Dr David Jukes, The University of Reading, UK

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Food Law News - FAO / WHO / WTO / Codex - 2016

WHO News Item, 9 May 2016

INFANT FORUMLAE – WHO Report: Laws to protect breastfeeding inadequate in most countries

A new report by WHO, UNICEF, and the International Baby Food Action Network (IBFAN) reveals the status of national laws to protect and promote breastfeeding.

Of the 194 countries analysed in the report, 135 have in place some form of legal measure related to the International Code of Marketing of Breast-Milk Substitutes and subsequent resolutions adopted by the World Health Assembly (the Code). This is up from 103 countries in 2011, when the last WHO analysis was done. Only 39 countries have laws that enact all provisions of the Code, however, a slight increase from 37 in 2011.

WHO and UNICEF recommend that babies are fed nothing but breast milk for their first 6 months, after which they should continue breastfeeding – as well as eating other safe and nutritionally adequate foods – until 2 years of age or beyond. In that context, WHO Member States have committed to increase the rate of exclusive breastfeeding in the first 6 months of life to at least 50% by 2025 as one of a set of global nutrition targets

The Code calls on countries to protect breastfeeding by stopping the inappropriate marketing of breast-milk substitutes (including infant formula), feeding bottles and teats. It also aims to and ensure breast-milk substitutes are used safely when they are necessary. It bans all forms of promotion of substitutes, including advertising, gifts to health workers and distribution of free samples. In addition, labels cannot make nutritional and health claims or include images that idealize infant formula. They must include clear instructions on how to use the product and carry messages about the superiority of breastfeeding over formula and the risks of not breastfeeding.

 “It is encouraging to see more countries pass laws to protect and promote breastfeeding, but there are still far too many places where mothers are inundated with incorrect and biased information through advertising and unsubstantiated health claims. This can distort parents’ perceptions and undermine their confidence in breastfeeding, with the result that far too many children miss out on its many benefits,” says Dr Francesco Branca, Director of WHO’s Department of Nutrition for Health and Development.

The breast-milk substitute business is a big one, with annual sales amounting to almost US$ 45 billion worldwide. This is projected to rise by over 55% to US$ 70 billion by 2019.

 “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 well-being 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.”

Overall, richer countries lag behind poorer ones. The proportion of countries with comprehensive legislation in line with the Code is highest in the WHO South-East Asia Region (36%, or 4 out of 11 countries), followed by the WHO African Region (30%, or 14 out of 47 countries) and the WHO Eastern Mediterranean Region (29%, or 6 out of 21 countries). The WHO Region of the Americas (23%, or 8 out of 35 countries); Western Pacific Region (15%, or 4 out of 27 countries); and European Region (6%, or 3 out of 53 countries) have lower proportions of countries with comprehensive legislation.

Among the countries that have any laws on marketing of breast-milk substitutes, globally:

IBFAN, with its International Code Documentation Centre (ICDC) taking the lead, has closely cooperated with WHO and UNICEF to prepare this report. The results are in line with the findings reported in ICDC’s own "State of the Code 2016".

 “IBFAN hopes that the report will lead more countries to improve and enforce existing legislation so that breastfeeding will have a better chance and save more lives,” says Annelies Allain, Director of IBFAN’s ICDC. “Legislation needs to keep pace with new marketing strategies and this report will help policy makers to do so.”

The report, "Marketing of breast-milk substitutes: National implementation of the International Code – Status report 2016", includes tables showing, country by country, which Code measures have and have not been enacted into law. It also includes case studies on countries that have strengthened their laws or monitoring systems for the Code in recent years. These include Armenia, Botswana, India and Viet Nam.

A copy of the report is available on this site.  See: Marketing of breast-milk substitutes: National implementation of the international code

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