Women in South Africa are exposed to marketing of commercial formula milk

South African researchers have just published an article in the Global Health Action journal entitled Exploring Women’s Exposure to Marketing of Commercial Formula Products: A Qualitative Marketing Study from Two Sites in South Africa. The research was conducted as part of a larger multi-country study examining the impact of marketing of breast-milk substitutes on infant feeding decisions and practices commissioned by the World Health Organization.

The South Africa research reveals that the marketing of commercial formula products continues to take place despite global guidance and national legislation to restrict the promotion of breast-milk substitutes. Global guidance exists in the form of the International Code of Marketing of Breast-milk Substitutes established in 1981 together with subsequent World Health Assembly resolutions. National legislation was established in South Africa in 2012, when the Regulations R991 relating to foodstuffs for infants and young children were published.

The South African regulations restrict the marketing of commercial milk formulas indicated for children under the age of 36 months (3 years). Therefore, the research found limited overt marketing of products for children under 3, although there were some covert marketing strategies used for these products. These covert strategies included the use of online marketing tactics, namely social media marketing (sponsored adverts and support groups), websites and mobile phone applications (apps) providing infant and young child feeding information and price discounts, print and TV advertisements, and competitions. Companies are using innovative strategies and new platforms such as the digital space to circumvent regulation and consumers report being confused and overwhelmed by the information available. 

Covert strategies included the use of online marketing tactics, namely social media marketing (sponsored adverts and support groups), websites and mobile phone applications (apps)

There was an abundance of marketing reported for products for children over 36 months of age (not currently restricted by the national legislation), and this allows formula companies to provide messages about branding and the use of certain products to children. Companies use a practice called “cross-promotion”, where they use similar labels, designs, and names of products, so that products that are not restricted from marketing are promoted in a way that indirectly markets products that are restricted from being marketed. This creates confusion amongst mothers about which products can be used for which ages. This range of products for so many different ages also creates a belief that these products are needed at different stages, which is untrue. 

The reason why these marketing practices are problematic is because they idealise the use of expensive, commercially processed products that may undermine optimal nutrition and health. These products are highly processed and often contain large amounts of sugar, and do not offer a significant advantage over standard cow’s milk and a healthy balanced diet. Regulating the marketing of commercial formula is important to protect breastfeeding, which is the foundation of optimal infant and young child feeding. Unfortunately, in South Africa, breastfeeding rates are low and therefore more needs to be done to protect, promote and support breastfeeding to contribute to improved nutrition, health and development of young children in South Africa.

In South Africa, breastfeeding rates are low and therefore more needs to be done to protect, promote and support breastfeeding to contribute to improved nutrition, health and development of young children

The South African legislation was published 10 years ago, and marketing strategies have evolved since then. Therefore, legislation should be regularly updated, but also the implementation of legislation requires urgent priority to protect consumers from inappropriate marketing practices thereby safeguarding optimal infant and young child feeding.

Original article published on 10/08/2022: Pereira-Kotze CJ, Horwood C, Haskins L, Kingston G, Luthuli S & Doherty T. 2022. Exploring Women’s Exposure to Marketing of Commercial Formula Products: A Qualitative Marketing Study from Two Sites in South Africa. Global Health Action. 15(1).