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International Code of Marketing of Breast-milk Substitutes

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The International Code of Marketing of Breast-milk Substitutes (also known as the WHO Code) is an international health policy framework for breastfeeding promotion adopted by the World Health Assembly (WHA) of the World Health Organization (WHO) in 1981.[1] The Code was developed as a global public health strategy and recommends 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. The Code also covers ethical considerations and regulations for the marketing of feeding bottles and teats. A number of subsequent WHA resolutions have further clarified or extended certain provisions of the Code.[2][3]

Since 1981, 84 countries have enacted legislation implementing all or many of the provisions of the Code and subsequent relevant WHA resolutions.[4]

Discover more about International Code of Marketing of Breast-milk Substitutes related topics

Health policy

Health policy

Health policy can be defined as the "decisions, plans, and actions that are undertaken to achieve specific healthcare goals within a society". According to the World Health Organization, an explicit health policy can achieve several things: it defines a vision for the future; it outlines priorities and the expected roles of different groups; and it builds consensus and informs people.

Breastfeeding promotion

Breastfeeding promotion

Breastfeeding promotion refers to coordinated activities and policies to promote health among women, newborns and infants through breastfeeding.

World Health Assembly

World Health Assembly

The World Health Assembly (WHA) is the forum through which the World Health Organization (WHO) is governed by its 194 member states. It is the world's highest health policy setting body and is composed of health ministers from member states.

World Health Organization

World Health Organization

The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. Headquartered in Geneva, Switzerland, it has six regional offices and 150 field offices worldwide.

Public health

Public health

Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the determinants of health of a population and the threats it faces is the basis for public health. The public can be as small as a handful of people or as large as a village or an entire city; in the case of a pandemic it may encompass several continents. The concept of health takes into account physical, psychological, and social well-being.

Marketing

Marketing

Marketing is the process of exploring, creating, and delivering value to meet the needs of a target market in terms of goods and services; potentially including selection of a target audience; selection of certain attributes or themes to emphasize in advertising; operation of advertising campaigns; attendance at trade shows and public events; design of products and packaging attractive to buyers; defining the terms of sale, such as price, discounts, warranty, and return policy; product placement in media or with people believed to influence the buying habits of others; agreements with retailers, wholesale distributors, or resellers; and attempts to create awareness of, loyalty to, and positive feelings about a brand. Marketing is typically done by the seller, typically a retailer or manufacturer. Sometimes tasks are contracted to a dedicated marketing firm or advertising agency. More rarely, a trade association or government agency advertises on behalf of an entire industry or locality, often a specific type of food, food from a specific area, or a city or region as a tourism destination.

Breast milk

Breast milk

Breast milk or mother's milk is milk produced by mammary glands located in the breast of a human female. Breast milk is the primary source of nutrition for newborns, containing fat, protein, carbohydrates and variable minerals and vitamins. Breast milk also contains substances that help protect an infant against infection and inflammation, whilst also contributing to healthy development of the immune system and gut microbiome.

Infant formula

Infant formula

Infant formula, baby formula, or simply formula ; or baby milk or infant milk, is a manufactured food designed and marketed for feeding to babies and infants under 12 months of age, usually prepared for bottle-feeding or cup-feeding from powder or liquid. The U.S. Federal Food, Drug, and Cosmetic Act (FFDCA) defines infant formula as "a food which purports to be or is represented for special dietary use solely as a food for infants by reason of its simulation of human milk or its suitability as a complete or partial substitute for human milk".

Breastfeeding

Breastfeeding

Breastfeeding, or nursing, is the process by which human breast milk is fed to a child. Breast milk may be from the breast, or may be expressed by hand or pumped and fed to the infant. The World Health Organization (WHO) recommends that breastfeeding begin within the first hour of a baby's life and continue as often and as much as the baby wants. Health organizations, including the WHO, recommend breastfeeding exclusively for six months. This means that no other foods or drinks, other than vitamin D, are typically given. WHO recommends exclusive breastfeeding for the first 6 months of life, followed by continued breastfeeding with appropriate complementary foods for up to 2 years and beyond. Of the 135 million babies born every year, only 42% are breastfed within the first hour of life, only 38% of mothers practice exclusive breastfeeding during the first six months, and 58% of mothers continue breastfeeding up to the age of two years and beyond.

