Innovative and continuously changing methods of digital marketing are routinely used to reach young women and their families with advertisements that normalise infant artificial feeding and undermine breastfeeding. Legislation and provisions regulating digital and social media marketing are limited across countries. The aim of this scoping review was to systematically identify and summarise worldwide legislation implemented to regulate breast-milk substitutes (BMS) marketing on digital and social media, as well as identifying areas of opportunity to strengthen and improve it. Documents published from January 2012 to April 2022 were examined using search strategies including multiple databases and citation tracking. A total of 127 sources were evaluated, and only 28 documents from 24 countries meeting the inclusion criteria were retained. Most of the reviewed documents explicitly stated that digital marketing was prohibited (n=23), as opposed to being regulated only, with prior approval from the relevant authorities in each country. Regarding monitoring, from the countries included in this scoping review, only 14 of 24 (58.3%) stipulate a monitoring process for compliance with legal measures and have designated an actor responsible for monitoring. In addition, 22 of 24 (91.6%) countries included have defined sanctions, but only 17 (70%) countries specify the entity responsible for enforcement. The results highlight the urgent call for the explicit regulation of BMS marketing in digital and social media worldwide, as well as the public documentation of such legal measures. Likewise, it is important that there are effective, transparent and free of commercial influence national monitoring systems used to ensure compliance with legal measures.

As a nutrient rich emulsion extracted from plant materials, plant-based milk (PBM) has been the latest trend and hot topic in the food industry due to the growing awareness of consumers toward plant-based products in managing the environmental (carbon footprint and land utility), ethical (animal well-fare) and societal (health-conscious) issues. There have been extensive studies and reviews done to discuss the distinct perspective of PBM including its production, health effects and market acceptance. However, not much has been emphasized on the valuable antioxidants present in PBM which is one of the attributes making them stand apart from dairy milk. The amounts of antioxidants in PBM are important. They offered tremendous health benefits in maintaining optimum health and reducing the risk of various health disorders. Therefore, enhancing the extraction of antioxidants and preserving their activity during production and storage is important. However, there is a lack of a comprehensive review of how these antioxidants changes in response to different processing steps involved in PBM production. Presumably, antioxidants in PBM could be potentially lost due to thermal degradation, oxidation or leaching into processing water. Hence, this paper aims to fill the gaps by addressing an extensive review of how different production steps (germination, roasting, soaking, blanching, grinding and filtration, and microbial inactivation) affect the antioxidant content in PBM. In addition, the effect of different microbial inactivation treatments (thermal or non-thermal processing) on the alteration of antioxidant in PBM was also highlighted. This paper can provide useful insight for the industry that aims in selecting suitable processing steps to produce PBM products that carry with them a health declaration.

Globally, too few children are breastfed as recommended. Commercial promotion of breast-milk substitutes (BMS) is one factor undermining breastfeeding globally. Although the International Code of Marketing of BMS prohibits all forms of marketing, promotion has been observed in digital environments. We aimed to understand the scope and impact of digital marketing for the promotion of BMS.
BMS are promoted strategically and in an integrated fashion across multiple digital channels (social media, manufacturer websites, online retailers, blogs, mobile apps and digital streaming services). Traditional marketing strategies like gifts, discounts and coupons are also disseminated digitally. Data mining, real-time direct-to-consumer advertising and partnering with peer-group social media influencers are additional avenues. Exposure to digital marketing is common. Research on the impact of digital marketing is scarce, but its negative impact on breastfeeding intention and initiation has been documented. Case reports from marketing industry press corroborate academic evidence by highlighting the benefits of digital marketing to BMS companies in recruiting new users and increasing sales. To protect and promote breastfeeding, coordinated global action and strengthened national measures will be needed to implement, monitor and enforce the International Code in a digital context. Further action could include voluntary restrictions on BMS marketing by social media platforms and greater use of government-led data and health privacy regulation.

