Table 3 Digital marketing strategies of commercial breastmilk substitutes and baby foods and recommendations for strengthening regulations in Mexico

Peer recommendation in digital media

Anyone who posts or comments in favor of commercial milk formula and baby foods on social media (i.e., Facebook, Instagram) hired by companies.

Not contemplated

The General Health Law on advertising should:

Include within the definition of advertising the positioning of products and the use of influencers in digital media and social media.

Make the declaration of advertising content in digital media mandatory when receiving any payment or benefit for recommending a product.

Train influencers about the Code and Mexican regulations.

Influencers

Influencers on social media post videos, photos and any other material on their accounts where they directly or indirectly recommend commercial milk formula or baby food products so that parents or caregivers of infants and young children, who seek to imitate their lifestyle, consume these products.

Podcast

Marketing and promotion for commercial milk formula and baby foods on music streaming platforms.

Mailing /newsletters

Subscription to electronic newsletters with information on food and nutrition, where personal data such as the baby’s date of birth is shared. In this way, companies promote their products according to the age of the baby.

The General Health Law on advertising states that BMS may not be promoted in health centers but does not contemplate the promotion in traditional or digital media.

The General Health Law on advertising and the Regulation for Sanitary Control of Products and Services should:

Prohibit the marketing of any BMS, and those baby foods with added sugars, salt, trans fats, excess fats, additives, or any ingredient not suitable for infants and young children in any media, including digital media.

Prohibit contact of commercial milk formula and baby food companies with pregnant women, mothers, fathers, caregivers of infants and young children, and health professionals, including digital media.

Prohibit BMS and baby food companies from creating, sponsoring, and/or disseminating educational material related to breastfeeding, food, nutrition, and child health in any media.

Online parent clubs promoted by formula and baby food companies

Aimed at new mothers and fathers who sign up for these clubs to receive child nutrition orientation and by doing so expose themselves to the use of their personal data for targeted marketing of commercial milk formula and baby foods.

Companies pay for displays during navigation on Internet, or spaces in specialized magazines/blogs

When searching for an infant feeding concern on the internet, parents often come across a website for a formula and baby food brand, as these companies pay for their products to appear in searches and on electronic magazines/blogs.

Sponsorship by companies of educational material, lives, webinars, congresses, and events related to health and nutrition topics

Companies engage with health professionals to give webinars, live broadcasts, videos, and virtual educational material, among others, or events that are sponsored by companies where commercial milk formula and baby food products are promoted.

Images that idealize the use of formulas, health and nutrition declarations, and endorsement by health professionals of commercial milk formula and baby foods.

Nutritional claims in commercial milk formula that refer to its nutritional content, suggesting the product is similar or better than breast milk.

Health claims that indicate that the product is recommended for the relief of a specific disease or symptom (i.e., gastrointestinal symptoms and other common ailments in babies)

Images with graphics, pets, landscapes and other figures idealize these products’ consumption.

The Regulation for Sanitary Control of Products and Services indicates that marketing of infant formulas should promote breastfeeding, indicate correct handling, preparation and care of commercial formula milk, and recommend its use only due to breastmilk intolerance, mother’s absence, inability to give milk or any other well-founded health reasons.

The official norm NOM-131-SSA1–2012 indicates that those responsible for the sale or supply of formulas must comply with the Code and subsequent resolutions and that formulas must not display images or text that suggest they are identical and superior to breastmilk, nor display nutritional or health claims.

The Regulation for Sanitary Control of Products and Services, and the NOM-131-SSA1–2012 should indicate:

Plain packaging for BMS and front-of-package warning labeling about the content of sugars, sodium, and fats in formulas and baby food.

No product should include any imagery that could undermine or discourage breastfeeding, make a comparison to breast milk, or suggest that the product is nearly equivalent or superior to breast milk.

Do not allow claims of nutritional and health properties and the endorsement of any health professional or organization to commercial milk formula and baby foods.

Define a nutrition profile for baby foods to