title: Understanding women's interpretations of infant formula advertising.
abstract: BACKGROUND
  Exclusive breastfeeding for 6 months and continued breastfeeding for at least 1 year is recommended by all major health organizations. Whereas 74.6 percent of mothers initiate breastfeeding at birth, exclusivity and duration remain significantly lower than national goals. Empirical evidence suggests that exposure to infant formula marketing contributes to supplementation and premature cessation. The objective of this study was to explore how women interpret infant formula advertising to aid in an understanding of this association.
  
  
  METHODS
  Four focus groups were structured to include women with similar childbearing experience divided according to reproductive status: preconceptional, pregnant, exclusive breastfeeders, and formula feeders. Facilitators used a prepared protocol to guide discussion of infant formula advertisements. Authors conducted a thematic content analysis with special attention to women's statements about what they believed the advertisements said about how the products related to human milk (superior, inferior, similar) and how they reported reacting to these interpretations.
  
  
  RESULTS
  Participants reported that the advertisements conveyed an expectation of failure with breastfeeding, and that formula is a solution to fussiness, spitting up, and other normal infant behaviors. Participants reported that the advertisements were confusing in terms of how formula-feeding is superior, inferior or the same as breastfeeding. This confusion was exacerbated by an awareness of distribution by health care practitioners and institutions, suggesting provider endorsement of infant formula.
  
  
  CONCLUSIONS
  Formula marketing appears to decrease mothers' confidence in their ability to breastfeed, especially when provided by health care practitioners and institutions. Therefore, to be supportive of breastfeeding, perinatal educators and practitioners could be more effective if they did not offer infant formula advertising to mothers.
authors.affiliation: Public Health, Carolina Global Breastfeeding Institute, Chapel Hill, NC, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Parry
authors.forename: Emily
authors.initials: E
authors.lastname: Taylor
authors.forename: Pam
authors.initials: P
authors.lastname: Hall-Dardess
authors.forename: Marsha
authors.initials: M
authors.lastname: Walker
authors.forename: Miriam
authors.initials: M
authors.lastname: Labbok
mesh_terms: D000293:Adolescent; D000328:Adult; D000329:Advertising; D001294:Attitude to Health; D001942:Breast Feeding; D005260:Female; D017144:Focus Groups; D006801:Humans; D007223:Infant; D041943:Infant Formula; D008875:Middle Aged; D011247:Pregnancy; D020377:Self Efficacy; D055815:Young Adult
keywords: advertising; breastfeeding; infant formula; maternity care; perinatal education