Maternal and Child Nutrition最新文献

{"title":"Peer Support and Community Interventions Targeting Breastfeeding in the UK: Systematic Review of Qualitative Evidence to Identify Inequities in Participants' Experiences.","authors":"Rhiannon Evans, Caitlyn Donaldson, Rabeea'h Aslam, Joelle Kirby, Sophie Robinson, Joanne Clarke, Stephanie J Hanley, Siang Lee, Joht Singh Chandan, Ruth Garside, Jo Thompson-Coon, Kate Jolly, Kath Maguire, Sean Harrison, G J Melendez-Torres","doi":"10.1111/mcn.70041","DOIUrl":"https://doi.org/10.1111/mcn.70041","url":null,"abstract":"<p><p>Rates of breastfeeding remain low in the UK, with variations between population groups. Peer support and community interventions are intended to increase breastfeeding, but there is limited understanding if they cause inequities in participants' experiences. We conducted a systematic review synthesising qualitative evidence from the UK to understand: (1) what social characteristics are relevant to participants' experiences of interventions? and (2) how are participants' experiences influenced by different social characteristics? The scope of the review was informed through stakeholder consultation with women (n = 7) and peer supporters (n = 6). Searches of nine databases updated an existing systematic review. We screened relevant systematic reviews and undertook citation tracking. We conducted framework synthesis and assessed certainty of evidence with GRADE-CERQual. Fifty-five studies, with 68 linked reports, were included. Inequity generating experiences were identified across the course of intervention participation: (1) lack of information about intervention eligibility and culturally appropriate recruitment procedures; (2) limited accessible provision for continued attendance; (3) inadequate consideration of participation needs related to socioeconomic status, socio-cultural background, physical characteristics, and individuals' breastfeeding journeys; and (4) enduring structural barriers (e.g. community norms) to breastfeeding inhibiting sustained behaviour post-intervention. Evidence suggests that differential intervention experiences may lead to inequities in outcomes, particularly among individuals from different socioeconomic and ethnic backgrounds. Peer and community provision needs to be tailored to the social characteristics of different populations. Future qualitative research needs to move beyond participants' general intervention experiences and consider specific issues pertaining to recruitment, drop-out and post-intervention behavioural maintenance. Systematic Reveiw Registration: PROSPERO CRD42024537108.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70041"},"PeriodicalIF":2.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"I Am Going to Take It Up\": Implementing Skin-to-Skin Contact in Uganda.","authors":"Karin Cadwell, Anna Blair, Kajsa Brimdyr, Kristin Svensson, Melissa Reyes, Mike Kagawa, Louise Racine Bastarache, Scovia Nalugo Mbambla","doi":"10.1111/mcn.70047","DOIUrl":"https://doi.org/10.1111/mcn.70047","url":null,"abstract":"<p><p>Timely and prolonged skin-to-skin contact (SSC) immediately after birth is recommended in the Ugandan Clinical Guideline, the 2023 International Research and Practice Guideline on SSC and by the WHO/UNICEF Baby-Friendly Hospital Initiative. Skin-to-skin contact is safe, low-resource, evidence-based and contributes to short- and long-term health outcomes. However, practice is inconsistent. A rapid-change intervention, PRECESS (Practice, Reflection, Education and training, Combined with Ethnography for Sustainable Success), encouraged adaptation of the SSC Guideline protocol in a regional referral hospital in Uganda. Fifteen key informants, including leadership and staff members, were interviewed before and after the practice change about perceived barriers and solutions for implementing SSC. The semi-structured pre- and post-intervention interviews were recorded, transcribed and analyzed for meaningful units and themes. Three themes emerged: (1) Commitment to consistent, evidence-based care within constraints; (2) Addressing knowledge and skill regarding the optimal practice of SSC; and (3) Willingness to \"take-up\" the practice change for the benefit of mothers and babies. Our findings support the experiential method of practice change PRECESS to implement immediate, continuous, uninterrupted SSC for at least the first hour after birth. Despite the challenges and barriers identified in key informant interviews, significant progress was made in increasing the duration of SSC for both vaginal and cesarean births. The identified themes provide insight for future implementation of skin-to-skin contact.