What is the who code and how does it affect staff in an early childhood education and care service

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The WHO Code (or simply, “The Code”) is a short name for the International Code of Marketing of Breastmilk Substitutes, which was adopted by the World Health Assembly and UNICEF in 1981. Since that time, a number of resolutions have also been passed to clarify and add to the Code.

The Code is a marketing code that aims to protect breastfeeding, to protect all mothers and babies (whether breastfeeding, formula-feeding or combination feeding) and to prevent aggressive marketing practices that often prevent mothers from meeting their own breastfeeding goals. Infant formula, feeding bottles, and artificial nipples are the main products that fall within the scope of the Code. Pacifiers and breast pumps are not under the scope of the Code. Note that the Code only applies to the marketing of these items– it does not affect whether they are sold or used.

Is the Code intended to make parents who use formula feel guilty? No!

The Code is primarily aimed at governments and companies. Health care workers and facilities also have a role to play.

“The aim of this Code is to contribute to the provision of safe and adequate nutrition for infants, by the protection and promotion of breastfeeding, 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.” — Article 1 of the Code

• It is not directed at parents.
• It does not advocate against parents choosing to use formula.
• It does require that parents be given complete and factual information about infant feeding including, when applicable, how to properly and safely prepare infant formula.
• It does not suggest that formula sales to the public should be limited.
• It does require that infant formula meet strict quality standards, that the label include clear instructions for safe preparation, and that inappropriate foods (such as canned milk, rice milk, etc.) not be advertised for use as the sole source of nourishment for babies.
• It does say that companies should stop marketing practices that undermine breastfeeding and prevent mothers from meeting their own breastfeeding goals.
• It does say that, instead of advertising hype, parents who use formula should receive unbiased, factual information.

More information

The International Code of Marketing of Breast-Milk Substitutes – 2017 Update: Frequently asked questions (World Health Organization)

Understanding the International Code (IBFAN)

A Summary of the WHO Code (including WHERE, WHAT, WHEN and HOW) (Snugabell)

What is the WHO-CODE? (Best for Babes)

Why Keep Infant Formula Marketing Out of Healthcare Facilities? (KellyMom)

Health Implications of Direct Advertising of Infant Formula (World Health Organization)

The WHO Code and You (ILCA – written for IBCLCs)

Summary of WHA Resolutions Relevant to the Code (INFACT Canada)

International Baby Food Action Network: Overview of Code Monitoring (IBFAN)

How to report unethical promotion of formula, bottles and other breastmilk substitutes (PhD in Parenting)

International Code Documentation Center – Report Code violations here.

Looking for WHO Code compliant companies? See On the Trail of Code Compliancy

The International Code of Marketing of Breast-milk Substitutes is a set of recommendations for member states of the World Health Organization (WHO) designed to regulate the marketing of breast milk substitutes, feeding bottles and teats. It is referred to as the ‘WHO Code’.

It was introduced in 1981 in response to the concerns being raised about the marketing of breast milk substitutes in developing countries.

How was it created?

The WHO Code was adopted as a resolution by the World Health Assembly (WHA), the decision making body of the WHO, in May 1981. This followed extensive consultation with key stakeholders - including governments, United Nations agencies, civil society and infant food manufacturers.

Why was the Code introduced?

The Code aims to contribute ‘to the provision of safe and adequate nutrition for infants, by the protection and promotion of breastfeeding, and by ensuring the proper use of breast-milk substitutes, when these are necessary, on the basis of adequate information and through appropriate marketing and distribution’.

It is important to note that the Code recognises that breast milk substitutes have a legitimate role to play in circumstances where an infant is not breastfed.

Is the WHO Code an international law?

No. The Code is a set of recommendations to member states of the WHO.

It states governments should take action to give effect to its aim and principles, through legislation or other means.

How has Nestlé changed its marketing practices since the Code was adopted?

