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Natalie Clauss

That's why we need the WHO Code

Breastfeeding is political.

This is the title of Gabrielle Palmer's book, translated from English. Yes, actually everything is political. I know that.

But what does breastfeeding have to do with politics?

Feeding babies has become a business. The first formula food, i.e. milk substitute food for babies, was available from the middle of the 19th century and became known as soup for babies. Compared to the history of mankind, that was not so long ago.

Aufnahme eines Glases mit Milch.

Over the next few decades and less than two centuries in total, more and more businessmen sensed the big money. There were strange mixtures and opaque promises. Companies influenced not only mothers, but also doctors and clinics with free samples and much more.

The role of advertising and the influence of company policies on breastfeeding became increasingly clear. Breastfeeding rates fell, families faced a major financial burden and children were at risk of poor health. In 1981, the WHO Code of Marketing of Breast-milk Substitutes was therefore adopted.

The aim of the Code is to promote breastfeeding and to provide appropriate information where substitutes are necessary. I often encounter resistance when I talk about the Code. Women feel they have to justify the fact that they are not (no longer/only) breastfeeding.

Aufnahme eines stillenden Babys.

But the Code is not about condemning. It's not about demanding breastfeeding at all costs and portraying everything else as bad. The Code of Marketing of Breastmilk Substitutes is about mothers and pregnant women being able to make a fact-based decision that is not influenced by advertising promises.

And by the way, as I'm writing these lines, I'm seeing ads for follow-on milk on Instagram. This shows me once again how topical and important the issue is.

But what does the Code actually say?

I will briefly describe the most important points set out in the WHO Code below.

There must be no public advertising for any breastmilk substitutes. This applies to formula (ready-to-drink and powdered) as well as bottles and teats. There must also be no advertising in healthcare facilities such as surgeries and clinics or to other medical staff. This includes free samples or any discounts. This includes, for example, free nursing pads, soothers, pens, notepads and brochures.

All content must be scientifically correct, i.e. reflect the current state of knowledge and must not constitute advertising. The marketing of complementary foods must not portray breastfeeding as meaningless.

Manufacturers' packaging must contain clear, comprehensible and complete content and instructions. Feeding with a bottle or formula must not be idealized and baby pictures must not be shown on the packaging.

The products as a whole must comply with the quality and safety standards of the WHO. In Germany, the corresponding EU regulation is legally binding and can be viewed by everyone.

Aufnahme eines Babys, welches mit der Flasche gefüttert wird.

Companies always have a duty to comply with the code, even if a government does not. (Unfortunately, I am not aware of any company that complies with the Code.) At the same time, governments have an obligation to provide objective and comprehensible information on infant nutrition. Conflicts of interest should be avoided.

The Code and its implementation

Even if countries have signed the Code, this does not mean that they will adhere to it. For this to be the case, the Code would have to be enshrined in the relevant law. The extent to which this is the case varies greatly.

In Germany, for example, parts of it are legally binding, while others are not. Here, infant formula such as PRE or formula 1 may not be advertised, but follow-on formula and so-called children's milk may be.

Aufnahme einer Skulptur von Justitia.

Overall, Germany is in the middle of the field in terms of implementation. In other countries, the entire Code is enshrined in law. In these countries, there has since been a significant increase in breastfeeding rates, as well as an improvement in the health of mother and child. This is particularly significant for countries with difficult medical care or a high level of poverty, when this means that medical care is not utilized.

Of course, it would be easy to say that we have a relatively good healthcare system in Germany and are therefore not dependent on the Code. But put another way: what do we lose if the Code is implemented?

Companies lose revenue, yes. But what do we lose as a society? What do mothers, fathers and children lose? I can't think of any argument that would show that we as a society and as individuals would be at a disadvantage if the Code were fully legally binding.


In this article, I have shared with you some of my thoughts on the Code of Marketing of Breastmilk Substitutes. I have described what the Code is and what it says.

At this point, it is important for me to emphasize once again that everyone, except the companies concerned, would benefit from full implementation. Safe nutrition with formula is just as much the goal as the promotion of breastfeeding itself.

What are your thoughts on the subject? I look forward to reading about them in the comments!

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