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ABSTRACT
Purpose: Thai government agencies and the business sector have been promoting milk consumption. Considering the robust and continual movements by those actors to promote milk consumption among children in Thailand at the national level, this study aims to investigate milk-consumption practices and values towards milk consumption at pre-school, family and individual levels. Methods: This cross-sectional qualitative study employs observation and interview methods, along with the Ecological System Theory as a framework. Data were collected from three kindergartens used by families of varying socio-economic status, and the homes of 18 pre-schoolers, aged 3-5 years old, attending these kindergartens, from October 2013-September 2014. Results: Findings reveal kindergartens implemented daily routines to make children drink milk. Practices at home include (i) overfeeding of milk, (ii) preference for fortified milk and (iii) using sweetness to make children drink milk. These practices were underpinned by values that milk is good for children and good parents feed their children milk. These values, in combination with other macro-level measures such as the government’s milk-promotion campaigns and the milk industry’s marketing, influence the milk-drinking practices of pre-schoolers. Conclusion: The promotion of the benefits of milk prompted children to exceed the recommended milk consumption of 400ml per day. Balanced information on moderation in milk drinking was absent.
Acknowledgments
The study is supported by Thai Health Promotion Foundation. The Health Intervention and Technology Assessment Program (HITAP) is funded by the Thailand Research Fund (TRF) under a grant for Senior Research Scholar (RTA5980011). The findings, interpretations, and conclusions expressed in this article do not necessarily reflect the views of the funding agencies.
Disclosure statement
No potential conflict of interest was reported by the authors.
Notes
1. The NMDCB was established in 1985 at the behest of the Ministry of Agriculture and Cooperatives (MoAC) and operated under the office of the Prime Minister. The board consisted of representatives from relevant government agencies (mainly from the MoAC) and milk business representatives.
2. The Food and Agriculture Organization, a United Nations agency established to support the development of the food and agricultural sector.
3. Dumex Hi-Q: https://www.youtube.com/watch?v=4g4ky2LCKiM
4. “More chaos to be created by government reforms”, Ibiz channel (2007), http://www2.manager.co.th/iBizChannel/ViewNews.aspx?NewsID=9500000099193 (accessed 23 February 2015).
5. Weight >+1.5 SD. to +2 SD.
6. Dumex Hi-Q: https://www.youtube.com/watch?v=4g4ky2LCKiM
7. Source of image: http://www.hiqkidsclub.com/product/1-plus-pre-bio-proteq.
8. The grandparents are retired and work as day labourers earning 300 THB (6GBP) per day (the minimum wage) when work is available.
Additional information
Funding
Notes on contributors
Jomkwan Yothasamut
Dr. Jomkwan Yothasamut is a researcher of Health Intervention and Technology Assessment Program (HITAP), Thailand since 2006. She was awarded a 2012-2016 Ph.D. Scholarship from the Thailand’s Health Policy and Systems Research Program, Ministry of Public Health. Dr. Yothasamut completed her Ph.D. degree in Research related to International development from Faculty of Social Sciences, University of East Anglia, England in 2017. Her thesis’ title is “Understanding actors and factors that influence the development of obesity among pre-schoolers in the Bangkok metropolitan area”. Her research work at HITAP focuses on health promotion, public health policy, programs evaluation, and the use of qualitative methods for program evaluation.
Laura Camfield
Professor Laura Camfield has had 21 years international research experience using qualitative and quantitative methods and is an active participant in academic networks with a strong record of publication and presentation. Her research interests include well-being in developing countries, with a particular emphasis on more subjective/psychological aspects and developing measures that reflect local priorities; poverty research and evaluation using qualitative and mixed methods approaches; and children and young people. She has experience applying anthropology to complex problems in interdisciplinary environments and ensuring the quality of qualitative research within large international projects. She also teaches on the UEA’s short course and masters’ programme.
Michael Pfeil
Dr. Michael Pfeil a Senior Lecturer of School of Nursing Sciences, Faculty of Medicine and Health Sciences, UEA. He is a Registered Nurse (RN) Adult and Child Health and a Specialist Nurse for Paediatrics & Intensive Care (Germany). His completed his Ph.D. in Nursing from University of East Anglia. He has been working as a tutor (Child Care) at Norfolk College of Nursing and Midwifery, Norwich and a lecturer at Nursing and Midwifery Research Unit, UEA since 1993.