25 years ago, the International Code of Marketing of Breastmilk Substitutes (the Code) was adopted by the World Health Assembly (WHA). The Code set out simple, basic rules to regulate harmful marketing practices.

·     no advertising of breastmilk substitutes, feeding bottles and teats;

·     no free samples to mothers;

·     no promotion in healthcare facilities, including no free or low-cost formula;

·     no company personnel to contact mothers;

·     no gifts or personal samples to health workers. Health workers should never pass samples on to mothers;

·     no pictures of infants or words idealizing artificial feeding, including that on labels, should explain the benefits and superiority of breastfeeding and the dangers associated with artificial feeding.

Breastfeeding: the priority for public health

More women are exclusively breastfeeding in the first six months. But even where breastfeeding is part of the culture, practices can be less than ideal and where artificial feeding is usual, they can be appalling. Delaying and restricting breastfeeds and giving other products before six months are still common practices which increase the risk of infection, allergy, long-term disease and death. Ignorance, inadequate health professional training and neglect of women’s rights contribute to these problems. None however can compare with the harmful effects of product promotion. The millions spent on marketing directly compete with breastfeeding.

The Code is the cornerstone of protection
Leaders in public health have spoken out against the aggressive promotion of breastmilk substitutes for decades. This stance was formalized 25 years ago when the WHA adopted the Code as the minimum basis for regulation of harmful marketing practices. Every WHO Member State has committed itself to the Code, but pressure from powerful companies can impede implementation.

Some examples of Code violations

- Company materials and websites disguise promotion as infant feeding information. They minimize the risks of not breastfeeding and make claims such as that fatty acids in formula will make a baby more intelligent.

- Companies give large quantities of brochures, containing misleading information, to health professionals who often pass them to mothers.

- Follow-on formulas are marketed as essential for babies’ health, convincing women to give up breastfeeding early. WHA has declared follow-on formulas to be unnecessary.

- Huge financial incentives are paid to health facilities to distribute discharge packs containing infant formula samples to new mothers.

A lot has been achieved

In 1990 only nine governments had the Code in law. By 2005, over 60 countries had legislation enforcing all or many provisions. Research shows that where the Code is law the community is better protected from product promotion than where the Code is merely voluntary. When there is no regulation at all there is a commercial free-for-all, mothers lose confidence and breastfeeding declines. Much success is due to the commitment of groups and individuals dedicated to Code implementation.

Code violations in Hong Kong

Let's have a look at local supermarkets and pharmacies. Do you see any promotional items? In clinics, there are lots of brochures introducing different brands of baby food. Formula samples are of course provided free. Check magazines and other print media, the web, TV and radio, advertising is all around.

25 Years of Protecting Breastfeeding    Together we can make a difference

The Code forbids the use of baby faces on formula labels. Today, they are replaced with cuddly stuffed animals and cartoon characters. Companies would use all kinds of tricks to have us believe that their products are ideal. Be a smart parent, let us say “No”to Code violations! The next time you see a violation, try to tell more to your friends. More people will be aware of the fact that harmful marketing strategies are hindering our breastfeeding environment.