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70047"},"PeriodicalIF":2.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial Predictors of Infant and Young Child Feeding Practices Among Mother-Child Dyads in Malawi and South Africa.","authors":"Taryn J Smith, Chikondi Mchazime, Pious Makaka, Giulia Ghillia, Donna Herr, Marlie Miles, Chloë Jacobs, Sadeeka Williams, Thandeka Mazubane, Zayaan Goolam Nabi, Michal R Zieff, Emmie Mbale, Melissa J Gladstone, Kirsten A Donald","doi":"10.1111/mcn.70045","DOIUrl":"https://doi.org/10.1111/mcn.70045","url":null,"abstract":"<p><p>Maternal capacity to adhere to recommended infant and young child feeding (IYCF) practices may be influenced by psychosocial factors. However, research examining associations between psychosocial factors and IYCF practices, and in particular complementary feeding indicators, is limited. As part of the Khula birth cohort study, we aimed to investigate associations between maternal depression, exposure to intimate partner violence (IPV), social support and stimulating home environments with IYCF practices among mother-child dyads in Malawi (n = 153) and South Africa (n = 255). When children were 10-16 months of age, mothers completed a series of psychosocial and child diet questionnaires. Regression modelling assessed associations between maternal psychosocial measures and IYCF indicators, adjusting for maternal age, education, marital status and household socioeconomic status. IYCF practices were suboptimal in both settings, with 50%-54% meeting the minimum dietary diversity (MDD), 67%-73% the minimum meal frequency (MMF) and 39%-45% the minimum acceptable diet (MAD) indicators. In South Africa, mothers exposed to IPV in the previous 12 months were less likely to meet the MDD and MAD recommendations (MDD: OR 0.38, 95% CI: 0.19, 0.75; p = 0.006; MAD: OR 0.41, 95% CI: 0.20, 0.85; p = 0.02). There was a significant positive association between stimulation (i.e., more books/toys/play activities) and dietary diversity scores in South Africa. In adjusted analyses, maternal depression and social support were not significantly associated with IYCF indicators in either setting. IYCF programmes may benefit from supporting maternal psychosocial wellbeing and integrating nurturing care to improve children's dietary intakes, growth and development.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70045"},"PeriodicalIF":2.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting the Consumption of Iron-Rich Foods During Pregnancy in Senegal: A Path Analysis.","authors":"Blaney Sonia, Dupuis Jérémie Bobby, Ndene Ndiaye Aminata, Ba Lo Nafissatou, Thiam El Hadj Momar, Sall Mohamadou","doi":"10.1111/mcn.70037","DOIUrl":"https://doi.org/10.1111/mcn.70037","url":null,"abstract":"<p><p>A limited consumption of iron-rich foods (IRF) is associated with a higher risk of anemia throughout the human life cycle, particularly during pregnancy. Using the extended version of the theory of planned behavior (eTPB), this study aims to identify pathways by which individual (attitude, subjective norm, the perceived behavioral control) and environmental-related factors may influence IRF consumption among pregnant women (PW) from all regions of Senegal. To evaluate IRF consumption in the past day and night, a food frequency questionnaire consisting of a list of IRF with yes/no responses was used. Constructs of the eTPB were assessed through a face-to-face interview conducted with each woman using a valid and reliable questionnaire with Likert scales. Our findings reveal that 9 out of 10 PW (n = 429) had the intention to consume IRF, while about 80% did consume them. Path analyses were conducted. There was no association between the intention and the behavior of interest. The consumption of IRF was predicted by control beliefs or the perceived ability of women to perform the behavior (β = 0.23, p < 0.001). In turn, control beliefs were positively associated with environmental barriers (β = 0.40, p < 0.001). In light of the results, we reiterate the importance of implementing a multisectoral approach to improve the consumption of IRF among PW. Yet, further research is required to better understand pathways through which the intention, psychosocial and environmental factors influence IRF consumption as well as the role of other potential causes of anemia among PW.