Recommendations for Adopting the International Code of Marketing of Breast-milk Substitutes Into U.S. Policy

J Hum Lact. 2017 Aug;33(3):582-587. doi: 10.1177/0890334417703063. Epub 2017 Apr 18.


In 1981, the World Health Organization adopted the International Code of Marketing of Breast-milk Substitutes ( International Code), with subsequent resolutions adopted since then. The International Code contributes to the safe and adequate provision of nutrition for infants by protecting and promoting breastfeeding and ensuring that human milk substitutes, when necessary, are used properly through adequate information and appropriate marketing and distribution. Despite the World Health Organization recommendations for all member nations to implement the International Code in its entirety, the United States has yet to take action to translate it into any national measures. In 2012, only 22.3% of infants in the United States met the American Academy of Pediatrics recommendation of at least 6 months of exclusive breastfeeding. Countries adopting legislation reflecting the provisions of the International Code have seen increases in breastfeeding rates. This article discusses recommendations for translating the International Code into U.S. policy. Adopting legislation that implements, monitors, and enforces the International Code in its entirety has the potential to contribute to increased rates of breastfeeding in the United States, which can lead to improved health outcomes in both infants and breastfeeding mothers.

Keywords: International Code of Marketing of Breast-milk Substitutes; breastfeeding; breastfeeding promotion; human milk; infant formula; nutrition policy.

MeSH terms

  • Bottle Feeding / standards*
  • Health Policy / legislation & jurisprudence
  • Humans
  • Infant
  • Infant Formula / legislation & jurisprudence
  • Infant, Newborn
  • Marketing / legislation & jurisprudence*
  • Milk Substitutes / standards*
  • Nutritional Requirements*
  • United States
  • World Health Organization / organization & administration