To Breastfeed or Bottle-feed? WHO tackles the ethical issue of baby formula

The debate over breast-milk substitutes is heating up as the first Global Congress on the implementation of the International Code of Marketing of Breast-milk Substitutes kicks off in Geneva, Switzerland. The event, hosted by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF), aims to end the unethical marketing of formula milk products that undermine breastfeeding and jeopardize infant and maternal health.

Photo by Sarah Chai, Pexel

The International Code of Marketing of Breast-milk Substitutes was adopted by the World Health Assembly in 1981 to protect breastfeeding from the aggressive and inappropriate promotion of breast-milk substitutes, bottles, and teats by the formula milk industry. The Code prohibits any form of advertising, free samples, gifts, or sponsorship to health workers and mothers. It also requires that labels on formula milk products contain clear information on the benefits of breastfeeding and the risks of artificial feeding.

However, despite the Code and subsequent resolutions by the World Health Assembly, formula milk companies continue to violate these principles and place commercial interests before children’s and families’ health. According to WHO and UNICEF, only 70% of countries have enacted legislation that covers at least some provisions of the Code, but many have gaps and loopholes that allow violations to persist. Most countries do not have effective systems to monitor and enforce the Code, and many face pressure and lobbying from the industry to weaken their regulations.

The Global Congress, which runs from 20 to 22 June 2023, brings together delegates from around 130 countries to share their experiences and challenges in implementing the Code, develop national work plans to strengthen legislation, monitoring and enforcement, and build regional networks to support national action. The Congress also features speakers from WHO, UNICEF, civil society organizations, academia, and parliamentarians who advocate for the protection of breastfeeding and the implementation of the Code.

One of the speakers is Dr. Francesco Branca, Director of Nutrition and Food Safety at WHO, who said: “Over 70% of Member States have enacted legislation that puts in place at least some of the provisions of the Code. But industries are still expanding to push an ever-increasing range of formula milk products on families, using insidious tactics to access their networks and influence their choices. Parents have the right to impartial information on infant feeding, which is actively undermined by exploitative industry marketing.”

Another speaker is Ms. Henrietta Fore, Executive Director of UNICEF, who said: “Breastfeeding is one of the best investments we can make for children’s health and development. It saves lives, prevents infections and diseases, promotes brain development and cognitive abilities, and protects against obesity and diabetes later in life. Yet only 40% of infants under six months are exclusively breastfed globally. We need to ensure that every mother has access to skilled breastfeeding counselling and support, and that no mother is misled or coerced by the marketing of breast-milk substitutes.”

The Global Congress is expected to generate renewed momentum and commitment from countries to fully implement the Code and end the unethical marketing of breast-milk substitutes. It is also expected to foster collaboration and solidarity among countries and stakeholders to protect breastfeeding as a human right and a public health priority.