The introduction of fluids other than breast milk during the first few days of life or later neonatal period has been identified as a risk factor for suboptimal breastfeeding (BF) outcomes in numerous studies using varying study designs. However, the relationship between early introduction of fluids other than breast milk and BF outcomes has not been systematically assessed using only prospective studies that can establish temporality, which is critical for determining whether observed associations are causal. We conducted a systematic review and meta-analysis of prospective studies to assess if there is a difference in BF outcomes as a result of the introduction of: (a) milk-based prelacteals, (b) water-based prelacteals and (c) breast milk substitutes (BMS) between 4 days and 4 weeks postpartum. We searched PubMed, Lilacs, Web of Science and other repositories for original research investigating the relationship between early introduction of prelacteals and/or BMS and BF outcomes. Forty-eight studies met the inclusion criteria for the systematic review. Of the 39 prelacteal feeding studies, 27 had the prerequisite statistical information for inclusion in the meta-analysis. Findings from the meta-analysis showed a relationship between prelacteals and exclusive BF cessation (RR 1.44; 1.29-1.60) and any BF cessation (2.23; 1.63-3.06) among infants under 6 months old. Nine studies focusing on the introduction of BMS during the neonatal period identified this practice as a statistically significant risk factor for a shorter BF duration. Effective interventions are needed to prevent the introduction of unnecessary milk-based prelacteals and BMS during the perinatal and neonatal periods to improve BF outcomes.

The influence of marketing on infant and young child feeding and health is well recognized, and an International Code was adopted by the World Health Assembly (WHA) in 1981 to reduce inappropriate marketing and protect breastfeeding. Yet the marketing and influencing continue. This scoping review systematically examined the published research evidence on the nature and extent of exposure to International Code violations from 1981 to August 2021. We used several search strategies involving multi-language databases, organization websites, citation tracking, and expert consultation, to find research items meeting our inclusion criteria. We evaluated 657 items and retained 153 studies from at least 95 countries in the review. The majority of the studies (n = 113) documenting exposure to inappropriate marketing were published since 2010. Studies reported a broad range of marketing violations targeting mothers and families, health workers, and the general public. Marketing via digital platforms and brand extension has become more frequent. The evidence shows the use of misleading and inaccurate labeling and health and nutrition claims in breach of the Code. Our review confirms that violations of the Code have not ceased and calls for renewed attention from the WHA and national governments to protect the health of children and their mothers.

This is the protocol for a scoping review that aims to systematically explore and summarise the published evidence of violations of the International Code of Marketing of Breast-milk Substitutes (the Code) and subsequent World Health Assembly Resolutions globally. The planned scoping review will seek to identify what research has been conducted on the topic, examine the geographic spread and nature of violations, and summarise knowledge gaps. The Code was adopted in 1981 by the World Health Assembly to protect infant health, in particular from aggressive and inappropriate marketing of breastmilk substitutes including formula and related products. Non-compliance with the Code or violations are described in reports, however, no existing systematic review of the global research appears to have been conducted that encompasses the varied disciplines including health, economics, and gender. The review will inform international and national decision-makers on the nature of violations and potentially highlight the need for new modalities to regulate this marketing. The proposed scoping review will use the six-step process of Arksey and O\'Malley which includes defining the research question; identifying the relevant literature; selecting studies; charting the data; collating, summarising and reporting the findings; and will include a consultative group.

Concerns about environmental impact and sustainability, animal welfare, and personal health issues have fueled consumer demand for dairy alternatives. The aim of this study was to conduct a cross-sectional survey of plant-based non-dairy beverages from three different continents (USA, Australia, and Western Europe) to assess their nutritional content and health profile. A total of 148 non-dairy beverages were analyzed from the nutrition label and ingredients listed on the commercial package or from the information located on the website of the manufacturer or retailer. The different types of beverages were extracts of nuts or seeds (n = 49), grains (n = 38), legumes (n = 36), coconut (n = 10), and mixed blends (n = 15). On average, the plant-based beverages generally scored well in terms of not containing high levels of sodium, saturated fat, or calories. Over half of the beverages were fortified with calcium to levels equal to or greater than that of dairy milk. The protein content varied from 0 to 10 g/serving. Levels of vitamin D and B12 fortification were quite low. Consumers should be informed of the nutritional profile and potential health benefits of plant-based dairy alternatives as the nutritional content can vary greatly between the different types of beverages.

