# Cross‐Sectional Associations Between Exposure to Commercial Milk Formula Marketing, Beliefs About Its Use, and Socioeconomic Position Among Pregnant Women and Mothers in the UK

## TL;DR

All UK pregnant women and mothers in this study saw formula milk ads, and lower-income women were more likely to believe formula is as good as or better than breastfeeding.

## Contribution

This study reveals socioeconomic disparities in beliefs about formula milk and highlights the need for stricter marketing regulations.

## Key findings

- All women reported exposure to commercial milk formula marketing through multiple channels.
- Lower and middle SEP women held stronger beliefs that formula provides equal or greater benefits than breastfeeding.
- No association was found between the amount of marketing exposure and the strength of positive beliefs about formula.

## Abstract

International provisions are in place to restrict marketing practices that idealise the use of commercial milk formula (CMF) and discourage breastfeeding. In high‐income countries, women of lower socioeconomic position (SEP) are less likely to breastfeed. This study aimed to characterise the nature of exposure to CMF marketing in the UK, the extent to which women hold positive beliefs about CMF and examine the relationship between exposure to CMF marketing, holding positive beliefs about CMF and SEP. Data on these topics were collected for 1052 pregnant women and mothers of children under 18 months of age between February 2020 and February 2021. Participants were assigned a ‘CMF marketing score’ according to the number of locations where they recalled seeing advertisements, engaging with companies or receiving promotional activity. The extent to which women held positive beliefs about CMF (‘CMF positivity score’) was determined by level of agreement with 17 statements. Principal component analysis, analyses of covariance and regression analyses were applied. Every woman reported exposure to CMF marketing from multiple channels. CMF marketing score did not vary across SEP groups (p = 0.342). Women of lower and middle SEP held stronger CMF positive beliefs than women of higher SEP, including ‘Breastfeeding and formula feeding provide a baby with the same health benefits’ (p < 0.005). CMF marketing score was not associated with CMF positivity score. Marketing suggesting CMF provides benefits similar to, or greater than, breastfeeding should be restricted to help mitigate current inequalities in infant feeding practices.

All women in this UK study reported exposure to formula milk marketing. Women of lower and middle socioeconomic position (SEP) were more likely than those of higher SEP to believe formula provides equal or greater benefits than breastfeeding. Tighter legislation is needed to restrict marketing suggesting formula is breastmilk equivalent/superior.

Every woman in this UK sample reported exposure to commercial milk formula (CMF) marketing, including frequently seeing advertisements on TV and receiving pop‐up advertisements on social media.Women of lower and middle socioeconomic position held stronger beliefs that CMF provides the same or greater benefits than breastfeeding than women of higher SEP.No association was found between the number of forms of CMF marketing women were exposed to and holding more positive beliefs about CMF.To support a reduction in infant feeding inequalities, detailed legislation is needed to restrict marketing that suggests CMF provides equal or superior benefits to breastfeeding.

Every woman in this UK sample reported exposure to commercial milk formula (CMF) marketing, including frequently seeing advertisements on TV and receiving pop‐up advertisements on social media.

Women of lower and middle socioeconomic position held stronger beliefs that CMF provides the same or greater benefits than breastfeeding than women of higher SEP.

No association was found between the number of forms of CMF marketing women were exposed to and holding more positive beliefs about CMF.

To support a reduction in infant feeding inequalities, detailed legislation is needed to restrict marketing that suggests CMF provides equal or superior benefits to breastfeeding.