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International code of marketing of breast-milk substitutes—three decades later time for hostilities to be replaced by effective national and international governance
  1. J S Forsyth
  1. Correspondence to Professor Stewart Forsyth, Honorary Consultant Paediatrician, formerly of NHS Tayside, 1 Ellieslea Road, West Ferry, Dundee DD51JG, UK; stewartforsyth{at}

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On the 23 May 1980, the Thirty-Third World Health Assembly (WHA) supported the proposal that there should be an International Code of Marketing of infant formula and other products that are used as breast-milk substitutes.1 The WHA had previously expressed concern about declining breastfeeding rates and had recommended to Member States that they give priority to preventing malnutrition in infants and young children by supporting and promoting breast feeding, taking legislative and social action to facilitate breast feeding and by regulating the inappropriate promotion of infant foods that could be used to replace breast milk. The WHO and UNICEF responded to these earlier concerns by convening a meeting in Geneva in October 1979 that was attended by a wide range of representatives including government officials, organisations of the United Nations system, non-governmental organisations and the infant-food industry. It was from that discussion that the concept of an International Code of Marketing of Breast-Milk Substitutes emerged, and this was subsequently presented to the WHA in May 1980. WHO and UNICEF were requested to take forward the preparation of the code and were specifically asked to involve all concerned parties and to reach a conclusion as soon as possible.

On 21 May 1981, the Thirty-Fourth WHA adopted the fourth draft of the International Code of Marketing of Breast-Milk Substitutes as a minimum requirement to protect and promote appropriate feeding for infants and young children.2 It was decided that the code should be adopted as a recommendation rather than a regulation and that the implementation of the code should be closely monitored according to existing WHO constitutional procedures, with future assemblies assessing the situation in the light of reports from member states, and taking measures, it judged necessary for its effective application.

The code is underpinned by 11 articles with article …

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  • Competing interests Longstanding research interest in infant and child nutrition. Publications on health benefits of breast feeding. Undertaken clinical trials in collaboration with several milk formula companies. Received research funding and honoraria from industry including milk formula companies.

  • Provenance and peer review Not commissioned; externally peer reviewed.