Protection of Breastfeeding, Marketing of Human Milk Substitutes and Ethics

Abstract

Although human milk provides adequate nutrition, many children are weaned early and fed human milk substitutes. Breastfeeding replacement by commercial infant formula represents an important source of profit generation for formula manufacturers. Therefore, selling and marketing these products are planned carefully as mothers stop breastfeeding. The World Health Organization (WHO) established an International Code of Marketing of Breast Milk Substitutes in 1981 (WHO-UNICEF 1981) [Fig. 1]. These WHO standards have been in effect in Brazil since 1988, and were revised twice: in 1992 (NBCAL 1992) and in 2002. The Code provides one special article dealing with Health Workers (Article 7), in which rules for ethical procedures of infant formula companies are defined. The Brazilian Code was disseminated to pediatricians by professional associations and the Minister of Health. Copies of the Code also were distributed to pediatricians by the largest infant food company in Brazil, indicating how the company interprets the national Code.