Intended for healthcare professionals


Monitoring the marketing of infant formula feeds

BMJ 2003; 326 doi: (Published 18 January 2003) Cite this as: BMJ 2003;326:113

Manufacturers of breast milk substitutes violate the WHO code—again

  1. Tony Waterston (, consultant paediatrician,
  2. James Tumwine, associate professor of paediatrics and child health
  1. Newcastle General Hospital, Newcastle upon Tyne NE4 6BE
  2. Makerere Medical School, PO Box 7072, Kampala, Uganda

    Papers p 127

    Breast feeding is one of the most cost effective interventions to improve health and prevent illness in early childhood. Protection of breast feeding from commercial exploitation should be among the highest priorities for the international community, yet violations of the World Health Organization's code of marketing of breast milk substitutes have been seen regularly, despite companies' expressed intentions to conform.13 The study by Aguayo et al in west Africa in this issue (p 127) provides further evidence that many manufacturers fly in the face of the code by providing free samples, giving donations to health workers, and contravening standards for labelling.4

    How reliable is the methodology of the study? The selection of health centres to be monitored was either random or complete. The number of mothers interviewed was modest: 105 compared with 1582 in the 1998 study,2 and, surprisingly, more health workers than mothers were …

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