WHA RESOLUTION 45.34
The Forty-fifth World Health Assembly,
Having considered the report by the
Director-General on infant and young child nutrition;
Recalling resolutions WHA33.32,
WHA34.22, WHA35.26,
WHA37.30, WHA39.28,
WHA41.11 and WHA43.3
on infant and young child feeding and nutrition, appropriate
feeding practices and related questions;
Reaffirming that the International
Code of Marketing of Breastmilk Substitutes is
a minimum requirement and only one of several important
actions required in order to protect healthy practices
in respect of infant and young child feeding;
Recalling that products that may
be promoted as a partial or total replacement for breastmilk,
esecially when these are presented as suitable for bottle
feeding, are subject to the provisions of the International
Code;
Reaffirming that during the first
four to six months of life no food or liquid other
than breastmilk, not even water, is required to meet the
normal infant's nutritional requirements, and that
from the age of about six months infants should begin
to receive a variety of locally available and safely prepared
foods rich in energy, in addition to breastmilk, to meet
their changing nutritional requirements;
Welcoming the leadership of the Executive
Heads of WHO and UNICEF in organizing the "baby-friendly"
hospital initiative, with its simultaneous focus on
the role of health services in protecting, promoting and
supporting breastfeeding and on the use of breastfeeding
as a means of strengthening the contribution of health
services to safe motherhood, child survival, and primary
health care in general, and endorsing this initiative
as a most promising means of increasing the prevalence
and duration of breastfeeding;
Expressing once again its concern
about the need to protect and support women in the
workplace, for their own sakes but also in the light
of their multiple roles as mothers and care-providers,
inter alia, by applying existing legislation fully
for maternity protection, expanding it to cover any women
at present excluded or, where appropriate, adopting new
measures to protect breastfeeding;
Encouraged by the steps being taken
by infant-food manufacturers towards ending the donation
or low-price sale of supplies of infant formula to maternity
wards and hospitals, which would constitute a step towards
full implementation of the International Code;
Being convinced that charitable and
other donor agencies should exert great care in initiating,
or responding to, requests for free supplies of infant
foods;
Noting that the advertising and promotion
of infant formula and the presentation of other products
as breastmilk substitutes, as well as feeding-bottles
and teats, may compete unfairly with breastfeeding which
is the safest and lowest-cost method of nourishing an
infant, and may exacerbate such competition and favour
uninformed decision-making by interfering with the advice
and guidance to be provided by the mother's physician
or health worker;
Welcoming the generous financial and
other contributions from a number of Member States that
enabled WHO to provide technical support to countries
wishing to review and evaluate their own experiences in
giving effect to the International Code;
1. THANKS the Director-General for
his report;
2. URGES Member States:
(1) to give full expression at national
level to the operational targets contained in the Innocenti
Declaration, namely:
(a) by appointing a national breastfeeding
coordinator and establishing a multisectoral breastfeeding
committee;
(b) by ensuring that every facility
providing maternity services applies the principles
laid down in the joint WHO/UNICEF statement on the
role of maternity services in protecting, promoting
and supporting breastfeeding;
(c) by taking action to give
effect to the principles and aim of the International
Code of Marketing of Breastmilk Substitutes and
subsequent relevant Health Assembly resolutions in
their entirety;
(d) by enacting legislation
and adopting means for its enforcement to protect
the breastfeeding rights of working women;
(2) to encourage and support all
public and private health facilities providing maternity
services so that they become "baby-friendly":
(a) by providing the necessary
training in the application of the principles laid
down in the joint WHO/UNICEF statement;
(b) by encouraging the collaboration
of professional associations, women's organizations,
consumer and other nongovernmental groups, the food
industry, and other competent sectors in this endeavour;
(3) to take measures appropriate
to national circumstances aimed at ending the donation
or low-priced sale of supplies of breastmilk substitutes
to health-care facilities providing maternity services;
(4) to use the common breastfeeding
indicators developed by WHO, with the collaboration
of UNICEF and other interested organizations and agencies,
in evaluating the progress of their breastfeeding programmes;
(5) to draw upon the experiences
of other Member States in giving effect to the International
Code;
3. REQUESTS the Director-General:
(1) to continue WHO's productive
collaboration with its traditional international partners,
in particular UNICEF, as well as other concerned parties
including professional associations, women's organizations,
consumer groups and other nongovernmental organizations
and the food industry, with a view to attaining the
Organization's goals and objectives in infant and young
child nutrition;
(2) to strengthen the Organization's
network of collaborating centres, institutions and organizations
in support of appropriate national action;
(3) to support Member States, on
request, in elaborating and adapting guidelines on infant
nutrition, including complementary feeding practices
that are timely, nutritionally appropriate and biologically
safe and in devising suitable measures to give effect
to the International Code;
(4) to draw the attention of Member
States and other intergovernmental organizations to
new developments that have an important bearing on infant
and young child feeding and nutrition;
(5) to consider, in collaboration
with the International Labour Organization, the options
available to the health sector and other interested
sectors for reinforcing the protection of women in the
workplace in view of their maternal responsibilities,
and to report to a future Health Assembly in this regard;
(6) to mobilize additional technical
and financial resources for intensified support to Member
States.
14 May 1992
(1) Document WHA43/1990/REC/1, p.35
(2) Protecting, promoting and supporting
breastfeeding: the special role of maternity services.
A joint WHO/UNICEF statement, Geneva, World Health Organization,
1989
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