Breast pump companies and the WHO Code

photo by Jesse McClain

There is a belief in breastfeeding organizations that the WHO/UNICEF Code (International Code of Marketing of Breast-milk Substitutes) does not pertain to breast pump companies. In examining the original document written in 1981, I am rather surprised that breastfeeding advocates have come to that conclusion. In the beginning of this document breast-milk substitute is defined as, "any food being marketed or otherwise presented as a partial or total replacement for breast milk, whether or not suitable for that purpose."

http://www.who.int/nutrition/publications/code_english.pdf

Thus, I suppose a strict interpretation would be that legally this document is only directed at "food." Although it is also directed at bottles/bottle nipples. So it isn't just about food but also products involved in delivering alternative food to the infant/child. In 2003 UNICEF wrote a document called, "Global Strategy for Infant and Young Child Feeding." On page 10 of this document under the title, "Exercising other feeding options," they state: "For these few health situations where infants cannot, or should not, be breastfed, the choice of the best alternative-expressed breast milk from an infant's own mother, breastmilk from a healthy wet-nurse or a human-milk bank, or a breastmilk substitute fed with a cup, which is a safer method..." I would interpret this to mean that any mother who is not breastfeeding directly is using other feeding alternatives. And, thus pump companies are marketing alternatives to breastfeeding and therefore must comply with the WHO Code. UNICEF created this Code to "emphasize the importance of maintaining the practice of breast-feeding." (1981) Hasn't UNICEF in later years showed us that the view is that infant feeding options go in descending order of choice with breastfeeding the priority? Thus products marketed that endanger the practice of breast-feeding must be regulated? While breast pumps were created to maintain breastfeeding, they are a two-edged sword. The use of pumps carries a degree of risk. And the risk of breastfeeding failure is higher, if the pump was unnecessary from the start. If one takes a more flexible view of the WHO Code, I believe that one could present a good case for breast pump companies having to comply with the Code. So why are breastfeeding organizations taking a strict view of the Code and letting the pump companies off the hook? Possibly their legal advisers, view the law strictly and believe that all other legal adviser's and the courts would take a similar view. I would suggest that that is not necessarily true. It is also possible that this strict view is a reflection of the fears of "opening up a can of worms." Many breastfeeding organization events/conferences, professional journals and individual IBCLCs are funded by breast pump companies. Pump companies would not be happy about some of the rules of the Code (no advertising products to the public, no promotion of products to health-care facilities, no gifts or personal samples to health workers).

Of course an issue that overshadows this quite a bit is the fact that one pump company has decided to patent their invention of a human milk fortifier using human milk--Medela. They have patent applications in the US, Australia. etc. They had a European patent on the fortifier but lost the patent because they didn't pay the fees on time. But, of course, these patent applications will never be discussed publicly in breastfeeding organizations. Was it Shakespeare that said, "The world is a stage."? Find a mask and play the game.

copyright 2008 Valerie W. McClain