A Longitudinal Study to Describe Changes in Breastfeeding, Milk Intake and Infant Feeding Practices in Côte d’Ivoire between December 2022 and June 2024

Background and Aims: In Ivory Coast, since the ministerial decree number 689/MSHPCMU/MCI on August 2, 2021, pharmacies have become the exclusive points of sale for infant formula (0 - 36 months). This study assesses the impact of this regulation on infant feeding practices. Methods: This study was conducted in 3 waves: December 2022 (n = 632), September 2023 (n = 716), and June 2024 (n = 629). Mothers with infants under 24 months from Ivory Coast’s four main regions were interviewed face-to-face, with participants stratified by residence, socio-economic class, and infant age. Results: The restriction on infant formula sales did not have a significant impact neither on total nor exclusive breastfeeding (EBF) rates before 6 months. The introduction of non-adapted beverages (water, teas and herbal drinks) and foods before 6 months remains high and unchanged. If those were removed, the EBF rate would be 85% in 2024. The average age for stopping breastfeeding remains at 17 months. The new legislation had a neutral (41%) or positive (52%) impact on mothers’ perceptions of infant formula quality. There was no significant change in the use of infant formula before 6 months (23% in 2022 and 25% in 2024). Family milk remains the primary milk alternative to breastmilk for one year. Conclusions: The new legislation has not significantly impacted breastfeeding practices or the use of infant formula and non-adapted foods and drinks before 6 months in Ivory Coast between 2022 and 2024.