INDIAN NATIONAL CODE FOR PROTECTION AND PROMOTION OF BREAST-FEEDING

Item

Title: INDIAN NATIONAL CODE
FOR
PROTECTION AND PROMOTION
OF
BREAST-FEEDING
extracted text: CH 1.2COMMUNITY BTALTH CEU
47/1,(First Floor)Sc. Marks Ro«&
8ANGAkO.it: -560 001

INDIAN NATIONAL CODE
FOR

PROTECTION AND PROMOTION
OF

BREAST-FEEDING

GOVERNMENT OF INDIA
MINISTRY OF SOCIAL WELFARE
NEW DELHI

[Copy of Ministry of Social Welfare,
Government of India,
Resolution No. 18-11/81-NT
dated 19 December 1983]

Indian National Code for Protection and
Promotion of Breast-feeding
The Government of India affirms the right of every child
to be adequately nourished as a means of attaining and
maintaining health. Infant malnutrition is a major contri
butory cause of high incidence of infant mortality and
physical and mental handicaps. The health of infants, and
young children cannot be isolated from the health and
nutrition of women. The mother and her infant form a bio
logical unit. Breast-feeding is an integral part of the
reproductive process. It is the natural and ideal way of feeding
the infant and provides a unique biological and emotional
basis for healthy child development. The anti-infective
properties of breast-milk protect infants against disease. The
effect of breast-feeding on child-spacing, on the health and
well-being of the mother, on family health, on family and
national economy and on food production is well-recognised.
Breast-feeding is, therefore, a key aspect of self-reliance and
primary health care. It is the nation’s responsibility to
encourage and protect breast-feeding, and to protect pregnant
women and lactating mothers from any influence that could
disrupt it. Inappropriate feeding practices lead to infant
malnutrition, morbidity and mortality in our children.
Promotion of breast-milk substitutes and related products like
feeding bottles and teats do constitute a health hazard.
Promotion of breast-milk substitutes and related products has
been more extensive and pervasive than the promotion of

information concerning the advantages of breast-milk and
breast-feeding, and contributes to decline in breast-feeding. In
the absence of strong interventions designed to protect,
promote and support breast-feeding, it can be anticipated that
this decline will continue, and that even larger numbers of
infants and young children will be placed at risk of infections,
malnutrition and death. Only when young infants cannot be
breast-fed, and when other sources of human milk are
unavailable, other food becomes necessary. It is important for
infants to receive appropriate complementary foods, usually
when the infant reaches four to six months of age, and the
emphasis should be placed on local foods and traditional
practices, complemented only when necessary, and under
proper guidance, by industrially processed products. Govern
ment appreciates that, guided by the highest considerations
for the proper nutrition and health of the World’s children,
the World Health Assembly adopted in May 1981, an
International Code of Marketing of Breast-Milk Substitutes.
Government recognises that this code, although an important
measure to regulate production and marketing of products
which interfere with breast-feeding, is only one aspect of the
measures government should undertake to protect and
promote the healthy growth and development of infants and
young children.
Educational systems, social services, families, commu
nities, women’s organisations and other non-governmental
organisations should be involved in the protection and
promotion of breast-feeding and other activities aimed at the
improvement of maternal, infant and young child health and
nutrition. In the light of the foregoing considerations, and in
view of the vulnerability of infants in the early months of life
and the risks involved in the inappropriate feeding practices,
including the unnecessary and improper use of breast-milk
substitutes and feeding accessories, it is necessary to regulate
the marketing of such products. Government, therefore,
resolves to adopt the following Code:
2

Article 1. Aim of the Code
The aim of this Code is to contribute to the provision of
safe and adequate nutrition for infants, by the protection and
promotion of breast-feeding, 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.

Article 2. Scope of the Code
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.

Article 3. Definitions
For the purposes of this Code:

“Breast-milk
substitute”

means

any food being marketed or otherwise represented as a partial or
total replacement for breast-milk,
whether or not suitable for that
purpose.

“Complementary food”

means

any food, whether manufactured
or locally prepared, suitable as a
complement to breast-milk or to
infant formula, when either be
comes insufficient to satisfy the
nutritional requirements of the
infant. Such food is also com
monly called “weaning food” or
“breast-milk supplement”.
3

“Container”

means

any form of packaging of products
for sale as a normal retail unit,
including wrappers.

“Distributor”

means

a person, corporation or any
other entity in the public or pri
vate sector engaged in the business
(whether directly or indirectly) of
marketing at the wholesale or
retail level a product within the
scope of this Code. A “primary
distributer” is a manufacturer’s
sales
agent,
representative,
national distributor or broker.

“Health
care system”

means

governmental, non-governmental
or private institutions or organi
sations engaged, directly or
indirectly, in health care for
mothers, infants and pregnant
women; and nurseries or child
care institutions. It also includes
health workers in private practice.
For the purpose of this Code, the
health care system does not
include pharmacies or other
established sales outlets.

“Health worker” means

a person working in a component
of such a health care system,
whether professional or non
professional, including voluntary,
unpaid workers.

