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 
  • Other milk products, food and beverage substitutes for human milk, such as foods marketed for babies under six months or formula aimed at children up to 36 months of age including bottle-fed complementary foods, that would be a substitute for breastfeeding
  • Bottles 
  • Nipples/teats

Why was the Code needed?

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?

In May, 2020, the World Health Organization (WHO), United Nations International Children’s Emergency Fund (UNICEF), and the International Baby Food Action Network (IBFAN) jointly published a report titled “Marketing of breast milk substitutes: national implementation of the international code, status report 2020.” The report provides updated information on the status of implementing the Code and subsequent relevant World Health Assembly resolutions globally. Read the press release, which concludes “that despite efforts to stop the harmful promotion of breast-milk substitutes, countries are still falling short in protecting parents from misleading information.”

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?

Although the Code is not directed specifically to parents, it 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 that emphasizes 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.

The Code does not restrict parents from choosing to use formula.  

Learn More

The International Code of Marketing of Breast-milk Substitutes (English)

Code and Subsequent Resolutions

Marketing of breast milk substitute: national implementation of the international code, status report 2020

Status report 2020 Press Release

International Baby Food Action Network/International Code Documentation Centre has publications for sale on the Code.