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Does the International Code of Marketing of Breast-milk Substitutes applies for Ready to Use commercially produced complementary foods ?

This question was posted the Infant and young child feeding interventions forum area and has 5 replies.

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Anonymous 31123

Irish Aid

Normal user

17 Jan 2019, 14:50

this question is regarding how the Code applies to commercially produced complementary foods and if they could be used as a demonstration method by health workers for introducing complementary food to children +6months in the health sector as an alternative for real food demonstrations in settings where this is not possible. Intended purpose of the ready to use complementary food is to showcase mothers on hygiene, food groups and consistency of complementary food, not as sale or marketing. Does this comply with the code?

Alessandro Iellamo

Save the Children UK

Normal user

17 Jan 2019, 15:09

Thanks for this important question.

Now, when looking at the Code please note that we need to look at the 1981 recommendations and all the subsequent relevant WHA Resolutions;

There is excellent guidance on the Code and the Inappropriate marketing of foods for infants and young child feeding:

I strongly recommend you and all of us gets familiar with it. All Member States have endorsed this guidance.

So, the question you raised may have different answers according to:

a. what products?
b. do the products that you intend to use comply with the Code requirements as well as the Guide I just share?
b. what brands?
c. what ages?
d. why using a commercial product? why not a fresh/locally available in the market?
if as you say the fresh ones are not available? but will the mothers be able to access what you use in the demonstration?

and more more questions ...before I even attempt to answer...your question

In general the Code does not cover complementary foods ....but covers the way they are marketed and promoted.

Please also note that the IYCF-E Ops Guidance (2017) provides clear recommendations on complementary feeding during emergencies, in case there is a plan to provide such support to families

The general principle please is really to look at all the implications of our actions, even when well motivated

Happy to discuss farther



Normal user

17 Jan 2019, 16:02

I would agree with Alessandro. As part of my work in India and Kenya, we do Complementary feeding demonstrations all the time. We use locally available foods and demonstrate how to make them more nutrient dense, and how to incorporate different food groups in their childrens' diets.

Another drawback to using commercially available foods to carry out such demonstrations is that families think that the commercially available foods are superior to their local diets (no matter what you say otherwise).

If the circumstances permit, start with what families in that area (where are you conducting these demonstrations, by the way?) typically feed their children.

I'd be happy to answer more queries, if you'd like



Consultant Paediatrician/Professor of Paediatrics

Normal user

17 Jan 2019, 22:44

Does the International Code of Marketing of Breast-milk Substitutes applies for Ready to Use commercially produced complementary foods ?
My response is YES:

At the SIXTY-NINTH WORLD HEALTH ASSEMBLY through its provision agenda item 12.1 of 13th May, 2016 (A69/7 Add.1) and titled " Guidance on ending the inappropriate promotion of foods for infants and young children" this issue was clarified by the definition of "foods"as follows:
"2. The term “foods” is used in this guidance to refer to both foods and beverages (including complementary foods). Guidance on the inappropriate promotion of breast-milk substitutes is contained in the Code of Marketing of Breast-milk Substitutes and subsequent relevant Health Assembly resolutions. The current document does not replace any provisions in the Code but clarifies the inclusion of certain products that should be covered by the Code and subsequent resolutions.
3. This guidance applies to all commercially produced foods that are marketed as being suitable for infants and young children from the age of 6 months to 36 months. Products are considered to be marketed as being suitable for this age group if they (a) are labelled with the words “baby”, “infant,” “toddler” or “young child”; (b) are recommended for introduction at an age of less than 3 years; (c) have a label with an image of a child who appears to be younger than 3 years of age or feeding with a bottle; or (d) are in any other way presented as being suitable for children under the age of 3 years. This approach is in line with the relevant Codex guidelines and standards on foods for infants and young children that refer to young children up to the age of 3 years.1"
Consequently, the use of commercially prepared ready to use complementary food is prohibited by the Code and Subsequent WHA resolutions. Another challenge with using a commercially prepared complementary food is the fact that it tends to convey the message that the brand has been adopted for use for infants and young children and its use will be inadvertently promoted to the detriment of breastfeeding and the use of locally available complementary foods.

Anonymous 31123

Irish Aid

Normal user

18 Jan 2019, 09:07

Thank you all for the clarification.

Adding on to the questions posed by Allesandro:

The commercially complementary food used for the YICF education session at the health centres is a cereal based fortified pre-mix blended food. It is used during the under5yrs health days at the facilities to showcase mothers on how to make complementary food for children above 6months. It is manufactured by a local food company. The product label is revealing the nutritional content and method of use as well stating that this is only suitable for children 6+ months. Producer's name is also mentioned on the label. The company also have a similar market product (other name) which differs from this product as it does not contain the added micronutrients.
My concern is mainly on recommendation 5 and 6 (cross-promotion and conflict of interest) of the WHA 2016 Guidance note on ending the inappropriate promotion of foods for infants and young children, and that this practice is not in compliance with those recommendations?

Anonymous 2778

Normal user

18 Jan 2019, 09:56

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 bottlefed 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; feeding bottles and teats. It also applies to their quality and availability, and to information concerning their use.

So long as the manufacturers and distributors of the products do not promote them as being suitable for use as partial or total replacements for breast milk, the code's provisions concerning limitations on advertising and other promotional activities do not apply to these products.

However, the best option is to do feeding demonstrations using local foods since they are more sustainable, cheaper and relatively less expensive than ready to eat packets. however, in cases they can be used if the content is close to premixes and are not high in sugar, sugar or unhealthy fats (labels present). More so, the information must be supplemented with alternatives available. I say this since there are other packaged foods also readily available in the market which are uncontrolled and if mothers dont have time to cook, they will feed their children convenience foods. so there is a need to weigh the risks in the community settings.

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