Protecting breast feeding from breast milk substitutes

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7138.1103 (Published 11 April 1998) Cite this as: BMJ 1998;316:1103

The WHO code is widely violated and needs monitoring and supporting

  1. Anthony Costello, reader in international child health,
  2. Harshpal S Sachdev, Professor
  1. Institute of Child Health, University College, London WC1N 1EH
  2. Divsion of Clinical Epidemiology, Department of Paediatrics, Maulana Azad Medical College, New Delhi 110 002, India

    Papers p 1117

    In all societies breast feeding is one of the most important measures to improve child health. An important component of the global effort to protect breast feeding is the WHO's international code of marketing of breast milk substitutes. In this week's issue an interagency group on breast feeding monitoring produces compelling evidence that the code is widely violated (p 1117).1

    The World Health Organisation estimates that 1.5 million deaths a year could be prevented by effective breast feeding protection.2 A recent systematic review estimated that in a low income country with a postneonatal mortality rate of 90 per 1000 children, artificial feeding would produce an excess of postneonatal deaths per million births ranging from 11 290 (13%) to 112 900 (59%) at prevalences of artificial feeding at 6 months of 10% and 100% respectively.3 In the industrialised world a failure to breast feed increases the risk of childhood diseases,4 impairs child development,5 and may increase the risk of adult disease.6

    The international code, devised in 1981, reaffirmed in 1996, and endorsed by the manufacturers, was developed to protect mothers and …

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