A study found that commercial infant formula and meals are marketed online and that these marketing techniques are linked to poor parental feeding practices.

The study was published in the journal BMJ Global Health. According to the research, mothers who were heavily exposed to digital marketing were less likely to exclusively breastfeed their infants during the first six months and more likely to feed them processed foods and sugary drinks. This led the researchers to call for stricter regulations to protect young children's nutrition and health.

According to the International Code of Marketing of Breast-milk Substitutes (Code), any educational and informational materials must outline the advantages and superiority of breastfeeding as well as provide guidelines for using infant formula properly. They cannot, however, include illustrations that idealise the use of breast milk substitutes.

No corporation is permitted to make direct or indirect contact with expectant mothers, parents, or carers, including through social media platforms, according to the Code.

The researchers wanted to estimate the exposure of Mexican parents with infants aged under 24 months to digital marketing of formula and baby food, its association with the purchase of these products, and breastfeeding and complementary feeding practices.

Parents (1074) were recruited from a nationally representative market research panel and surveyed about the brands, products, and digital platforms where they reported seeing ads for formula milk and baby foods between December 2020 and January 2021.

The survey included questions about how and why purchases were made, and how feeding practices were influenced by digital marketing. Parents' knowledge of the Code, their views of digital marketing regulations, and whether the ads made them think that formula milk and commercial baby foods were as good or better than breast milk were also captured.

Exposure to digital marketing of formula and baby foods was classified as the weekly frequency with which parents reported observing advertisements and the number of advertised products they reported seeing over the past month.

Nearly two-thirds (62 per cent) of the participants were women. On average, they were 28 and had 2 children, half of whom were under 12 months of age. They were mostly educated to a degree level and relatively affluent.

A third of the mums (33 per cent) exclusively breastfed their infants under 6 months and nearly half (45 per cent) continued breastfeeding after 12 months.

Among children up to 23 months, 58 per cent were given formula milk, 43 per cent consumed sugary drinks, and nearly three-quarters (72 per cent) had eaten processed foods the day before the survey.

During the preceding month, most (82 per cent) parents said they had bought formula milk or baby foods. The main reasons given were nutritional content (45 per cent), convenience (37 per cent), and shelf life (22.5 per cent).

In all, 94 per cent of parents reported seeing digital marketing on at least one site in the preceding month, with 86 per cent reporting weekly frequency. Marketing was seen primarily on social media (77 per cent).

The average number of advertised products reported was 26; the most advertised formulas on digital media were infant formulas (0-6 months; 92 per cent) and growing-up milk (12-36 months; 89 per cent). Porridge (77 per cent) and yoghurt (71 per cent) were the most commonly advertised baby foods.

Only 13 per cent of the parents knew about the Code, and only around half (48 per cent) felt that the existing regulations for marketing formula and baby foods were inadequate. Close to 55 per cent felt that advertising portrayed formula as equal to or better than breast milk.

Ninety-five parents were asked to make three 10-minute screen recordings of their mobile devices while browsing the internet or checking their social media and smartphone apps. The number of ads for formula and baby food products seen in each recording was counted and classified as intentional or unintentional searches.

Eighty-nine (94 per cent) observed at least one formula and/or baby food ad in their 30 minutes of recordings, with an average of around 7 ads seen in each recording during an intentional search, and around 2 during unintentional searches.

The most advertised product seen was growing-up milk (42 per cent), although advertising for infant formulas (0-6 months) was also identified (20 per cent). In each recording, at least one ad for infant formula or baby food was identified, and all contained Code violations.

These were primarily the absence of statements about the superiority of breastfeeding (96 per cent); lack of warnings on the risks of improper formula preparation (95 per cent) or advice to consult health professionals about the use of these products (93.5 per cent); and invitations to visit websites, social media, or links to purchase their products (70 per cent).

Overall, parents who reported seeing a higher number of ads were 62 per cent less likely to exclusively breastfeed their children during the first 6 months than those reporting a lower number, and more than twice as likely to feed them breast and other milk.

They were also 84 per cent more likely to give their children formula, more than twice as likely to give them processed foods, and 66 per cent more likely to give them sugary drinks.

Higher exposure to ads was associated with a two-fold greater chance of purchasing product-based on nutritional and organic claims made in digital marketing. This is an observational study, and as such, can't establish cause. And the participants were relatively affluent and well educated, so the findings may not be more widely applicable, caution the researchers.

Nevertheless, they concluded: "Marketing regulations should ban breast-milk substitutes and baby food promotion in digital media and the use of health claims, since they may confuse parents about optimal (infant and young child feeding practices). This call for action is urgent to safeguard the health and right of children to breastfeeding and natural, nutritious, sufficient, and quality food."