Importance Of The WHO Code

What is the WHO CODE? It is a “code of ethics” developed by the World Health Organization (WHO) to regulate the marketing and distribution of breast milk substitutes. It is a VOLUNTARY code which companies, medical facilities, doctors and organizations are encouraged to follow, but it is not mandatory and there are no repercussions for not following it. It is a code of ethics – much like the honor codes that many colleges have. As taken from code itself, it’s aim is to:

contribute to the provision of safe and adequate nutrition for infants, by the protection and promotion of breast-feeding, and by ensuring the proper use of breast-milk substitutes, when these are necessary, on the basis of adequate information and through appropriate marketing and distribution.

What products/services/behaviors are covered by the Code? “The Code applies to the marketing, and practices related thereto, of the following products: breast-milk substitutes, including infant formula; other milk products, foods and beverages, including bottlefed complementary foods, when marketed or otherwise represented to be suitable, with or without modification, for use as a partial or total replacement of breast milk; feeding bottles and teats. It also applies to their quality and availability, and to information concerning their use.” (this wording was taken directly out of the code itself).


Why is it important?
Because, weather we want to believe it or not – marketing works. And big powerful companies who sell products that affect a mother’s ability to successfully breastfeed her baby spend millions of dollars to make sure that she doesn’t succeed – because if she does – then she won’t buy their products. So they undermine the best efforts of all moms, making us question our choices and abilities. And they promote products and practices that will only shorten our breastfeeding relationships with our babies. They affect our relationships with our pediatricians and caregivers and they hamper our ability to get good, accurate information that will help us to meet our breastfeeding goals.

Did you notice that I said “Breastfeeding Goals”?
I didn’t say they prohibit us from breastfeeding for a year – or that they prohibit us from reaching the WHO breastfeeding goals – I said they prohibit us from meeting OUR breastfeeding goalsUS – as mothers.

Did you know that >75% of mothers WANT TO BREASTFEED? And that by the time a baby reaches 3 months of age, only 33% of mothers are exclusively breastfeeding? Do you think that this is because most mothers don’t want to breastfeed for 3 months? No – it’s because mothers are booby-trapped. They don’t have the support they need, they are given poor advice by their doctors and they read and listen to advertising by companies that don’t want them to succeed.

Shouldn’t we be smart enough to see through the ads? It’s not about being smart enough or seeing through it. It’s about deception. When companies and doctors who are supposed to be “authorities” are giving mothers poor advice and when “breastfeeding support” hotlines are set up by companies who don’t want you to breastfeed. (have you heard of the breastfeeding “counselors” that formula companies have hired to steer moms in the wrong direction?). Not to mention the fact that a new mother is at her most vulnerable when it comes to feeding her baby and feeling competent. She is already “questioning” her abilities to take care of this fragile being that has come out of her body. She is looking for reassurance that she is doing everything right – and that is not what she gets. Marketing is powerful – companies are fooled, doctors are fooled and mothers are fooled. It doesn’t mean you are weak or less smart – it means that the companies are getting what they pay for – effective marketing.

It is for all of these reasons that the WHO Code is so important. And it is for all of these reasons that we as mothers and business owners and members of society need to tell companies that we will not tolerate their open recklessness and lack of caring about the Code. Are breastmilk substitutes necessary? Absolutely! Should they be marketed responsibly? You bet! And should all companies that manufacture products in these categories abide by the code of ethics and responsibility outlined by the World Health Organization? A RESOUNDING YES!

12 comments to Importance Of The WHO Code

  • Your second to last point is the fence here that people fall on either side of. If they believe that women can be misled, they understand the Code. But so many women feel that everyone is immune to marketing as long as they’re “smart” or “do their research” so by implying that women can be misled, they believe we’re calling women stupid.
    But as a mother who busted her butt to learn how to do the best for her baby, I didn’t start out thinking about conspiracies and being mistrusting. I didn’t REALIZE that the What to Expect book and the 20-page booklet that had “Abbot Laboratories” stamped on the back given to my by my OB was a BAD thing. I read them religiously, studied them, like any good mother would… right?
    It took not only learning about breastfeeding to do this “right”, but learning how much was out there that would screw me up, from sources that had a lot more money and access than the good sources.
    Anyway, apparently I need to just go write my OWN post. :) Thanks for writing this! The Code is SO important!

  • You got it exactly right Christie – that is the biggest hurdle to overcome. So many of us (me included) were fooled by the information given to us – that we didn’t even realize we were being manipulated. My favorite breastfeeding guide was one that I got in my “diaper bag” from the hospital – and yes, it was produced by a formula company – but I didn’t know that there was anything wrong with that – and I passed it along to so many others before I realized it. These companies spend BIG MONEY on advertising and they do it because IT WORKS. And those of us who are supporting breastfeeding and supporting moms are either non-profits (like Best For Babes and La Leche League) or are small companies (like me) that don’t even begin to have the budgets or the staff to compete with the misinformation that is out there. Thanks for commenting and please leave a link when you write your own post. — Judy

  • Jennifer

    At some point in my pregnancy, I received two separate “samples” (generous sizes!) of formula. Because I had been in retail for so long, and because I studied marketing in college, I knew exactly what was going on. I felt fortunate that I possessed this knowledge and wrote fuming emails to both companies, railing against them because of their violation of the WHO guidelines (sending them links, of course!). I received apologies in both cases, and a removal from their marketing lists, but many moms-to-be would be totally snookered by this. My niece struggled with BF her son, and in SW MIssouri (to Judy’s point), there isn’t a lot of support for it, so she opened the free can of formula one night and fed him.

