The code of marketing of breastmilk substitutes

The code of marketing of breast milk substitutes

The code of marketing breastmilk substitutes is a hot topic that has been heatedly debated on ‘mommy blogs’ country wide: How does this affect you and what are the most important aspects of the code that you should be aware of? This blog post aims to provide background as to why the code was legislated and why it is a big step in the right direction for South Africa. This fits in nicely with Human Rights Day just behind us, because surely it is a human right to have freedom of choice when it comes to how one chooses to feed one’s baby!

Artificial feeding is not a new invention; it has evolved over hundreds of years with scientists trying to formulate non-human milk to resemble human milk, first in liquid form and later in powdered form for better preservation. As infant formula has evolved and more research has been done on it’s efficacy and safety, manufacturers have started to directly advertise their products to physicians. By the 1950’s, formula milk was actively being promoted and recommended as a popular and safe substitute for breast milk. As a result, breastfeeding rates steadily declined. Formula companies developed aggressive marketing strategies and formula feeding quickly replaced breastfeeding as the norm. Advertising was aimed specifically at developing countries and in 1988 companies were allowed to directly advertise to the public. The issue was not so much that mothers were formula feeding or that there was concern over the quality of the formula milk but rather that mothers in third world countries (like South Africa) who could not afford formula milk and those who lived in unsanitary conditions, were now attempting to formula feed. This fact, due to being led to believe that formula feeding was a better option for their infants as a result of shrewd marketing strategies. The Code of Marketing of Breastmilk Substitutes was drafted in order to address this concerning issue.¹

In South Africa we have an incredibly high infant mortality rate (40 per 1000 live births) and a low exclusive breastfeeding rate (8%). These stats have led our government to put into place a comprehensive legal framework that protects parents and healthcare professionals from aggressive or inappropriate marketing of breastmilk substitutes. According to Ann Behr, who is the Department of Health’s nutrition director, ‘These regulations do not, in any way, compel women to breastfeed against their will (and) do not stop infant formula and complementary foods from being made widely available in retail outlets. They are designed to remove commercial pressure from the infant feeding arena, to ensure that all parents receive independent and objective information and to ensure that all mothers who wish to breastfeed are supported to do so.’²

The following items are covered by the regulations:

• Starter formula
• Follow-up formula
• Starter and follow-up formula made for special needs
• Complementary foods
• Liquid milks, powdered milks, modified milk powers or powdered drinks marketed or otherwise represented as a suitable substitute for infant and young children
• Feeding bottles, teats and feeding cups with spouts, straws or teats

Gazette practices: (please read here for all the practices)

• No promotion of any items covered in the code
• No direct or indirect contact between company personal and member of the public with regards to promotion to items covered in the code
• No distribution of any information and educational on nutrition or infant feeding or promotional items like pens, t-shirts, stationary with brand names
• Health care facilities should not be used to promote or sell products like formula or complimentary foods
• No gift pack can be given were products are promoted
• No free or low cost distribution of formula
• No display of product or educational material from companies
• All educational material provided by companies should have the following criteria:
• Technical scientific material not advertising
• No health care or nutritional claims
• No promotion of products³

So the short and sweet of it is… The government is promoting and protecting breastfeeding in the hopes of decrease South Africa’s alarming infant mortality rates. They are not forcing you to breastfeed, but are placing a ban on advertising and promotion of breastmilk substitutes so that mothers who are breastfeeding do not feel undue pressure to formula feed. Together with this, it is also hoped that through this legislative act, mothers who are formula feeding have access to correct and objective information on how to prepare the formula and feed it to their babies in a safe manner.

References:

1. Stevens EE, Patrick TE, Pickler R, A history of infant feeding. Perinat Educ. 2009 Spring; 18(2): 32–39.
2. http://www.bdlive.co.za/business/media/2012/12/13/department-of-health-publishes-baby-milk-ad-controls
3. Department of Health. Regulations relating to food stuffs for infants and young children. Food stuffs, cosmetics and disinfectants acts, 1972. (ACT 54 of 1972). 2012.