title: Media audit reveals inappropriate promotion of products under the scope of the International Code of Marketing of Breast-milk Substitutes in South-East Asia.
abstract: OBJECTIVE
  To review regulations and to perform a media audit of promotion of products under the scope of the International Code of Marketing of Breast-milk Substitutes ('the Code') in South-East Asia.
  
  
  METHODS
  We reviewed national regulations relating to the Code and 800 clips of editorial content, 387 advertisements and 217 Facebook posts from January 2015 to January 2016. We explored the ecological association between regulations and market size, and between the number of advertisements and market size and growth of milk formula.
  
  
  METHODS
  Cambodia, Indonesia, Myanmar, Thailand and Vietnam.
  
  
  RESULTS
  Regulations on the child's age for inappropriate marketing of products are all below the Code's updated recommendation of 36 months (i.e. 12 months in Thailand and Indonesia; 24 months in the other three countries) and are voluntary in Thailand. Although the advertisements complied with the national regulations on the age limit, they had content (e.g. stages of milk formula; messages about the benefit; pictures of a child) that confused audiences. Market size and growth of milk formula were positively associated with the number of newborns and the number of advertisements, and were not affected by the current level of implementation of breast-milk substitute laws and regulations.
  
  
  CONCLUSIONS
  The present media audit reveals inappropriate promotion and insufficient national regulation of products under the scope of the Code in South-East Asia. Strengthened implementation of regulations aligned with the Code's updated recommendation should be part of comprehensive strategies to minimize the harmful effects of advertisements of breast-milk substitutes on maternal and child nutrition and health.
authors.affiliation: 1Department of Nursing and Health Promotion,Oslo and Akershus University College of Applied Sciences,Postboks 4,St. Olavs Plass,0130 Oslo,Norway.
authors.forename: Kristine Hansen
authors.initials: KH
authors.lastname: Vinje
authors.affiliation: 2Alive & Thrive Southeast Asia,Hanoi,Vietnam.
authors.forename: Linh Thi Hong
authors.initials: LTH
authors.lastname: Phan
authors.affiliation: 2Alive & Thrive Southeast Asia,Hanoi,Vietnam.
authors.forename: Tuan Thanh
authors.initials: TT
authors.lastname: Nguyen
authors.affiliation: 1Department of Nursing and Health Promotion,Oslo and Akershus University College of Applied Sciences,Postboks 4,St. Olavs Plass,0130 Oslo,Norway.
authors.forename: Sigrun
authors.initials: S
authors.lastname: Henjum
authors.affiliation: 3FIAN Norway,Oslo,Norway.
authors.forename: Lovise Omoijuanfo
authors.initials: LO
authors.lastname: Ribe
authors.affiliation: 2Alive & Thrive Southeast Asia,Hanoi,Vietnam.
authors.forename: Roger
authors.initials: R
authors.lastname: Mathisen
mesh_terms: D002160:Cambodia; D002675:Child, Preschool; D006801:Humans; D007214:Indonesia; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D040541:Marketing / Q000331:legislation & jurisprudence* / Q000592:standards*; D041941:Milk Substitutes / Q000737:chemistry / Q000331:legislation & jurisprudence* / Q000592:standards*; D008895:Milk, Human / Q000737:chemistry*; D002052:Myanmar; D018673:Nutrition Policy / Q000331:legislation & jurisprudence; D013785:Thailand; D014744:Vietnam; D014944:World Health Organization
keywords: International Code of Marketing of Breast-milk Substitutes; Market size and growth; Media audit; South-East Asia