The Influence of Human-Milk Substitutes Marketing on Breastfeeding Intention and Practice among Native and Immigrant Brazilians

Abstract

Background: The International Code of Marketing of Breast-Milk Substitutes is a global public health policy aiming to protect breastfeeding from the influence of human-milk substitutes marketing. Brazil is one of the few countries substantially implementing it. Most countries adopted selected provisions, including Portugal. Research Aim: To explore whether Brazilians’ perspectives about breastfeeding intention and practice are influenced by human-milk substitutes marketing upon migration to Portugal. Methods: A qualitative, prospective, cross-sectional survey design was conducted in Brazil and Portugal (2018–2019). Qualitative semi-structured interviews were performed with native (n = 16) and immigrant (n = 15) Brazilians. Women aged 18 or above, mothers of 0–12 month infants, and without contraindications to breastfeed, were eligible for the study. Heterogeneity sampling was employed based on socioeconomic status and infants’ age. Content analysis was conducted using NVivo. Results: Brazilian immigrants were more aware of the potential negative influence of human-milk substitutes marketing than natives. Sociocultural factors contributed to Brazilian immigrants being less permeable to the influence of human-milk substitutes marketing in the host country, where a less protective breastfeeding environment was perceived. Conclusions: Sociocultural factors including breastfeeding promotion strategies and a strong breastfeeding culture in the home country appear to play a protective role on breastfeeding intention and practice among Brazilians migrating to Portugal. © The Author(s) 2022.The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study is funded by FEDER funds through the Operational Programme for Competitiveness and Internationalization, and by national funding through the Foundation for Science and Technology (FCT; Portuguese Ministry of Science, Technology and Higher Education), under the scope of the project ‘‘Perinatal Health in Migrants: Barriers, Incentives and Outcomes’’ (POCI-01-0145-FEDER-016874; PTDC/DTPSAP/6384/2014), the projects UIDB/04750/2020 e LA/P/0064/2020, the PhD grant PD/BD/128082/2016 (C. L.) co-funded by the FCT and Human Potential Operating Program of the European Social Fund (POPH/FSE Program) and the contract DL57/2016/CP1336/CT0001 (C.F.). A. M. has a research scholarship from the Brazilian National Council for Scientific and Technological Development (CNPq)