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ACTA PAEDIATRICA SCANDINAVICA. 1988 Mar; 77(2):183-90.The acceptance of the World Health Organization (WHO) International Code for Marketing of Breastmilk Substitutes has stimulated governments to design programs for the more energetic promotion of breastfeeding, but promotional efforts in developing nations may not be getting through to the mothers or may not be designed to meet their specific needs. In a prospective study in Istanbul, it was observed that all infants, whether delivered in a hospital or at home, received not only mixtures of sugar and water and other mixtures soon after birth and for about 1 week thereafter, but also complementary foods now and then until this became a regular practice. This pattern can be defined as regular complementary feeding or partial breastfeeding. Yet, the mothers described it as exclusive breastfeeding. The early and haphazard introduction of water and food in those environments where contamination is common exposes the infants to concentrated amounts of microorganisms which may overwhelm the immunological protection provided by breastmilk and also reduces the milk supply through insufficient stimulation of the breast. Exclusive breastfeeding should be encouraged, and irregular complementary feedings during the early weeks of life should be strongly discouraged, unless there is a medical indication. When exclusive breastfeeding is no longer sufficient, i.e., at the age of about 5 months, complementary feeding should be promoted. Programs for the promotion of breastfeeding have been criticized for devoting too much attention to the infant and little or no attention to the needs of the mother. In a given society, it may be difficult to promote breastfeeding if women regard it as a means of preventing them from improving their socioeconomic situation. Women who want to breastfeed their children should not be prevented from doing so by their working conditions.
JORDEMODERN. 1987 Jun; 100(6):172-3.As long as breast-feeding in the developing and developed countries is threatened by bottle-feeding and too early introduction of supplementary diets, the discussion about how breast-feeding is best protected must be kept alive within the organizations and the mass media. Representatives of the Swedish private organizations' foreign assistance programs participated in a seminar on April 3, 1987 in Stockholm, arranged by the Nordic Work Group for International Breast-Feeding Questions in cooperation with International Child Health (ICH). Breast-feeding increased strongly in Sweden during the 1970s, but bottle-feeding is still the norm in large parts of Europe and continues to increase in the developing countries. 6 years have passed since the international code for marketing of breast milk substitutes (even called the child food code) was approved by WHO, in 1981. It contains rules that limit companies' marketing efforts and establish responsibilities and duties that apply to health personnel. The application of these rules is slow and differences between company policies and practice exist. In a larger perspective, we are dealing with the position and significance of woman and children within the family and society. During a WHO meeting in 1986, a resolution was adopted that reinforces the content of the code, e.g., it stops the distribution of free breast milk substitutes to the hospital, where free samples are often given to leaving mothers. The WHO countries also expressed negative feeling toward marketing child food during a period where breast-feeding may be affected negatively. How the resolution is going to be implemented in Sweden is not yet known. There are signs that even in Sweden the existence of the code is being forgotten. The seminar participants recommended that the Social Board issue a simplified and easily read reminder about the code for wider distribution in Sweden.