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70037"},"PeriodicalIF":2.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Gestational Weight Trajectories With Neonatal Outcomes Among Pregnant Slum-Dwelling Women, India.","authors":"Swapna Deshpande, Tarja I Kinnunen, Rubina Mandlik, Anuradha Khadilkar, Suhas Otiv, Sangita Kulathinal","doi":"10.1111/mcn.13805","DOIUrl":"https://doi.org/10.1111/mcn.13805","url":null,"abstract":"<p><p>The influence of early pregnancy weight and gestational weight gain (GWG) on neonatal outcomes among Indian slum-dwellers remains understudied. A prospective cohort study summarised maternal weight trajectories using the longitudinal clustering technique and explored associations between these clusters and neonatal outcomes (low birthweight, small for gestational age [SGA] and preterm births) among 423 pregnant slum-dwelling women in Pune, India. Sociodemographic data, height and weight were measured at enrolment (< 12 weeks, 'early pregnancy'). Weight was additionally measured at 23 ± 1 ('mid-pregnancy'), 33 ± 1 ('late pregnancy'), 36-37 and 39-40 weeks. The mean age was 24.7 (95% CI, 23.3, 25.1) years and the mean BMI at enrolment was 22.3 (95% CI, 21.9, 22.7) kg/m². Underweight women had the highest GWG rates and total GWG, while obese women had the lowest. Four clusters were identified: Cluster 1 (n = 124, 97% normal and overweight women, GWG rate: 0.27 (95% CI, 0.24, 0.30) kg/week early-late pregnancy) was the reference group. Women in Cluster 2 (n = 146, 93% underweight and normal weight women, GWG rate: 0.31 (95% CI, 0.28, 0.34) kg/week early-late pregnancy) had a higher risk of having SGA and preterm newborns and women in Cluster 3 (n = 68, 100% overweight and obese women, GWG rate: 0.17, 95% CI, 0.12, 0.22 kg/week early-late pregnancy) had a higher risk of having preterm newborns than Cluster 1. The women in Cluster 4 (n = 85, 100% underweight and normal weight, mean early-late pregnancy GWG rate of 0.47, 95% CI, 0.44, 0.50 kg/week) showed no higher risk of adverse neonatal outcomes. This study highlights the need to monitor both pre-pregnancy BMI and weight throughout pregnancy to enhance the possibility of favourable neonatal outcomes.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e13805"},"PeriodicalIF":2.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Maternal Undernutrition During Pregnancy and Newborn Low Birth Weight in Ethiopia: A Systematic Review and Meta-Analysis.","authors":"Worku Necho Asferie, Amare Kassaw, Demewoz Kefale, Solomon Demis Kebede, Molla Azmeraw, Yeshiambaw Eshetie Ayenew, Tigabu Munye Aytenew","doi":"10.1111/mcn.70040","DOIUrl":"https://doi.org/10.1111/mcn.70040","url":null,"abstract":"<p><p>Maternal undernutrition is a key contributor for poor fetal growth, low birth weight and infant morbidity and mortality. Globally, 15%-20% of all births were low birth weight, accounting more than 20 million births a year. This review aims to estimate the pooled association of maternal undernutrition during pregnancy with newborn low birth weight in Ethiopia. A systematic literature search was done from PubMed, Scopus, Hinari, Google Scholar and online research repositories. All studies reporting the association of undernutrition with low birth weight among pregnant women in Ethiopia were included. Heterogeneity between the included studies was assessed using the Cochrane Q-test and I² statistics. Publication bias was also assessed using Egger's regression test with 5% significance level. Finally, the random effects analysis model was used to estimate the overall pooled effect size. Among 596 identified studies, 15 articles were met inclusion criteria and included in this meta-analysis. A total of 6441 mother-neonate pairs were involved in this analysis. The pooled effect size revealed that there was a significant association between maternal undernutrition during pregnancy and newborn low birth weight in Ethiopia AOR: 2.52 (2.01-3.15, I² = 78.42%). This review was estimated that maternal undernutrition during pregnancy had a significant association with newborn low birth weight in Ethiopia. Undernutrition pregnant women had an increased chance of giving low birth weight. The finding of this review may help the stakeholders to focus on managing pregnancy malnutrition.