Healthcare professionals' perspectives on commercial milk formula marketing in the UK: a qualitative study

Objectives: To understand (1) healthcare professionals' (HCPs) perceptions and experiences of commercial milk formula (CMF) marketing to consumers and HCPs and (2) HCPs' perspectives on regulation of CMF marketing.

Setting: UK.

Design: In-person and online interviews with 41 HCPs with regular contact with pregnant women and mothers. Individual semistructured interviews were conducted from October 2019 to March 2021, focusing on experiences of CMF marketing and perceptions of legislation. Data were analysed using reflexive thematic analysis.

Results: Three themes were developed: (1) 'Industry relationships have changed and not disappeared'-some HCPs reported contact with industry ceasing due to the Baby Friendly Initiative (BFI) but contact with HCPs in other roles was believed to have increased; (2) 'Direct-to-consumer marketing presents challenges for HCPs'-to support women to make informed choices about infant feeding, HCPs felt they had to challenge misinformation families receive from the CMF industry; (3) 'System changes are needed to support informed infant feeding decisions'-HCPs wanted policy changes, including effective legislation to restrict CMF marketing to both HCPs and families. They also felt initiatives to normalise breastfeeding were important.

Conclusions: Reduced contact with CMF representatives was reported by HCPs covered by the BFI but continued or increased contact was seen with other HCPs. HCPs believed CMF marketing impacted women's beliefs about infant feeding and they had to work hard to provide a balanced perspective. HCPs wanted stricter regulation of CMF marketing.