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WHO CODE
What is the WHO Code?
The International Code of Marketing of Breast-milk
Substitutes is a set of recommendations for member states
of the World Health Organization (WHO) designed to
regulate the marketing of breast milk substitutes, feeding
bottles and teats. It is referred to as the ‘WHO Code’.
It was introduced in 1981 in response to the concerns
being raised about the marketing of breast milk substitutes
in developing countries.
A non-breastfed child is 14 times more likely to die in the
first six months than an exclusively breastfed child,
according to The Lancet.
WHO recommends exclusive breastfeeding for the first
six months of an infant's life. Thereafter, local nutritious
foods should be introduced, while breastfeeding continues
for up to two years or beyond.
Why it is important to share and act on this
information
The deaths of 823,000 children and 20,000 mothers each year
could be averted through universal breastfeeding, along with
economic savings of US$300 billion.
The Lancet Series confirms the benefits of breastfeeding in
fewer infections, increased intelligence, probable protection
against overweight and diabetes, and cancer prevention for
mothers
Infants who are not breastfed are at an increased risk of illness
that can compromise their growth and raise the risk of death or
disability.
.
How was it created?
The WHO Code was adopted as a resolution by the
World Health Assembly (WHA), the decision making
body of the WHO, in May 1981.
The Code aims to contribute ‘to the provision of safe
and adequate nutrition for infants, by the protection
and promotion of breastfeeding, and by ensuring the
proper use of breast-milk substitutes.
Is the WHO Code an international law?
No. The Code is a set of recommendations to member states of
the WHO.
It states governments should take action to give effect to its aim and
principles, through legislation or other means.
How has Nestlé changed its marketing practices since the Code was
adopted?
We’ve learnt a great deal from our experiences, and we recognize our
responsibility to go beyond what were common marketing standards in
the past. We strive to continuously improve our practices and our efforts
have been recognized externally. We are proud to have been the first
Breast milk Substitutes (BMS) manufacturer included in the FTSE4Good
Index and to have consistently met its rigorous criteria for the responsible
marketing of BMS since 2011.
Alongside the Access to Nutrition Index (ATNI), FTSE4Good is the only
other independent, transparent, third-party assessing marketing practices
of Breast milk Substitutes (BMS).
Does Nestlé follow the WHO Code?
In 152 countries that are considered to be higher risk
in terms of infant mortality and malnutrition, we
follow our own stringent policy drawn from
the WHO Code, or national regulations, whichever is
stricter.
This is necessary because many ‘higher risk’
countries have not fully implemented the Code. In
fact, according to a recent WHO report only 37 out
of 199 member states had passed laws reflecting all
its recommendations and subsequent resolutions as of
2011.
Main Points of WHO
Breast milk is the ideal food for newborns and
infants. It gives infants all the nutrients they
need for healthy development. It is safe and
contains antibodies that help protect infants
from common childhood illnesses such as
diarrhea and pneumonia, the two primary
causes of child morality worldwide.
Breastfeeding also benefits mothers
Exclusive breastfeeding is associated with a
natural method of birth control (98%
protection in the first six months after birth). It
reduces risks of breast and ovarian cancer,
type II diabetes and postpartum depression.
Breastfeeding has long term benefits for children
Beyond the immediate
benefits for children,
breastfeeding contributes to
a lifetime of good health.
Adolescents and adults who
were breastfed as babies are
less likely to be overweight
or obese. They are less
likely to have type II
diabetes and perform better
in intelligence tests.
Infant formula does not contain the antibodies found in
breast milk
The long term benefits of breastfeeding for mothers and
children cannot be replicated with infant formula when
infant formula is not properly prepared, there are risks
arising from the use of unsafe water and unsterilized
equipment or the potential presence of bacteria in
powdered formula.
Breast milk offers all the antibodies and immunity a baby
needs to fight life-threatening disease like pneumonia,
which kills more children under five years of age than any
other disease.
Marketing of breast-milk substitutes are highly
monitored
An international code to regulate the marketing of breast-
milk substitutes was adopted in 1981. It calls for:
All formula labels and information to state the benefits of
breastfeeding and the health risks of substitutes;
No promotion of breast-milk substitutes
No free samples of substitutes to be given to pregnant
women, mothers or their families and
No distribution of free or subsidized substitutes to health
workers or facilities
Mother should continue breastfeeding at work
Many mothers who return at work abandon breastfeeding
partially or completely because they do not have sufficient
time, or place to breastfeed, express and store their milk.
