Ambrosone CB, Zirpoli G, Ruszczyk M Parity and breastfeeding among African-American women: differential effects on breast cancer risk by estrogen receptor status in the women's circle of health study. Cancer Causes Control. 2014; 259-265

Baby Feeding Law Group Ireland. 40 Years of the WHO Code. 2020. (accessed 10 March 2022)

Baby Friendly Initiative. Breastfeeding in the UK - baby friendly initiative. 2022. (accessed 15 June 2022)

Baerug A, Sletner L, Laake P Recent gestational diabetes was associated with mothers stopping predominant breastfeeding earlier in a multi-ethnic population. Acta Paediatr. 2018; 107:(6)1028-1035

Both D. Der Internationale Kodex zur Vermarktung von Muttermilchersatzprodukten: Entstehungsgeschichte, Inhalt und Bedeutung. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz. 2018; 61:1008-1011

Calin MF, Sandu ML, Neagu VR. The importance of breastfeeding on the development of the mother-child relationship from an emotional point of view. Tech Soc Sci. 2021; 23:467-489

Eidelman AI, Schanler RJ, Johnston M Breastfeeding and the use of human milk. Pediatrics. 2012; 129:e827-e841

Gibbs G. Learning by doing: a guide to teaching and learning methods.Oxford: Further Education Unit; 1988

Health and Safety Executive. Working within the code HSE policy on the marketing of breast milk substitutes a guide for staff. 2021. (accessed 14 June 2022)

Heinig MJ. The international code of marketing of breastmilk substitutes: the challenge is choice. J Hum Lact. 2006; 22:265-266

Liu B, Jorm L, Banks E. Parity, breastfeeding, and the subsequent risk of maternal type 2 diabetes. Diabetes Care. 2010; 33:1239-1241

Martin GP, Finn R. Patients as team members: opportunities, challenges and paradoxes of including patients in multi-professional healthcare teams. Sociol Health Illn. 2011; 33:1050-1065

Palmer G. The politics of breastfeeding.London: Pinter & Martin Ltd; 2009

Palmer G, Arendt M. An interview with Gabrielle Palmer, campaigner author and nutritionist, who learned from women around the world. J Hum Lact. 2021; 37:449-455

Soldavini J, Taillie LS. Recommendations for adopting the international code of marketing of breast-milk substitutes into U.S. policy. J Hum Lact. 2017; 33:582-587

UNICEF. The international code of marketing of breastmilk substitutes. 2021. (accessed 12 March 2022)

UNICEF Ireland. Ireland's Breastfeeding rates worst in the world. 2022. (accessed 15 June 2022)

UNICEF, World Health Organization. Joint Statement by UNICEF Executive Director Henrietta Fore and WHO Director-General Dr. Tedros Adhanom Ghebreyesus on the 40th anniversary of the adoption of the International Code of Marketing of Breastmilk Substitutes. 2021. (accessed 16 June 2022)

Vogt F, Schwappach DLB, Bridges JFP. Accounting for tastes: a German perspective on the inclusion of patient preferences in healthcare. PharmacoEconomics. 2006; 24:419-423

World Health Organization. International code of marketing of breast-milk substitutes. 1981. (accessed 10 March 2022)

World Health Organization. Marketing of breast-milk substitutes: national implementation of the international code status report 2020. 2020. (accessed 14 June 2022)

World Health Organization. Infant and young child feeding. 2021. (accessed 14 June 2022)

Understanding the code

02 July 2022
7 min read
Volume 30 · Issue 7


Omobolanle Adeyela, a student midwife, uses Gibbs' reflective cycle to understand the international code of marketing of breastmilk substitutes

My third year elective placement was centred on increasing my knowledge in relation to the international code of marketing of breastmilk substitutes (known as the code) (World Health Organization (WHO), 1981). In 2021, the code marked its 40th anniversary. The code is a guideline developed by the WHO to protect and promote breastfeeding for mother, infant and family. The code is designed to stop commercial interests endangering the health and wellbeing of infants. The code ensures that when human milk substitutes are required, they are used properly through adequate information and appropriate marketing and distribution (Soldavini and Taillie, 2017).

The purpose of the code is to restrict marketing and advertising of breastfeeding substitutes, such as formula milk, teats, bottles, baby foods marketed for use before 6 months (eg cereals, juices or baby teas) and soothers to mothers, families and wider public/society. The reason for this is that exposure to formula marketing can affect exclusive breastfeeding, informed choice in relation to infant feeding methods or the choice not to breastfeed (Heinig, 2006). The code ensures that women and their families have the necessary factual information to make a decision that is right for their family.

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