Maternal Experiences and Perspectives of Marketing and Regulation of Commercial Milk Formula in Thailand: A Qualitative Study.

Abstract

Commercial milk formula (CMF) marketing adversely influences breastfeeding practices globally. Thailand enacted the Control of Marketing Promotion of Infant and Young Child Food Act ('Thai Code') in 2017 to restrict the marketing of CMF for infants aged 0-12 months. This qualitative study aimed to explore mothers' experiences and perspectives of CMF marketing and its regulation by the Thai Code through semistructured interviews with 15 mothers across Thailand between July 2023 and March 2024. Our findings revealed that while traditional advertising and healthcare-setting promotions decreased, CMF marketing strategies evolved toward social media platforms, particularly TikTok and Facebook, and through building relationships with mothers for CMF products for young children. Participants reported varying perceptions toward CMF marketing, with those of lower socioeconomic status appearing to be more susceptible to marketing claims, for example, CMF boosts cognitive development and is equivalent to breast milk. While participants reported receiving strong breastfeeding support from healthcare facilities, subtle CMF promotional practices persisted in private settings through free sample distribution and invitations to join company-sponsored digital platforms. Despite general awareness that some form of CMF marketing regulation exists, participants had limited knowledge of the Thai Code's specific provisions. Therefore, enhanced monitoring of digital marketing and private healthcare settings, alongside improved public communication about the Thai Code, could strengthen its implementation, particularly in lower income settings in which mothers may be more vulnerable to marketing claims.