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Indian National Code for Protection and Promotion of Breast-feeding. [Resolution No. 18-11/81-NT dated 19 Dec 1983].
Indian Pediatrics. 1984 Mar; 21(3):259-64.The objective of the Indian National Code for Protection and Promotion of Breastfeeding is to contribute to the provision of safe and adequate nutrition for infants by the protection and promotion of breastfeeding and by ensuring the proper use of breast milk substitutes, when these are necessary, on the basis of adequate information and through appropriate marketing and distribution. The Code applies to the marketing and practices related thereto, of the following products: breast milk substitutes, including infant formula; other milk products, foods, and beverages, including bottle fed complementary foods, when marketed or otherwise represented to be suitable, with or without modification, for use as a partial or total replacement of breast milk; and feeding bottles and teats. It also applies to their quality and availability and to information about their use. Article 4 of the Code maintains that the government shall ensure that objective and consistent information is provided on infant and young child feeding for use by families and those involved in the field of infant and young child nutrition. This responsibility shall cover the planning, provision, design, and dissemination of information and their control. Informational and educational materials, whether, audio, or visual, should include clear information on the following: the benefits and superiority of breastfeeding; maternal nutrition and preparation for the maintenance of breastfeeding; the negative effect on breastfeeding of introducing partial bottle feeding; the difficulty of reversing the decision not to breastfeed; and where needed, the proper use of infant formula. According to the Code, there shall be no advertising or other form of promotion to the general public of products within the scope of the Code. Manufacturers and distributors should not provide, directly or indirectly, to anybody, samples of products within the scope of this Code. Other provisions of the Code include: health authorities should take appropriate measures to encourage and protect breastfeeding and promote the principles of the Code; health workers should encourage and protect breastfeeding; in systems of sales incentives for marketing personnel, the volume of sales of products within the scope of this Code should not be included in the calculation of bonuses, nor should quotas be set specifically for sales of these products; labels should be designed to provide the necessary information about the appropriate use of the product so as not to discourage breastfeeding; the quality of products is an essential element for the protection of the health of infants and should be of a high recognized standard; and the government shall give effect to the principles and objective of the Code through legislation and other appropriate measures.
Lancet. 1992 Oct 17; 340(8825):962-3.[The Indian] parliament has passed the Infant Milk Substitutes, Feeding Bottles and Infant Foods (Regulation of Production, Supply and Distribution) Bill, which, when it comes into force, will severely restrict the advertising and promotion of these baby products. Essentially the bill incorporates the contents of the International Baby Food code adopted by the World Health Assembly in 1981, but expands its scope to include infant foods--i.e., foods being marketed "as a complement to mother's milk to meet the growing nutritional needs of the infant after the age of 4 months". Apart from disallowing the advertising of these products, the bill prohibits the distribution of free samples and the offer of other inducements for promoting them. Donations of infant-milk substitutes and bottles may be made only to orphanages. The law also lays down stringent conditions for the labeling of baby foods and categorically bans the use of pictures of an infant or a woman or both, or the use of words such as "humanized" or "maternalized" in the information printed on the containers. All information material on the product must promote breastfeeding and stress the "financial and social implications" of using infant formulas and baby bottles. Further, manufacturers are forbidden from offering inducements to or fixing salaries of employees on the basis of volume of sales. Offenses under this act may be punishable by imprisonment for up to 3 years or a fine of up to Rs 500. Not surprisingly, baby-food manufacturers opposed the bill tooth and nail and succeeded in stalling it for a considerable time. There is, after all, a huge and growing market at stake. According to a Voluntary Health Association of India estimate, the market for baby foods, worth nearly Rs 7200 million (approximately 180 million pounds)--almost entirely shared between Amul, the manufacturing unit of a highly successful and pathbreaking Indian milk cooperative venture, and Nestle--is growing at 6%/year. The bill has had a long and interrupted passage. A diluted version was 1st introduced in Parliament in 1986, when it was passed by the Upper House but lapsed with the dissolution of the Lower House. The current version of the bill was introduced in January; again it lapsed with the dissolution of the House and was reintroduced in May. Institutions such as the Indian Academy of Pediatrics, the Consumer Guidance Society of India, and the Voluntary Health Association of India have endorsed the bill and have played a leading role in having it enacted in parliament. The question now is whether the law can be implemented successfully. The problems are many. For one, the law makes food inspectors appointed under the food Adulteration Act responsible for taking cognizance of any offenses under it. The already overworked and often corrupt inspection staff is hardly likely to take the new task seriously. Secondly, the bill makes illegal the use of the health system or its employees for the promotion or advertising of these baby products, which implies the existence of an agency that will monitor or at least keep watch over the functioning of the health system. There is no such agency and the proliferating private sector in health care is largely unregulated. And thirdly, there is the other side of the coin--restricting the promotion of baby food must be accompanied by creation of conditions that enable the vast majority of poor women to breastfeed. Such a task in a country where most women are forced to work in the unorganized sector would be colossal. (full text)