The importance of breastfeeding has been well established and inadequate laws protecting breastfeeding leave mothers vulnerable to marketing pressures and barriers to feeding their babies naturally.

For example, a recent, comprehensive breastfeeding report presented in a world leading medical journal, The Lancet, demonstrated that increasing breastfeeding to near-universal levels could save the lives of more than 820,000 children under the age of 5 years.

The report also found that, when compared with a scenario in which no women breastfed, current global breastfeeding rates of breastfeeding prevent around 20,000 breast cancer deaths each year.

It was also estimated that around $300 billion could be added to the global economy if all babies were breastfed until at least 6 months (based on improvements in cognitive ability and expected increased income later in life).

Leading health organisations, such as the World Health Organization (WHO), recommend exclusive breastfeeding for 6 months and then for breastfeeding to continue alongside suitable complementary foods for 2 years, or as long as mother and child desire.

However, The Lancet Breastfeeding Series reports that only 37% of babies less than 6 months are exclusively breastfed.

There are many factors which have an impact on breastfeeding rates.

One factor which negatively affects breastfeeding rates is the marketing of breastmilk substitutes.

A 2016 status report, Marketing of breast-milk substitutes: National implementation of the International Code, by the WHO, United Nations International Children’s Emergency Fund (UNICEF), and the International Baby Food Action Network (IBFAN) indicates that laws to protect breastfeeding against the growing and highly profitable breastmilk substitute industry are inadequate in most countries, exposing infants and young children to a greater risk of various diseases.

So, what can countries do to help combat the aggressive marketing of the breastmilk substitute industry?

They can implement the International Code of Marketing of Breastmilk-Milk Substitutes (WHO Code) into their law.

The Establishment Of The WHO Code

In 1979, the WHO and UNICEF organised, in Geneva, a historic meeting on infant and young child feeding. The meeting’s recommendations addressed the importance of:

promoting breastfeeding
improving training about infant and young child feeding
preparing an International Code of Marketing of Breast-Milk Substitutes

Subsequently, the recommendations were endorsed by the World Health Assembly (WHA).

In 1981, 118 countries at the WHA voted overwhelmingly in favour of adopting the International Code of Marketing of Breast-Milk Substitutes (WHO Code). Three countries didn’t vote and the USA voted against adopting the WHO Code. Later, in 1996, the USA advised that they now supported the WHO Code, although this has not been translated into action.

So what is the intention of the WHO Code and what does it cover?

The WHO Code Is About The Marketing Of Breastmilk Substitutes

The intention of the WHO Code is to protect breastfeeding by stopping the inappropriate marketing of breastmilk substitutes, including formula, feeding bottles and teats. It forbids all forms of promotion of breastmilk substitutes, including advertising, gifts to health workers, and distribution of free samples.

The WHO Code recognises there is a legitimate market for formula when mothers do not breastfeed, but seeks to ensure products are not marketed or distributed in ways that can interfere with breastfeeding.

What are countries around the world doing today in relation to the WHO Code, and what more can be done?

Status Report Calls Upon Countries To Fully Adopt The WHO Code Into Law

The 2016 status report shows that 135 of the 194 countries analysed have some form of legal measure in place related to the WHO Code, but that only 39 countries have laws that enact all recommendations of the WHO Code.

“The breast-milk substitutes industry is strong and growing, and so the battle to increase the rate of exclusive breastfeeding around the world is an uphill one – but it is one that is worth the effort,” says UNICEF Chief of Nutrition, Werner Schultink. “Mothers deserve a chance to get the correct information: that they have readily available the means to protect the health and wellbeing of their children. Clever marketing should not be allowed to fudge the truth that there is no equal substitute for a mother’s own milk.”

The 2016 status report calls upon countries without WHO Code legislation to adopt legal measures that fully reflect the WHO Code. Countries with partial WHO Code legislation have been asked to review, amend and strengthen existing measures.

More specifically, the report recommends that countries ensure that legislation:

includes all breastmilk substitute products marketed for infants to the age of 36 months
prohibits all advertising and other forms of promotion of breastmilk substitutes
prohibits the provision of free or low-cost supplies to health workers or facilities
specifies government obligations to establish robust and sustainable monitoring and enforcement methods

Breastfeeding is important and, as The Lancet Breastfeeding Series has shown, there are health and economic advantages to improving breastfeeding rates. Marketing of breastmilk substitutes continues, however, to undermine efforts to improve breastfeeding rates. Therefore, more countries need to adopt the WHO Code, in its entirety, into their law.

Recommended Reading: How We Could Prevent 20,000 Breast Cancer Deaths Annually — The Lancet