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Helen Gray, London, Great Britain

The International Code of Marketing of Breastmilk Substitutes from the World Health Organization (the Code) covers marketing and promotion of products meant to substitute for breastfeeding. It does not ban their sale or use; it simply restricts their promotion.

Why do we need a Code?

The Code is needed to support infant health and prevent unscrupulous practices in the sale of breast milk substitutes.

What is the Code in law?

The Code is a World Health Assembly Resolution; a recommendation that nations pass legislation to uphold the resolution. However there is no legal penalty if a nation does not implement a resolution that they adopted.

An updated version http://www.ibfan-icdc.org/index.php/publications/publications-for-sale of the Code has just been issued which discusses the rules governing the marketing of breast milk substitutes.

What does the Code cover?

  • Formula milk
  • Any food or drink that would substitute for breastfeeding e.g. teas or foods aimed at babies under six months, or formula aimed at any age
  • Bottles
  • Teats or nipples

Who is expected to follow the Code?

  • Manufacturers, distributors, and retailers of any of the above items
  • Health care workers, both professionals and volunteers
  • Health care facilities—hospitals, clinics, etc

What must be on the label?

  • Labels must be in the local language
  • Information must include the hazards associated with artificial feeding
  • Labels cannot use idealising language or images e.g. a happy baby sleeping, or a protective shield suggesting baby is in a protected bubble against disease 

What IS allowed under the Code?

  • Use of formula with safe preparation, for babies who need it
  • Sale of products with technical information e.g. “125 ml polycarbonate bottle”
  • Scientific and factual information for health professionals e.g. “contains certain proteins”
  • Accurate information on safe formula preparation is required on all labels

What is NOT allowed?

  • Promotion to parents: advertising, free samples
  • Promotion to health professionals: gifts, free samples
  • Promotion in health facilities: posters, free formula, gifts
  • Promotion of unsuitable products for babies (such as sweetened condensed milk)

Got questions?

Please send in all your questions on understanding the Code to editorlt@llli.org so that we can have a topical article addressing these in a future issue.

Further information

Useful background on the Code can be found on the IBFAN website http://ibfan.org/code-monitoring.

Baby Milk Action has a selection of publications and educational materials http://www.babymilkaction.org/shop#!/~/product/id=13951&prid=0&ctid=4&scid=2&tp=pl_.

Baby Milk Marketing. Who needs WHO?

Global Health Agencies and Breastfeeding

International Code of Marketing of Breast-Milk Substitutes (1981)

Breaking the Rules, Stretching the Rules, 2014, International Code and relevant WHA resolutions (printed version)

International Code FAQ

Protecting Infant Health, A Health Worker’s Guide to the International Code of Marketing of Breastmilk Substitutes

Originally from the USA, Helen Gray is a La Leche League Leader in London, UK, where she and her husband Julian live with their three teenaged children. Helen is an IBCLC (International Board Certified Lactation Consultant) and joint coordinator of the UK working group of the World Breastfeeding Trends Initiative (WBTi). She represents LLL Great Britain on the Baby Feeding Law Group, which works to implement the WHO International Code of Marketing of Breastmilk Substitutes into UK and European law. Helen tweets as @HelenGrayIBCLC.
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