Practice in a manner that protects, promotes and supports breastfeeding: WHO CODE

Summary of the International Code on Marketing of Breast Milk Substitutes

  1. No advertising of breast milk substitutes to families.
  2. No free samples or supplies in the health care system.
  3. No promotion of products through health care facilities, including no free or low-cost formula.
  4. No contact between marketing personnel and mothers.
  5. No gifts or personal samples to health workers.
  6. No words or pictures idealizing artificial feeding, including pictures of infants, on the labels or the product.
  7. Information to health workers should be scientific and factual only.
  8. All information on artificial feeding, including labels, should explain the benefits of breastfeeding and the costs and hazards associated with artificial feeding.
  9. Unsuitable products should not be promoted for babies.
  10. All products should be of high quality and take account of the climate and storage conditions of the country where they are used.

The AAP Conflict of Interest Policy states:

“A potential conflict of interest exists when an individual’s personal interests might lead an independent observer to reasonably question whether the individual’s professional actions are determined by significant personal interest. In accordance with federal regulations, the goal of the AAP’s system is to ensure that the personal interests of an individual do not unduly influence their work on a sponsored project. The AAP requires that all investigators (see definition of Investigator below) disclose any significant financial interests. This policy applies to all investigators and includes project consultants.”

The principles of the WHO Code encourage providers to support breastfeeding mothers in their efforts and to not influence them to stop breastfeeding. The AAP Conflict of Interest Policy is designed to help support the delivery of evidence-based care that is not unduly influenced by commercial interests. While they vary in their specifics and expectations, they are consistent in their intent to promote delivery of the best evidence-based care.

Many physicians’ office policies have changed because they have become aware that the presence of pharmaceutical logos on items in the office implicitly endorses a particular brand. The office policies, however, have often not applied these same standards to formula company logos even though they also send the same type of implicit message. Promotion of formula through display of formula company logos should not be accepted any more than the promotion of branded pharmaceuticals is accepted.