(Non)Marketing of Breastmilk Substitutes in South African Parenting Magazines: How Marketing Regulations May Be Working.

Although exclusive breastfeeding (EBF) for the first six months is optimal for child health, it remains low globally. Breastmilk substitutes (BMS) marketing undermines breastfeeding. In 2012, South Africa introduced Regulation 991, which prohibits marketing BMS products for infants below 6 months. Our study aimed to explore if and how BMS products were presented in South African parenting magazines post-R991. We applied a mixed-methods cross-sectional content analysis design, analyzing all 2018 issues of two popular parenting magazines. We descriptively analyzed quantitative codes, derived from an a priori framework, and conducted qualitative content analysis on a subset of texts and images. We found there was no overt marketing of BMS to parents with infants below 6 months. However, BMS advertisements were placed next to articles about young infants, and vague wording and images were ways by which BMS companies may indirectly benefit. Medical experts in both magazines promoted the introduction of solids before six months. To conclude, while BMS companies in South Africa were abiding by R991 by not overtly advertising BMS in parental print media, their influence persists. Continued monitoring of print media as well as other channels is advisable. This study may be of interest to countries considering stronger regulations of BMS advertising.