Evidence map›Paper›PMID 39670338›Full record

ArticleMaternal & child nutrition2025

Assessing Compliance: Violations of WHO Code in Breast Milk Substitute Marketing, Ecuador.

Betzabé Tello, Silva-Jaramillo Katherine, Tutasi-Lozada Angélica, Caicedo-Borrás Rocío, Valencia Luz María, Rodríguez Estefanía

Abstract read
In one paragraph

Article in Maternal & child nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Betzabé TelloCenter for Research on Health in Latin America (CISeAL), Pontificia Universidad Católica del Ecuador, Quito, Ecuador.ORCID 0000-0001-5890-6436
Silva-Jaramillo KatherineUNICEF, Quito, Ecuador.
Tutasi-Lozada AngélicaUniversity at Buffalo, State University of New York, Getzville, New York, USA.
Caicedo-Borrás RocíoFUNBBASIC/IBFAN, Quito, Ecuador.
Valencia Luz MaríaFUNBBASIC/IBFAN, Quito, Ecuador.
Rodríguez EstefaníaFacultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Breast milk substitute (BMS) marketing significantly influences global infant feeding practices. Ecuador, like many countries, seeks to regulate these promotions under the WHO's International Code of Marketing of Breast-Milk Substitutes. This cross-sectional analysis assessed BMS marketing compliance with WHO's Code in Ecuador. Surveys were conducted with mothers (n = 330) and healthcare professionals (n = 66), complemented by observations at health facilities (n = 33) and retail outlets (n = 44). Media monitoring and product labelling evaluations were also conducted. The study revealed widespread exposure to BMS marketing outside health facilities (91.21% of mothers). Promotional activities targeted healthcare professionals, with significant interactions involving free supplies (26.09%) and gifts (21.74%). Retail outlets prominently displayed BMS promotions, often featuring discounts (95%). Compliance with labelling criteria was notably low, particularly concerning nutrition and health claims (39%). TV emerged as the dominant platform for BMS advertising, with 2884 ads aired over 16 h and 24 min, totalling $1,876,915.50 in expenditures. Digital platforms also featured BMS ads, with significant engagement on social media (533,845 interactions). This study reveals widespread violations of the WHO Code in Ecuador, emphasizing the need for stronger regulations and targeted education for healthcare professionals and the public to protect infant health and promote breastfeeding. Despite existing regulations, the pervasive advertising and substantial investment in BMS marketing across various media underscore significant enforcement gaps. To effectively safeguard maternal and child health, Ecuador must fully incorporate and rigorously enforce all Code recommendations within its national legislation.

Indexed as

Guideline AdherenceInfant FormulaMarketingMilk SubstitutesAdultAdvertisingBreast FeedingCross-Sectional StudiesEcuadorFemaleFood LabelingHealth PersonnelHumansInfantMilk, HumanMothersbreast feedingcommercial milk formulainfant formulalegislationmarketingmass mediamilk substitutesnutrition policy

Identifiers

PMID39670338
PMCPMC11956041

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.