“Infant formula” means

a breast-milk substitute formu
lated industrially in accordance
with applicable ISI standards, to
satisfy the normal nutritional

“Label”

“Manufacturer”

“Marketing”

“Marketing
personnel”

requirements of infants up to
between four and six months of
age, and adapted to their physio
logical characteristics. Infant
formula may also be prepared at
home, in which case it is
described as “home prepared”.
means any tag, brand, mark, pictorial or
other descriptive matter, written,
printed, stencilled, marked, em
bossed or impressed on, or
attached to, a container (see
above) of any products within the
scope of this Code.
means a corporation or other entity in
the public or private sector
engaged in the business or
function (whether directly or
through an agent or through an
entity controlled by or under
contract with it) of manufacturing
a product within the scope of this
Code.
means product promotion, distribution,
selling, advertising, product pub
lic relations, and information
services.
means Any persons whose functions
involve the marketing of a
product or products coming
within the scope of this Code.

“Samples”

means

single or small quantities of a
product provided without cost.

“Supplies”

means

quantities of a product provided
for use over an extended period,
free or at a low price, for special
purposes, including those pro
vided to families in need.

Article 4. Information and education
4.1 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.
4.2 Informational and educational materials, whether
written, audio, or visual, dealing with the feeding of infants
and intended to reach pregnant women and mothers of
infants and young children, should include clear information
on all the following points: (a) the benefits and superiority of
breast-feeding; (b) maternal nutrition, and the preparation for
and maintenance of breast feeding; (c) the negative effect on
breast-feeding of introducing partial bottle-feeding; (d) the
difficulty of reversing the decision not to breast-feed; and (e)
where needed, the proper use of infant formula, whether
manufactured industrially or home-prepared. When such
materials contain information about the use of infant formula,
they should include the social and financial implications of its
use; the health hazards of inappropriate foods or feeding
methods; and, in particular, the health hazards of unnecessary
or improper use of infant formula and other breast-milk
substitutes. Such materials should not use any pictures or text
which may idealize the use of breast-milk substitutes.
4.3 Donations of informational or educational equipment
or materials by manufacturers or distributors should be made
only at the request and with the written approval of the
appropriate government authority or within guidelines given
by government for this purpose. Such equipment or materials
may bear the donating company’s name or logo, but should
not refer to a proprietary product that is within the scope of
this Code, and should be distributed only through the health
care system.

6

Article 5. The general public and mothers
5.1 There shall be no advertising or other form of
promotion to the general public of products within the
scope of this Code.

5.2 Manufacturers and distributors should not provide,
directly or indirectly, to anybody, samples of products within
the scope of this Code.
5.3 In conformity with paragraphs 1 and 2 of this Article,
there should be no point-of-sale advertising, giving of samples,
or any other promotion device to induce sales directly to the
consumer at the retail level, such as special displays, discount
coupons, premiums, special sales, loss-leaders and tie-in-sales,
for products within the scope of this Code. This provision
should not restrict the establishment of pricing policies and
practices intended to provide products at lower prices on a
long-term basis.

5.4 Manufacturers and distributors should not distribute
to pregnant women or mothers of infants and young children
any gifts of articles or utensils which may promote the use of
breast-milk substitutes or bottle-feeding.
5.5 Marketing personnel, in their business capacity,
should not seek direct or indirect contact of any kind
with pregnant women or with mothers of infants and young
children.

Article 6. Health care systems
6.1 The health authorities in the country should take
appropriate measures to encourage and protect breast-feeding
and promote the principles of this Code, and should give
appropriate information and advice to health workers in
regard to their responsibilities, including the information
specified in Article 4.2.

7

6.2 No facility of a health care system should be used for
the purpose of promoting infant formula or other products
within the scope of this Code. This Code does not, however,
preclude the dissemination of information to health
professionals as provided in Article 7.2.
6.3 Facilities of health care systems should not be used for
the display of products within the scope of this Code, for
placards or posters concerning such products, or for the
distribution of material provided by a manufacturer or
distributor other than that specified in Article 4.3.

6.4 The use by the health care system of “professional
service representatives”, “mothercraft nurses” or similar
personnel, provided or paid for by manufacturers or dis
tributors, should not be permitted.
6.5 Feeding with infant formula, whether manufactured
or home-prepared, should be demonstrated only by health
workers, or other community workers if necessary; and only
to the mothers or family members who need to use it; and the
information given should include a clear explanation of the
hazards of improper use.

6.6 Donations or low-price sales to institutions or
organizations of supplies of infant formula or other products
within the scope of this Code, whether for use in the
institutions or for distribution outside them intended for the
recuperation of malnourished children and other medical
reasons or for the infants of mothers who cannot breast-feed
and who cannot afford to purchase adequate amounts, may be
made. If these supplies are distributed for use outside the
institutions, this should be done only by the institutions or
organisations concerned. Such donations or low-price sales
should not be used by manufacturers or distributors as a sales
inducement.
6.7 Where donated supplies of infant formula or other
products within the scope of this Code are distributed outside
8

an institution, the institution or organization should take steps
to ensure that supplies can be continued as long as the infants
concerned need them. Donors, as well as institutions or
organizations concerned, should bear in mind this res
ponsibility.
6.8 Equipment and materials, in addition to those
referred to in Article 4.3, donated to a health care system may
bear a company’s name or logo, but should not refer to any
proprietary product within the scope of this Code.

