2 Nutrition of Healthy Infants, Children and Adolescents
Key Words
Breast milk · Infant milk substitutes · International
Code of Marketing of Breast-Milk Substitutes ·
Marketing, formula · Millennium Development
Goals
Key Messages
- Breast milk is best for optimal growth and develop-
ment of a baby; breast milk substitutes are an alter-
native where breast milk is not available - Particularly in poor populations, a reduction in child
mortality [Millennium Development Goal (MDG) 4]
and improved maternal health (MDG 5) can be
achieved through exclusive breastfeeding during
the first 6 months and continued breastfeeding as
appropriate for most mothers - The International Code of Marketing of Breast-Milk
Substitutes was developed to enhance breastfeed-
ing practices and to prevent uninterrupted market-
ing of formulae - Governments and nongovernmental organizations
need to monitor the implementation of the code
and report violations - Health care workers should promote breastfeeding
by providing counseling and lactation support be-
fore and after the birth of a child
© 2015 S. Karger AG, Basel
Introduction
An estimate by the WHO suggests that 1.5 mil-
lion babies could be prevented from dying each
year if women breastfed their infants (exclusively
up to the age of 6 months, and then until the in-
fants are 2 years old) [1]. Breastfeeding was al-
most universal in the 19th century until the first
commercial breast milk substitutes came out [2].
Thereafter, substitute feeding became available
as an alternative to breastfeeding. Soon, in vari-
ous countries breastfeeding rates decreased sig-
nificantly, and this had an impact in the form of
increased mortality because of diarrhea and in-
fections in developing countries. One main rea-
son behind the drastic fall in breastfeeding to low
rates in the late 19th century and in the 20th cen-
tury was widespread advertising by formula
companies. During the 1970s and 1980s, breast-
feeding rates picked up again, especially with old-
er and educated mothers in industrialized coun-
tries. Formula companies responded by vigor-
ously seeking new markets in the developing
world. Companies started giving gifts and other
incentives to health workers for promoting for-
mulae. Due to improper preparation of formulae
Koletzko B, et al. (eds): Pediatric Nutrition in Practice. World Rev Nutr Diet. Basel, Karger, 2015, vol 113, pp 104–108
DOI: 10.1159/000360326
2.3 Marketing of Breast Milk Substitutes
Neelam Kler Naveen Gupta Anup Thakur