Análisis de los argumentos recibidos en la consulta pública para el etiquetado frontal de advertencia mexicano.

OBJETIVO: Analizar los diferentes elementos en los argumentos recibidos durante la consulta pública del Proyecto de Modificación a la Norma Oficial Mexicana-051 (NOM-051), con énfasis en la protección de niñas, niños y adolescentes (NNA). Material y métodos. Se analizó la información de 1 095 argumentos, se identificó a los actores clave y se realizó un análisis de contenido para conocer la postura, a favor o en contra de los numerales relacionados con la protección a NNA. El análisis se hizo en el programa NVivo. RESULTADOS: Se identificaron 781 actores clave. Durante la consulta pública se identificaron cuatro tácticas del sector privado para interferir en el proceso de la NOM-051: a) grupos fachada que enviaron comentarios en contra de la NOM-051; b) cuestionar la evidencia científica sobre la relación del consumo de edulcorantes y el desarrollo de obesidad en escolares; c) cuestionar la efectividad del uso del etiquetado de advertencia para edulcorantes; d) responsabilizar a los individuos de su enfermedad. Conclusión. La interferencia del sector privado en el proceso de implementación de la NOM-051 fue evidente en los argumentos enviados durante la consulta pública.

Can "Becoming Breastfeeding Friendly" Impact Breastfeeding Protection, Promotion, and Support in Mexico? A Qualitative Study.

BACKGROUND: The Becoming Breastfeeding Friendly (BBF) initiative includes a guide that helps countries worldwide assess their readiness to scale up national breastfeeding programs. Country committees of breastfeeding experts across government, academia, and civil society engage with BBF by applying the BBF toolbox that includes (1) the BBF Index (BBFI) to measure and score a country's breastfeeding environment, (2) case studies that illustrate how countries have created enabling environments for breastfeeding, and (3) a 5-meeting process, during which country committees develop policy recommendations intended to improve breastfeeding outcomes based on the BBFI scores. OBJECTIVE: This study seeks to understand how the application of the BBF toolbox impacted plans to improve the enabling environment for breastfeeding in Mexico. METHODS: Semi-structured interviews were conducted with Mexico's 11 BBF country committee members about the 5-meeting process between May and June 2017. Audio recordings were transcribed and were coded and analyzed using a grounded theory approach. RESULTS: Three major themes emerged: (1) the unique enabling environment for breastfeeding consisted of obstacles and opportunities for improvement, (2) favorable country committee member dynamics positively affected the utility of the BBF toolbox, and (3) BBF revealed and shaped country committee members' shared vision of change that laid the foundation for a shared public policy agenda. CONCLUSIONS: Becoming Breastfeeding Friendly can generate multisectoral breastfeeding champions who can advance the public policy agenda to improve breastfeeding outcomes at the national level both in Mexico and elsewhere.

Scaling Up Breastfeeding Programs in Mexico: Lessons Learned from the Becoming Breastfeeding Friendly Initiative.

BACKGROUND: Given the magnitude of the health and economic burden of inadequate breastfeeding practices in Mexico, there is an urgency to improve breastfeeding practices to increase the health and well-being of children and mothers. The Becoming Breastfeeding Friendly (BBF) Toolbox was recently developed to guide countries in assessing their readiness to and progress with scale-up of breastfeeding protection, promotion, and support and to develop policy recommendations to high-level decision makers. OBJECTIVE: The aim of this study was to document the BBF process in Mexico, which led to evidence-based recommendations for policymakers to improve breastfeeding protection, promotion, and support in the country. METHODS: We followed the BBF methodology. First, a group of experts, with the use of scientific and gray literature, face-to-face interviews, and their own experience, analyzed and assigned a score to each of the 8 gears from the BBF index and identified scaling-up gaps on the basis of the Breastfeeding Gear Model. Then, we developed and presented evidence-based recommendations to improve breastfeeding protection, promotion, and support. RESULTS: Mexico's BBF score was 1.4 out of a maximum total of 3 points, which indicates that there is a low to moderate scaling-up environment to protect, promote, and support breastfeeding. None of the gears were rated as "outstanding," and the legislation and policies gear was the only one rated as strong. CONCLUSIONS: The BBF initiative is a useful tool for assessing the environment for breastfeeding. The Mexican environment for breastfeeding is weak. On the basis of these results, it is strongly recommended to raise national awareness on breastfeeding, incorporate the Code of Marketing of Breastmilk Substitutes in the Mexican legislations, extend maternity leave to 6 mo, and strengthen evidence-based advocacy and hence the political will that is needed to secure stable funding and resources for a successful national strategy for the protection, promotion, and support of breastfeeding in Mexico.