International Code protects breastfeeding from inappropriate marketing of breast-milk substitutes

Breastfeeding is considered one of the most critical behaviours for health promotion and protection, and the best option for infant feeding. It ensures the best trajectory for growth, development, and the prevention of noncommunicable diseases later in life, and should be exclusive during a child's first 6 months. Children who have been breastfed perform better on intelligence tests, are less likely to be overweight or obese, and are less prone to diabetes later in life. Mothers who breastfeed also reduce their risk of developing breast and ovarian cancers.

Despite this knowledge, breastfeeding rates in the WHO European Region remain the lowest in the world, partly due to the aggressive marketing of breast-milk substitutes. In 2006–2012, only an estimated 25% of infants in the WHO European Region were exclusively breastfed for the first 6 months, compared with 43% in the WHO South-East Asia Region.

International Code of Marketing of Breast-milk Substitutes

In 1981, the International Code of Marketing of Breast-milk Substitutes was adopted by the World Health Assembly to limit inappropriate marketing practices. The Code outlines measures that countries can take to limit aggressive, inappropriate marketing of breast-milk substitutes by:

  • enacting legislation to restrict the marketing and promotion of infant formulas and other products used as breast-milk substitutes; 
  • monitoring and enforcing effective sanctions in case of violations; and 
  • engaging in partnerships with civil society organizations to help governments advocate for enactment, implementation, enforcement and monitoring of the Code.

Globally, 135 countries have some form of legal measure in place covering some provisions of the Code. Some progress has been made since 2011, when only 103 countries had relevant legal measures in place.

Armenia adopts dedicated law

In 2014, Armenia upgraded its Code regulations by adopting a law on Breastfeeding Promotion and Regulation of Marketing of Baby Food. The law covers all provisions of the Code and relevant World Health Assembly resolutions, and in some aspects even goes beyond them.

The law was developed as a response to observed weaknesses in implementing an earlier Article to the Law on Advertisement. Inappropriate marketing of breast-milk substitutes had continued, hindering the Armenian government's action on achieving optimal infant and young child feeding. Civil society recognized the need for more stringent legal measures. With support from the Ministry of Health and UNICEF, the draft law was submitted to Parliament in 2003. In 2012, the process was revived under the leadership of the Committee for Mother and Child Health of the National Assembly. The draft was strengthened with convincing evidence for the need to regulate the unethical marketing of breast-milk substitutes, and was finally adopted.

The Armenian experience points to the need for governmental leadership, and the important role civil society can play when accompanied by adequate capacity building, the identification of political allies, patience and persistence.