between digital marketing of formula and baby food and infant and young child feeding (IYCF) practices.

Objective Assess parents’ exposure to digital marketing of formula and baby food for children <2 years and its association with the purchase and IYCF practices in Mexico.

Methods Parents ≥18 years recruited from a market research panel completed an online survey (n=1074) and capture-on-screen (n=95) between December 2020 and January 2021. Logistic regressions were used to estimate the association between exposure to digital marketing of formula and baby foods with its purchase, motivation, consumption and IYCF practices.

Results Digital marketing of formula and baby food was self-reported by 93.9% of parents in the online survey and observed by 93.7% in the capture-on-screen. Recorded ads did not comply with the International Code of Marketing of Breast-milk Substitutes. Parents who self-reported seeing a higher versus lower number of ads were less likely to exclusive breast feed (OR=0.38; 95% CI: 0.19 to 0.78), and more likely to give mixed feeding (OR=2.59; 95% CI: 1.28 to 5.21), formula (OR=1.84; 95% CI: 1.34 to 2.53), processed foods (OR=2.31; 95% CI: 1.59 to 3.32) and sugary drinks (OR=1.66; 95% CI: 1.09 to 2.54). Higher exposure to ads was associated with a higher chance of purchasing products motivated by nutritional (OR=2.1; 95% CI: 1.32 to 3.28) and organic claims (OR=2.1; 95% CI: 1.21 to 3.72).

Conclusions Digital marketing of formula and baby food may negatively influence IYCF and should be regulated to ensure children’s nutrition and health.

  • Cross-sectional survey
  • Child health
  • Nutrition
  • Public Health

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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  • Handling editor Seye Abimbola

  • Twitter @mishaunar, @marena_ceballos, @SBarquera, @abonvecchioa

  • Contributors MUM is the principal investigator on the grant from United Nations International Children's Emergency Fund. MUM, MS, FCA, MC, LT, SB and ABA conceptualized the project and contributed to the study design. All authors informed the study protocol. MUM, ASG, PJMC, MC, MS and FCA were involved in instrument design. MUM led the study, and ASG and PJMC participated in different subcomponents of the study. Data collection was mainly managed by MUM, ASG and PJMC. MS and FCA supervised the study. MUM contributed to the conceptual design of the analysis and the interpretation of the results. ASG conducted the statistical analyses and presentation of results. MUM and ASG developed the first draft of the manuscript. PJMC, MS, FCA, MC, LT, SB and ABA provided important intellectual content, interpretation of results and policy recommendations. All authors reviewed, revised, and approved the final manuscript. MUM is responsible for the overall content of the manuscript as guarantor.

  • Funding This study is supported by UNICEF, Mexico.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.