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14/07/2023

2023: Lancet Breastfeeding Series

This three-paper Series outlines the multifaceted and highly effective strategies used by commercial formula manufacturers to target parents, health-care professionals, and policy-makers. The industry’s dubious marketing practices—in breach of the breastfeeding Code—are compounded by lobbying of governments, often covertly via trade associations and front groups, against strengthening breastfeeding protection laws and challenging food standard regulations. https://www.thelancet.com/series/Breastfeeding-2023

2022 – three new WHO reports

  1. How the marketing of formula milk influences our decisions on infant feeding. – Marketing a 55 billion dollar formula milk industry. (February 22, 2022) See also our News Post

2. Scope and impact of digital marketing strategies for promoting breastmilk substitutes (April 28, 2022) https://www.who.int/publications/i/item/9789240046085

3. WHO Status report 2022 on the national implementation of the International Code (May 12, 2022)

GIFA – Information brochure in French

In 1981, the Code was born in Geneva. After 40 years, in 2021, the Code, together with the relevant World Health Assembly (WHA) resolutions, form a regularly updated and still relevant body of law.

This 4-page brochure is intended for anyone who wishes to have an overview of the scope and issues of the International Code of Marketing of Breast-milk Substitutes. Updated March 22, 2021.

Film about IBFAN-GIFA

Film about IBFAN A 7-minute film summarizing the work of IBFAN – GIFA, which was shown at the ceremony for the 40th anniversary of the International Code in 2021. The International Code of Marketing of Breast-milk Substitutes and Relevant Resolutions, abbreviated as “The Code”: an indispensable tool to protect, encourage and support breastfeeding and infant and young child feeding (IYCF).

2021 – 40th anniversary of the International Code – May 21, 2021

40 Years of the International Code: see the program and video of the speakers and our News Post 40 ans de Code international 1981 – 2021

On May 21, 1981, the World Health Assembly (WHA) endorsed one of the most powerful tools to protect breastfeeding- the “International Code of Marketing of Breastmilk Substitutes” It recognised that commercial marketing of baby foods is harmful to the health of infants. Decades of relentless struggle of mothers, health professionals, public health experts, feminists, activists, against corporate push to powdered milk formula, made it possible.

21 May – World Breastfeeding Protection Day

In 2021, on the occasion of the 40th anniversary of the Code, breastfeeding advocates globally have decided to celebrate 21 May of each year as the World Breastfeeding Protection Day. This day highlights that women and children need protection from this onslaught of bad marketing of baby foods. While several countries has a good law to provide protection to breastfeeding, it needs action for enforcement. 

The Code around the World

Every two years, WHO and its partners assess the status of Code implementation and publish the State of the Code Report.

The webinar at the launch of the 2020 Report takes stock of the situation with reference to the COVID-19 context (see our NEWS POST on this subject):

“The COVID-19 pandemic highlights the importance of protecting optimal nutrition, including breastfeeding, to improve child health and survival. Artificial milk manufacturers are exploiting panic and fears of contagion to escalate their aggressive marketing practices.”

What is the Code?

The International Code of marketing of breastmilk substitutes consists of 11 articles and some 20 subsequent Resolutions. WHO, UNICEF and IBFAN have released the 2022 State of the Code Report on the implementation of the International Code in countries around the world.

The practice of breastfeeding, although crucial for the healthy development of infants and young children, is threatened by abusive and misleading marketing aimed at promoting the sale of breastmilk substitutes, bottles and teats. The Code sets out a strict framework for the advertising of such products to ensure that parents have adequate and commercially independent information on which to base their child’s feeding decisions. The Code protects both breastfed and non-breastfed babies from commercial pressures.

