The World Health Organization (WHO) International Code of Marketing of Breastmilk Substitutes (WHO Code), first published in 1981, was devised to protect and promote breastfeeding and restrict the marketing of breastmilk substitutes, such as infant formula.
Infant formula manufacturers have, however, been regularly accused of failing to adhere to the principles of the WHO Code.
Referencing recent reports by Save the Children and the International Baby Food Action Network (IBFAN), Dave Clark, nutrition specialist and legal adviser at UNICEF, said "promotion to mothers in shops, promotion to health workers and in health facilities” were among the most common WHO Code violations.
"I believe these reports provide an accurate assessment of what is happening in terms of Code compliance, and lack thereof," Clark told DairyReporter.com.
Approached regarding the sector's attitude to the WHO Code, the Infant Nutrition Council (INC), the International Association of Infant Food Manufacturers (IFM) and the International Formula Council (IFC) each insisted they fully support its principles.
Speaking with DairyReporter.com, Jan Carey, CEO of INC, which represents New Zealand-based manufacturers including Fonterra and Nutricia, said it is the industry's responsibility to do so.
"...I most certainly do think that it is the industry's responsibility to adhere to the Code," she said.
“No one knows more than the researchers, nutritionists and other health professionals that work in the infant formula industry about the unique and unsurpassed benefits of breast milk as they have been studying it and attempting to replicate its properties for many years."
"The infant formula industry and the people that work in it are in the infant nutrition business and for that very reason they have a responsibility to recommend the best possible nutrition for infants, breast milk and to provide a high quality and safe alternative only when required," said Carey.
Voluntary measures
In 2011, just 37 of the 199 countries that report to WHO on the WHO Code had passed legislation reflecting its recommendations, said a 2013 report.
At that time, the principles of the WHO Code had also been adopted on a voluntary bases in 31 countries, including New Zealand, Australia, and the United States, the report added.
Despite New Zealand's current 'voluntary' status, INC recently took steps to enforce its own policy, the INC Code of Practice for the Marketing of Infant Formula in New Zealand (INC Code of Practice).
In November 2014, it asked the New Zealand Commerce Commission to grant it the authority to restrict the infant formula marketing practices of its members. This, INC argued, would give the New Zealand Ministry of Health time to push through mandatory regulations.
“As you would know it is against the trade practices laws in New Zealand to be anti-competitive," Carey continued.
“As the industry’s behaviour in adhering to the INC Code of Practice could be regarded as anticompetitive, the Ministry of Health and INC thought it was wise to have the Code authorised by the Commerce Commission," she added.
Geneva-based IFM, which represents FrieslandCampina, Fonterra, Mead Johnson Nutrition, Abbott Nutrition, Danone, and Heinz, last year took a similar approach to the WHO Code.
In January 2014, IFM members adopted its Rules of Responsible Conduct (RRC).
“The WHO Code is a standard that the infant and young child nutrition industry takes seriously,” said Matt Doran, executive director, IFM.
“The RRC represent a step forward for the industry globally. The IFM and its member companies encourage other companies operating in the sector to support and adopt this voluntary code. One of the best ways to strengthen the RRC is to have more companies participate in them. We welcome a dialogue with stakeholders to ensure these rules are as effective as possible.”
Inconsistent with US law
Earlier this year, the Infant Formula Council (IFC), which counts Mead Johnson Nutrition, Abbott Nutrition and Nestlé USA among its members, came under fire for its attitude to the distribution of infant formula samples in US healthcare facilities.
It said then that because "the voluntary Code is inconsistent with US law and policy, and was therefore not adopted" the common US practice of providing free hospital discharge bags containing samples of infant formula is not in violation of the WHO Code.
Speaking with DairyReporter.com yesterday, Mardi Mountford, executive vice president, IFC, acknowledged the WHO Code is "inconsistent with US law" but insisted, however, that its members fully support the WHO Code's recommendations.
“All IFC members support the aim and principles of the World Health Organization’s (WHO) International Code of Marketing of Breast Milk Substitutes (the Code),” she said.
“That said, the voluntary Code is inconsistent with US law and policy, and was therefore not adopted in the US. Further, IFC members respectfully adhere to applicable laws and regulations of national authorities.”