Provisions

The Code aims to shield breastfeeding from commercial promotion that affects mothers, health workers and health care systems. The Code and resolutions also contain specific provisions and recommendations relating to labelling of infant formula and other breastmilk substitutes.

i. Mothers
  • Information and educational materials on infant and young child feeding should be objective and consistent and emphasize the importance of breastfeeding. In no case should such materials refer to a brand name of a product.
  • All forms of product advertising and promotion are prohibited.
  • Mothers should not be given free product samples.
  • Promotional devices such as discounts and special displays at the retail level are prohibited.
  • Company representatives may not initiate direct or indirect contact with mothers.
  • Health risks to infants who are artificially fed or who are not exclusively breastfed should be highlighted through appropriate labeling and warnings.
ii. Health workers
  • The Code gives health workers the responsibility to encourage and protect breastfeeding.
  • Materials regarding products given to health professionals by manufacturers and distributors should be limited to ‘scientific and factual’ matters. They should not be tools to promote the use of products.
  • Product samples may be given only when necessary for professional evaluation or research at the institutional level. In no case should these samples be passed on to mothers.
  • In order to prevent conflicts of interest, manufacturers and distributors should not give material or financial inducements to health workers. Three WHA resolutions on infant and young child nutrition subsequent to the adoption of the Code specifically cautioned against conflicts of interest.[5] A 1996 resolution (WHA resolution 49.15) called for caution in accepting financial support for health professionals working in infant and young child health which may create conflicts of interest. The need to avoid conflicts of interest was expanded in 2005 (WHA resolution 58.32) to cover programmes in infant and young child health and reiterated in 2008 (WHA resolution 61.20).
iii. Health care systems
  • Promotion of any product is forbidden in a health care facility. This includes the display of products, placards and posters concerning such products and distribution of materials provided by manufacturers and distributors.
  • Formula feeding should be demonstrated only to those mothers or family members who need to use it and the information given should include a clear explanation of the risks of formula feeding and hazards of improper use of products.
  • Donated equipment and materials should not refer to brand names of products.
  • Free Supplies: Two subsequent resolutions (WHA 39.28 [1986] and WHA 47.5 [1994]) effectively call for an end to all free or low-cost supplies to any part of the health care system.[6] Manufacturers and distributors are therefore prohibited from providing products to health care facilities for free or at low cost. (According to guidelines under the Baby Friendly Hospital Initiative, ‘low cost’ means less than 80% of the retail price.)
iv. Labelling
  • Information on labels for infant formula must be in simple and easy to understand terms in an appropriate language.
  • Labels of infant formula must contain a statement on the superiority of breastfeeding and that the product should only be used after consultation with health professionals.
  • Pictures or text which may idealize the use of infant formula and certain wordings, such as 'humanized” or “materialized” or similar terms should not be used.
  • Nutrition and health claims on labels for breastmilk substitutes should not be permitted unless allowed by national legislation (WHA resolution 58.32 [2005]).[7]
  • Labels must contain explicit warnings on labels to inform consumers about the risks of contamination of powdered formula with pathogenic microorganisms (WHA resolution 58.32 [2005]).[7]
  • Labels must conform with WHO/FAO guidelines on safe preparation, storage and handling of powdered infant formula (WHA resolution 61.20 [2008]).[8]

In line with the recommendation for exclusive breastfeeding in WHA resolution 54.2 [2001],[9] all complementary foods must be labeled as suitable for use by infants from six months and not earlier.

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Mother

Mother

A mother is the female parent of a child. A woman may be considered a mother by virtue of having given birth, by raising a child who may or may not be her biological offspring, or by supplying her ovum for fertilisation in the case of gestational surrogacy.

Infant feeding

Infant feeding

Infant feeding is the practice of feeding children under 1 year of age. The World Health Organization recommends that infants be exclusively breastfed until approximately six months of age, followed by continued breastfeeding and gradual introduction of solid foods. This means that no other foods or drinks other than possibly vitamin D are typically given. In developed countries, infant formula is considered to be an acceptable substitute for breastmilk, although exclusive breastfeeding is still recommended.

Health care provider

Health care provider

A health care provider is an individual health professional or a health facility organization licensed to provide health care diagnosis and treatment services including medication, surgery and medical devices. Health care providers often receive payments for their services rendered from health insurance providers.

