Assessment of Knowledge of Kenya’s Breast Milk Substitutes Act (2012) among Nurses in Mbagathi and Pumwani Hospital, Kenya

Breast Milk Substitutes Regulation and Control Act, 2012 aimed to provide for appropriate marketing and distribution of breast milk substitutes, safe and adequate nutrition for infants, through the promotion of breast-feeding and proper use of breast milk substitutes. Nurses are responsible for providing information about benefits of breastfeeding to help the new mother to make a fully informed decision about infant nutrition. The aim of this study was to determine nurses' knowledge on the recommendations of the BMS Act in Mbagathi and Pumwani Hospitals, Nairobi County. This study used a cross-sectional descriptive research/study design. The target population were nurses who all work in maternity wards because of their responsibility for counseling mothers on infant nutrition. The study used a sample of 200 nurses. Questionnaires were use to collect data. Data analysis involved descriptive statistics and chi-square Analysis with the help of SPSS. Majority (68%) of the respondents had high knowledge. There was a significant relationship (p=0.014) between the level of education and nurses knowledge on BMS. Nurse’s knowledge on the recommendations of the BMS Act was generally high. Nurses with bachelors and postgraduate degree were more likely to have high knowledge than those with certificates and diplomas in nursing. Diploma curriculum therefore needs to be bolstered to include current recommendations of breastfeeding in line with the BMS Act. Keywords: Breastfeeding, Breast Milk Substitutes Regulation and Control Act, Nurses knowledge.

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IS ANYBODY KEEPING THE CODE IN BULGARIA? A STUDY TO EXPLORE LOCAL PARENTS' AWARENESS REGARDING THE INTERNATIONAL CODE FOR THE MARKETING OF BREAST-MILK SUBSTITUTES.

Proceedings of CBU in Medicine and Pharmacy ◽

10.12955/pmp.v2.188 ◽

2021 ◽

Vol 2 ◽

pp. 144-151

Author(s):

Ivanichka Serbezova ◽

Daniela Lyutakova

Keyword(s):

Breast Milk ◽

Postnatal Care ◽

Current Knowledge ◽

Parental Attitudes ◽

Local Level ◽

Prenatal Education ◽

Cross Sectional ◽

Who Code ◽

Breast Milk Substitutes ◽

Milk Substitutes

This paper reviews Bulgarian parents’ awareness concerning the existence of the WHO Code for the marketing of breast-milk substitutes and how it can help them optimize their breastfeeding journey. Frequently occurring problems and breaches of the Code in Bulgaria are discussed, and their context explained. We focus on parental attitudes and investigate whether they acknowledge the significant necessity for a Code-compliant prenatal education and postnatal care. We also explore their viewpoints on the implementation of the Code and maximizing compliance with it on a local level. The research findings are presented graphically, and we present tendencies showcased by respondents’ opinions they have expressed in the survey. OBJECTIVES: Purposes of this research are: (1) to explore parents’ awareness about the WHO Code and their encounter with local prenatal classes in this regard (2) to assess their viewpoints on implementing the Code and if they see it as a significant step towards an optimal breastfeeding experience. METHODS: The methods we applied include an online-based cross-sectional semi-quantitative questionnaire with closed-ended and open-ended questions, aiming to explore parents’ current knowledge and viewpoints in regard to the Code and its implementation in Bulgaria. The research has been carried out via social media, and it samples parents from a local parent peer support group. Acquired data from closed-ended questions is presented, demonstrating percentages and tendencies. RESULTS: A total of 463 respondents are included CONCLUSION: It is a common practice in Bulgaria for prenatal classes not to comply with the WHO Code. Disregarding recommendations and evidence-based medicine, both some experts and companies under the scope of the Code breach its main points. Code-compliant prenatal education is practically almost non-existent with the lack of midwife-led care and classes, predominantly in the private sector, where they are almost entirely, sponsored by those companies. Nearly all parents included in this survey are more than willing and motivated to have access to Code-compliant prenatal education and postnatal care. The lack of such leaves almost no choice for Bulgarian parents actually to have access to code-compliant education and care. This inevitably influences their decision making, attitudes and behavior, potentially leading to lower breastfeeding rates and suboptimal breastfeeding satisfaction and success. Adequate measures must be reinforced to ensure implementation and proper legislation, providing monitoring and enforcement, protecting parents and their babies when they are most vulnerable.

