Marketing of breast milk substitutes in relation to crying, sleeping and posseting on Instagram by influencers in South Africa, 2018-2020

Abstract

Introduction: Global trends have seen a decline in the rates of breastfeeding. This has resulted in increased infant mortality due to infectious diseases and inappropriate feeding practices. The decline in breastfeeding rates is attributed partly to increasedand aggressive marketing of breastmilk supplements by companies that produce them, despite several regulations prohibiting marketing targeted at parents and caregivers of children less than six months of age. With the progressive use of social media, marketing has shifted from traditional methods to the use of influencers, who command a huge following on their social media accounts and influence the daily decisions of the thousands and sometimes millions of people who follow them. This study investigates the marketing of breastmilk substitutes in relation to crying and sleeping and posseting by companies using South African Instagram influencers. Methods: This was a retrospective study, which used a mixed methods approach to analyse posts related to infant feeding methods that were made by South African Instagram influencers between January 2018 to December 2020. A total of seven influencers, their 62 Instagram posts and 18 333 subsequent follower comments were included in the sample. Framing analysis was used to analyse qualitative data in NVivo 12 software while quantitative data were analysed manually. Results: Of the 62 posts that addressed infant feeding methods from the 7 influencers, 27 were manufacturer-sponsored advertisements (some of which violated local regulations), while 35 posts encouraged breastfeeding. The main qualitative themes showed that breastmilk substitute products are portrayed as solutions to infants who constantly cry and have trouble with sleep. This is done by manufacturers through influencers, who are paid to market these products to their followers, depicting this as their own personal methods of infant feeding. Breastfeeding posts were not sponsored. Conclusion: Closer monitoring of social media and stiffer regulations should be enforced for companies marketing BMS on social media. Influencers and health professionals giving advice contrary to the guidelines from the WHO should be reported according to Regulation 991 and made accountable. Nevertheless, the potential for Instagram influencers to promote and normalise breastfeeding should be considered by health communicators.