An evaluation of on-package marketing and nutrients of concern of infant formula, follow-up formula, young child formula and commercially available complementary foods and compliance thereof by manufacturers in South Africa
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Date
2025
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University of the Western Cape
Abstract
Background: The long-term benefits of breastfeeding on both maternal and infant health are well known. Breastfeeding influences a child's ability to pursue further education and future income generation (Victoria et al, (2015). Research reveals that the promotion of commercial milk formula (CMF) has negatively impacted breastfeeding practices. It is for this reason that South Africa’s Regulation 991, aims to protect breastfeeding by restricting marketing tactics that can mislead parents into thinking that CMF is superior to breastmilk. The aim of this study was to determine the nutritional content specifically nutrients of concern in relation to the SA and WHO nutrient profiling models and compliance of young child formulas and commercially available complementary foods with marketing requirements in South Africa. Methodology: This is a cross- sectional descriptive study. Secondary photographic data of packaged products sold in South African supermarkets was used to assess compliance of infant and young child foods to the marketing requirements in R991 (n = 266) in addition to evaluation of the nutritional composition (n = 236). Results: Most products displayed some form of front-ofpack (FOP) marketing namely health claims, catchy terms/phrases, expert claims and digital means of making contact with the manufacturer. Cross-promotion (n = 81) was also evident among the five companies as the majority of products (83.3%) display identical label elements across products from different brands and different product categories (i.e. complementary food and/or follow-up formula) within the same brand. As for the nutritional composition, the paediatric juices (100%) and follow-up formulas (64.6%) had the highest rates of noncompliance with the South African Nutrient Profiling Model (SA NPM) due to excessive median sugar content. Overall, 64.8% of products met the SA NPM criteria, while only 51.2% complied with the WHO Nutrient and Promotion Profile Model. Conclusion: This study underscores the ongoing challenges in ensuring compliance with R991. Despite the regulation, the widespread use of FOP marketing suggests that some brands continue to use tactics that could influence parental perceptions of commercial milk formulas. Additionally, the high sugar content found in a significant proportion of these products raises concerns regarding their nutritional quality for infants and young children.
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Keywords
Breastfeeding, Breastmilk-substitute, Infant Formula, Complementary foods, Young Child Formula