Tuesday, 28 September, 2021
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World Breastfeeding Week

Protecting Breastfeeding: Where Lies the Responsibility?

Dina Farhana

Every year the World Breastfeeding Week (WBW) is celebrated in the first week of August. WBW-2021 focuses on awareness among governments, civil society organisations, and health workers to protect breastfeeding from the aggressive marketing of the Breast-milk Substitute (BMS) industry and call the action for effective implementation and enforcement of the Act.

Evidence already available showed that breastfeeding is the best for infant and young child survival, nutrition, development and maternal health. It contributes to short and long-term benefits for individuals, family and the economy as a whole. Optimal infant feeding is defined as exclusive breastfeeding for the first six months and continued breastfeeding for two years or beyond along with appropriate complementary feeding beginning after six months.

Despite the importance of breastfeeding, mothers and families have been facing significant commercial pressures that undermine breastfeeding in Bangladesh. The BMS Act in Bangladesh was adopted by Parliament in 2013 and supported with additional laws in 2017. The aim of this BMS Act was developed specifically to ensure that mothers and families receive accurate and unbiased information about the healthiest way to feed their infants and young children, free of commercial influence. The Bangladesh BMS Act is based on the International Code of Marketing of Breast-milk Substitutes. The Code aims to protect and promote breastfeeding by regulating the marketing and distribution of BMS, including advertising, promotions, and labelling. It applies to all BMS and related products including infant formula, follow-up formula, other milk products, feeding bottles and nipples, and commercially manufactured complementary foods.

State of BMS Act in Bangladesh

The BMS Act is violating in many ways. Common violations include the direct promotion of the products to mothers by the companies. They offer gifts or free samples to the mother or caregiver in personal contact. Besides, the promotion of BMS products inside hospitals applies in many ways. Some hospitals display the formula products and permit the sale of formula at medical stores or even through health workers. Health professionals are offered gifts and different supports cash or kind by the company’s representative inside premises. Labelling violations are very common in Bangladesh. Advertising and labels make unsubstantiated claims about the product’s health benefits, imply that the product is equal to or superior to breast milk, or include imagery that idealises formula feeding. Sales in commercial settings mostly have special promotions. Companies' representatives offer samples, or even approaching mothers directly for purchasing the product. Sponsorship and financial support to the medical associations and health care providers to attend conferences, seminars and workshops at home and abroad by companies practices widely.

Provisions of the BMS Act

BMS Act is violated

•             If the manufacture or its representative distributes the products or samples of BMS to any person, mother or health care provider. 

•             If the importers, producers, distributors, or sellers/marketers of the BMS give health workers any kind of incentives like discounts or gifts etc for the use or sales to anyone.

•             If the importers, producers, distributors, or sellers/marketers give information and educational material related to the promotion of infant milk substitutes, feeding bottles and infant foods to mothers, families etc.

•             If proper instructions, warnings, and health concerns are not attached to all BMS products.

•             If no labels or statements may be added to BMS products regarding any approval by doctors or similar authorities.

•             If the size of the BMS company logo is more than half of the name of the product while labelling the product.

•             If incentives, including commissions or financial benefits, offer to health workers.

•             If the hospital, chemist shop display placards, posters of baby food companies for promoting their products.

WHO recommends exclusive breastfeeding—with no other foods or fluids, including water—until a baby is six months of age, as it contains all nutrients that a baby needs within this age. According to the 2017 Bangladesh Demographic and Health Survey (BDHS), 64 per cent of babies 0-5 months of age were being exclusively breastfed.

Call for Action

Regardless of measures taken by the government in developing and operationalising a monitoring system for tracking the violations of the BMS Act, ensuring fine and other enforcement to protect the law in combination with the capacity strengthening of health professionals to provide support and counselling on infant and young child feeding (IYCF), joint effort and individual commitment are required to stop unethical marketing practices.

 

The writer is a Public Health and Nutrition Professional. Email: [email protected]