What is the Code?
The International Code of Marketing of Breastmilk Substitutes (the Code) is an international health policy framework to regulate the marketing of breastmilk substitutes in order to protect breastfeeding. It was published by the World Health Organization in 1981 and is an internationally agreed voluntary code of practice.
The Code was written in response to the marketing activities of the infant feeding industry which were promoting formula feeding over breastfeeding, in turn leading to dramatic increases in maternal and infant morbidity and mortality.
The underlying basis for the Code is the belief that the health of babies is so important that the usual rules governing market competition and advertising should not apply to products intended for feeding babies. Therefore, all Governments should legislate to prevent commercial interests from damaging breastfeeding rates and the health of their population.
What does the Code do?
The Code regulates the marketing of breastmilk substitutes, which includes infant formulas, follow-on formulas and any other food or drink, together with feeding bottles and teats intended for babies and young children.
The Code also sets standards for the labelling and quality of products and for how the law should be implemented and monitored within countries.
Restricting marketing does not mean that the products cannot be sold, or that factual and scientific information about them cannot be made available. Nor does it restrict parents’ choice. It simply aims to make sure that their choices are made based on full and impartial information rather than misleading, inaccurate or biased marketing claims.
Does the UK have legislation that reflects the Code?
The UK’s legislation, named “The Infant Formula and Follow On Formula Regulations” incorporates some but not all of the Code into law. These regulations only cover infant formula intended for babies under six months old – they do not cover any food and do not cover the numerous products for babies older than six months. This loophole allows widespread advertising on television, in print media, online and via billboards. By using similar branding for all their products, companies can in effect advertise all their products while still staying within the UK law. In addition, the monitoring and enforcement of the UK legislation is very weak, which means that companies are rarely prosecuted for breaking the law.
Why does it matter?
Advertising influences our behaviour. The formula milk industry spends millions of pounds every year on advertising and marketing its products, encouraging mothers not to breastfeed or to stop breastfeeding early, and to use an array of different, expensive formula milks as soon as possible and for as long as possible. In addition, parents are then urged to use costly processed baby food, oftentimes before six months of age, which is the recommended age for starting solids. There is no evidence that more expensive formula milks or baby foods are beneficial to a baby’s health. Most of these are unnecessary and can be harmful. Where these products differ from most others is that such advertising can damage the short- and long-term health of our children by undermining breastfeeding and misleading parents who bottle feed about what milk to use.
What does this mean for practice?
To maintain and increase their profits, breastmilk substitutes companies need to persuade parents to formula feed rather than breastfeed, to choose their formula milk rather than that of a competitor’s and to use their brand of baby food as early and as much as possible. Health workers are widely trusted by the public and have constant access to new parents, making them the ideal conduit for relaying the company’s messages to parents. They are therefore frequent targets for marketing tactics. Influence from companies can be subtle and can involve research, education, supplies and materials which are often related to topics that seem to have nothing to do with feeding babies.
Baby Friendly accreditation requires services to implement the requirements of the Code. Health workers should ensure that there is:
- No advertising for infant feeding products anywhere within public services
- No contact between company personnel and pregnant women or mothers
- No items bearing company logos on public service premises or used by its staff, e.g. stationery, diary covers, key fobs, lanyards, pens, tourniquets, gestational / age in weeks calculators, weight conversion charts, post-it note pads, etc.
- No free samples to health professionals or mothers
- Only scientific and factual information, free from commercial bias, used in the care of babies and their parents.
Our guide to working within the Code has full guidance to ensure your services meets the required standards.