Linkt to the International Code and subsequent Resolutions

Objectives of the International Code of Marketing of Breast-milk Substitutes

Breastfeeding is normal food and nourishes the baby lifelong, protects the baby from disease and deaths. According to an international study, annually, 100,000 child deaths could be saved in India if breastfeeding practices were adequate. In COVID -19 times breastfeeding can protect both babies and mothers with its antibodies. But, Baby food companies continue to attack and replace breastfeeding with their products; blatantly breaking the Indian law to protect breastfeeding, the Infant Milk Substitutes Feeding Bottles, and Infant Foods (Regulation of Production, Supply and Distribution) Act 1992, and Amendment Act 2003.(IMS Act)

Adopted in 1981 by the World Health Assembly (WHA) through Resolution 34.22 and subsequently supplemented by subsequent WHA Resolutions (which form an integral part of the Code), the Code is a “minimum requirement” that Member States are required to adopt and implement in full through national legislation or other national measures.

In addition, it represents a way to comply with the Maastricht Principles on Extraterritorial Obligations of States (2011). IBFAN GIFA has described the relationship between these Principles and the Code in a document available in English:

Who monitors compliance with the Code?

Although generally not binding on states, WHA resolutions “carry moral or political weight because they constitute the judgment of the entire membership of the highest international body in the field of health on a health issue.” (Shubber S., 1985, The International Code, Digest of Health Legislation, 36 (4): 884).

In addition, the Code applies directly to industry, regardless of the implementation measures taken by Member States (Article 11.3) and national legislation.

Non-governmental organizations, professional groups, institutions and individuals concerned are responsible for reporting violations of the Code to the relevant industry and to the competent national authority. In this regard, the International Code Documentation Center of the IBFAN network collects, catalogues and publishes violations in its report “Breaking the rules, stretching the rules” (latest edition: 2017). Other international organizations, such as the Joint FAO/WHO Codex Alimentarius Commission, are responsible for supporting and promoting the implementation of the Code.

2023 – violations continue..

As Baby Milk Action (IBFAN UK) notes with regret, violations of the International Code continue around the world, to the detriment of breastfeeding and unbiased information to parents. http://www.babymilkaction.org/monitoring-global

Levers for enforcing the Code

The provisions of the Code and related subsequent resolutions have been incorporated into other international instruments such as :

  • The Innocenti Declaration 1990 and 2005
  • The Global Strategy for Infant and Young Child Feeding (IYCF, 2002)
  • The Committee on the Rights of the Child (CRC) through its General Comment No 15 (paragraphs 44 and 81) and General Comment No 16 (paragraph 57). The Committee considers the implementation of the International Code as one of the measures to enable States to fulfil their obligations with regard to the rights of the child, and more particularly the right of the child to the enjoyment of the highest attainable standard of health (Article 24 of the Convention on the Rights of the Child).
  • The Committee on Economic, Social and Cultural Rights (CESCR) refers in its General Comment No 24  to the International Code and subsequent WHA resolutions as a measure to be considered by States in the context of their obligation to protect public health (paragraph 19).
  • Since 2005, the WBTi (World Breastfeeding Trends initiative) has included in its assessment the status of implementation of the Code in the country where the audit is conducted. This is indicator 3 (among a total of 10 indicators). For Switzerland, see here
  • The BFHI (Baby-Friendly Hospital Initiative) emphasizes the importance of Code compliance in its 2018 criteria revision by stating that “Full compliance with the International Code of Marketing of Breastmilk Substitutes and subsequent relevant WHA Resolutions is required.”

The following document, taken from “Code Essentials 1: Annotated International Code of Marketing of Breastmilk Substitutes and subsequent WHA resolutions” (updated 2016) lists the subsequent WHA resolutions relevant to the Code.

Who is responsible for compliance with the International Code?

It is the responsibility of all – governments, manufacturers and retailers, the health and care community – to monitor compliance with the Code and to report violations to state health officials and/or state representatives in parliament in their countries. Everyone has the right to alert public opinion and policy makers to inappropriate and/or irresponsible marketing practices of breastmilk substitutes.

Role and responsability of health professionals

WHO FAQ 26 mai 2020 The international code of marketing of breast-milk substitutes: frequently asked questions on the roles and responsibilities of health workers (en anglais).
https://www.who.int/publications/i/item/9789240005990