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70040"},"PeriodicalIF":2.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of the Behaviour Change Wheel to Optimise Infant Feeding in Bangladeshi and Pakistani Communities in the UK: Co-Development of the Learning About Infant Feeding Together (LIFT) Intervention.","authors":"Kayleigh Kwah, Naomi Bartle, Maxine Sharps, Kubra Choudhry, Jackie Blissett, Katherine Brown","doi":"10.1111/mcn.70019","DOIUrl":"https://doi.org/10.1111/mcn.70019","url":null,"abstract":"<p><p>Breastfeeding rates in the UK are amongst the lowest in the world, largely driven by individual- and social-level barriers. Evidence has also highlighted that cultural factors can play an important part, such as for the UK South Asian community. Although aggregated breastfeeding data indicates that initiation is high amongst the UK South Asian population, sub-group data shows that this is substantially lower amongst people of Pakistani and Bangladeshi ethnicity. As such, culturally tailored interventions are called for. This research aimed to systematically develop an evidence-based culturally tailored intervention to support the optimisation of infant feeding in these communities. The 'Learning about Infant Feeding Together' (LIFT) intervention was co-developed by researchers, six community peer group champions, and a 3rd sector organisation supporting UK South Asian women. Development was guided by the REPLACE approach (a framework for the development of culturally specific community-based interventions) and the Behaviour Change Wheel (a framework for describing, designing and evaluating behaviour change strategies). It involved three co-development intervention workshops as part of a rigorous systematic intervention development approach. A culturally tailored intervention incorporating nine behaviour change techniques was produced. The intervention aims to increase breastfeeding by targeting six infant feeding behaviours identified as important, changeable and pertinent to the communities involved. The final intervention includes posters, leaflets, and an animation. The transparent reporting of intervention content and the approach taken to development will support the growth of evidence-based practice in the field of infant feeding.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70019"},"PeriodicalIF":2.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Exclusive Breastfeeding and Diarrhoea Morbidity in Infants Aged 0-6 Months: A Rapid Review and Meta-Analysis.","authors":"Gantsetseg Ganbold, Nadia Farnaz, Taylah Scutts, Bindi Borg, Seema Mihrshahi","doi":"10.1111/mcn.70042","DOIUrl":"https://doi.org/10.1111/mcn.70042","url":null,"abstract":"<p><p>Diarrhoea remains a major cause of mortality among children under five, despite global efforts to reduce childhood morbidity and mortality. Exclusive breastfeeding (EBF) has been recognised as an effective and cost-effective intervention to reduce diarrhoeal disease burden in infants. This rapid review and meta-analysis aimed to assess the association of EBF on diarrhoea morbidity in early childhood, a critical period for growth and development, while addressing existing gaps by employing standardised definitions of EBF. A systematic search was conducted in Medline, Scopus, Embase, and Web of Science databases for studies published between 2010 and 2024. Seventeen studies met inclusion criteria and underwent quality assessment using the Joanna Briggs Institute (JBI) critical appraisal tool. Data from the identified studies were extracted, and a meta-analysis was conducted using random effects models to calculate the pooled effect size, with odds ratios (OR) and 95% confidence intervals (CI). This review found that EBF significantly reduces the risk of diarrhoeal diseases in infants under 6 months of age across diverse geographical regions and study designs. The meta-analysis of the association between exclusive breastfeeding and diarrhoea in infants aged 0-6 months resulted in a pooled OR of 0.57 (95% CI: 0.51, 0.63; I² = 57.66%). These findings underscore the critical role of promoting and supporting EBF as a pivotal public health strategy to enhance early childhood health outcomes and contribute to achieving global child health goals.