We’ve learnt a great deal from our experiences, and we recognise our responsibility to go beyond what were common marketing standards in the past. We strive to continuously improve our practices and our efforts have been recognised externally. We are proud to have been the first Breastmilk Substitutes (BMS) manufacturer included in the FTSE4Good Index and to have consistently met its rigorous criteria for the responsible marketing of BMS since 2011.

Alongside the Access to Nutrition Index (ATNI), FTSE4Good is the only other independent, transparent, third-party assessing marketing practices of Breastmilk Substitutes (BMS). Read more about FTSE4Good.

Does Nestlé follow the WHO Code?

The WHO has consistently clarified that governments have the responsibility for defining implementation of the Code within their countries. Therefore, we follow the WHO Code as implemented by national governments everywhere in the world.

In 152 countries that are considered to be higher risk in terms of infant mortality and malnutrition, we follow our own stringent policy (pdf, 3Mb) drawn from the WHO Code, or national regulations, whichever is stricter.

This is necessary because many ‘higher risk’ countries have not fully implemented the Code. In fact, according to a recent WHO report (pdf, 587Kb), only 37 out of 199 member states had passed laws reflecting all its recommendations and subsequent resolutions as of 2011.

What is meant by ‘higher-risk’ country?

Countries are classed as higher-risk by the FTSE4Good Breast Milk Substitutes Marketing Criteria when they have high rates of mortality (more than 10 per 1,000) or acute malnutrition (more than 2%) in children under five. This is based on data from UNICEF.

What is the difference between Nestlé's policy and the WHO Code?

The WHO Code is a set of recommendations for member states. The WHO has consistently clarified that it is up to governments to define how to implement the code in their countries.

Our policy (pdf, 3Mb) is a set of detailed implementation instructions to our infant nutrition marketing and sales staff. It explains concretely what can and can’t be done against each article of the Code. It was first drawn up in 1982 and then refined in 1984 after consultations with stakeholders including the WHO, the United Nations Children’s Fund (UNICEF) and civil society organisations. Since then it has been revised and strengthened a number of times.

Our policy is in line with the FTSE4Good Inclusion Criteria for the Marketing of Breast Milk Substitutes.

What are the Nestlé products covered by the Nestle policy?

Our policy applies to the marketing of all products specified in local legislation implementing the WHO Code.

In higher-risk countries, this policy applies to all infant and follow-up formulas designed to satisfy the nutritional requirements of infants from birth to 12 months, including infant and follow-up formulas classified as Food for Special Medical Purposes (iFSMPs) under local legislation and which fall within the following product range:

• infant formula for the reduction of the risk of allergy "HA" branded (or equivalent)
• infant formula for constipation relief
• infant formula for low hygiene conditions

Are Nestlé's marketing practices independently assessed?

Yes. As part of a continuous assessment process, Bureau Veritas audits our practices in three different countries every year against our policy (pdf, 3Mb).

In addition, PricewaterhouseCoopers (PwC) is commissioned by FTSE4Good to independently and regularly verify our breast milk substitutes marketing practices against a set of 104 criteria in higher-risk countries.

Do you donate infant formula during crises?

Breastmilk is the ideal food for infants. For infants who cannot be fed on breast milk as recommended, infant formula is the only suitable breastmilk substitute recognized as appropriate by the WHO.

Nestlé recognizes the heightened health risks for babies that are not breastfed in emergency circumstances. Our standard for donations (pdf, 500Kb) aims to both protect breastfeeding and respond to humanitarian requests.

Where permitted by national legislation and when specific criteria are met, we may donate limited quantities of infant formula to humanitarian organizations for babies who need to be fed breastmilk substitutes. This is only provided in response to official requests and through an organization which is authorized to distribute formula, safely and appropriately, and is strictly monitored. In no instance should any formula be delivered directly to mothers or caregivers.
 

Find out more

Related documents

Raising a concern

It is our strong commitment to market our infant food products in accordance with the principles and aim of the WHO Code.To find out more about how you can raise a concern, visit this page.