Blog Posts

Repost from Baby Milk Action IBFAN UK

Original source:

Global trading standards must follow WHO in restricting harmful marketing

75th World Health Assembly, Geneva, 22-28th May, 2022

IBFAN, the global network that has helped governments stop harmful marketing of baby feeding products for the last 40 years, attended the 75th World Health Assembly (WHA) in May. With so many difficult political issues on the Assembly agenda  –  emergencies,  military conflicts, decisions on pandemics, the climate crisis, the need for sustainable WHO financing to name just a few – infant health and the global trade of baby feeding products seemed to some a small topic that had to take its turn.

Most governments know that the unethical marketing of baby feeding products contributes to the annual toll of 800,000 baby deaths from unsafe feeding and that many more do not reach their full potential because they are not breastfed. However, with the pressure to join multi-stakeholder initiatives,  health-harming corporations are being accepted as legitimate ‘partners’ and funders in health and are gaining increased access to policy-making processes at all levels, including at WHO.  Risky technologies and products claiming to protect and solve all manner of problems are being promoted,  obscuring the fact that for infants and young children, breastfeeding is a resilient practice that provides food, care, immune support and protection, even from the worst of emergency conditions. It also protects against malnutrition in all its forms.  However, breastfeeding needs strong legal protection from predatory marketing.(1)

In 1981 the World Health Assembly – the world’s highest health policy setting body – passed the first consumer protection tool of its kind –  the International Code of Marketing of Breastmilk Substitutes followed by 20 subsequent Resolutions  This ‘code’ is a minimum obligation for all governments and the global baby-feeding products industry (whose US $55 billion turnover is led by the corporate giants Nestlé, Danone, Abbott and Mead Johnson/Reckitt) must also comply with it. 144 countries have adopted laws based on the Code since 1981, however, because of undue commercial influence, too many have legal loopholes that allow harmful marketing to flourish. The corporations are never held financially responsible for the harm they cause and all the ‘costs’ are externalized to governments, families and babies. Indeed the financial cost of sub-optimal feeding is especially important at this time of global inflation following the pandemic.

Four WHO reports published this year look at the global nature of the corporate strategies, with the report on digital marketing explaining how companies target new mothers with algorithms and celebrity influencers that reach millions with single postings.(2)

Over 45 countries spoke on the Maternal, Infant and Young Child Nutrition Agenda Item when it came up, many stressing the importance of protection against deceptive tactics that idealise and mislead all parents about the safety and nutritional value of baby feeding products.(8)

Ensuring that global trade rules do not harm infant and young child health:

High on IBFAN’s list of concerns (3) was the need for policy coherence between global trading standards and WHO decisions – a critically important matter that some exporting countries would prefer not be raised at the WHA. WHO and the Food and Agriculture Organisation (FAO) are the funders and ‘parents’ of the Codex Alimentarius Commission, the food standard setting body with the dual mandate of protecting health and ensuring fair practices in trade. All Codex work is subject to approval FAO and WHO and the Codex Code of Ethics for International Trade requires observance of the Code and Resolutions. (4) Clearly Codex should follow WHA decisions, not the other way around as suggested by the USA in its intervention:

“It is also critical that the [digital] guidance does not infringe upon the work and mandate of other international bodies, especially Codex Alimentarius given its leading role in developing science-based safety standards for food products.”

Since 1995 IBFAN has advocated the incorporation of WHA resolutions into baby food standards and guidelines and has witnessed how often decisions are not based on credible scientific evidence but on politically influenced consensus that favours the interests of agri-food industry and exporting countries. In March 2023, Codex will make an important decision on the revision of the Codex Follow-up Formula standard: should companies be allowed to freely promote the unnecessary, sweetened, flavoured, ultra-processed milk drinks for young children 12-36 months that fuel the obesity epidemic and add to the environmental burden? Or should the standard follow WHO guidance that clearly states that these products – confusingly cross-promoted with infant formulas for newborn babies ­– function as breastmilk substitutes and should not be promoted anywhere, but especially where breastfeeding into the second year is a lifeline for babies.(5,6)

‘Cross Promotion’ or ‘brand stretching’ is a well-known, deceptive marketing technique used to expand the sale of products such as alcohol, tobacco, soft drinks and baby formulas. In June 2022 the Brazilian Institute for Consumer Protection (Idec) filed a Public Civil Action (ACP) against Nestlé Brasil, Mead Johnson Brasil and Danone, claiming that the Cross Promotion strategy causes confusion, deception and harm, especially for fathers, mothers, caregivers and young children.

