What is the International Code?

The Code refers to an international recommendation drawn up by WHO and UNICEF and adopted by the World Health Assembly in 1981 seeks to protect breastfeeding by ensuring the ethical marketing of breastmilk substitutes by industry.

The Code includes these ten important provisions:

1. Aim: aims to “contribute to the provision of safe and adequate nutrition for infants, by the protection and promotion of breastfeeding, and by ensuring the proper use of breastmilk substitutes, when these are necessary, on the basis of adequate information and through appropriate marketing and distribution”.
2. Scope: the Code applies to breastmilk substitutes, including infant formula; to other milk products, foods and beverages, when marketed or otherwise represented as a partial or total replacement for breastmilk; to feeding bottles and nipples. It also applies to their quality and availability, and to information concerning their use.
3. Advertising: no advertising of above products to the public.  An end to inappropriate health claims for foods.
4. Samples: no free samples to mothers, their families or health care workers.
5. Facilities of Health Care Systems: no promotion of products, i.e., no product displays, posters or distribution of promotional materials. No use of mothercraft nurses or similar company-paid personnel. The "health care system" does not include pharmacies or other established sales outlets
6. Health Care Workers: no gifts or samples to health care workers as these create a conflict of interest .
7. Supplies: no free or low-cost supplies of breastmilk substitutes to maternity wards and hospitals.
8. Information: informational and educational materials must explain the benefits of breastfeeding, the health hazards associated with bottle feeding, and the costs of using infant formula. Product information must be factual and scientific.
9. Labels: product labels must clearly state the superiority of breastfeeding, to use only on the advice of a health care worker, instructions for the appropriate preparation and a warning about the health hazards of inappropriate preparation, and risk of Enterobacter Sakazakii. No pictures of infants, or other pictures or text idealising the use of infant formula.
10. Products: unsuitable products, such as sweetened condensed milk, should not be promoted for babies and products high in saturated or trans fats, free sugars and salts not marketed for children. All products should be of a high-recognized standard.  Proper product labeling of Enterobacter Sakazakii hazard with powdered artificial baby milks
11. Complementary feeding: foster appropriate complementary feeding from the age of about six months recognizing that any food or drink given before complementary feeding is nutritionally required may interfere with initiation or maintenance of breastfeeding.
12. Exclusive breastfeeding:  promote and support exclusive breastfeeding for six months as a global public health recommendation with continued breastfeeding for up to two years of age or beyond.
13. Marketing: ensure that complementary foods are not marketed for or used in ways that undermine exclusive and sustained breastfeeding.
14. Sponsorship: financial assistance from the infant feeding industry may interfere with professionals' unequivocal support for breastfeeding and create a conflict of interest  
      

Taken From the Canadian Pharmacists Association Position Statement on Breastfeeding and Infant Feeding 2001  www.pharmacists.ca  January 2011  J Peddlesden