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70042"},"PeriodicalIF":2.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Wasting in Children Under 5 in Arid Regions of Kenya.","authors":"Dickson A Amugsi, Estelle Sidze, Faith Thuita, Valerie L Flax, Calistus Wilunda, Linda Adair, Bonventure Mwangi, Esther Anono, Hazel Odhiambo, Stephen Ekiru, Gillian Chepkwony, Webale Albert, Ng'ang'a Monica, Joshua D Miller, Bradley Sagara, Elizabeth Kimani-Murage, Chessa Lutter","doi":"10.1111/mcn.70036","DOIUrl":"https://doi.org/10.1111/mcn.70036","url":null,"abstract":"<p><p>Child wasting is a major public health problem in low- and middle-income countries. Our study aimed to identify immediate, underlying and basic factors influencing wasting among children in Turkana and Samburu, two arid and semi-arid regions in Kenya. Data are from a longitudinal study of children under 3 years of age at baseline, with follow-up every 4 months for 2 years. Generalized estimating equations were used to assess risk factors of wasting in this population. Among immediate factors, children who recently experienced diarrhoea had 19% and 23% higher odds of wasting, and those who consumed animal-source foods had 12% and 22% lower odds of wasting in Turkana and Samburu, respectively. Among underlying factors, children in Turkana whose caregivers used alcohol had 32% higher odds of wasting, whereas there was no effect of household food insecurity or factors related to water and sanitation on wasting in either county. Children in Turkana whose caregivers had 3-5 or 6 or more children had 39% and 70% higher odds, whereas those in female-headed households had 34% and 81% higher odds of wasting in Turkana and Samburu, respectively. Male children also had increased odds of wasting; 21% and 41% in Turkana and Samburu, respectively. Children in Turkana's fisherfolk communities had 36% higher odds of wasting compared with those in urban or peri-urban areas. Key risk factors for wasting included child sex, reported diarrhoea, caregiver's use of alcohol (in Turkana), caregiver's number of children, female-headed households and fisherfolk livelihood (in Turkana) while consuming animal-source foods was associated with lower risk. Interventions should target these intersecting factors to reduce wasting in these counties.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70036"},"PeriodicalIF":2.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infant Formula in the Digital Age: How US Online Formula Marketing Targets Parents.","authors":"Simone Froley, Cristina Watkins, Cecília Tomori","doi":"10.1111/mcn.70034","DOIUrl":"https://doi.org/10.1111/mcn.70034","url":null,"abstract":"<p><p>Despite recommendations by the International Code of Marketing of Breastmilk Substitutes (the Code), regulatory bodies in the United States continue to permit commercial milk formula (CMF) marketing that threatens public health. The increasing popularity of online shopping highlights the need for more research on virtual CMF product marketing. To assess marketing strategies from the e-customer standpoint, we analyzed a sample of 26 bestselling virtual infant formula (IF) products from three US-based e-commerce giants. All product display content, including visual and audible components, was evaluated according to Code guidelines, analyzed thematically and assessed for theme co-occurrence. No IF labels were compliant with the Code due to widespread health benefit claims and idealization of IF. Furthermore, no US-based products were compliant with critical Code guidelines for powdered IF reconstitution instructions. Thematic analysis of virtual product web pages revealed 17 themes, of which four were novel to public health literature: purity, nature, innovation and eco-friendly. These themes co-occurred in patterned ways to capture consumers. The most popular online IF products in the United States combine Code violations with compelling online materials that idealize IF and shape cultural expectations about infant feeding and care. These practices reinforce the formula industry's well-documented efforts to undermine breastfeeding. A review of US regulations and implementation of the Code is urgently needed to protect public health.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70034"},"PeriodicalIF":2.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}