198266 Effects of direct-to-consumer marketing of infant formula on formula choice and loyalty

Wednesday, November 11, 2009

Sara B. Fein, PhD , Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD
Conrad Choiniere, PhD , Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD
Yi Huang, PhD , Dept of Mathematics and Statistics, University of Maryland, Baltimore, MD
Judith Labiner-Wolfe, PhD , Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD
Objective: Estimate effects of direct-to-consumer advertising of infant formula on formula choice and loyalty to assess importance of Code violations.

Methods: Data are from the Infant Feeding Practices Study II, a U.S. national longitudinal study. Mothers were asked about exposure to formula advertising during pregnancy and about receiving a hospital gift pack that included formula samples and coupons and receiving samples in the mail when their infants were 1 month old. Switching formula was asked when infants were 2 and 5 months old and was also measured by use of different formulas monthly. Analysis used logistic regression.

Results: Mothers receiving a sample of formula in hospital gift packs were more likely to use that formula at 1 month after adjusting for demographics, infant characteristics, and breastfeeding (p=.007). Prenatal exposure to advertising or receiving a sample in the mail was not related to using the hospital formula. Mothers using the hospital formula at month 1 and receiving a coupon in the gift pack were less likely to switch formula in the first half of infancy (p=.05). However, those using the hospital formula were more likely to switch if they saw information about formula on the web (p=.0004). Receiving a sample in the mail was not related to switching.

Conclusion: Providing formula samples in hospital gift packs increases use of that formula, and other marketing activities do not cancel the effect. Among hospital formula users, providing a coupon for formula reduces switching and formula web information, which often includes coupons, increases switching.

Learning Objectives:
1) Assess the importance of various types of direct-to-consumer marketing activities for formula brand choice and loyalty in the US. 2) List demographic, infant, and feeding characteristics associated with mothers’ formula choice. 3) Estimate strength of opposition to efforts to reduce violations of the International Code of Marketing of Breast Milk Substitutes in the US.

Keywords: Breast Feeding, Marketing

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Sara B. Fein is a sociologist with extensive experience researching infant feeding practices. She has served as director for two infant feeding practices studies for the US Food and Drug Administration. In October 2008, the journal Pediatrics dedicated a Supplement to her most recent analyses on infant feeding. In addition, Dr. Fein has served as a presenter at many professional conferences, including APHA annual meetings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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