Research

Research

Research is "creative and systematic work undertaken to increase the stock of knowledge". It involves the collection, organization and analysis of evidence to increase understanding of a topic, characterized by a particular attentiveness to controlling sources of bias and error. These activities are characterized by accounting and controlling for biases. A research project may be an expansion on past work in the field. To test the validity of instruments, procedures, or experiments, research may replicate elements of prior projects or the project as a whole.

Conflict of interest

Conflict of interest

A conflict of interest (COI) is a situation in which a person or organization is involved in multiple interests, financial or otherwise, and serving one interest could involve working against another. Typically, this relates to situations in which the personal interest of an individual or organization might adversely affect a duty owed to make decisions for the benefit of a third party.

Baby Friendly Hospital Initiative

Baby Friendly Hospital Initiative

The Baby Friendly Hospital Initiative (BFHI), also known as Baby Friendly Initiative (BFI), is a worldwide programme of the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF), launched in 1992 in India following the adoption of the Innocenti Declaration on breastfeeding promotion in 1990. The initiative is a global effort for improving the role of maternity services to enable mothers to breastfeed babies for the best start in life. It aims at improving the care of pregnant women, mothers and newborns at health facilities that provide maternity services for protecting, promoting and supporting breastfeeding, in accordance with the International Code of Marketing of Breast-milk Substitutes.

Labelling

Labelling

Labelling or using a label is describing someone or something in a word or short phrase. For example, the label "criminal" may be used to describe someone who has broken a law. Labelling theory is a theory in sociology which ascribes labelling of people to control and identification of deviant behaviour. It has been argued that labelling is necessary for communication. However, the use of the term is often intended to highlight the fact that the label is a description applied from the outside, rather than something intrinsic to the labelled thing. This can be done for several reasons:To provoke a discussion about what the best description is To reject a particular label To reject the whole idea that the labelled thing can be described in a short phrase.

Health policy

Health policy

Health policy can be defined as the "decisions, plans, and actions that are undertaken to achieve specific healthcare goals within a society". According to the World Health Organization, an explicit health policy can achieve several things: it defines a vision for the future; it outlines priorities and the expected roles of different groups; and it builds consensus and informs people.

Microorganism

Microorganism

A omar abdelwahab, or microbe, is an organism of microscopic size, which may exist in its single-celled form or as a colony of cells.

Implementation

The baby food industry has been the subject of pointed criticism from non-governmental organizations, international agencies and campaign groups for failing to abide by the Code. One of the largest food and beverage manufacturers in the world, the Swiss giant Nestlé, has been the subject of an international boycott campaign since 1977 for its milk-substitute marketing practices prior to and since the development of the Code (see Nestlé boycott).

On its own, the International Code is not legally enforceable. Companies are only subject to legal sanctions 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 adopted the Code as law.[4] Other countries have no legislation on baby food marketing at all.

Code violations by baby food manufacturers are still widespread, especially (but not exclusively) in countries that have not implemented the Code as a national measure or where monitoring and enforcement is weak.[10] The WHO, International Baby Food Action Network (IBFAN), UNICEF, Save the Children and other international organizations perform monitoring of implementation of the Code across the world both independently and with governments.[11][12][13]

Discover more about Implementation related topics

Baby food

Baby food

Baby food is any soft easily consumed food other than breastmilk or infant formula that is made specifically for human babies between four and six months and two years old. The food comes in many varieties and flavors that are purchased ready-made from producers, or it may be table food eaten by the family that has been mashed or otherwise broken down.

Non-governmental organization

Non-governmental organization

A non-governmental organization (NGO) or non-governmental organisation is an organization that generally is formed independent from government. They are typically nonprofit entities, and many of them are active in humanitarianism or the social sciences; they can also include clubs and associations that provide services to their members and others. Surveys indicate that NGOs have a high degree of public trust, which can make them a useful proxy for the concerns of society and stakeholders. However, NGOs can also be lobby groups for corporations, such as the World Economic Forum. NGOs are distinguished from international and intergovernmental organizations (IOs) in that the latter are more directly involved with sovereign states and their governments.

Nestlé

Nestlé

Nestlé S.A. is a Swiss multinational food and drink processing conglomerate corporation headquartered in Vevey, Vaud, Switzerland. It is the largest publicly held food company in the world, measured by revenue and other metrics, since 2014. It ranked No. 64 on the Fortune Global 500 in 2017 and No. 33 in the 2016 edition of the Forbes Global 2000 list of largest public companies.