    I think the ultimate frustration came in the form of the “breastfeeding kit” I received from Mercy Hospital – with the Gerber formula in the “diaper bag.”

    Thanks for posting, Judy. I’m so very lucky that my l’il guy nursed like a champ from day one. By day three, my milk had not yet come in, and he had been screaming for 12 hours. When we took him into the pediatrician, he checked him over and said, “There’s nothing wrong with him. He just wants you to make more milk.” Lucky that our PCP “got it” and didn’t send me home with formula.

  • You are lucky, indeed Jennifer. I got quite a few cans of formula when I was pregnant too – and I hung onto each and every one – “just in case”. Luckily when my Dr told me I had to supplement because my milk hadn’t come in by day 5, I told him I wanted to use a supplemental feeding system so that my son wouldn’t have to take a bottle. He got 3 cc’s of formula and the rest was pumped milk that I used through the SNS – but in both of our cases, many moms would have derailed – I am just lucky that I wasn’t. — Judy

  • Kate

    You know, some of this information is actually useful however some of it is absolutely ridiculous. That we are such sheep we can’t make our own decisions because marketing companies blind us? Preposterous! The 45% (roughly) of breastfeeding moms who QUIT before the 3 month mark are being brainwashed by the BREASTFEEDING community to believe that it’s EASY. When they discover it’s not only not as easy as they thought, but much harder than mixing a bottle they quit. Plain and simple. Of course breastfeeding is touted as being better for baby. It is. And natural. It is that as well. However EASY it is NOT. Certainly not compared to warming a bottle and it’s definitely no where NEAR what the breastfeeding ads I saw portrayed. Mother and baby bonding while baby gently nurses in the rocking chair… bull crap. How about sleep depriving that mother for 4 or 5 nights, starving the baby for the same amount of time, and shooting that commercial again? Perhaps that’s a bit extreme however it’s (IMO) alot closer than the bonding scene described previously. Especially the first month or so. And what mother wouldn’t break down and FEED their starving child? Isn’t that what we’re wired to do, take care of our babies? I don’t know about the rest of you but I’m absolutely 100% certain that my breastfed child was hungry at least 60% of her waking hours for the first 3 months. I agree that the education isn’t in place but formula companies aren’t the only ones in the advertising “wrong” here!

  • Kate, I am sorry that you had such a difficult time breastfeeding. No, it isn’t easy for many of us – for some it is – and they are truly lucky. But I would never say that mixing a bottle is easier. And I think you are comparing apples and oranges here. Just because breastfeeding may or may not be as easy or as hard as we expect, doesn’t absolve the formula companies of their duty to partake in ethical marketing. And the most difficult thing to convince someone is that “marketing works” – but believe me – it does. I only wish the breastfeeding organizations had the marketing $$ that big pharma has – then we could educate mothers about breastfeeding and provide them with the resources they need. You are right – not every one of those mothers who quit before 3 months quit because of formula companies – but many of them quit because they were given bad information by their pediatricians – who should also abide by the code and should help moms by referring them to lactation specialists.

    All moms are sleep deprived – whether they are breastfeeding or not. And while breastfeeding may be more difficult for some than others, most moms get into a good routine with their babies sometime between 2-4 weeks post-partum. Is that time difficult while they are learning, yes indeed – is formula feeding easier – maybe in the short term, but certainly not in the long term. This post is about the WHO code – there are many other aspects of breastfeeding support that we need to work on for moms as you have pointed out. — I hope that breastfeeding did eventually get to be ‘easier’ and ‘more enjoyable’ for you and your baby. Kudos to you for sticking with it. — Judy

  • Erin

    I’ve received FOUR “samples” of formula in the mail, and all went straight to the trash and it broke my heart. I’m not a waster, and if I didn’t know that just having the formula IN THE HOUSE would decrease my chances of sticking with breastfeeding, they’d be sitting in my cabinet right now, because throwing away “perfectly good food” goes against so much in me. The good news is that I had that information in mind when those boxes came in the mail, largely because of the advocacy organizations Judy mentioned above. They may have quite a battle, but they do so much good!

  • Noura

    I also received several containers of formula but didn’t have to toss them. I work @ a 500+ employee company where there is always new babies. We have a huge breakroom & everyone puts unwanted items on the long tables- clothing, foods, formula, coupons, fresh picked fruits & vegies …etc. they disappear within an hour or so. I bf my son for over 2 years but that’s how I was raised. My mom bf me for 3 1/2 years so I had to make it to 2 years just to satisfy my goal. He NEVER had formula even tho we had latch issues for 3 months, & even tho my milk took a week to come in, it was imbedded into me from birth that formula is bad for babies.

  • Great post Judy! It is hard to compete with the deep pockets of the formula companies, however if we all band together to spread the word, it *will* get out there little by little…

  • Siam

    “When we took him into the pediatrician, he checked him over and said, “There’s nothing wrong with him. He just wants you to make more milk.” Lucky that our PCP “got it” and didn’t send me home with formula.”
    What a great Paed!

  • Siam

    Good article!

    Interesting point left by Kate – “we are such sheep we can’t make our own decisions because marketing companies blind us? Preposterous!”

    The trouble though, with the advertising, is not just that it encourages women to bottlefeed instead of breastfeed – its not just about that. Its how the advertising impacts on the would-be supporters of breastfeeding women – the family, friends and health workers of them, the ones who misadvise to top up, give up. The advertising reinforces this and we have people not even realising they are acting as corporate agents of a commercial product and undermining the women who already do, genuinely, want to breastfeed

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