Abstract
To examine the association between the place of residence and receiving free samples and advice to feed the baby with infant formula. A cross-sectional study. The current study covered twelve counties/districts in China. 5112 mothers with infants aged 0-5·9 months. About 16 % of the mothers received free samples of infant formula. During pregnancy, this likelihood was higher among mothers in small and medium cities (OR: 1·96; 95 % CI 1·14, 3·38) and non-poor rural counties (OR: 4·65; 95 % CI 1·65, 13·14) compared with mothers in big cities. During the hospital stay, it was lower in big cities. After discharge, it was lower in poor rural counties (OR: 0·14; 95 % CI 0·05, 0·41). About 26 % of the mothers were advised to feed their infants with infant formula. The likelihood of receiving advice to feed the baby with infant formula from hospitals was lower in non-poor (OR: 0·37; 95 % CI 0·21, 0·66) and poor rural counties (OR: 0·35; 95 % CI 0·13, 0·91) than in big cities. Mothers in non-poor rural counties were less likely to receive advice from traditional mass media (OR: 0·17; 95 % CI 0·06, 0·48), while mothers in small and medium cities were more likely to receive advice from modern mass media (OR: 1·84; 95 % CI 1·20, 2·80) compared with mothers in big cities. The promotion strategy of infant formula varies from different places of residence in China. The study suggests the need to strengthen enforcement of relevant regulations, especially within health facilities and through modern mass media.
Highlights
The first question was ‘when did the mothers receive free samples of infant formula?’ We examined three time points: [1] during pregnancy, [2] during hospital stay and [3] after discharge as well as an overall measure of receiving free samples of infant formula (No, when the mother did not receive any free samples of infant formula in any of the three time points; and Yes, for any alternative scenarios)
General characteristics Among 5112 mothers with infants 0–5 months old, 86·1 % belonged to the Han ethnicity, 63·3 % were between 26 and 35 years old, 21·4 % had at least a college degree and 44·7 % participated in business, professional or industry-related occupations (Table 1)
Principal results In the current study, we found that the promotion of infant formula in the form of free samples and advice was common in China
Summary
Study design and data collection In the current study, we used secondary data from 10 408 mothers with infants aged 0–11 months old who participated in a cross-sectional survey on determinants of breast-feeding practices in China[8]. The data collection team visited the corresponding immunisation clinic and invited mothers who brought their 0–11-month-old children to the clinic for immunisation to participate in the study. Outcome variables Promotion of infant formula in the current study was defined as having received free samples of infant formula or advice to feed the baby with infant formula, which was assessed using two retrospective questions. For the first set of outcome variables on receiving free samples of infant formula, we control for all of the above-mentioned covariates. The selection of mothers with infants aged 0–5·9 months was to minimise recall bias of the exposure to infant formula free sample and advice. Mothers with a university education or higher, and mothers who worked as white-collar workers or professionals as the reference groups in the multivariate logistic regression models
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