The marketing of breast milk substitutes (BMS) significantly influences infant feeding practices worldwide. In Ecuador, despite regulatory efforts aligned with the WHO's International Code of Marketing of Breast Milk Substitutes, industry advertising strategies continue to impact the decisions of both mothers and healthcare professionals. This cross-sectional study assessed compliance with the Code in Ecuador through surveys of mothers (n=330) and healthcare professionals (n=66), observations in healthcare facilities (n=33) and retail outlets (n=44), as well as media monitoring and product labeling evaluations.
The results revealed high exposure to BMS marketing outside healthcare facilities (91.21% of mothers). Direct interactions with healthcare professionals were identified, including the distribution of free supplies (26.09%) and gifts (21.74%). In retail outlets, 95% of products featured promotions, primarily discounts. Product labeling largely failed to meet nutritional and health information criteria (39%). Television emerged as the main advertising medium, with 2,884 commercials aired over a period of 16 hours and 24 minutes, amounting to an investment of $1,876,915.50. On digital platforms, 533,845 interactions were recorded on BMS advertisements.
These findings demonstrate widespread violations of the WHO Code in Ecuador, highlighting the need for stricter regulations and educational strategies targeting healthcare professionals and the public. Despite the existence of national regulations, the industry's intensive advertising and high marketing investment expose significant enforcement gaps. To protect maternal and infant health, Ecuador must adopt and rigorously enforce all Code recommendations within its national legislation.
Key Points
- BMS advertising in Ecuador has significantly increased over the last decade, incorporating strategies in social media and digital platforms.
- Current regulations on digital BMS marketing are insufficient, underscoring the need for greater control and specific legislation.
- Systematic violations of both the International Code and national laws hinder effective regulation.
- Widespread exposure to infant formula advertising across multiple platforms reinforces the perception of these products as equivalent or superior to breastfeeding.
- To strengthen breastfeeding protection, Ecuador must improve its legislation and ensure effective enforcement.
