Celebrating 40 Years of the Code

Forty years ago today, on May 21, 1981, the World Health Assembly (WHA) adopted the International Code of Marketing of Breastmilk Substitutes (the Code). Recognizing the extent to which the promotion of breastmilk substitutes was adversely influencing infant feeding patterns throughout the world, the World Health Organization (WHO) published the Code as a set of recommendations to regulate the marketing of breastmilk substitutes to ensure that safe breastmilk substitutes were available when needed, but were not promoted as the infant feeding norm or in a manner that undermines the superiority of breastfeeding.

It was a bold stance, and it is still challenging forty years later. Yet, the Code remains a vital tool which is admirable in its practicality and its simplicity.

Each of us as healthcare providers plays a critical role in upholding the highest standards of infant feeding care. Every day, we must make ethical decisions based on individual patients’ needs, goals and specific circumstances. It is imperative that our judgment not be clouded by commercial interests. The Code guides us to make those decisions based on what’s best for the patient. It is significant that Step 1A in the WHO/UNICEF’s revised Ten Steps to Successful Breastfeeding requires compliance with the Code and relevant World Health Assembly resolutions. Everything that we do in the care of mothers and babies and infant feeding must be done in the context of the Code.

For more detailed information, please see this recent publication from the WHO, which contains answers to frequently asked questions about the roles and responsibilities of healthcare workers supporting the Code.

BFUSA is proud to uphold the Code through the Baby-Friendly Hospital Initiative (BFHI) and applauds all Baby-Friendly designated hospitals and your providers for their commitment to these principles. It takes courage for an institution to step up and pay for formula when they can get it for free. It takes courage for health professionals to say “No thanks” to the gratuities and perks offered by formula companies. But because you’ve done these things, and you continue to do them every day, we know, you know, and most importantly, your patients know that your recommendations and decisions are based solely on what’s best for them and their child.