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    <title>The International Code of Marketing of Breastmilk Substitutes</title>
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      <h1 id="top">9.1 The International Code of Marketing of Breastmilk Substitutes</h1>
      <div>In 1981, the World Health Assembly adopted the <span style="font-style: italic;">International Code of Marketing of Breastmilk Substitutes</span> (the WHO Code). This document was prepared jointly by the World Health Organisation and UNICEF. The original document has continued to be developed as more resolutions have been passed by the World Health Assembly to see the WHO Code refined into the working document which we know today.<br /></div>
      <div class="section" id="Aim_of_the_WHO_Code"><h2>Aim of the WHO Code</h2>
    <div class="section" id="The_safe_and_adequate_nutrition_of_all_infants."><h3>The safe and adequate nutrition of all infants.</h3>
      <blockquote>
        <div>The WHO Code aims <span style="font-style: italic;"> to contribute to the provision of safe and adequate nutrition for infants</span> 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.</div>
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    <div>To achieve this aim <ul><li> Protect, promote and support breastfeeding. </li><li> Ensure that breastmilk substitutes are used properly when they are necessary. </li><li> Provide adequate information about infant feeding </li><li> Prohibit the advertising or any other form of promotion of breastmilk substitutes. </li></ul> The WHO Code does not aim to compel women to breastfeed against their will. It protects artificially fed infants by ensuring that the choice of products is impartial, scientific and protects these children's health. The WHO Code ensures that labels carry warnings and the correct instructions for preparation, so they are prepared in a safe manner if they are used. <p> The WHO Code is clear that the manufacture and availability of safe and appropriate products is not prohibited, but <span style="font-style: italic;"> promoting </span> them in the way most consumer products are marketed is unacceptable. </p></div>
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              <p>Complete Activity 9.1 in your workbook.</p>
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      <div class="section" id="What_s_covered_by_the_WHO_Code_"><h2>What's covered by the WHO Code?</h2>
    <div class="section" id="Breastmilk_substitute"><h3>Breastmilk substitute</h3>
      <div>......is any food being marketed or otherwise presented as a partial or total replacement for breastmilk, whether or not suitable for that purpose.<br /><br /></div>
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    <div>The WHO Code applies to: <br /> <ul><li> breastmilk substitutes, including bona fide artificial infant formula </li><li> other milk products, foods (cereals) and beverages (teas and juices for babies), when marketed or otherwise represented to be suitable for use as a partial or total replacement of breastmilk before 6 months </li><li> anything that replaces the milk part of the child's diet after 6 months, which would ideally be fulfilled by breastmilk, is a breastmilk substitute, for example 'follow-on' milks or cereals promoted to be offered by bottle </li><li> feeding bottles and teats/artificial nipples </li><li> the quality of these, the availability and information concerning their use <br /> </li></ul> <p class="listTitle"> The scope of the WHO Code does not include any food, solid or semi-solid intended to be given to infants after 6 months. Such foods are complementary or weaning foods and can not be considered breastmilk substitutes. </p></div>
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              <h3>Workbook Activity 9.2</h3>
              <p>Complete Activity 9.2 in your workbook.</p>
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      <div class="section" id="Promotion_and_product_information"><h2>Promotion and product information</h2>
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      <ul>
        <li>Product labels must clearly state their inferiority to breastfeeding, the need for the advice of a health care worker, and a warning about health hazards. They may not show pictures of babies, or other pictures or text idealising the use of infant formula.</li>
        <li>Advertising of breastmilk substitutes to the public is not permitted.</li>
        <li>Companies can provide necessary information to health workers on the ingredients and use of their products. This information must be scientific and factual, not marketing materials. This product information should not be given to mothers.</li>
        <li>No financial or material inducements (pens, lunches) which promote products within the WHO Code should be provided for health workers or accepted by health workers.<br /></li>
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      <div class="section" id="Free_samples"><h2>Free samples</h2>
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        <li>No free or low-cost breastmilk substitutes can be supplied in any part of the health care system.</li>
        <li>The small amount of infant formula needed for any babies who are not breastfeeding should be bought through regular purchasing channels. <br /></li>
        <li>Free samples should not be given to mothers, their families or health care workers. Small samples of artificial formula may not be given to mothers either from hospital or in the community, as these are samples to encourage mothers to use those products.</li>
        <li>Supplies of breastmilk substitutes to be given by the institution for free or at a reduced price to mothers or caregivers for social welfare purposes must continue to be provided for each baby for as long as the baby needs them. (ie, the responsibility of continued cost)<br /></li>
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      <div class="section" id="What_can_you_do_"><h2>What can you do?</h2>
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      <ul>
        <li>Remove posters that advertise formula, teas, juices or baby cereal, as well as any that advertise bottles and teats and refuse any new posters.</li>
        <li>Refuse to accept free gifts from companies.</li>
        <li>Refuse to allow free samples, gifts, or leaflets to be given to mothers.</li>
        <li>Give individual private teaching of artificial infant formula use postnatally when a baby has a need for it. Do not allow group teaching of artificial formula preparation to pregnant women. <br /></li>
        <li>Accept only product information from companies that is scientific and factual, not marketing materials.</li>
        <li>Report breaches of the Code to the appropriate authorities.</li>
      </ul>
      <p> As a health care worker who cares about the health of mothers and babies it is up to each individual to uphold the WHO Code, regardless of your country's commitment to it. If your hospital intends to seek Baby Friendly accreditation it must comply with the WHO Code in its entirety, including the WHA Resolutions. </p>
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        <p>
				Click on the icon to be taken to the IBFAN site, which gives you a quick and easy summary called <img alt="External" src="design/external.gif" /><a href="http://www.ibfan.org/code-brief_guide.html" title="External link" target="_blank">"A brief guide to spotting a violation"</a>. Print this out to keep, and also put a copy on the staff notice boards at your place of work.
