Buyer beware: 35 Years of the ‘Code’

by Robin Rideout, RN

This year marks the 37th Anniversary of the International Code of Marketing of Breast-Milk Substitutes by the World Health Assembly (WHA). The ‘Code’ was developed as the optimal way to combat worldwide infant malnutrition and declining breastfeeding rates. Marketing practices of infant formula companies had become seen as a global ideal as opposed to the practice of getting the maximum amount of product (formula) sold and generating the most dollars for the parent company as possible. Buyer Beware!

Prior to the 1940’s exclusive breastfeeding was the primary way most infants were fed. During the 1970’s breastfeeding dropped to an all time low. In the U.S. in 1971 only 21% of mothers even initiated breastfeeding! Experts at UNICEF and the World Health Organization (WHO) decided to target the marketing practices of infant formula companies and the ‘Code’ was born to stop the downward spiral of infants being fed breast milk. Company marketing policies that try to influence a mother’s decision to breastfeed are the ‘Code’s target. Briefly the key concepts of the ‘Code’ state that there should be no advertising of breast milk substitutes to the public, no promotion of such products through the health care system, and infant formula must not be portrayed as equally healthy as breast milk. Buyer Beware!

So how is Canada doing? Canada has agreed in principal to participate and uphold the ideas built into the ‘Code’ yet we haven’t made it a Canadian law. That means the government is relying on the formula companies to police themselves. This isn’t working out so well. There are dozens of ways that formula is marketed in Canada. Our Ontario hospitals are given millions of dollars’ worth of free formula. Ideally mothers should be able to identify that their babies were fed a milk substitute or formula – not a specific brand name. Ask any mother in Chatham-Kent and I’m sure she’ll be able to tell you exactly which brand of formula she received. Free sponsorship of conferences and research for health professionals are offered in every province. New mothers are targeted with direct mailing of ‘free’ formula when their names and addresses are identified through signing up at ‘baby club’ websites, etc. Advertising through ‘baby clubs, magazines, T.V. commercials, grocery shelf talkers and websites are growing. The advertisements are increasing their pressure on families to provide the very best, the A+ of formula. A study of the scientific literature presented by a noted gastroenterologist at the CKHA reported that in reality the extra expense of these types of formulas was not supporting their claims or duplicating the benefits provided by breast milk. Buyer Beware!

With all this ‘free formula, coupons, etc” available for new families they must be saving lots of money right? In reality that hook of free formula will cost a family almost $1500 dollars in the first year of an infant’s life in product and delivery system (bottles, nipples, etc.) for a family that switches from breast milk to formula. A typical direct marketing plan is to send a can of powdered formula that may typically cost $10 retail. This is a pretty cheap marketing investment for the formula company that will affect the buying habits of a family for a lifetime. Buyer Beware!

For more information please contact the Chatham-Kent Public Health Unit at 519.352.7270 or visit


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