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IBFAN – International Baby Food Action Network

Codex green-lights wasteful, sweetened, Ultra-Processed drinks for older babies

10 December 2023 – IBFAN-BMA


IBFAN has been attending the 46th Session of the Codex Alimentarius Commission (CAC46), the United Nations body created in 1963 by the World Health Organisation (WHO) and the FAO to develop global food standards.  This week, after over 10 years of frustrating negotiations at the industry dominated Nutrition Committee, the Revision of the 1987 Follow-up Formula Standard was finally adopted –renamed the Standard for Follow-up Formula for Older Infants and Product for Young ChildrenCodex also approved maximum residue levels (MRLs) for the highly controversial growth promoter given to cattle, Zilpaterol.

46th Session of the Codex Alimentarius Commission – Morning Session (28.11.2023, Rome)
– Plenary Hall (FAO Headquarters) – Patti Rundall (IBFAN) explains the risks of the revised Follow-up formula standard, sitting in front of Jean Christophe Kremer, the Secretary General and Xavier Lavigne, the Vice President of the International Special Dietary Foods Industries (ISDI).

While the revised FUF standard does ban health and nutrition claims and sets some limits on sugar, the products it covers are still sweetened, unnecessary, ultra-processed and flavoured and can contain GM and industrially modified, hydrolysed ingredients. They are certainly not the healthy option that the WHO (i) and many governments and health bodies recommend and that manufacturers such as NestléDanone and Abbott pretend they are.  IBFAN urged governments to bring in laws to stop the promotion of these products at least up to 36 months and ideally beyond.

Thanks to the advocacy of IBFAN, WHO, UNICEF, public interest NGOs, Brazil, Ecuador, Nigeria and many other countries, and despite opposition from the USA, the new standard does now refer to the International Code of Marketing of Breastmilk Substitutes and subsequent relevant WHA Resolutions in a Preamble, The USA tried again to remove these safeguards during CAC46 but failed. However it succeeded in  getting some of IBFAN’s warnings removed from the report.(ii). Although governments have the sovereign right to adopt any legislation they consider necessary to protect child health (provided they follow international trade principles) the clear reference to the International Code in the Standard will mean that they can now do so without fear of triggering costly, time-consuming challenges at the World Trade Organisation (WTO) and elsewhere.(iii)

Several countries made comments. Brazil made a strong intervention stressing the need to â€œcontextualise the standard, indicating that its development had considered guidelines and policies of the WHO and World Health Assembly (WHA) resolutions and that these paragraphs guided the application of the Standard, i.e. that it should be applied in a manner that was consistent with national health and nutrition policies, taking into account the recommendations outlined in the International Code of Marketing of Breast Milk Substitutes.”

It is clear that strong marketing laws are urgently needed to curb the multi-billion $global market for formulas for older babies that is wreaking havoc on child health and obesity levels, undermining breastfeeding and adding to the environmental burden. In one third of the world’s countries breastfeeding is a lifeline and the majority of children are breastfed into the 2nd year of life.(iv)

Can Codex reform to meet Today’s challenges? Throughout the week and in the debate about the future of Codex (v) IBFAN stressed the need for Codex to move away from the corporate-led model to a One Health Approach addressing not just human health, but the impact that food systems have on the environment and bio-diversity. To do this, Codex will have to stop green-lighting harmful UPFs and drugs such as Zilpaterol.

IBFAN called for policy coherence,  much stronger transparency and Conflict of Interest safeguards and for:

  • safeguards to ensure that the  Codex Trust Fund will always be publicly funded;
  • the old and very bad standard on Canned Baby Food to be revoked;
  • consistency on terminology related to ‘science’ with the removal of the meaningless industry friendly term â€œestablished history of safe use” from Codex texts (it appears several times in infant formula and follow-up milk standards (it appears several times in infant formula and follow-up milk standards and opens the door for untested/unsafe ingredients)
  • Member States to protect their policy setting processes and not include  businesses on their delegations (and certainly not allow them to speak in this capacity);
  • business front groups such as Health for Animals and  Council for Responsible Nutrition to be renamed to reflect their nature and clarity regarding the use of the term â€˜stakeholder’.
  • much more caution before green-lighting harmful ultra processed foods.
  • extra safeguards for e-commerce and digital packaging
  • the transformation of Codex away from the corporate-led model to a One Health Approach with greater protection of the environment and biodiversity;
  • no adoption of the Maximum Residue levels (MRLs) for Zilpaterol,  the growth enhancing drug that is banned in the EU, UK and many countries. Zilpaterol is manufactured by the US  pharmaceutical giant Merck (owned by Bayer) and given purely for commercial purposes. The deceptively named industry front group, Health for Animalswas present throughout the Zilpaterol debates but rarely spoke.

