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Table of Contents   
LETTER TO THE EDITOR  
Year : 2017  |  Volume : 10  |  Issue : 1  |  Page : 280-282
Supporting and encouraging breastfeeding through strengthening of the existing legal provisions globally


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chennai, Tamil Nadu, India

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Date of Web Publication5-May-2017
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Supporting and encouraging breastfeeding through strengthening of the existing legal provisions globally. Ann Trop Med Public Health 2017;10:280-2

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Supporting and encouraging breastfeeding through strengthening of the existing legal provisions globally. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Sep 21];10:280-2. Available from: http://www.atmph.org/text.asp?2017/10/1/280/205572
Dear Sir,

Exclusive breastfeeding (EBF) has been acknowledged as one of the best available natural resources, which has the potential to lay a strong foundation for the newborn's growth, development, and survival.[1] In-fact, by ensuring EBF for the first 6 months of an infant's life and continuing breastfeeding up to 2 years of age can reduce the child mortality rates by 13%.[1] Furthermore, it has been estimated that universal adoption of breastfeeding can save the lives of 0.82 million under-five aged children annually, and can add almost US$ 300 billion into the global economy (due to the improved cognitive levels and better earnings in the future).[1] In addition, it is beneficial for the health system as it minimizes caseload of some of the commonest childhood morbidities requiring hospitalization.[1],[2]

Acknowledging the numerous benefits associated with breastfeeding for both mother and child, it is our responsibility to promote and protect it worldwide.[2] In fact, the International Code of Marketing of Breast-milk Substitutes has been adopted in the year 1981 to discourage the promotion or marketing of breast milk substitutes-feeding bottles-teats, and hence encourage breastfeeding practices.[2],[3] At the same time, it lays down the criteria for the safe use of breast-milk substitutes when they are necessary, and prohibits advertisement or free distribution of them to health professionals.[2],[3]

Even though, since its adoption, a gradual progress has been achieved, nevertheless the current estimates suggest that only 20% of the nations have laws to implement all the provisions of the code, whereas 59 nations still have no laws to protect breastfeeding despite the adoption of the code since more than three decades.[1],[4] Shortcomings have been observed in various areas such as prohibition of advertisement, free distribution of products to health facilities, offering gifts, scope of banned products covered, prohibition on nutritional benefit claims, etc.[1],[4] This means that in many settings mothers are wrongly informed about the health benefits attributed with these substitutes and hence it takes a toll on their confidence level to either initiate or continue breastfeeding for the recommended period of time.[2],[3],[5] Furthermore, it is also important to realize that breast-milk substitutes industry is growing worldwide and it is estimated that the sale of these products is further expected to increase by 55% till the year 2019.[1]

Despite the implementation of various strategies to discourage the usage of these substitutes, the desired gains have not been accomplished.[1] This is because of the presence of various challenges such as lack of political will to implement the provisions stringently, poor financial support, constant interference from the industry stakeholders to delay the enforcement of the code, dearth of adequate data and technical assistance on the available provisions, lack of coordination among stakeholders, deficiencies in the systematic monitoring of the provisions recommended, no streamlined mechanism to punish the violators, and lack of revisions in the Code depending on the current harmful practices.[2],[3],[4],[5]

To effectively respond to the prevalent challenges, a wide range of measures such as establishing of a global network to assist in monitoring and implementation of the legal provisions, keeping a strong vigilance on marketing practices to ensure that in no ways breast milk is equated with other available substitutes, expand the scope of the legal provisions and cover all milk products till the age of 3 years, prohibit all modes of product promotion, improve the funding for monitoring bodies and other stakeholders, periodically train health professionals regarding breastfeeding, extend technical and legal assistance to the nations, build partnerships with various international agencies, encourage community-based activities and peer-to-peer promotions, ensure strict enforcement and adequate penalties to the violators, and conduct various awareness campaigns to promote breastfeeding, can be systematically planned and implemented to effectively respond to the problem.[1],[2],[3],[4],[5]

To conclude, even though the battle to increase the prevalence of exclusive breastfeeding is difficult, amidst the pressure from the breast-milk substitutes industry, it is worth trying as every mother deserves a chance to get the correct information, what is good for their and their child health.

Acknowledgement

SRS contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work.

PSS contributed in the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work.

JR contributed in revising the draft, approval of the final version of the manuscript, and agreed for all aspects of the work.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
World Health Organization UNICEF IBFANMarketing of breast-milk substitutes: National implementation of the international code Status Report 2016. Geneva: WHO press; 2016.p. 1-13.  Back to cited text no. 1
    
2.
Barennes H, Slesak G, Goyet S, Aaron P, Srour LM. Enforcing the International Code of Marketing of Breast-milk Substitutes for better promotion of exclusive breastfeeding: Can lessons be learned. J Hum Lact 2016;32:20-7.  Back to cited text no. 2
[PUBMED]    
3.
Hardy BJ, Commentary: Getting to compliance. Multisector dialogue, collaboration and the International Code of Marketing of Breast Milk Substitutes. J Public Health (Oxf) 2013;35:191-2.  Back to cited text no. 3
    
4.
World Health OrganizationLaws to protect breastfeeding inadequate in most countries; 2016. Available from: http://who.int/mediacentre/news/releases/2016/breastfeeding/en/ [Last accessed on 2016 May 11].  Back to cited text no. 4
    
5.
Piwoz EG, Huffman SL, The impact of marketing of breast-milk substitutes on WHO-recommended breastfeeding practices. Food Nutr Bull 2015;36:373-86.  Back to cited text no. 5
    

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Correspondence Address:
Saurabh RamBihariLal Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur Guduvancherry Main Road, Sembakkam Post, Kancheepuram, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.205572

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