International Code of Marketing of Breast-milk Substitutes

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International Code of Marketing of Breast-milk Substitutes is a global health policy framework adopted by the World Health Assembly (WHA) in 1981. The Code aims to contribute to the provision of safe and adequate nutrition for infants by protecting and promoting breastfeeding, and by ensuring the proper use of breast-milk substitutes, when these are necessary, on the basis of adequate information and through appropriate marketing and distribution.

Background

The 1970s saw growing concern among health professionals and the public about the aggressive marketing practices of companies producing infant formula. These practices were believed to be contributing to a decline in breastfeeding rates in developing countries, leading to malnutrition and increased mortality among infants. In response, the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) convened a meeting in 1979, which led to the drafting of the International Code of Marketing of Breast-milk Substitutes.

Provisions

The Code sets out a number of principles and recommendations for the marketing of breast-milk substitutes, including:

  • No advertising of breast-milk substitutes to the public.
  • No free samples of substitutes to be given to pregnant women, mothers, or their families.
  • No promotion of products through health care facilities, including the distribution of free or low-cost supplies.
  • No company representatives to advise mothers.
  • All products should be of a high quality and unsuitable products, such as sweetened condensed milk, should not be promoted for babies.
  • Labels on breast-milk substitute products should clearly state the benefits of breastfeeding and the health hazards of substitutes.

Implementation

The Code is not legally binding, but countries are encouraged to implement its provisions through national legislation. As of now, many countries have enacted laws reflecting the principles of the Code, but the extent and effectiveness of implementation vary widely. The WHO monitors the status of implementation and provides support to countries in adopting and enforcing the Code.

Controversies and Challenges

Despite its intentions, the implementation of the Code has faced challenges and controversies. Some critics argue that the Code restricts the availability of information about breast-milk substitutes, making it difficult for parents to make informed choices. Others point to the continued aggressive marketing practices of some infant formula companies, particularly in developing countries where regulation may be less stringent.

Impact

Studies have shown that the Code has had a positive impact on breastfeeding rates in several countries, contributing to improved infant health outcomes. However, the global decline in breastfeeding rates suggests that more needs to be done to support and promote breastfeeding as the best source of nutrition for infants.

Conclusion

The International Code of Marketing of Breast-milk Substitutes represents a significant effort to protect and promote breastfeeding worldwide. While it has made important strides in addressing the inappropriate marketing of breast-milk substitutes, ongoing vigilance, and stronger implementation efforts are needed to ensure that all infants have the best start in life.

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Contributors: Prab R. Tumpati, MD