An International Code of Marketing of Breast-Milk Substitutes was passed by the World Health Assembly in 1981. Papua New Guinea had already introduced legislation to control feeding bottles in 1977. This legislation has been effective in reducing bottle feeding, severe malnutrition and diarrhoeal diseases and deaths amongst infants in Port Moresby. Several favourable conditions in Papua New Guinea have allowed the legislation to be successful, but constant vigilance is necessary to maintain the present success.
PIP: The World Health Assembly, in an effort to protect breastfeeding and thereby improve the health of young children, passed in May 1981 by 118 votes to 1, as a recommendation, an International Code of Marketing of Breast Milk Substitutes. This was the 4th distinct draft of the code, being the result of a long process of consultations carried out with member states of the World Health Organization (WHO) and UN specialized agencies, nongovernmental organizations, industry and experts, in close cooperation with the UN International Childrens Emergency Fund (UNICEF), extending over several years. The code is a compromise. Several Executive Board members wanted it strengthened and made more precise. They also wished for its adoption as a regulation and not as a recommendation, but fears that further changes to the code could lead to postponement of its adoption kept the code as the 4th draft. It was realized that it might be necessary to revise the code at an early date in view of experience gained in the implementation of its various provisions. The recommendation must now be translated into national legislation by different countries. Papua New Guinea had already introduced legislation in 1977--the Baby Feed Supplies (Control) Act. The objective of this Act is to limit the availability of feeding bottles and to ensure that those who use them know how to use them safely. In particular, it aims to prevent the spread of bottle feeding to rural areas. The government, assisted by the medical and nursing professions, mass media, and lay organizations mounted a mass education campaign, which was backed by legislation in support of breastfeeding. Commercial advertising of breast milk substitutes was banned. The sale of feeding bottles was restricted. Under the Baby Feed Supplies (Control) Act, feeding bottles, teats, and dummies can only be obtained from a registered pharmacist on a prescription signed by a registered health worker. It is illegal for a pharmacist to supply a feeding bottle except on prescription. Health workers who fail to follow the instruction laid down in the Act render themselves liable to a fine. Similar fines apply to shopkeepers and others who supply feeding bottles illegally or without a proper prescription. The Act also focuses on the community's attention to the dangers of bottle feeding without adequate safeguards. The legislation has had a major beneficial impact on the promotion of breastfeeding. A survey revealed a statistically significant increase in the prevalence of breastfeeding. Reasons for success of the legislation include the fact that breastfeeding is still very much the norm, and the national government is strongly committed.