International Code of Marketing of Breast-milk Substitutes

What is the International Code of Marketing of Breast-milk Substitutes?

The International Code of Marketing of Breast-milk Substitutes (the Code) is a global health plan of action developed to support “safe and adequate nutrition for infants by the protection and promotion of breast-feeding, and by ensuring the proper use of breastmilk substitutes, when these are necessary, on the basis of adequate information and through appropriate marketing and distribution.”  (From Aim 1 of the Code).

What products are covered in the Code?

  • Infant formula
  • Feeding Bottles 
  • Nipples/teats
  • Foods and beverages targeted for babies under 6 months of age
  • Follow up formulas and growing up milks targeted for toddlers

What does the Code mean for BUSINESSES? 

You may be wondering if you can sell formula and still be compliant with the Code? Yes, you can sell formula and the other products covered by the Code.  What can your business do?

  • Sell formula and other products covered by the Code? YES!
  • Ensure that all labels include accurate and clear instructions on proper and safe formula preparation? YES!
  • Advertise any of the products covered by the Code? NO!
  • Provide coupons for or free samples of any products covered by the Code? NO!
  • Offer promotions or discounts on any covered products or give “any gifts of articles or utensils which may promote the use of breast-milk substitutes or bottle-feeding?” NO!
  • Display products in a preferential location in the store (e.g., formula or bottles sold on the “end caps”)? NO!

What does the Code mean for healthcare providers and facilities, and for health departments? How does the Code impact your healthcare practice.  What can healthcare workers and facilities do?

  • Protect and promote breastfeeding? YES!
  • Provide information and education on the benefits of breastfeeding? YES!
  • Avoid conflicts of interest by not accepting any materials or financial inducements from manufacturers and distributors of breastmilk substitutes or any products covered by the Code? YES!
  • Promote or display products covered by the Code, which includes the products and signs, placards, and posters concerning the products? NO!
  • Distribute materials provided by a manufacturer or distributor of products covered by the Code? NO!
  • Accept any free or low-cost supplies from manufacturers or distributors of covered products? NO!
  • Use personnel in your facilities who are paid for by manufacturers or distributors? NO!

What does the Code mean for parents?

  • The Code does NOT say that families can’t choose to use formula.  
  • The Code works to support families to be able to meet their own breastfeeding goals by protecting parents from aggressive and inappropriate marketing of breastmilk substitutes. 
  • The Code requires that parents receive objective, accurate and consistent information about the importance of breastfeeding, and that is not influenced by manufacturers/distributors of breastmilk substitutes, to allow parents to make informed decisions about infant feeding.

Why is the Code needed?

By the 1970’s, breastfeeding was declining dramatically in many parts of the world. One important reason for the decline was the aggressive promotion of breastmilk substitutes by manufacturers and distributors to workers in healthcare facilities and directly to parents. The Code was adopted in 1981 by the World Health Assembly (WHA), the decision-making body of the World Health Organization (WHO), and has been updated by the WHA through resolutions to strengthen, clarify, and provide guidance, especially as new products are developed and new marketing tactics are used. Together, the Code and Subsequent Resolutions aim to protect breastfeeding from commercial influences, prevent aggressive marketing and distribution of breastmilk substitutes, and ensure the appropriate marketing and distribution of breastmilk substitutes when they are needed.  

What is the current status of the Code?

The World Health Organization (WHO), United Nations International Children’s Emergency Fund (UNICEF), and the International Baby Food Action Network (IBFAN) jointly publish a status report to provide regular updates about the implementation in countries of the International Code of Marketing of Breast-milk substitutes. Marketing of breast‐milk substitutes, national implementation of the international code, status report 2022 continued to show that “[d]espite 41 years of global efforts to curb the promotion of breast-milk substitutes, bottles and teats, unethical marketing practices continue to be used throughout the world.” While the conclusions are similar to those in the 2020 report that showed that countries were not protecting families from misleading information, there are some signs of hope.

…many countries are fighting back. Since 2020, nine countries have put into effect new legal measures to protect breastfeeding by restricting the marketing of breast-milk substitutes, bottles and teats.

Status Report 2022

Learn More

The International Code of Marketing and subsequent WHA Resolutions are considered together when interpreting or speaking about The Code of Marketing: https://www.who.int/publications/i/item/9241541601

The International Code of Marketing of Breast-milk Substitutes: Frequently Asked Questions (https://www.who.int/publications/i/item/WHO-NMH-NHD-17.1)

Marketing of breast-milk substitutes: national implementation of the international code, status report 2022 (The US has “no legal measures” in place regarding The WHO Code.): https://apps.who.int/iris/handle/10665/354221 

Marketing of breast-milk substitutes: national implementation of the international code, status report 2020: https://www.who.int/publications/i/item/9789240006010

Countries failing to stop harmful marketing of breast-milk substitutes, warn WHO and UNICEF Press Release (https://www.who.int/news-room/detail/27-05-2020-countries-failing-to-stop-harmful-marketing-of-breast-milk-substitutes-warn-who-and-unicef)

Page updated: 09/22/2023