The International Code of Marketing of Breastmilk
Substitutes
Questions and Answers for Health Workers
Q1. What is meant by the Code?
The Code refers to an international recommendation drawn up by the WHO and
UNICEF and adopted by the World Health Assembly in 1981.
Q2. What is the aim of the Code?
The Code seeks to protect and promote breastfeeding by eliminating
inappropriate marketing and distribution of breastmilk substitutes.
Q3. Why is there such a Code?
It was recognised internationally that commercial promotion of infant
feeding products has a negative impact on the prevalence and duration of
breastfeeding. The Code was adopted to end marketing practices that interfere
with breastfeeding.
Q4. Who voted for the Code?
Of the 119 countries attending the WHA in 1981 all but one (the USA) voted
in favour of the recommendation.
Q5. Is there only one Code?
Yes, but many countries have passed national laws or developed their own
national codes based largely on the International Code. (The best way to
implement the Code is by making it law.)
Q6. What is covered by the Code?
All products that are marketed to substitute for breastmilk. These include
formulae, other milks, infant foods, or juices. Feeding bottles and teats are
also covered. The Code does not prohibit the sale of these products, only the
way they are promoted.
Q7. Who is responsible for the implementation of the Code?
The onus is on the manufacturers and distributors to conform to the
provisions of the Code. Few countries have set up mechanisms for reporting and
dealing with violations. Health workers need to be familiar with the Code in
order to protect mothers and infants from commercial promotion.
Q8. Does the Code specify and age group, or any set of countries?
No, the Code is concerned with breastmilk substitutes for any age, and in
all countries.
Q9. How does on assess whether a promotional practice is contrary to the
intention of the Code?
The cardinal rule is to ask whether it tends to discourage or undermine
breastfeeding. (See Q12 for more details.)
Q10. What does the Code not do?
 | No advertising of products to the public. |
| No free samples to mothers or their families. |
| No promotion of products in healthcare facilities, including the
distribution of free or low-cost supplies. |
| No company sales representatives to contact or advise mothers. |
| No gifts or samples of products to health workers. If health workers do
receive products, they should not pass them on to mothers. |
| No words or picture idealising artificial feeding, including pictures of
infants, on the labels of the products. |
| Information to health workers should be scientific and factual. |
| All information on artificial infant feeding, including that on labels,
should explain the benefits of breastfeeding, and the costs and hazards
associated with artificial feeding. |
| Unsuitable products, such as sweetened condensed milk, should not be
promoted for babies. |
| Manufactures and distributors should comply with the Code's provisions
even if countries have not adopted related laws or other measures. |
