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Marketing of Breast-milk Substitutes: National Implementation of the International Code: Status Report 2016

Breastfeeding is a human rights issue for babies and mothers, and should be protected and promoted for the benefit of both.

As a response to poor infant feeding practices around the world, the International Code of Marketing of Breast-milk Substitutes was introduced to stop the inappropriate marketing of breast-milk substitutes, feeding bottles and teats. Where necessary, it also supports the safe use of breast-milk alternatives.

In this report, the World Health Organization (WHO), UNICEF and the International Baby Food Action Network (IBFAN) provide updates on the legal status of implementing the Code in countries to protect and promote breastfeeding, including approaches to monitor and enforce the Code.

For the report, 194 countries were assessed. Of these, 135 have in place some type of legal framework in relation to the Code and only 39 countries implement all components of the Code.  This is an increase from 103 and 37 countries, respectively, from 2011.

Poorer countries are ahead of richer countries in implementing the Code. The WHO South-East Asian Region (36% or 4 out of 11 countries) has the most wide-ranging laws in place followed by the WHO African Region (30% or 14 out of 47 countries).

In 2012, Kenya adopted comprehensive legislations in relation to the Code including bans on promotional activities. Enforcement is underway as Kenya finalises its regulations for implementation. Tanzania also reportedly has a comprehensive legal framework in place since 2013.

Here is a status update on countries that have laws in place to regulate the marketing of breast-milk substitutes:

  • Just over half prohibit advertising and promotion
  • Fewer than half ban free or inexpensive supplies of breast-milk alternatives to health facilities
  • Just over half prohibit gifts to health personnel or their family members
  • Only one third actively cover formula for children one year and over
  • Less than half ban health and nutrition claims on substitute products

Of the 55 countries that submitted information on monitoring and enforcement mechanisms, only 32 reported having a mechanism in place and fewer countries reported that they were functioning.

Challenges to the effective implementation of the Code in countries are:

  • Lack of political will to legislate and enforce the Code
  • Interferences from substitute manufacturers and distributors in governments’ efforts to implement the Code
  • Lack of sufficient data and relevant expertise
  • Low coordination among stakeholders
  • Limited resources

The report provides case studies on several countries (Armenia, Botswana, India and Vietnam) and recommendations for action.

The implementation of the Code will help countries carry out WHO’s recommendations to exclusively breastfeed babies in their first six months of life then continue breastfeeding while introducing appropriate foods up to two years or more. By ensuring these practices, countries will contribute to meeting the global nutrition target of an increase rate of exclusive breastfeeding in the first six months of a baby’s life to at least 50% by 2025.

States should take urgent action to stop the marketing of breast-milk substitutes to promote and protect breastfeeding.

To browse and download the full report and summary for free, click here.

To read the WHO news release, click here.

Click here to read a post from UNICEF on the protection and promotion of breastfeeding in West and Central Africa, including case studies from four countries– Benin, Togo, Niger and Mauritania.

To find out more about the Code, click here to read and download the booklet on frequently asked questions.

World Health Organization, UNICEF and the International Baby Food Action Network. (2016). Marketing of Breast-milk Substitutes: National Implementation of the International Code: Status Report 2016. WHO: Geneva.

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