For decades the World Health Organisation (WHO) has advocated for mothers to breastfeed their children rather than use formula or breast milk substitutes. Their position is that breast milk provides the best nutrition, and protection against a range of diseases including respiratory diseases, childhood obesity, and diarrhoeal diseases. They note that suboptimal breastfeeding contributes to the deaths of hundreds of thousands of infants each year.
In line with this policy perspective, the WHO set a target that by 2025, 50% of all mothers should use exclusive breastfeeding within the first six months of a child’s life, and ideally continue breastfeeding up to one year. They outline four actions that need to be taken in order to meet this target, one of which is to significantly limit the marketing of breast milk substitutes, and strengthen the monitoring and enforcement of legislation related to the International Code of Marketing of Breast Milk Substitutes (the Code).
The Code was introduced in 1981 by the WHO as a response to the declining rates of breastfeeding across the world, and with the intention of promoting breastfeeding above all other substitutes. Despite the challenges of poverty and food security for many countries around the world, there is positive growth in the number of countries adhering to the Code.
Laws that promote breastfeeding can help matters because they imply a financial allocation towards the health goals of the Code. The latest WHO report notes that of the 194 countries analysed, 135 (69.6%) have some form of legislation in place to support the Code. This is a further 32 countries since 2011, indicating an improvement and the commitment to meeting these goals. However, many of these laws meet just partial criteria, with only 39 countries (20.1%) having laws that fully meet the requirements.
Positively, South Africa is one of the countries listed as having full provisions in law to support the Code. These were introduced in 2012, in the Regulations Relating to Foodstuffs for Infants and Young Children. Diarrhoea and pneumonia are the leading causes of infant death in South Africa, and these regulations could go a long way to reducing the number of deaths. The most recent South African data suggest that over 80% of South African babies had ever been breastfed as of 2003. One gap in the implementation of the Code in South Africa was the availability of information (for publicity and other materials) related to the benefits of breastfeeding and information on breast milk substitutes.
Laws that promote breastfeeding and the regulation of marketing of breast milk substitutes are in the interests of women, infants and in the interests of States. They ensure that each woman receives quality and balanced information on the options relating to breastfeeding, and that health care workers are able to inform patients about these options. Where infants receive the nutrition and antibodies they need through breastfeeding, this reduces the amount that the State has to spend on treating childhood illnesses such as pneumonia, diarrhoea and asthma.
