Only 20% of countries have adopted infant formula marketing code, says WHO


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Only 20% of countries have adopted infant formula marketing code: WHO

Related tags Breastfeeding

Less than one in five World Health Organisation (WHO) Member States have passed legislation reflecting the recommendations of the International Code of Marketing for Breast-milk Substitutes – the guidelines that support restrictions on the marketing of infant nutrition products.

According to WHO​, which drafted the International Code of Marketing for Breast-milk Substitutes in 1981, just 37 of the 199 (19%) countries that report to it regarding the Code have passed legislation reflecting all its recommendations.

It also found that only 69 of the 199 countries reporting to it (35%) fully prohibit the advertising of breast-milk substitutes, and just 83 (42%) have introduced legislation requiring a message about the superiority of breastfeeding on breast-milk substitute labels.

The aim of the Code is to “contribute to the provision of safe and adequate nutrition for infants, by the protection and promotion of breast-feeding, 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.”

Countries that adopt all the Code’s recommendations will prohibit the advertising of breast-milk substitutes, such as infant formula, and sales promotions for and free samples of these products would be outlawed.

Code “vital” to prevent promotion

According to Dr Carmen Casanovas, a breastfeeding expert with WHO’s Department of Nutrition for Health and Development, full implementation of the Code at a national level is “vital”​ to prevent the promotion of breast-milk substitutes such as infant formula.

“Nearly all mothers are physically able to breastfeed and will do so if they have accurate information and support,”​ said Casanovas, who coordinated the report.

“But in many cases, women are discouraged from doing so, and are misled to believe that they are giving their children a better start in life by buying commercial substitutes.”

“Full implementation of the Code is vital for reducing or eliminating all forms of promotion of breast-milk substitutes, including direct and indirect promotion to pregnant women and mothers of infants and young children,”​ Casanovas added.

Code “inconsistent with US law and policy”

Much of Europe, including Italy, Ireland, France, the UK, and the Netherlands, has incorporated aspects of the Code in national legislation, according to the report. China - the largest market in the world for infant formula products, has also implemented ‘Many provisions into law’, according to the WHO report.

The US government has, however, taken ‘No Action’ - meaning it has made no effort to slot the Code’s recommendations into legislation.

According to the International Formula Council (IFC), which represents the interests of many infant formula manufacturers in North America including Abbott Nutrition, Mead Johnson Nutrition, Nestlé Infant Nutrition and Perrigo Nutritionals, the Code “is inconsistent with US law and policy, and was therefore not adopted in the US.”

Parental decision “should be trusted”

Despite this, its members still adhere to the Code’s principles, IFC executive vice president, Mardi Mountford, told

“All International Formula Council (IFC) members support the aim and principles of the World Health Organisation’s (WHO) International Code of Marketing of Brest-milk Substitutes (Code), which includes contributing ‘to the provision of safe and adequate nutrition for infants, by the protection and promotion of breast feeding’,”​ he said.

Mountford added that while the IFC “agrees with the American Academy of Pediatrics and other health care professional organisations that breastfeeding is ideal and offers specific infant and maternal health benefits,”​ it believes parents can be trusted to make their own decisions.

“We agree that more can be done to support and encourage breastfeeding,”​ said Mountford.

“The IFC also believes that parents should be trusted to make the best feeding choices for their babies according to their life circumstances and the needs of their families. Parents have a right to information and full support of their infant feeding decisions so that infants are fed properly.”​ 

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