Digital marketing of formula and baby food negatively influences breast feeding and complementary feeding: a cross-sectional study and video recording of parental exposure in Mexico

There is little evidence of the association between digital marketing of formula and baby food and infant and young child feeding (IYCF) practices. Assess parents' exposure to digital marketing of formula and baby food for children <2 years and its association with the purchase and IYCF practices in Mexico. Parents ≥18 years recruited from a market research panel completed an online survey (n=1074) and capture-on-screen (n=95) between December 2020 and January 2021. Logistic regressions were used to estimate the association between exposure to digital marketing of formula and baby foods with its purchase, motivation, consumption and IYCF practices. Digital marketing of formula and baby food was self-reported by 93.9% of parents in the online survey and observed by 93.7% in the capture-on-screen. Recorded ads did not comply with the International Code of Marketing of Breast-milk Substitutes. Parents who self-reported seeing a higher versus lower number of ads were less likely to exclusive breast feed (OR=0.38; 95% CI: 0.19 to 0.78), and more likely to give mixed feeding (OR=2.59; 95% CI: 1.28 to 5.21), formula (OR=1.84; 95% CI: 1.34 to 2.53), processed foods (OR=2.31; 95% CI: 1.59 to 3.32) and sugary drinks (OR=1.66; 95% CI: 1.09 to 2.54). Higher exposure to ads was associated with a higher chance of purchasing products motivated by nutritional (OR=2.1; 95% CI: 1.32 to 3.28) and organic claims (OR=2.1; 95% CI: 1.21 to 3.72). Digital marketing of formula and baby food may negatively influence IYCF and should be regulated to ensure children's nutrition and health. [Abstract copyright: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Digital marketing of commercial breastmilk substitutes and baby foods: strategies, and recommendations for its regulation in Mexico

Background: Parents are exposed to breastmilk substitutes and baby foods marketing on the internet and social media, which hinders adequate breastfeeding and complementary feeding. This study identifies digital marketing strategies for breastmilk substitutes, specifically commercial milk formula and baby foods used by the industry to influence infant and young children’s feeding practices in Mexico and proposes regulatory recommendations that can be useful for similar countries. Methods: Qualitative study based on the CLICK monitoring framework developed by the World Health Organization, adapted for digital marketing of commercial milk formula and baby foods. Semi-structured interviews (n = 53) with key actors were conducted between November 2020 and March 2021, and used grounded theory for the analysis and interpretation with the MAXQDA 20 software. Results: Commercial milk formula and baby food companies use digital media to contact and persuade parents to use their products by sending electronic newsletters with advertising. Companies hire influencers to market their products because there is no regulation prohibiting the advertisement of breastmilk substitutes on social media, and promote formula among health professionals inviting them to participate in sponsored webinars on infant nutrition, ignoring conflict of interest and the International Code of Marketing of Breastmilk Substitutes. Parents trust formula and baby food advertisements, which use emotional messages and health and nutrition claims to encourage their consumption. Health professionals consider that claims contribute to the indiscriminate use of formula, and some actors propose the use of plain packaging for these products. Conclusions: Breastmilk substitutes companies promote their products in digital media using unethical strategies that fail to comply with the International Code of Marketing of Breastmilk Substitutes. They generate strong conflicts of interest with health professionals, taking advantage of legal framework gaps and the lack of monitoring and effective sanctions for non-compliers. Updating the legal framework and monitoring compliance, including digital media, is urgently needed to protect children’s right to breastfeeding, healthy nutrition and life, and the rights of women to health and informed decision-making

Non Hodgkin T cell lymphoma: an atypical clinical presentation Linfoma não Hodgkin de células T citotóxico: uma apresentação clínica atípica

