Scope

The Code covers the marketing of all breastmilk substitutes (Article 2). These include:

• infant formula (including so-called ‘hypo-allergenic’ formula, preterm milks and other ‘special’ baby milks);
• follow-up milks;
• complementary foods such as cereals, teas and juices, water and other baby foods marketed for use before the baby is six months old.

The Code also covers feeding bottles and teats.

The Provision of Clear Information

Informational and educational materials dealing with the feeding of infants and intended to reach health professionals, pregnant women and mothers of infants and young children, should include clear information on all the following points:

a) the benefits and superiority of breastfeeding;
b) maternal nutrition and the preparation for and maintenance of breastfeeding;
c) the negative effect on breastfeeding of introducing partial bottle feeding;
d) the difficulty of reversing the decision not to breastfeed; and
e) where needed, the proper use of infant formula.

When such materials contain information about the use of infant formula, they should include:

a) the social and financial implications of its use;
b) the health hazards of inappropriate foods or feeding methods;
c) the health hazards of unnecessary or improper use of infant formula and other breastmilk substitutes.

Such materials should not use pictures or text, which may idealise the use of breastmilk substitutes (Articles 4.2, 7.2).

No Promotion to the Public

There should be no advertising or other form of promotion to the general public of products within the scope of the Code. There should be no point-of-sale advertising, giving of samples or any other promotional device to induce sales directly to the consumer at the retail level, such as special displays, discount coupons, premiums, special sales, loss-leaders and tie-in sales. Marketing personnel should not seek direct or indirect contact with pregnant women or with mothers of infants and young children (Article 5).

No Gifts to Mothers or Health Workers

Manufacturers and distributors should not distribute to pregnant women or mothers of infants and young children any gifts of articles or utensils, which may promote the use of breastmilk substitutes or bottle feeding. No financial or material inducements to promote products within the scope of the Code should be offered to health workers or members of their families. Financial support for professionals working in infant and young child health should not create conflicts of interest (Articles 5.4 ,7.3, WHA 49.15 [1996]).

No Promotion to Health Care Facilities

Facilities of health care systems should not be used to promote infant formula or other products within the scope of the Code. Nor should they be used for the display of products, or placards or posters concerning such products, or for the distribution of material bearing the brand name of products covered by the Code (Articles 6.2, 6.3, 4.3).

No Promotion to Health Workers

Information provided to health professionals by manufacturers and distributors regarding products covered by the Code should be restricted to scientific and factual matters, and should not imply or create a belief that bottle feeding is equivalent or superior to breast-feeding. Samples of products covered by the Code, or equipment or utensils for their preparation or use, should not be provided to health workers except where necessary for professional evaluation or research at the institutional level (Articles 7.2, 7.4).

No Free Samples or Supplies

Neither manufacturers nor health workers should give pregnant women or mothers of infants and young children, samples of products covered by the Code. Free or low-cost supplies of breastmilk substitutes should not be given to any part of the health care system which includes maternity wards, hospitals, nurseries and child care institutions. Donated supplies in support of emergency relief operations should only be given for infants who have to be fed on breastmilk substitutes and should continue for as long as the infants concerned need them.

Supplies should not be used as a sales inducement (Articles 5.2, 7.4). Note: Articles 6.6, 6.7 of the Code have been superseded by WHA Resolutions 39.28 (1986), WHA 45.34 (1992) and WHA 47.5 (1994).

No Promotion of Complementary Foods Before They Are Needed

It is important for infants to receive appropriate complementary foods, at about six months of age. Every effort should be made to use locally available foods. Any food or drink given before complementary feeding is nutritionally required may interfere with the initiation or maintenance of breastfeeding and therefore should not be promoted for use by infants during this period. Complementary foods should not be marketed in ways that undermine exclusive and sustained breastfeeding. (Code Preamble; WHA Resolution 39.28 [1986], WHA 45.34 [1992] and WHA 47.5 [1994], WHA 49.15 [1996]).

Adequate Labels: Clear Information, No Promotion, No Baby Pictures

Labels should provide the necessary information about the appropriate use of the product, and should not discourage breastfeeding. Infant formula manufacturers should ensure that each container has a clear, conspicuous and easily readable message in an appropriate language, which includes all the following points:

a) the words “Important Notice” or their equivalent;
b) a statement about the superiority of breastfeeding;
c) a statement that the product should only be used on the advice of a health worker as to the need for its use and the proper method of use; and
d) instructions for appropriate preparation, and a warning of the health hazards of inappropriate preparation.

Neither the container nor the label should have pictures of infants, or other pictures or text which may idealise the use of infant formula. The terms ‘humanised’, ‘maternalised’ or similar terms should not be used (Articles 9.1, 9.2).

Companies Must Comply with the International Code

Monitoring the application of the International Code and subsequent Resolutions should be carried out in a transparent, independent manner, free from commercial influence (WHA 49.15 [1996]).

Independently of any other measures taken for implementation of the Code, manufacturers and distributors of products covered by the Code should regard themselves as responsible for monitoring their marketing practices according to the principles and aim of the Code. Manufacturers should take steps to ensure that their conduct at every level conforms to all provisions above (Article 11. 3).

Full text of the International Code