While all governments have a sovereign right and duty to adopt health-protective laws to protect citizens, a weak industry-friendly Codex standard could dissuade some. Aware of these risks, several countries called on WHO for help with trade and marketing matters, to ensure that health takes priority over trade concerns.

Bangladesh delivered a strong statement on behalf of eleven Member States of South East Asia, reminding the meeting that breastfeeding is a “socio-cultural component of human heritage binding the newborn with the mother after their birth through skin-to-skin contact” and calling for stronger implementation and monitoring of the Code.  As Bangladesh,  the delegate also asked WHO to:

“mobilize global support … to  address trading and export standards, guidelines and regulations in compliance with the International Code of Marketing of Breastmilk Substitutes and subsequent WHA Resolutions and … to promote gradual phasing out of the cross-branded products that function as breastmilk substitutes within the Codex Alimentarius revision of the draft standard for Follow-up Formula.”

Thailand supported Bangladesh’s call for curbs on digital marketing and cross-promotion and asked WHO to:

“collaborate with the World Trade Organisation (WTO) or other relevant trade agreement bodies to ensure our global efforts to catch up with this modern marketing into this guidance. Otherwise, this will be another piece of paper without implementation … impossible for us to follow.”

Mexico regretted the marketing that is leading to a reduction in breastfeeding across the world and picking up on the WHO EU policy brief, called on the WHO Secretariat:

“to strengthen the document, EB 150.7 to provide assistance to Member State so that guides, regulations and standards on marketing correctly implement the International Code of marketing of breastmilk substitutes  …  the adoption of legal frameworks that cover all children, children’s food and related products, as well as covering all foods that are taken by pregnant women.   We see that there is a conflict of interest, so we need to ensure that we have proper policies for children, following the 10 steps for the  promotion of breastfeedi


Photo above: Maternal milk promoted in Timor-Leste Danoné Lactamil, misleadingly and confusingly cross-promoted with infant formula for newborn babies. Is this for the mother or the baby? This ultra-processed product targets breastfeeding mothers, undermining confidence in breastfeeding and normal family foods.

Argentina regretted the high early suspension of breastfeeding, stressed that health teams should make  decisions and that Member States should base their sanitary or phyto-sanitary measures on standards, international guidelines or recommendations.

Dr Francesco Branca, WHO Director of Nutrition and Food Safety, speaking after the debate, appreciated the requests from Bangladesh and committed to identify actions to address those concerns, and help ensure the strongest possible safeguards for child health , including in the discussion of the forthcoming Codex standards

IBFAN highlighted the cruelty of expecting poorly-resourced countries to tackle cross-border marketing problems alone. Babies in these countries stand to suffer the most when breastfeeding is undermined. Exporting nations such as the USA, Canada, New Zealand, Australia, Europe, Japan and China all profit from formula sales, yet take no responsibility for their companies.

The European Union is often outspoken on food safety matters at Codex, including on baby feeding products and  growth hormones. But they are weak on the issue of promotion of  Follow-on formulas. In 1992, in an attempt to address problems with the EU’s enormous export of breastmilk substitutes to Africa and other developing countries, an EU  Council Resolution was passed, calling on EU-based companies to comply with the Code when marketing in importing countries. The Resolution also outlined monitoring, reporting and accountability proposals.[7]  It’s high time this idea was revisited, strengthened and converted into binding EU Regulation.

Although the USA expressed support for breastfeeding as a priority programme area, it made no reference to the contamination in the Abbott factory apart from mentioning the critical importance of safe breast milk substitutes. No mention was made of the lack of US Code legislation and mandatory paid maternity leave that has underscored and exacerbated the current long-running infant formula shortage.

The draft Decision approved by the January Executive Board meeting (EB150/7) was adopted without amendment.  It calls on the WHO Director General to “develop guidance for Member States on regulatory measures aimed at restricting the digital marketing of breastmilk substitutes, so as to ensure that existing and new regulations designed to implement the International Code of Marketing Breastmilk Substitutes and relevant Health Assembly resolutions subsequent to its adoption adequately address digital marketing practices..” and to report back in 2024.



For more: Elisabeth Sterken (, Dr Magdalena Whoolery (, Ellie MacGregor (, Alison Linnecar (, Maryse Arendt ( ) Patti Rundall (

Leave a Reply

Your email address will not be published. Required fields are marked *