Article in Archives of Diseases in Childhood

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 Arch Dis Child published online July 26, 2010 J S Forsyth

International code of marketing of breast-milkand international governance --three decades later time for hostilities to be replaced by effective national substitutes 

An article  in  the Archive of Diseases in Childhood by Prof Stewart Forsyth (who declares long-standing collaboration with the formula companies) portrays a harmful message about Baby Milk Action and other groups monitoring and campaigning to stop the harmful marketing of baby foods. Below are some comments about the article and the media coverage it is generating: 


While we do agree with the author ,  that there need to be better safeguards at national and international level when companies do not meet their responsibilities under the Code, we are very concerned about the implication  that Baby Milk Action is keeping 'hostilities' going to the detriment of infant health.  A piece in Nutraingredients, stated: "Writing in the Archives of Disease in Childhood, Professor Stewart Forsyth says the 30 year-old International Code of Marketing of Breast-Milk Substitutes is mired by a series of alleged violations and boycotts, which are counter productive to the code’s goal. "


The article focuses much on a reference to the need for  'cooperation' in the introduction to the Code and goes on to suggest that  there was an "aspiration of collective cooperation"   that had not been fulfilled. However a key aspect that is ignored are the many World Health Assembly Resolutions that have been  adopted since 1981, which address conflicts of interest - especially in the monitoring process. 


The author proposes a  governance body but does not explain how this would work, or whether it would monitor the current UK legislation or the full International Code -  two very different things!  


The article refers to 'self-appointed monitoring groups who have 'opportunistically'  elected to fill this vacuum" as if all those who carry out the obligation to monitor (outlined in article 11.4) do so out of self-interest. 


The article fails to mention that  Baby Milk Action and its partners has been working successfully over decades for effective implementation of the International Code and subsequent, relevant Resolutions of the World Health Assembly, and that these have been introduced in legislation in over 60 countries. Where these laws are being monitored and enforced, they are having a significant impact. For example, median breastfeeding duration has increased in Brazil from less than 3 months in the 1970s to over 10 months today.


The article fails to acknowledge the ongoing communication with the companies that exists and the many times Nestle has been asked  to set out its terms and conditions for an independent, expert tribunal to investigate claim and counter claim. It has repeatedly refused to do. Our current campaign asking members of the public to email the company over its latest global marketing strategy where it claims its formula 'protects' babies and is 'The new "Gold Standard" in infant nutrition', would not have been necessary if Nestlé had respected the Code, which clearly prohibits such practices. Nestlé continues to defend the very misleading practice.



The article does not  mention the existing international system of the UN Global Compact and the OECD Guidelines for Multinational Enterprises which are worse than useless, because  they are voluntary and the bodies responsible for them refuse to investigate reports of violations.  The result is that they simply provide public relations cover to companies. (As a member of the UN System Standing Committee on Nutrition Task Force on Food Security, we developed proposals for strengthening the international framework, which are included in the publication, Global Obligations for the Right to Food.) 


Useful links:




Below  are some excerpts from resolutions which refer to the need for truly independent monitoring -  an aspect of the Code that cannot really  be done  'in collaboration' with companies! 


Resolution WHA 49.15 adopted in 1996

Preambular para: “Concerned that health institutions and ministries may be subject to subtle pressure to accept, inappropriately, financial or other support for professional training in infant and child health” 

urged Member States to ensure that:

"financial support for professionals working in infant and young child health does not create conflicts of interest."

"monitoring carried out in a transparent and independent manner, free from commercial influence.”        


then again


Resolution (WHA 54.2 ) passed in 2001

REQUESTS the Director-General:

(2) to foster, with all relevant sectors of society, a constructive and transparent dialogue in order to monitor progress towards implementation of the International Code of Marketing of Breastmilk Substitutes and subsequent relevant Health Assembly resolutions, in an independent manner and free from commercial influence, and to provide support to Member States in their efforts to monitor implementation of the Code;


Resolution WHA58.32  2005

Urges Member States:  "to ensure that financial support and other incentives for programmes and health professionals working in infant and young child health do not create conflicts of interest".


2008 resolution on infant and young child nutrition, WHA 61.20  urges Member States to scale up efforts to monitor and enforce  national measures to implement the International Code and its resolutions,  "while keeping in mind the WHA resolutions to avoid conflicts of interest". 













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