REPORT FROM THE BOARD
The WHO Code-A Primer for Leaders
Anne Devereux
LLLI Board of Directors
From: LEAVEN, Vol. 35 No. 2, April-May 1999, p. 26
History of the Code
Breastfeeding has long been
promoted as a simple, low-cost, essential maternal and child health
measure. However this century has witnessed an increasing reliance on
infant formula and a decline in the practice of breastfeeding. There
were many reasons for this, but the end result was a belief that modern
women could not produce enough milk to satisfy their babies.
Following a joint World Health
Organization (WHO) and UNICEF meeting on Infant and Young Child Feeding
in Geneva in October 1979, a recommendation was made that "there
should be an international code of marketing of infant formula and other
products used as breast milk substitutes." In May 1980 the
33rd World Health Assembly (WHA, the governing body of WHO) made particular
mention of this recommendation and requested the Director-General of
WHO to prepare such a code "in close consultation with Member
States and with all other parties concerned."
On May 21, 1981, the World
Health Assembly adopted the International Code of Marketing of Breast
Milk Substitutes, as a set of rules to protect breastfeeding from unethical
marketing practices. The Preamble to the Code explains that "the
marketing of breast milk substitutes requires special treatment, which
makes usual marketing practices unsuitable for these products."
Since then, the WHA has passed resolutions that "clarified and
strengthened" certain provisions of the Code, particularly
Article 2, Scope of the Code, and Article 6, Health Care Systems, which
deals with free and low-cost supplies of substitutes for breast milk.
The aim of the International
Code of Marketing of Breast Milk Substitutes is "to contribute
to the provision of safe and adequate nutrition for infants, by the
protection and promotion of breastfeeding and by the proper use of breast
milk substitutes, when they are necessary, on the basis of adequate
information and through appropriate marketing and distribution."
The Code does not restrict the availability of substitutes for breast
milk, nor prevent mothers from deciding to use them. When properly implemented,
the Code will protect breastfeeding and non-breastfeeding families,
as well as health workers, from unethical marketing practices.
Main Points of the WHO Code
In summary, the primary issues
addressed by the Code include:
- Breast milk substitutes
or products used to deliver breast milk substitutes to infants (such
as bottles and teats) are not advertised to the public;
- Free samples of breast
milk substitutes or other products are not distributed to mothers;
- Breast milk substitutes
or other products are not permitted in the health care system;
- Company personnel do not
advise mothers on infant feeding practices;
- Gifts or personal samples
of breast milk substitutes or other supporting products are not distributed
to health care workers;
- Pictures of infants or
other pictures idealizing artificial infant feeding products do not
appear on labels;
- All information to health
care workers should be scientific and factual;
- All information on artificial
feeding, including labels, should explain the benefits of breastfeeding
and the costs and dangers associated with artificial feeding;
- Unsuitable products, such
as sweetened condensed milk, are not promoted for use with babies.
When you read these points
you can see that everything LLL does, as well as what an individual
Leader does when she represents LLL, is fully in accord with the Code.
The International Code of
Marketing of Breast Milk Substitutes is
. . . a code of marketing,
not a code of ethics. The Code is a set of rules for industry, health
workers and governments designed to regulate marketing. Marketing is
much more than advertising. It includes all promotional activities including
labeling, shelf space, gifts to health workers, special displays in
shops, discount coupons, direct contact with mothers through phone help
advice lines and Internet sites, and specifically relations with health
workers and their associations.
The Code is also strengthened
when the formula marketing companies within each country work with their
government establish a self-regulatory code of practice.
. . . about breast milk
substitutes, not just infant formula. The Code covers other
milk products, cereals, teas and juices, bottles and teats. LLL Leaders
know that six months of exclusive breastfeeding is recommended. Any
other food or drink introduced during that time will replace breast
milk, therefore the marketing of cereals, teas, juices or water for
children under six months can be interpreted intending to replace breast
milk and undermine breastfeeding.
. . . a compromise, not
the ideal. The Code is the result of negotiations. Therefore
national measures could be stronger and adapted to include new products
and changing marketing practices. It is very important that the Code
is put into effect at a national level through legislation or enforceable
regulations. If this step is not taken, the Code will lack teeth.
. . . a tool, not an
end in itself. When properly implemented, the Code will regulate
marketing practices and will protect all mothers against the promotion
of breast milk substitutes. This will make the work of LLL Leaders in
their mother-to-mother support role easier and more effective.
International Code of Marketing
of Breast Milk Substitutes
LLLI fully supports the WHO
International Code of Marketing of Breast Milk Substitutes and reaffirms
the stand taken by the LLLI Board of Directors in 1981 and 1988. LLLI
Policies and Standing Rules 1981, 1988; revised Oct 1993
See additional article, "Leaders
and the WHO Code."
Page last edited Sun Oct 14 09:31:47 UTC 2007.
