Opportunity to join research project documenting Code violations

Surveying the Landscape of Breastmilk Substitute (BMS) Marketing Practices in Four Countries is well underway!

Launched this summer, the purpose of the research project is to document violations of the World Health Organization’s International Code on Marketing of Breast-milk Substitutes and subsequent WHA resolutions (the Code) in the U.S., Canada, the UK and Australia. 

On behalf of those conducting the study, Ellie Mulpeter, MPH, CLC Director, Academy of Lactation Policy and Practice (ALPP) says that they are excited about the level of engagement.

“It seems that participants are seeing and monitoring code violations across all four countries, perhaps even more than they expected!” she exclaims. “This is such a fun and engaging project – both active and practical – and is telling us so much already about what is happening throughout these four countries.” 

So far, the most prevalent violations have been reported on online social media platforms, influencers and online advertising and sales platforms. Read Scope and impact of digital marketing strategies for promoting breastmilk substitutes to understand why this finding is unsurprising. 

Mulpeter says of the research that “raising awareness is the first goal, particularly in countries that do not currently monitor or enforce the Code.” 

According to this 2022 WHO status report, “as of March 2022, a total of 144 (74%) of the 194 WHO Members States (countries) have adopted legal measures to implement at least some of the provisions in the Code. Of these, 32 countries have measures in place that are substantially aligned with the Code. This is seven more countries than reported in the 2020 report.” The U.S. and Canada have no legal measures. 

Mulpeter comments, “Policy makers in the U.S. are behind the ball when it comes to protecting breastfeeding individuals and their babies. That is nothing new. For many, I believe that seeing the sheer number of violations that the average individual can identify when walking along the aisles of their grocery store(s) will be eye-opening. Additionally, it’s great to have a study where those who care about maternal and child health can get out there and help with this project. If we are fortunate to find one or more advocates in the legislature that are passionate about this legislation, I think we can find a way to bring the U.S., Australia, the UK and Canada up to speed with other countries that effectively monitor and enforce The Code and its subsequent WHA resolutions.” 

Examples of countries with legal measures include Brazil, India and Bangladesh though compliance and enforcement is not always substantial. 

“It is inspiring to see the successes that other countries have had in protecting breastfeeding parents and their babies from the harmful practices of the infant formula and other breastmilk substitute industry,” Mulpeter continues. 

In the U.S., the Federal Trade Commission (FTC) provides an avenue to monitor false advertising and hold companies accountable for making claims that are not evidence-based. Mulpeter reports that INFACT USA has submitted several different reports of false advertising on infant formula cans and other commercial milk formulas in the U.S.

“Unfortunately, the FTC does not actively investigate those submissions, but does keep a database of those submitted,” she explains. “After submitting those cases, a message is relayed to the submitter notifying them that they will not receive a response from the FTC, but that the report will be logged in their database.” 

Though the U.S. has not adopted the Code, this research may eventually feed into the NetCode Protocol which supports the development of a monitoring framework, protocols and training materials for monitoring of the International Code and relevant WHA resolutions, and the formulation, monitoring and enforcement of national Code legislation. 

The study will be capped at 1,000 participants. Once enrollment closes, new submissions of violations will be accepted for approximately six months. You can join here

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