O COMPOSTO LÁCTEO COMO SUBSTITUTO DO LEITE MATERNO – UM DESAFIO PARA A SAÚDE PÚBLICA BRASILEIRA.

• Autor(a) principal: Lima, Juliane Fernandes de
• Data de Publicação: 2022
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações do UNIOESTE
• Texto Completo: https://tede.unioeste.br/handle/tede/6443
• topic: Lactentes; Marketing; Alimentação infantil; Comercialização de produtos; Legislação; Infants; Marketing; Infant feeding; MKarketing products; Legislation; CIÊNCIAS FARMACÊUTICAS

Introduction: The growing-up milk is a powdered food product, which follows minimum standards of identity, such as: 51% dairy ingredients and the possibility of adherence of non-dairy components. The product should not be consumed by infants (younger than 6 years) due to the content of sugar and the level of processing, however, aggressive marketing strategies confuse parents and caregivers by the visual similarity between the packaging of growing-up milk, powdered milk and especially, infant formula. The risk derived from the inappropriate consumption of the product by young children is not well elucidated yet. Objective: To verify the impact of growing-up milk consumption on children's nutrition and to evaluate the knowledge of health professionals about this product and the pertinent legislation (Norma Brasileira de Comercialização de Alimentos para Lactentes e Crianças de Primeira Infância, Bicos, Chupetas e Mamadeiras - NBCAL). Methods: This research was approved by the ethics committee for research with human beings at Unioeste under number 39704220.0.0000. 0107/ 2020, conducted in Toledo/Pr and structured in 5 stages: 1) integrative review on the growing-up milk; 2) survey and analysis of nutritional characteristics of the growing-up milk; 3) interview with prescribing professionals (physicians and nutritionists) of breastmilk substitutes, working in the Sistema Único de Saúde (SUS); and interview with pharmacists from the commercial area; 4) monitoring of the sale of the product in pharmacies; 5) proposition of solutions, based on the literature and the results of this research. In the integrative review, 11 articles from 3 different databases were analyzed, within the time limit of 10 years. The interviews were conducted remotely due to the COVID-19 pandemic with the support of an online tool. The approach towards pharmacists occurred in conjunction within the commercial promotion monitoring in pharmacies, where the research was exposed and an electronic contact form was requested in order to send the survey link to the professional. The contact with physicians and nutritionists occurred electronically, through e-mail and social networks, and in some cases, in person. The monitoring of the commercial promotion of the growing-up milk was conducted presentially and based on the NBCAL and Decree n. 9.579/2018. Excel software and descriptive statistics were used for data analysis and interpretation. Results: The growing-up milk sold in Brazil has excessive amounts of protein and added sugars, predominance of saturated fats, as well chemical additives. It was possible to categorize the growing-up milk into three different groups (1, 2 and 3) according to the kind of ingredients featured in each formulation. After statistical analysis, it was concluded that despite the group and the ingredients, the consumption of growing-up milk has a negative impact on children's health, and the younger the age at which growing-up milk is introduced, the bigger the impact on health. The NBCAL monitoring shows that 58% of the pharmaceutical establishments in Toledo violate the legislation in some way, as 91% of follow-up formulas and 96.9% of fluid or powdered milks and growing-up milk were commercially promoted without the mandatory warning phrases. Health professionals have insufficient knowledge of the NBCAL and have difficulty to identify the growing-up milk. Due to the lack of assurance about the potential harm caused by the growing-up milk, adherence to the Precautionary Principle is recommended.