The International Code of Marketing of Breast-milk Substitutes was established in 1981 by the general assembly of the World Health Organization (WHO). This Code, and a number of subsequent World Health Assembly resolutions, place restrictions on the marketing of breast milk substitutes, such as infant formula, to ensure that mothers are not discouraged from breastfeeding and that substitutes are used safely if needed.

Health issues relating to use of breast-milk substitutes

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Breastfeeding is an unequalled way of providing ideal food for the healthy growth and development of infants. It is also an integral part of the reproductive process with important implications for the health of mothers.

According to the World Health Organization, 1.5 million infants die each year because they are not breastfed. Exclusive breastfeeding reduces infant mortality due to common childhood illnesses such as diarrhoea or pneumonia, and helps for a quicker recovery during illness. In poor countries, however, the risk to children of unsafe breastfeeding is amplified: where water is unclean, a bottle-fed child is up to 25 times more likely to die as a result of diarrhoea than a breastfed child.

Provisions of the Code

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The Code forbids virtually all forms of advertisements and marketing methods for breast milk substitutes, especially against advertisements claiming health benefits from the substitutes. The Code also outlines the ways in which companies can communicate with mothers and health workers about their baby milk products.

• The Code forbids direct contacts between commercial representatives and medical personnel or mothers or pregnant women.
• Baby food companies may not distribute free samples of substitute milk in hospitals and other places providing public health services.
• Advertisements for baby foods must not target infants younger than six months.
• No promotional distribution of pacifiers or bottles for babies
• Manufacturers of breast milk substitutes may not distribute promotional gifts to health workers.
• Images of mothers and children on the packets or labels are forbidden.

The information required by the Code to be printed on labels must be printed in simple and easy to understand terms in the language of the area where the product is sold. Certain wordings, such as 'motherly', cannot be used. The labels must state that breastfeeding is the best way of feeding babies and that a substitute should only be used after consultation with health professionals.

Implementation of the Code

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The baby food industry has been the subject of pointed criticism from NGOs, international agencies and campaign groups for failing to abide by the code. The largest baby food manufacturer in the world, the Swiss giant Nestlé, has been the subject of an international boycott campaign since 1977 for its alleged widespread violation of the Code (see Nestlé boycott).

On its own, the International Code has no legal power. Companies are only subject to legal censure for failing to abide by the Code where it has been incorporated into the legislature of a nation state. Many countries have fully or partially integrated the provisions of the code into their own laws. Other countries, especially in the developing world, have no legislation on baby food marketing at all.

Code violations by baby milk companies are not as widespread as they were in the 1980s. Recent evidence suggests, however, that failure to abide by the provisions of the Code is still a significant cause for concern. The International Baby Food Action Network performs monitoring of baby food marketing in 69 countries across the world both independently and with governments. A study into code violations in Togo and Burkina Faso, West Africa, was published in the British Medical Journal in 2003.

Footnotes

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1. "Monitoring compliance with the International Code of Marketing of Breastmilk Substitutes in west Africa: multisite cross sectional survey in Togo and Burkina Faso", Aguayo, Ross, Kanon and Ouedraogo, British Medical Journal 326:127, 18 January 2003

See also

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• Infant formula
• Infant mortality
• Nestlé boycott
• World Health Organization

External links

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• International Baby Food Action Network
• Baby Milk Action (Great Britain)
• Baby Nahrung (Germany)
• Breaking the Rules, Stretching the Rules, International Baby Food Action Network, 2004
• ibfan (Spanish)

Infant feeding

Internationaler Kodex für die Vermarktung von Muttermilchersatzprodukten | Korvikekoodi | Międzynarodowy Kodeks Marketingu Produktów Zastępujących Mleko Kobiece