Health Canada will soon be revising acts and regulations to prevent formula shortages in Canada and modernizing the regulations so they are in line with other developed countries.Learn more
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Download the Code Action To Do List: Take these actions before February 20th, 2024
to make sure your voice is heard by the time the extended consultation period ends February 26, 2024
The WHO International Code of Marketing of Breastmilk Substitutes, approved by the member states participating at the World Health Assembly (except the US), was approved in 1981 to protect breastfeeding by ensuring the ethical marketing of breastmilk substitutes by industry.
Implementing the WHO Code through the BFI in Canada:
Many facilities find that one of the most difficult areas of BFI implementation is the application of the International Code of Marketing of Breastmilk Substitutes and subsequent relevant WHA Resolutions (WHO Code). In Canada the WHO Code is not legislated but there are some Canadian regulations which support a few of the tenets, for example, the Food and Drugs Act.
Multinational companies have a longstanding influence within our health care system and this historic relationship, together with the many loop holes within the Code itself, create much confusion and varying degrees of difficulty for facilities – particularly hospitals – to implement the BFI. By working through the BFI to inform individuals about the WHO Code and create institutional change with the focus being infant feeding best practices, much progress has been made since 1998 when BFI was launched in Canada and only one hospital in our country was paying for the infant formula used in the Facility.
Implementation of the WHO Code through the BFI lens requires a working knowledge of the requirements outlined in the BFI Implementation Guideline and BFI Guideline Checklist and the realization that these are minimum requirements. The WHO Code, from an activism perspective with its broad-based political meaning, does not fall into the scope of BFI designation. There are grey areas and many scenarios where things meet BFI criteria for designation but strong recommendations or even requirements may be made to the Facility to affect change around a document or situation. In this way, greater understanding of the meaning and importance of the WHO Code is brought about.
International Code of Marketing of Breastmilk Substitutes (WHO Code) and the Baby-Friendly Initiative:
The goal of the WHO Code and subsequent relevant World Health Assembly (WHA) Resolutions is to reduce the influence of commercial pressure on infant feeding decisions.
WHO Code Content
Very Clear ImplementationRemain vigilant
Areas for ImprovementEducation is needed
Major Code ViolationsAction plan is essential
No advertising of breast-milk substitutes and other products covered by the Code to the public
All information is scientific and factual and has no company branding
Company logo on donated equipment Magazines in a waiting area contain Code violations
Written or audio-visual instructional materials, advertising, posters etc. visible or distributed
No donations of breast-milk substitutes and feeding supplies to facilities
Facility pays for formula and related infant feeding products
Other unrelated products are donated by the company e.g., adult nutritional products, vaccines
Discharge packages/gift bags given to families containing products, samples, or coupons for items covered by the CODE.
No free samples to mothers/parents
Families are not given product samples or coupons Equipment recommended and utilized in specific circumstances on a 1:1 basis e.g., pacifiers, bottles, nipple shields etc.
Brands of pump or bottles/teats etc. are promoted occasionally
Formula or other products openly displayed and available or given to mothers/families to take home
No promotion in the health services
Appointed staff such as dietician or clinical educator receives product info – scientific and factual, and in turn educates staff
Company representative talks with general staff about unrelated products (e.g., family planning methods) Some product literature or samples are available in a partner organization e.g. Early years programmes run out of community facilities
Free lunches from company Seminars or educational offerings or product info is given to general staff Staff and students accept tokens, food, funding, equipment etc. from companies manufacturing or distributing products covered by the Code
No company personnel to advise mothers/parents
Health workers and students do not facilitate contact between clients and company reps. & distributors
Company representative deals with the mother at mothers’ request
Company representatives have access to general staff, clients/patients, staff or client identifying information Facility accepts funding and value adds with conditions attached to promote brand/products
No gifts or samples to health workers
Health workers and students decline all incentives from companies manufacturing or distributing products covered by the Code
Hospital Foundation receives donations from a variety of private and commercial sources including some industries covered by the Code, but the money is without condition
Learning Resources For The Code:
The following are links to jeopardy games based on the International Code of Marketing of Breastmilk Substitutes and the Baby-Friendly Initiative.
If you wish to revise the games, please create your own jeopardy game so that you will not alter the game found via the provided link.
This series of booklets supports countries in developing and strengthening measures to control the marketing of breastmilk substitutes. The materials are designed for government officials, health educators, and Code advocates.
The Code is a set of recommendations to regulate the marketing of breastmilk substitutes, feeding bottles, and teats, which aims to stop the aggressive and inappropriate marketing of breast-milk substitutes, adopted by the 34th session of the World Health Assembly (WHA) in 1981 as a minimum requirement to protect and promote appropriate infant and young child feeding. Several WHA resolutions adopted since 1981 clarify or extend issues covered in the Code.
This information note clarifies what WHO and UNICEF consider to be sponsorship with respect to associations, organizations, companies, and health care providers that organise meetings, conferences, or other events, including trainings for health care professionals.
This frequently asked questions document aims to provide health workers with information on their specific roles and responsibilities in protecting breastfeeding practices against the inappropriate promotion of breast-milk substitutes by baby food companies.
This report provides updated information on the status of implementing the International Code of Marketing of Breast-milk Substitutes and subsequent relevant World Health Assembly (WHA) resolutions (“the Code”) in countries.
This report – the largest of its kind to date – draws on the experiences of over 8,500 women and 300 health professionals across eight countries. It exposes the aggressive marketing practices used by the formula milk industry, and highlights impacts on families’ decisions about how to feed their babies and young children.