Invest in Protecting Babies

Breastmilk is baby’s first food, first vaccination, and first emotional bonding. It is so much more than food. Nutritionists know this. Pediatricians know it. Mothers often do not. To ensure that mothers are as well informed and protected as possible, the International Code of Marketing of Breastmilk Substitutes[i] was established to set limits on the marketing of these products. Code compliance is part of the child’s human right to health and adequate nutrition; governments have an obligation to enforce the Code and companies to abide by its provisions, as stated by the Committee on the Rights of the Child.[ii]

The Code and subsequent World Health assembly (WHA) resolutions are universal and should be complied with in all nations and by all companies, “independently of any other measures…” (Art 11.3). Yet the latest global monitoring report “Breaking the Rules 2014”,[iii] with evidence from 81 countries, concludes that there is not a single manufacturer who abides by the Code. In fact, the situation is worse now than 20 years ago. The main reason is that the profits are larger. In just 5 years, from 2008 to 2013, the babyfood market grew by 270% - from US$11.5 to US$42.5 billion. It is obvious that breastfeeding promotion cannot compete with the huge marketing budgets of the large manufacturers.

New products, new marketing techniques and cutthroat competition for huge new markets, like China, entice formula makers to ignore the Code. Monitoring of Code compliance is largely done by volunteers who work on a miniscule NGO budget to check and compile Code violations. Over the past 25 years, the International Baby Food Action Network's (IBFAN) monitoring reports have been published to get press attention. Naming and shaming the Code violators has been the main focus. Companies are very sensitive about their image.  Bad press can often yield better results than formal complaints. Reports of violations also send a message to WHO/UNICEF and governments to step up action.

To improve the monitoring and obtain better results will require both courage and investments. Now that close to 70 countries[iv] have implemented all or most provisions of the Code through legislation, there is the potential to improve monitoring at the national level. It is not enough to have regulations based on the Code. They must also be enforced and that requires well-trained monitors. Public health inspectors need the tools to back up findings and lead to sanctions. That in turn requires a legal system to verify Code violations and take on Code violators. The task will be easier once a few countries have led the way and are backed by WHO and UNICEF. Then companies will see the writing on the wall and begin to comply with Code provisions.

With support from the World Bank, IBFAN Asia recently launched the World Breastfeeding Costing Initiative[v] to put figures on a full package of measures, from programming to specific interventions, including monitoring Code compliance. A one-time investment of US$17.5 billion plus recurrent costs is needed to kick-start a worldwide push to really allow breastfeeding to take off. The blueprint for this is the implementation of the Global Strategy for Infant and Young Child Feeding.

While $17 billion sounds a lot, the return on that investment in terms of human lives saved and health improved is equally huge and will last for many years. The lessons learnt in the so-called baby food “controversy” can be instrumental in tackling the other big food questions, notably how to monitor and regulate the marketing of junk food, which leads to obesity and other Non-Communicable Diseases.

[i] International Code of Marketing of Breastmilk Substitutes, WHO, 1981

[ii] Convention on the Rights of the Child, Committee/General comments #15 and #16.

[iii] “Breaking the Rules 2014”, for reference and more details see ICDC website:

[iv] State of the Code by Country 2014.   See

[v] World Breastfeeding Costing initiative (WBCi) See