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      Misperceptions and misuse of Bear Brand coffee creamer as infant food: national cross sectional survey of consumers and paediatricians in Laos

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          Abstract

          Objective To investigate the use of Bear Brand coffee creamer as a food for infants and the impact on consumers of the logo of a cartoon baby bear held by its mother in the breastfeeding position.

          Design Interviews with paediatricians throughout the country and a national survey of potential consumers regarding their perceptions and use of the Bear Brand coffee creamer.

          Setting 84 randomised villages in south, central, and northern Laos.

          Participants 26 Lao paediatricians and 1098 adults in households in a cluster sampling.

          Results Of the 26 paediatricians, 24 said that parents “often” or “sometimes” fed this product to infants as a substitute for breast milk. In the capital city, paediatricians said that mothers used the product when they returned to work. In the countryside, they reported that poor families used it when the mother was ill or died. Of 1098 adults surveyed, 96% believed that the can contains milk; 46% believed the Bear Brand logo indicates that the product is formulated for feeding to infants or to replace breast milk; 80% had not read the written warning on the can; and over 18% reported giving the product to their infant at a mean age of 4.7 months (95% confidence interval 4.1 to 5.3).

          Conclusion The Bear Brand coffee creamer is used as a breast milk substitute in Laos. The cartoon logo influences people’s perception of the product that belies the written warning “This product is not to be used as a breast milk substitute.” Use of this logo on coffee creamer is misleading to the local population and places the health of infants at risk.

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          PEDIATRICS

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            A nutrition paradox--underweight and obesity in developing countries.

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              Deaths and years of life lost due to suboptimal breast-feeding among children in the developing world: a global ecological risk assessment.

              We estimate attributable fractions, deaths and years of life lost among infants and children < or = 2 years of age due to suboptimal breast-feeding in developing countries. We compare actual practices to a minimum exposure pattern consisting of exclusive breast-feeding for infants < or = 6 months of age and continued breast-feeding for older infants and children < or = 2 years of age. For infants, we consider deaths due to diarrhoeal disease and lower respiratory tract infections, and deaths due to all causes are considered in the second year of life. Outcome measures are attributable fractions, deaths, years of life lost and offsetting deaths potentially caused by mother-to-child transmission of HIV through breast-feeding. Developing countries. Infants and children < or = 2 years of age. Attributable fractions for deaths due to diarrhoeal disease and lower respiratory tract infections are 55% and 53%, respectively, for the first six months of infancy, 20% and 18% for the second six months, and are 20% for all-cause deaths in the second year of life. Globally, as many as 1.45 million lives (117 million years of life) are lost due to suboptimal breast-feeding in developing countries. Offsetting deaths caused by mother-to-child transmission of HIV through breast-feeding could be as high as 242,000 (18.8 million years of life lost) if relevant World Health Organization recommendations are not followed. The size of the gap between current practice and recommendations is striking when one considers breast-feeding involves no out-of-pocket costs, that there exists universal consensus on best practices, and that implementing current international recommendations could potentially save 1.45 million children's lives each year.
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                Author and article information

                Contributors
                Role: training and research coordinator
                Role: paediatrician, IFMT student
                Role: teaching assistant
                Role: paediatric residency coordinator
                Role: paediatric continuing medical education coordinator
                Journal
                BMJ
                bmj
                BMJ : British Medical Journal
                BMJ Publishing Group Ltd.
                0959-8138
                1468-5833
                2008
                2008
                09 September 2008
                : 337
                : a1379
                Affiliations
                [1 ]Institut de la Francophonie pour la Médecine Tropicale, BP 9519, Vientiane, Lao Popular Democratic Republic
                [2 ]Health Frontiers, University of Health Sciences, Vientiane
                Author notes
                Correspondence to: H Barennes hubert.barennes@ 123456auf.org
                Article
                barh579086
                10.1136/bmj.a1379
                2533525
                18782843
                1e0c4c44-0d53-4c2c-9339-1f42f3e95283
                © Barennes et al 2008

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 July 2008
                Categories
                Research

                Medicine
                Medicine

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