			</p>
        <p>Alternative download: <img alt="PDF" src="design/page_white_acrobat.png" /><a href="images/IBFAN_Brief%20guide%20to%20spotting%20a%20violation.pdf" title="PDF file">download the PDF here</a></p>
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        <img width="300" height="420" src="images/WHO_Code_lge.jpg" alt="The WHO Code" />
        <p>The WHO Code</p>
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            <td class="body"><a href="http://www.who.int/nutrition/publications/code_english.pdf" target="_blank"><img src="design/article.png" class="icon" alt="" /></a><h3><a href="http://www.who.int/nutrition/publications/code_english.pdf" target="_blank">A copy of the WHO Code</a></h3>
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      <p> Click on the icon above to be taken to a site where you can download and print a copy of the International Code of Marketing of Breastmilk Substitutes <span class="aside">(it's a .pdf document which will open your Acrobat Reader)</span>. If that website is 'down' it's also available at the <img alt="External" src="design/external.gif" /><a href="http://www.ibfan.org/issue-international_code.html" title="External link" target="_blank">IBFAN</a> website, which has all the WHA Resolutions listed for you to read and print also. </p>
      <p> Your workplace should have a copy (or several copies) of this document. It can be purchased inexpensively. <img alt="External" src="design/external.gif" /><a href="http://www.who.int/bookorders/anglais/detart1.jsp?amp;sesslan=1&amp;codlan=1&amp;codcol=15&amp;codcch=94" title="External link" target="_blank">CLICK HERE</a> to open the Order Form. </p>
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      <div class="section" id="What_should_I_remember_"><h2>What should I remember?</h2>
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        <ul>
          <li>What is the WHO Code</li>
          <li>The purpose of the WHO code</li>
          <li>What company products and marketing tactics are included in the scope of the Code</li>
          <li>How to identify and report breaches of the WHO Code</li>
          <li>My responsibilities as a health care worker<br /></li>
        </ul>
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      <div class="section" id="Self-test_quiz"><h2>Self-test quiz</h2>
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	new MCQ('The scope of the WHO Code excludes infants who are being formula fed.', [{text:'True',score:0},{text:'False',score:1}]),
	new MCQ('Under the provisions of the Code, it is acceptable for a health worker to take promotional gifts such as pens and notepads from infant formula manufacturers but the health worker must not show these products to a mother.', [{text:'True',score:0},{text:'False',score:1}]),
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        <li>1.0 <a href="topic_1-0.html">Why Breastfeeding is Important</a><ol><li>1.1 <a href="topic_1-1.html">Biochemistry</a></li><li>1.2 <a href="topic_1-2.html">Immunology</a></li><li>1.3 <a href="topic_1-3.html">Relative risks</a></li></ol></li>
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        <li>6.0 <a href="topic_6-0.html">A time to learn</a><ol><li>6.1 <a href="topic_6-1.html">Practical skills</a></li><li>6.2 <a href="topic_6-2.html">Breastfeeding messages</a></li><li>6.3 <a href="topic_6-3.html">Normal growth</a></li><li>6.4 <a href="topic_6-4.html">Sleep</a></li><li>6.5 <a href="topic_6-5.html">Psychological support</a></li><li>6.6 <a href="topic_6-6.html">Discharge planning</a></li></ol></li>
        <li>7.0 <a href="topic_7-0.html">Infant Challenges</a><ol><li>7.1 <a href="topic_7-1.html">Late preterm infant; Non-latching</a></li><li>7.2 <a href="topic_7-2.html">Hypoglycemia; Jaundice</a></li><li>7.3 <a href="topic_7-3.html">Supplementation</a></li><li>7.4 <a href="topic_7-4.html">Crying baby</a></li><li>7.5 <a href="topic_7-5.html">Inadequate weight gain</a><ol><li>7.5.1 <a href="topic_7-5-1.html">Feeding-line device at the breast</a></li><li>7.5.2 <a href="topic_7-5-2.html">Cup feeding</a></li><li>7.5.3 <a href="topic_7-5-3.html">Finger Feeding</a></li><li>7.5.4 <a href="topic_7-5-4.html">Bottle feeding</a></li></ol></li></ol></li>
        <li>8.0 <a href="topic_8-0.html">Maternal Challenges</a><ol><li>8.1 <a href="topic_8-1.html">Engorgement</a></li><li>8.2 <a href="topic_8-2.html">Nipple Pain</a></li><li>8.3 <a href="topic_8-3.html">Breast Problems</a></li><li>8.4 <a href="topic_8-4.html">Insufficient breastmilk</a></li><li>8.5 <a href="topic_8-5.html">Medical, Surgical Issues</a></li></ol></li>
        <li>9.0 <a href="topic_9-0.html">Promotion, Protection and Support</a><ol><li class="current">9.1 <img src="design/bullet_arrow_right.png" alt="*" title="You are here" /><a href="topic_9-1.html">The International Code of Marketing of Breastmilk Substitutes</a></li><li>9.2 <a href="topic_9-2.html">The Baby Friendly Initiative</a></li><li>9.3 <a href="topic_9-3.html">Young Child Feeding</a></li><li>9.4 <a href="topic_9-4.html">Local initiatives</a></li><li>9.5 <a href="topic_9-5.html">Infant feeding in emergencies</a></li></ol></li>
        <li>10.0 <a href="topic_10-0.html">Closing session</a><hr /></li>
        <li class="appendix"> <a href="references.html">List of references</a></li>
        <li class="appendix"> <a href="contents.html">Course contents</a></li>
        <li class="appendix"> <a href="full.html">Print version</a></li>
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