IBFAN welcomed the US proposal for work on recycled packaging, while calling for a phasing out of plastic and warning that this should not be used as ‘greenwashing’ to promote harmful products. Interestingly our call for biodegradable packaging in 2019 was dismissed – considered beyond the remit of Codex at the time!


  • (i). WHO Guideline for complementary feeding of infants and young children 6–23 months of age” recommends that infant not breastfed should be fed infant formula or full fat animal milk after 6 months,  and that Follow-Up Formulas or flavoured or sweetened milks should not be used. â€œBecause sweetened milks include added sugars, they are not appropriate for infants and young children 6–23 months of age.”
  • On the question of sweetness, the EU has tried hard to limit the sweetness of the products for children over 12 months and while there are some safeguards a whole range of sweeteners will be added. Additionally there are “no known validated methods to measure sweetness of carbohydrate sources and therefore no way to determine compliance for such a provision seems to be limited to the measurement of absolute sweetness.” 
  • (ii) Sentence removed from IBFAN’s statement: â€œThe Observer expressed concern that the commodities in question were ultra-processed, sweet tasting and flavoured and were replacing culturally appropriate, biodiverse family foods, and urged governments to introduce legislation to stop the marketing and promotion of these products.”
  • (iii) Since 1995 when  the World Trade Organisation (WTO) was established and was mandated  to refer to Codex Standards in trade disputes, corporations and powerful exporting nations that support them,  have attempted to stop governments bringing in strong marketing controls. The 1987 FUF Standard,   has been especially problematic and has been promoted as a ‘regulatory ceiling’  for trade purposes. This has had a chilling effect on policy-making, with many laws failing to cover the products over 6 months. These threats have been documented  in the 2023 Lancet Series on Breastfeeding  Interventions at WTO and Codex Related related to National implementation of the WHO Code  Katheryn Russ*
  • (iv) Global breastfeeding scorecard 2022: protecting breastfeeding through further investments and policy actions
  • (v) 2023 is the 60th Anniversary of Codex, and under the Chairmanship of Steven Wearne, Codex is consulting  on its Strategic Plan for 2026-2031 and considering whether it can support “the broader global goals around sustainability, one health, food security and environmental protection”, how it prioritizes its work and a process for revising, revoking or starting standards.

Transcript of IBFAN comments CAC46

Draft CAC46 Report

comments on the Follow Up Formula standard. Comments from countries and Observers

IBFAN  ENCA comments on PART 1 of the Codex Strategic Plan 2026-2031.

IBFAN/ENCA on Part 3 future of Codex we propose the 4th option in Table 1 – in person and virtual participation alongside web-streaming, with  further safeguards on Conflicts of Interest, Transparency, resource imbalance,  One Health and Report writing.

ENCA/IBFAN  Technology Labelling.IBFAN called for safeguards on foods for infants and young children to protect child health.  With Health warnings about inappropriate and needless use and safe preparation of the product, safeguards to prevent consumers being led commercial websites and  prevent user data being collected or tracked. Reference must also be made to the Code of Ethics for International Trade.

ENCA/ IBFAN approved the General Standard for Allergen labelling

ENCA/ IBFAN  called for the out of date, not fit for purpose 1981 standard for canned baby foods to be revoked, to stop an amendment giving the false impression that the standard is up-to-date.  

Zilpaterol  The MRLs for zilpaterol hydrochloride in cattle liver, kidney and muscle were adopted. IBFAN opposed the adoption.

Page further down for an explanation of why Codex is so important for IBFAN and the welcome address from Dr Tedros Adhanom Ghebreyesus, WHO Director-General  to last year’s CAC45.


Revised Standard for follow-up formula CL 2023/68/OCS – CAC presented for  final adoption at CAC  has improved the ingredients (the 1987 standard set no upper limits for added sugars) and does ban health and nutrition claims. However unresolved problems remain that increase the risks of these unnecessary ultra-processed products:

  • Two secondary names are permitted that contain the misleading and highly promotional claim “with added nutrients’;
  • the text of the Preamble should more clearly require compliance with the Code and WHA Resolutions.
  • the measurement of sweetness of these products is unresolved;
  • Genetically modified ingredients are not prohibited;
  • Flavours are permitted for the Drinks for Young Children
  • the is no specific prohibition of  Cross Promotion
  • There are no preparation instructions for powdered products clearly stating that the product is not sterile and must be reconstituted with safe water at 70 degrees centigrade,

WHO Guidelines on Complementary Feeding

MUSC The American Academy of Pediatrics CLINICAL REPORT| OCTOBER 20 2023


Statement by Dr Tedros CAC45 2022

Original text: Baby Milk Action