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Commercial foods for infants under the age of 36 months: an assessment of the availability and nutrient profile of ultra-processed foods

Public Health Nutrition ◽

10.1017/s1368980021001555 ◽

2021 ◽

pp. 1-20

Author(s):

Karini Freire da Rocha ◽

Célia Regina Barbosa de Araújo ◽

Inês Lança de Morais ◽

Patrícia Padrão ◽

Pedro Moreira ◽

...

Keyword(s):

Breast Milk ◽

Low Income ◽

Negative Impact ◽

Capital City ◽

Processed Foods ◽

Minimally Processed ◽

Cross Sectional ◽

Breast Milk Substitutes ◽

Milk Substitutes ◽

The One

ABSTRACT Objective: Considering the negative impact of the consumption of ultra-processed foods on health, this study assessed the availability and nutritional profile of commercial ultra-processed foods for infants in Natal, Brazil. Design: A cross-sectional exploratory study. Setting: Foods targeted at children under the age of 36 months sold in retail establishments located in high and low-income areas of the one capital city of Brazil. Participants: 1,645 food products consisting of 95 different types of food were available. The foods were assessed according to the NOVA classification: minimally processed, processed, and ultra-processed. The nutritional content per 100g was assessed according to processing classification. Results: Half of foods founded were breast milk substitutes and cereal foods (31.6% and 26.3%, respectively). The foods were predominantly ultra-processed (79%) and only 4.2% were minimally processed, with similar proportions of ultra-processed foods being found in both high and low-income areas. After excluding breast milk substitutes and follow-up formulas, all cereals, food supplements and some of the fruit or vegetable purees were ultra-processed, higher in energy density, fat, carbohydrate and protein, and low in fiber (P<0.05). Conclusions: The findings reveal that ultra-processed foods for infants are widely available in Brazil, reaffirming the need to strengthen the regulation of foods for infants and young children by introducing complementary measures designed to promote the production and marketing of foods manufactured using lower levels of processing.

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Evolution of infant nutrition

British Journal Of Nutrition ◽

10.1017/s0007114599000641 ◽

1999 ◽

Vol 81 (5) ◽

pp. 359-371 ◽

Cited By ~ 23

Author(s):

W. F. J. Cuthbertson

Keyword(s):