Article 7. Health workers
7.1 Health workers should encourage and protect breast
feeding; and those who are concerned in particular with
maternal and infant nutrition should make themselves
familiar with their responsibilities under this Code, including
the information specified in Article 4.2.

7.2 Information provided by manufacturers and dis
tributors to health professionals regarding products within
the scope of this Code should be restricted to scientific and
factual matters, and such information should not imply or
create a belief that bottle-feeding is equivalent or superior to
breast-feeding. It should also include the information specified
in Article 4.2.
7.3 No financial or material inducements to promote
products within the scope of this Code should be offered by
manufacturers or distributors to health workers or members of
their families, nor should these be accepted by health workers
or members of their families.

7.4 Manufacturers and distributors of products within the
scope of this Code should disclose to the institution to which a
recipient health worker is affiliated any contribution made to
him or on his behalf for fellowships, study tours, research
grants, attendance at professional conferences, or the like.
Similar disclosures should be made by the recipient.

9

Article 8. Persons employed by
manufacturers and distributors
8 1 m systems ofsales incentives for marketing personnel,
the volume ofsales 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.
This should not be understood to prevent the payment of
bonuses based on the overall sales by a company of other
products marketed by it.
8.2 Personnel employed in marketing products within
the scope of this Code should not, as part of their job
responsibilities, perform educational functions in relation to
pregnant women or mothers of infants and young children.
This should not be understood as preventing such personnel
from being used for other functions by the health care system
at the request and with the written approval of the appropriate
authority of the government concerned.

Article 9- Labelling
9.1 Labels should be designed to provide the necessary
information about the appropriate use of the product, and so
as not to discourage breast-feeding.

9-2 Manufacturers and distrubtors of infant formula
should ensure that each container has a clear, conspicuous,
and easily readable and understandable message printed on it,
or on a label which cannot readily become separated from it,
in an appropriate language, which includes all the following
points:
(a)

the words “Important Notice” or their equivalent;

(b)

a statement of the superiority of breast-feeding;

(c) a statement that the product should be used only on the
advice of a health worker as to the need for its use and the
proper method of use;
10

(d) instructions for appropriate preparation, and a warning
against the health hazards of inappropriate preparation.
Neither the container nor the label should have pictures of
infants, nor should they have other pictures or text which may
idealize the use of infant forumla. They may, however, have
graphics for illustrating methods of preparation. The’terms
“humanized”, “maternalized” or similar terms should not be
used. Inserts giving additional information about the product
and its proper use, subject to the above conditions, may be
included in the package or retail unit. When labels give
instructions for modifying a product into infant formula, the
above should apply.

9-3 Food products within the scope of this Code,
marketed for infant feeding, which do not meet all the
requirements of an infant formula, but which can be modified
to do so, should carry on the label a warning that the
unmodified product should not be the sole source of
nourishment of an infant. Since sweetened condensed milk is
not suitable for infant feeding, nor for use as a main ingredient
of infant formula, its label should not contain purported
instructions on how to modify it for that purpose.

9.4 The label of food products within the scope of this
Code should also state all the following points: (a) the
ingredients used; (b) the composition/analysis of the product;
(c) the storage conditions required; and (d) the batch number
and the date before which the product is to be consumed,
taking into account the climatic and storage conditions of the
country.

Article 10. Quality
10.1 The quality of products is an essential element for
the protection of the health of infants and therefore should be
of a high recognized standard.
10.2 Food products within the scope of this Code should,

11

when sold or otherwise distributed, meet applicable ISI
standards.

Article 11. Implementation and monitoring
11.1 Government shall give effect to the principles and
aim of this Code through legislation and other suitable
measures. National policies and measures, including laws,
which are adopted to give effect to the principles and aim of
this Code, shall be publicly stated, and shall apply on the same
basis to all those involved in the manufacture and marketing
of products within the scope of this Code.
11.2 The manufacturers and distributors of products
within the scope of this Code, and appropriate non
governmental organizations, professional groups, and
consumer organisations are expected to collaborate with
government in the implementation of this Code.
11.3 Independently of any other measures taken for
implementation of this Code, manufacturers and distributors
of products within the scope of this Code should regard
themselves as responsible for monitoring their marketing
practices according to the principles and aim of this Code, and
for taking steps to ensure that their conduct at every level
conforms to them.

11.4 Non-governmental organizations, professional
groups, institutions, and individuals concerned should draw
the attention of manufacturers or distributors to activities
which are incompatible with the principles and aim of this
Code, so that appropriate action can be taken. The appropriate
governmental authority should also be informed.
11.5 Manufacturers and primary distributors of products
within the scope of this Code should apprise each member of
their marketing personnel of the Code and of their res
ponsibilities under it.
12

Media: SDA-RF-CH-1.2.pdf

Position: 391 (15 views)