Accustomed Chaos™: WHO Code of Marketing of Breast-milk Substitutes And How It Protects Breastfeeding & Formula Feeding

International Code of marketing of Breast-milk Substitutes was drafted by the World Health Organization as a result of the 1977 boycott of Nestle after their formula campaign killed millions of babies in third world countries. The Code's main focus was to call for no advertising to the public and to distribute factual and ethical information to parents the code was signed by all nations in the early 1980's when it was drafted & finally signed by the United States in the mid 1990's.

WHO Code – related to the marketing & practices related to the marketing of the following:

breast-milk substitutes including infant formula, other milk products, food & beverages when marked (or represented) as full or partial substitute of breast-milk, feeding bottles and pacifiers & bottle nipples.

My abridged version of the code:

No advertising of any of these products to the public
No special displays, discount coupons, special sales for products within the code to consumer at retail level to induce sales
No free samples to mothers or pregnant women, infants or children – including gifts or articles which may promote use of breast-milk substitutes or bottle-feeding
No promotion of products in health care facilities, including the distribution of free or low-cost supplies – no posters, brochures or special displays in a health care setting
No company sales representatives, in their business capacity, are to advise mothers, pregnant women directly or indirectly
No gifts, personal samples or low-price sales to institutions, organizations or workers within the health care field
No words, pictures or statements idealizing artificial feeding, no pictures of infants on labels for breast-milk feeding substitutes.
Information on artificial infant feeding should clearly state the superiority of breast feeding & a clear advisement to only use at the advice of health care provider
Unsuitable products (sweetened condensed milk, almond milk etc) should not be promoted for babies & be clearly marked as so – including no instructions on how to modify for the purpose of infant feeding

I believe in this code and I do wish both Canada and the United States {and other countries} would make this a law. It might seem extreme to some people, but this really is not about the choice for women using formula – this really isn't even about formula itself – it is about the way formula is marketed every day, year after year which directly affects the breastfeeding rates of our country and the ability for women to make INFORMED decisions for infant feeding.

I have been wanting to write this post for some time but at first I was a bit conflicted on my feelings about the WHO Code and what it meant for all women. I have read the code over and over and tried to think about both “sides” {families who are breastfeeding and families who are formula feeding} because as you know I have used infant formula for my older children and my third child was exclusively breastfed for 10 months and is still continuing now {she is 18mo}.

One of the larger arguments that I have heard {or thought} against the WHO Code is that people should be able to choose for themselves and that we are not so easily swayed by advertising. Problem with this thinking is – we are easily swayed by advertising – it's a truth. If that wasn't true there would not be huge advertising campaigns for everything under the sun. If all companies were committed to fairness there would be no need for The Canadian Code of Advertising Standards. The WHO Code just protects us further from companies who are ruthless in their inaccurate advertising.

I can only speak from my life experience – I live in a predominately white middle/upper class area and I have had many conversations with well educated women who still feel that infant formula is “just as good” as breast milk. Advertising has led them to believe this. Any way you look at the situation infant formula is not the same as breast milk. Never will be. Yes, infant formula itself is NOT evil or poison – not what I am saying, but as with any synthetic product it does come with some potential risks – that's a fact. Women should be able to make informed decisions and if advertising is telling them infant formula is just as good as breast milk they are not making an informed decision.

Would you take a prescription medication without knowing the risk? Have you ever seen a medication commercial or print ad? More then half of the commercial/ad talks about the potential risks with it. Same should be done with infant formula. Not to scare off use or make those who NEED (or choose) to use it feel bad, but for the sake of being able to make an informed decision and be fully aware of what complications or issues they need to be aware of. They don't though. Formula uses statements like “our closest to breast milk” , “give your baby the best start”, “Nothing else is breast milk, nothing else is Good Start” - there are MANY more examples of this language.

Advertising bottles and nipples are also against the WHO Code. There is no bottle or liner that is close to breastfeeding and just like with formula advertising, bottles use misleading statements on the packaging and advertising that would suggest it's close to breastfeeding. Using statements like “deliver an experience closest to breastfeeding”, “closer to nature” , and the “breastflow bottle” give an incorrect and misleading descriptions and sway women to think they are just as good as breastfeeding which is not true. They also come with their own risks & need to be clearly marked as such.

One of my biggest peeves against the infant formula companies is not only their sneaky language but their intense campaign for handing out free samples to anyone who is pregnant, just given birth or on some sort of list they get a hold of. Hospitals sending out samples, infant formula companies handing out 'breastfeeding kits' with formula samples and coupons, doctors handing out formula. What this message totally sells to the women (even subliminally) is “Hey we know you are SUPPOSED to breastfeed, but when that doesn't work, when your milk doesn't come in or dries up – here is your formula”. I am not sure I can come up with a bigger way to make a women lose confidence in her body. Free samples are so dangerous to the breastfeeding relationship because when that woman is up at 3 am with her 4 day old baby who is latched on for the 5^th straight hour she is going to be so tempted to reach for that formula. That sample is sabotaging your confidence and your breastfeeding relationship.

You might be saying now, “What about those women who are not going to breastfeed and want the sample” - well, this affects you too. As you know formula is not cheap. The samples themselves are not cheap yet they are throwing them to any one who has a child (sometimes to women who don't have children) and anyone who is expecting a child. That's a lot of money being handed out. Where do you think that money is coming from? I can guarantee you it is not the infant formula companies doing that out of the goodness of their hearts. It is compensated through the price of formula so you end up paying more. If the marketing of formula was not done so aggressively (or better yet, not at all) the cost could actually be more reasonable and for those families who have to use it or wish to use it – the would not be paying out of their butt for it.

Breastfeeding is normal and I am tired of seeing women sabotaged left and right because of giant companies who wish to make lots of money. The inability to breastfeed is rare and even if you choose not to breastfeed you should be granted the right to make an informed decision and provided with the correct information. The WHO Code protects this right for all women and protects breastfeeding.

The WHO code has been signed & agreed on in both the United States and Canada (and other countries) although neither have yet made it a law.

The WHO Code is monitored by organizations in a variety of countries that are part of International Baby Food Action Network (IBFAN). A standard form can be downloaded & sent to the organization that monitors the WHO Code in your country :

United States: National Alliance for Breastfeeding Advocacy (NABA). Violations can be sent through mail to NABA, 254 Conant Rd, Weston MA 02493 email: Marshalact@aol.com, along with the code watch form.
Canada: INFACT Canada monitors the Code in Canada and has a form you can fill in on its website.