Breast Milk ◽

Infant Nutrition ◽

Adult Life ◽

Well Being ◽

Infant Survival ◽

Darwinian Selection ◽

Weaning Foods ◽

Breast Milk Substitutes ◽

Milk Substitutes ◽

Health And Well Being

Homo sapiens has developed during the course of over two million years. The social and physical conditions of life, the availability of milk and infant foods as well as the presence of diseases have all undergone radical transformations from the Stone Age, at first without and then with fire, to the hunter–gatherer, farmer–herder, agricultural and, now, developed societies. These changes in the human environment may have induced modifications in the length of pregnancy, the development of the neonate at birth, the duration of lactation, the composition of breast milk and use of weaning foods and milk substitutes. Darwinian selection for the nutrient, anti-infective and other components of breast milk may have been determined by the effects of nutrition, through genetic variations in milk composition, on the survival of infants and perhaps also on fecundity and disease resistance in later adult life. Today Darwinian selection may no longer be effective in maintaining or modifying human mammary function, because modern hygienic environments, together with the availability of nutritionally adequate breast-milk substitutes, permit infant survival even under conditions of total lactational failure. National and international promulgations strictly control the composition of infant formulas offered as breast-milk substitutes or as weaning foods. These recommendations are modified as beliefs suggest, and research indicates, the effects of nutrients and other factors on the health and well-being of the child. Preliminary observations on child health have often proved valuable in furthering research. Unquestioning acceptance of apparently desirable, but untested, epidemiological associations have led to unexpected but dangerous iatrogenic problems. Recommendations for change cannot safely be made without proper comparisons with present products and procedures under practical conditions. Such tests are time consuming and require protocols of appropriate statistical design and power while still meeting the required sociological and ethical constraints, but are essential to identify possible harmful effects of any proposed change. It is suggested that no novel ingredients should be added, or major changes permitted in any component, until appropriate trials have established the value and safety of the proposed modifications. Breast-feeding is vital to maximize infant survival in developing countries. There are major difficulties in assessing any differences in morbidity and mortality of breast-fed v. artificially reared infants in the developed world. Carefully controlled studies with comparisons of health and well-being, not only in infancy but throughout life, are desirable if the effects of infant nutrition on adult well-being, suggested by epidemiological studies, are to be validated and ultimately applied. There are considerable variations in the composition of breast milk. This variance suggests that it may ultimately be possible to design formulas better able to meet the needs of individual infants than the milk available from the mother's breast.

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Implementation of the Code of Marketing of Breast-Milk Substitutes in Vietnam: Marketing Practices by the Industry and Perceptions of Caregivers and Health Workers

Nutrients ◽

10.3390/nu13082884 ◽

2021 ◽

Vol 13 (8) ◽

pp. 2884

Author(s):

Tuan T. Nguyen ◽

Ha T. T. Tran ◽

Jennifer Cashin ◽

Van D. C. Nguyen ◽

Amy Weissman ◽

...

Keyword(s):

Breast Milk ◽

Pregnant Women ◽

Health Workers ◽

Milk Formula ◽

Cross Sectional ◽

Policy Makers ◽

Breast Milk Substitutes ◽

Milk Substitutes ◽

Commercial Milk ◽

Depth Interviews

Background: The promotion of breastmilk substitutes (BMS) is an important barrier to successful breastfeeding. Objective: To examine the enactment and implementation of the Code of Marketing of Breast-Milk Substitutes (the Code) in Vietnam with a focus on marketing practices by the baby food industry and perceptions of caregivers, health workers, and policy makers. Methods: From May to July 2020, we conducted a mixed-method, cross-sectional study including a survey of 268 pregnant women and 726 mothers of infants aged 0–11 months and in-depth interviews with a subset of interviewed women (n = 39), policy makers, media executives, and health workers (n = 31). Results: In the previous 30 days, two mothers (out of 726) participating in the quantitative survey reported that health workers had recommended BMS, at private hospitals in both cases. In-depth interviews with health workers showed that hospitals have internal procedures to prevent the promotion of BMS by health workers. However, companies employed representatives to promote products not covered under the Code (e.g., commercial milk formula for pregnant women) at antenatal care visits and by gaining contact information from women and using this information to promote BMS outside the hospital, often on social media. In the 30 days preceding the survey, one-fifth of pregnant women were exposed to promotions of commercial milk formula for pregnant women and 7.1% to promotions of BMS. Among mothers of infants, 7.3% and 10.7% of respondents with infants aged 0–5 and 6–11 months, respectively, were exposed to some form of BMS promotion in the past 30 days. Around the time of birth, parents commonly brought BMS to maternity facilities (52.5%) or purchased it nearby (35.4%). Conclusions: Although Vietnam has a strong regulatory environment for the protection, promotion, and support of breastfeeding, there are implementation, monitoring, and enforcement gaps. Stronger enforcement of national policies to regulate the presence of BMS industry representatives in health facilities—both public and private—and the promotion of BMS products on digital platforms are needed.

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