40th Anniversary of the International Code of Marketing of Breast Milk Substitutes, “The Code

In response to the predatory marketing practices of the infant formula industry, the World Health Organization (WHO) embraced the Code in 1981 as a means to protect breastfeeding mothers and infants from commercial pressures to avoid or abandon breastfeeding.

Its 11 articles and subsequent resolutions is a group of recommendations regarding the marketing of breastmilk substitutes, infant feeding bottles, and artificial nipples. The Code recognizes that some infants will be fed formula and contains recommendations for the safe use of the products. The Code does not forbid the use of infant formula but applies to how it is marketed. The scope of the Code includes infant formula and other fluids and foods designed to replace breastmilk, infant feeding bottles, and artificial nipples. Manufacturers, distributors, healthcare personnel, and the healthcare system are expected to follow the tenets of the Code. No portion of the Code is legislated in the US, but there are steps we can take to curb the use of often deceptive and misleading advertising and marketing practices that infects the marketplace.

  • Ask the Network Advertising Initiative and the Digital Advertising Alliance to include pregnancy and breastfeeding in their marketing codes. These are self-regulatory bodies for how the digital advertising industry collects and uses sensitive information
  • Work to remove formula discharge bags from your hospital if this has not been done already
  • Ask pediatric, obstetric, and other offices and departments (such as ultrasound) to avoid giving out formula-containing gifts or materials from Code violating companies
  • File a complaint with the Better Business Bureau. Its National Advertising Division (NAD) is the investigative arm charged with monitoring and evaluating truth and accuracy in national advertising directed towards consumers age 12 and over
  • Ask Facebook and Google to addresses infant formula marketing in their advertising policies

How to tell if a company is Code compliant

  • Does the company or entity manufacture or distribute products covered under the scope of the Code?
  • How is the product described? Any language regarding covered products on labels, packaging, printed materials, websites, or social media that idealizes the use of the product violates the Code. Are there photos of feeding bottles, artificial nipples, or infants being bottle-fed?
  • Check out the company’s lineage.
  • Is an organization, association, lactation personnel, conference, educational program, or any type of entity funded by or sponsored by a Code violating company?
  • Stores that distribute coupons for infant formula or feeding bottles and artificial nipples, who have special displays of infant formula, who mail infant formula ads to consumers, or who display shelf-talkers (little signs on the store shelf that are designed to grab the attention of shoppers) are not meeting their obligations under the Code.
  • Does the company collect names and contact information of childbearing families?
  • While breast pumps are not covered under the scope of the Code, some pump companies manufacture and distribute infant feeding bottles and artificial nipples. If these bottles and nipples are marketed in a Code violating manner, then the company is designated as a Code violator.
  • Are educational programs funded by Code violators? Do hospitals, physician offices, or other healthcare entities distribute covered products?
  • Are vendors or advertisers at conferences meeting their obligations under the Code?

We can all do something to give meaning to the Code and better help families meet their breastfeeding goals.

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