9.1 The International Code of Marketing of Breastmilk Substitutes
Aim of the WHO Code
The safe and adequate nutrition of all infants.
The WHO Code 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.
- Protect, promote and support breastfeeding.
- Ensure that breastmilk substitutes are used properly when they are necessary.
- Provide adequate information about infant feeding
- Prohibit the advertising or any other form of promotion of breastmilk substitutes.
The WHO Code is clear that the manufacture and availability of safe and appropriate products is not prohibited, but promoting them as you would harmless consumer products is unacceptable.
The WHO Code also protects artificially fed infants by ensuring that the choice of products available is impartial, scientific and protects the child's health. The WHO Code ensures that labels carry warnings and the correct instructions for safe preparation for when they are to be used.

Workbook Activity 9.1
Complete Activity 9.1 in your workbook.
What's covered by the WHO Code?
Breastmilk substitutes
- breastmilk substitutes, including bona fide artificial infant formula
- 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
- 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
- feeding bottles and teats/artificial nipples
- the quality of these, the availability and information concerning their use
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.

Workbook Activity 9.2
Complete Activity 9.2 in your workbook.
Promotion and product information
- 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.
- Advertising of breastmilk substitutes to the public is not permitted.
- 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.
- 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.
Free samples
- No free or low-cost breastmilk substitutes can be supplied in any part of the health care system.
- The small amount of infant formula needed for any babies who are not breastfeeding should be bought through regular purchasing channels.
- 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.
- 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)
What can you do?
- Remove posters that advertise formula, teas, juices or baby cereal, as well as any that advertise bottles and teats and refuse any new posters.
- Refuse to accept free gifts from companies.
- Refuse to allow free samples, gifts, or leaflets to be given to mothers.
- 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.
- Encourage all mothers to breastfeed their infants for a minimum of 2 years, only introducing complementary foods after 6 months of age (and that the use of follow-on milks is unnecessary and expensive).
- Accept only product information from companies that is scientific and factual, not marketing materials.
- Report breaches of the Code to the appropriate authorities.
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.

Workbook Activity 9.3
Complete Activity 9.3 in your workbook.

Monitoring the Code
Click on the link above to be taken to the IBFAN website. Here you'll find a lot of useful and interesting information about an organization that is working hard to protect children. As Health Professionals it is our joint responsibility to ensure the Code is adhered to.
This is also where you will be able to report violations of the Code at this link: Monitoring the Code.

The WHO Code

A copy of the WHO Code
Click on the title of this box, above, to be taken to a site where you can download and print a copy of the International Code of Marketing of Breastmilk Substitutes (it's a .pdf document which will open your Acrobat Reader) . If that website is 'down' it's also available at the IBFAN website, which has all the WHA Resolutions listed for you to read and print also.
Your workplace should have a copy (or several copies) of this document. It can be purchased inexpensively. CLICK HERE to open the Order Form.
What should I remember?

- What is the WHO Code
- The purpose of the WHO code
- What company products and marketing tactics are included in the scope of the Code
- How to identify and report breaches of the WHO Code
- My responsibilities as a health care worker