The Influence of Human-Milk Substitutes Marketing on Breastfeeding Intention and Practice among Native and Immigrant Brazilians.

This is qualitative, so it describes experiences and cannot show that marketing caused formula use or that counselling changes practice. The sample was small and purposively selected, so it may not represent all Brazilian mothers or immigrants. Immigrants had older infants, and feeding and marketing exposure were self-reported, so recall bias is possible. Native participants were recruited from private clinics while immigrants came from a public maternity cohort, so socioeconomic differences may remain. The first author alone analysed the qualitative data, which may introduce coding bias. Participants were classified as women by sex assigned at birth and gender identity was not asked.

The authors declared no competing financial or conflicts of interest. Funding came from Portuguese and European public research grants, including FCT and FEDER.

Do not read the similar intention and practice as proof that human-milk substitute marketing does not influence formula use. The study is qualitative and small, and participants reported formula use after perceived low milk supply, infant weight concerns, convenience, and health advice.