Provision of nutrients in appropriate amounts to meet nutrient requirements for growth, production, and reproduction is the basis for modern animal nutrition. Ration formulation systems predict nutrient requirements based on numerous inputs and then predict nutrient supply based on predicted intake and nutrient content of feeds. Energy systems are used to predict energy supply based on gross caloric content of feeds followed by adjustments for digestion and metabolism of ingested energy. Many models of energy supply use static coefficients of digestibility based on nutrient composition of feed. Other models partition digestion dynamically between ruminal and postruminal digestion but use static estimates of intestinal digestibility to predict energy supplied to the animal. In young calves, both ruminal fermentation and intestinal digestion are underdeveloped; therefore, existing models of energy supply might overestimate the energy available before complete gastrointestinal maturation. In a series of experiments, we reported that total-tract digestion of nutrients changes with advancing age and nutrient intake. Total-tract digestion was measured in calves from 3 to 16 wk of age when fed different amounts and types of milk replacers. Calves were also fed different types of calf starter for ad libitum consumption. Total-tract digestibility of protein, fat, neutral detergent fiber, and nonfiber carbohydrate (NFC) was used to calculate the metabolizable energy (ME) in starter. We used nonlinear regression to estimate the contribution of protein and fat from starter and milk replacer before weaning. Early in life, calculated ME of starter was low and increased with increasing intake of NFC. Cumulative intake of NFC was more highly correlated with changing ME values than other indices, including age, intake of milk replacer, or intake of other nutrients in starter. When calves consumed at least of 15 kg of NFC, ME calculated from digestibility measurements was similar to the ME calculated using National Research Council equations and indicated maturation of gastrointestinal digestion. Our data suggest that intake of NFC is critical to gastrointestinal maturation and the calf\'s ability to extract energy from calf starter.

Recent interest in increasing rates of body weight gain in heifer calves before weaning is based on the promise of an increase in milk production during first lactation. This increase is usually realized by increasing milk or milk replacer intake, delaying the onset of rumen development. Simultaneously feeding liquids and solid feeds brings about new challenges. Macronutrient metabolism in growing calves is reviewed, combining literature from heifer and veal calves with the objective to provide insights useful for developing novel feeding strategies. Growing calves are not efficiently retaining digested N when compared with other growing species. Energy and protein appear to be simultaneously limiting growth. With the possible exception of very young calves, low responses to incremental intakes of AA indicate that the limiting AA rarely explains the low efficiency of N utilization. Nonetheless, there are indications that disproportionate oxidation of AA as a result of AA imbalance may occur, notably in splanchnic tissues. Long-chain fatty acids, absorbed from the milk or calf milk replacer (CMR) are preferentially deposited as body fat, but this strongly depends on the need for ATP, fueled by the oxidation of carbohydrates. Hence, fatty acid oxidation typically decreases with an increased feeding level. Insulin sensitivity in calves is quite high at birth, but decreases independent of feeding strategy in early age to very low levels when compared with other species. Even though changes in insulin sensitivity may be provoked by early life nutrition, these effects are small and rather transient. In heavy calves, insulin sensitivity is invariably low. Large effects of dietary treatments on postprandial glucose and insulin responses, as often observed, are unlikely to be caused by differences in insulin sensitivity. Unlike in pigs, de novo fatty acid synthesis is not a significant route of disposal of glucose absorbed from the intestinal tract. Instead, high lactate fluxes in milk-fed calves suggest this may be an important route of disposal. When combining the feeding of milk or CMR with solid feeds, estimation of the contribution of the individual ration components is difficult, and interactions inside the gastrointestinal tract complicate the estimation of their feeding value. There are indications in veal calves that use of nutrients absorbed from a CMR is not dependent on the level of intake of solid feeds.

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