Cytotoxic lymphomas comprise a spectrum of peripheral T-cell lymphomas that can have a initial or late cutaneous presentation. We describe a 46-year-old man from Cape Verde, with a dermatosis involving his face and trunk, consisting of monomorphic papules with a smooth surface and both motor and sensory polyneuropathy.The hypothesis of leprosy was supported by the clinical and initial hystopathological findings and the patient was referred to our hospital with suspected Hansen's disease. In the new skin and lymph node biopsies a lymphocyte population was identified whose immunohystochemistry study allowed the diagnosis of T-cell lymphoma with expression of cytotoxic markers. The patient was started on chemotherapy with initial remission of the skin lesions but, subsequently, progression of systemic disease.<br>Os linfomas citot&#243;xicos compreendem um espectro de linfomas de c&#233;lulas T perif&#233;ricos e linfomas Natural Killer que podem ter express&#227;o cut&#226;nea prim&#225;ria ou secund&#225;ria. Descrevemos o caso de um homem com 46 anos de idade, natural de Cabo Verde,com dermatose envolvendo a face e tronco constitu&#237;da por p&#225;pulas monomorfas superf&#237;cie lisa e polineuropatia sensitivo motora.A hip&#243;tese de Hansen&#237;ase foi colocada suportada por achados histopatol&#243;gicos sugestivos sendo o doente referenciado &#224; consulta de Doen&#231;a de Hansen do nosso hospital. Em biopsia de pele e de g&#226;nglio identificou-se prolifera&#231;&#227;o linfocit&#225;ria cujo estudo imunohistoqu&#237;mico permitiu o diagn&#243;stico de linfoma T com express&#227;o de marcadores citot&#243;xicos. Iniciou quimioterapia verificando-se inicialmente remiss&#227;o parcial das les&#245;es cut&#226;neas mas posteriormente a progress&#227;o da doen&#231;a sist&#233;mica

Cartilaginous melanoma: case report and review of the literature Melanoma cartilagíneo: caso clínico e revisão da literatura

Malignant melanoma can present a variety of histopathological patterns. Cartilaginous change in the absence of osteogenic differentiation is extremely rare in malignant melanoma, being among the least frequent of the wide range of melanoma histologic patterns. We report a case of a 47-year-old woman with a subungual nodule on her right great toe for many years. Histopathological examination of the lesion led to a diagnosis of malignant melanoma with cartilaginous differentiation devoid of concomitant osseous areas. It would appear that this unusual form of melanoma has a predilection for acral location, particularly the subungual region. Malignant melanoma with chondroid stroma should therefore be considered in the differential diagnosis of cartilaginous lesions of the toes and fingers. Careful examination of the overlying epidermis and identification of an in situ component of melanoma may be necessary in order to establish the correct diagnosis.O melanoma maligno pode apresentar uma grande variedade de padr&#245;es histopatol&#243;gicos. A presen&#231;a de diferencia&#231;&#227;o cartilag&#237;nea, na aus&#234;ncia de diferencia&#231;&#227;o osteog&#233;nica, &#233; extremamente rara no melanoma maligno. O melanoma cartilag&#237;neo est&#225; entre os padr&#245;es histol&#243;gicos menos frequentes. Relatamos um caso de uma doente do sexo feminino de 47 anos de idade com um n&#243;dulo subungueal no 1&#186; dedo do p&#233; direito com muitos anos de evolu&#231;&#227;o. O exame histopatol&#243;gico da les&#227;o revelou melanoma cartilag&#237;neo, sem &#225;reas de diferencia&#231;&#227;o osteog&#233;nica. Esta variante de melanoma parece ter predile&#231;&#227;o pela extremidades, sobretudo pela regi&#227;o subungueal. Assim, o melanoma maligno com diferencia&#231;&#227;o condr&#243;ide, deve ser tido em considera&#231;&#227;o no diagn&#243;stico diferencial de les&#245;es acrais cartilag&#237;neas. A observa&#231;&#227;o cuidadosa da epiderme e a identifica&#231;&#227;o de um componente do melanoma in situ podem ser necess&#225;rios para estabelecer um diagn&#243;stico correto