Mothers need a safe , clean and private place in or near
their workplace to continue breastfeeding. Enabling
conditions at work, such as paid maternity leave, part-time
work arrangements, on-site crèches, facilities for
expressing and storing breast milk, and breastfeeding
breaks can help.
Solid foods should be phased in at six months
To meet the growing needs of babies at six months of age,
mashed solid foods should be introduced as a complement
to continued breastfeeding. Foods for the baby can be
specially prepared or modified from family meals. WHO
notes that:
Breastfeeding should not be decreased when starting on
solids.
Food should be given with a spoon or cup, not in a bottle
Food should be clean and safe and
Ample time is needed for young children to learn to eat
solid foods.
Breast Feeding In Pakistan
Pakistan’s current rate of child stunting is among the highest
in the world. According to recent estimates by UNICEF,
however, less than 40 per cent of babies are being breastfed
exclusively during their first six months. Excluding mothers
who understandably cannot breastfeed for health reasons.
Pakistan made the law for national breastfeeding in October
2002 in the shape of a presidential ordinance. The ordinance
is called “Protection of Breastfeeding and Child Nutrition
Ordinance 2002”.
The Pakistan Pediatrics Association (PPA) has been asking
for stricter implementation of the breastfeeding laws to
protect children from malnutrition.
Local Code In Pakistan
Scaling Up Nutrition Civil Society Alliance (SUNCSA,
Pak) a coalition of over 150 civil society organizations, has
condemned the unethical promotion of Breast Milk
Substitutes (BMS).
SUNCSA Pak has called on manufacturers and distributors
of breast milk substitutes, investors and governments to
create a conducive environment to help millions of
Pakistani children get the healthiest start in life.
Babies who are not breastfed are about nine times more
likely to die from pneumonia than those who are fed breast
milk.
Protection Of Breast-Feeding And Child Nutrition
Ordinance 2002
It is expediant to ensure safe and adeqaute
nutrition for infants and young children by
promoting and protecting breast-feeding, and by
regulating the marketing and promotion of
designated products.
This ordinance extends to whole Pakistan.
It consists of a chair person, a secretary and two
Members of the provincial Assembly of
respective province.
The secretary of the board shall call meetings of the board,
at the direction of the chair person.
It makes sure that no one is allowed to advertise or promote
any designated products.
No manufacturer or distributer shall offer any gift or pay to
a health worker.
Label of a designated product shall be designed so as not to
discourage breastfeeding.
Every container shall have a clear, conspicuous and easily
understood message printed on it. It may be written in Urdu
as well as in English .
Health workers shall not accept or give samples of any
designated product to any person, particularly pregnant
women, mothers of infants, young children and their
families.
Quality assurance: No designated product shall be
manufactured, sold or distributed in Pakistan unless
it is formulated according to standards
recommended by Codex Alimentarius Commission
and the Codex of Hygienic Practice for foods for
Infants and Children.
An inspector usually inspects the quality of the
designated product.
Penalties
Any manufacturer or distributer who controvenes
the provisions os sanctions shall be punishable
with imprisonment for a term which may extend
to two years, or with fine which shall not be less
than fifty thousand rupees or more than five
hundred thousand rupees, or both.
Provincial Food Authority
PFA is gearing up for implementation of Punjab protection
of Breast Feeding and Child Nutrition Act 2012 and Rules
2017 to have a check on infant milk manufacturing
companies.
PFA has also directed to the milk manufacturing
companies to remove tagline from milk packs that “ Infant
formula is alternative to breast milk”. There is also a
complete ban on the advertisement of infant milk.
Actions Taken by PFA
PFA has wasted almost 5400 litre adulterated milk.
Special Teams of PFA under the supervision of ADG
(Operations) Rafia Haider checked 238 vehicles at
different entry points of the city and found adulterated
milk in 91 vehicles which was wasted.
PFA teams also wasted 410 litres milk in Faisalabad, 470
litres in Gujranwala, 766 litres in Multan, 530 litres milk
in Rawalpindi.