International Baby Food Action Network

International Baby Food Action Network

The International Baby Food Action Network, IBFAN, consists of public interest groups working around the world to reduce infant and young child morbidity and mortality. IBFAN aims to improve the health and well-being of babies and young children, their mothers and their families through the protection, promotion and support of breastfeeding and optimal infant feeding practices. IBFAN works for universal and full implementation of the International Code of Marketing of Breast-milk Substitutes and Resolutions.

UNICEF

UNICEF

UNICEF, originally called the United Nations International Children's Emergency Fund in full, now officially United Nations Children's Fund, is an agency of the United Nations responsible for providing humanitarian and developmental aid to children worldwide. The agency is among the most widespread and recognizable social welfare organizations in the world, with a presence in 192 countries and territories. UNICEF's activities include providing immunizations and disease prevention, administering treatment for children and mothers with HIV, enhancing childhood and maternal nutrition, improving sanitation, promoting education, and providing emergency relief in response to disasters.

Save the Children

Save the Children

The Save the Children Fund, commonly known as Save the Children, is an international non-governmental organization established in the United Kingdom in 1919 to improve the lives of children through better education, health care, and economic opportunities, as well as providing emergency aid in natural disasters, war, and other conflicts. After passing a century, which it celebrated in 2019, it is now a global movement made up of 30 national member organizations that work in 120 countries.

Source: "International Code of Marketing of Breast-milk Substitutes", Wikipedia, Wikimedia Foundation, (2023, January 25th), https://en.wikipedia.org/wiki/International_Code_of_Marketing_of_Breast-milk_Substitutes.

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See also
  • Baby Friendly Hospital Initiative
  • Breastfeeding promotion
  • Gabrielle Palmer (2009). The Politics of Breastfeeding. Pinter & Martin, UK. p. 424. ISBN 9781905177165.
References
  1. ^ World Health Organization. International Code of Marketing of Breast-milk Substitutes. Geneva, 1981.
  2. ^ World Health Organization. International Code of Marketing of Breast-milk Substitutes: Frequently Asked Questions. Geneva, 2008. Accessed 5 August 2011.
  3. ^ FTSE. "FTSE4Good Inclusion Criteria for the Marketing of Breast Milk Substitutes." Archived 2011-07-28 at the Wayback Machine FTSE4Good Index Series, accessed 5 August 2011.
  4. ^ a b UNICEF. International Code of Marketing of Breast-milk Substitutes. Archived 2017-12-12 at the Wayback Machine Accessed 6 February 2012.
  5. ^ Baby Milk Action. "World Health Assembly: New UN Resolution tackles intrinsic contamination." Archived 2011-09-27 at the Wayback Machine Baby Milk Action Update, Issue 41, November 2008.
  6. ^ The Boycott Book. Reinstating the Nestlé Boycott (1988). Accessed 5 August 2011.
  7. ^ a b IBFAN. Understanding the International Code. Archived 2017-07-15 at the Wayback Machine Accessed 5 August 2011.
  8. ^ World Health Organization and Food and Agriculture Organization of the United Nations. Guidelines for the safe preparation, storage and handling of powdered infant formula. Archived 2010-03-10 at the Wayback Machine Geneva, 2007.
  9. ^ "WHA Resolution 54.2 - 2001: Infant and young child nutrition". Archived from the original on 2017-04-08. Retrieved 2011-08-05.
  10. ^ Aguayo VM, Ross JS, Kanon S, Ouedraogo AN (January 2003). "Monitoring compliance with the International Code of Marketing of Breastmilk Substitutes in west Africa: multisite cross sectional survey in Togo and Burkina Faso". BMJ (Clinical Research Ed.). 326 (7381): 127. doi:10.1136/bmj.326.7381.127. PMC 140002. PMID 12531842.
  11. ^ World Health Organization. The International Code of Marketing of Breast-Milk Substitutes: A common review and evaluation framework. Geneva, 1996.
  12. ^ IBFAN. Code Watch. Archived 2011-11-15 at the Wayback Machine Accessed 5 August 2011.
  13. ^ UNICEF Ukraine. Compliance with the International Code of Marketing of Breastmilk Substitutes. Archived 2017-02-19 at the Wayback Machine Kyiv, 2004.

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