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  3. Outcomes Of Implementing The International Code Of Marketing Of Breast-milk Substitutes As National Laws: A Systematic Review.
  1. Home
  3. Outcomes Of Implementing The International Code Of Marketing Of Breast-milk Substitutes As National Laws: A Systematic Review.

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Outcomes of implementing the International Code of Marketing of Breast-milk Substitutes as national laws: a

Chompoonut Topothai1,2,3, Nisachol Cetthakrikul4, Natasha Howard5,6

  • 1Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, 117549, Singapore. chompoonut@u.nus.edu.

International Breastfeeding Journal
|September 28, 2024

View abstract on PubMed

Summary
This summary is machine-generated.

Implementing the International Code of Marketing of Breast-milk Substitutes (the Code) into national law shows mixed results. While it regulates infant formula promotion, gaps remain in addressing growing-up milk marketing and ensuring consistent compliance, especially in private settings.

Keywords:
BreastfeedingCommercial milk formulaComplianceImplementationInfant formulaInternational Code of Marketing of Breast-milk SubstitutesNational legislation

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Area of Science:

  • Public Health
  • Health Policy
  • Nutrition Science

Background:

  • The International Code of Marketing of Breast-milk Substitutes (the Code) aims to protect breastfeeding by regulating commercial milk formula (CMF) marketing.
  • Legislation of the Code into national law is recommended for WHO member states, but implementation outcomes are not well understood.

Purpose of the Study:

  • To systematically review the implementation outcomes of countries that have legislated the Code into national law.
  • To examine legal compliance, acceptability, and feasibility of the Code's implementation.

Main Methods:

  • Systematic literature search of five databases (1982-2022).
  • Double-screening of titles/abstracts and full texts for eligible articles from 144 countries.
  • Quality assessment using the Mixed Methods Appraisal Tool and thematic synthesis guided by the Proctor et al. framework.

Main Results:

  • Sixty articles from 28 countries were included, focusing primarily on legal compliance.
  • Maternal exposure to CMF promotion persisted despite the Code, with issues in health worker compliance and inconsistent point-of-sale adherence.
  • The Code effectively regulated infant formula promotion in public settings and media but was insufficient for growing-up milk and emerging digital marketing strategies.

Conclusions:

  • Robust monitoring and reporting systems are crucial for enhancing legal compliance.
  • Technology-assisted solutions and targeted training for health workers and retailers can improve Code implementation and acceptability.
  • Addressing promotion of unregulated products and adapting to new marketing strategies are essential for comprehensive protection of breastfeeding.