(Protecting breast feeding from breast milk substitutes)
In an accompanying editorial in this week's BMJ, Dr Anthony Costello, from the Institute of Child Health, says that like the tobacco companies, the promotional activities of the baby milk manufacturers will only be brought into line when they face substantial claims for damages from consumers. He suggests that in the meantime countries and monitoring agencies can take four steps to prevent commercial pressures being placed on mothers.
Firstly, Costello advocates that governments should incorporate the articles of the code of marketing substitutes for breast milk into national legislation. Secondly, he suggests that monitoring for overt violations should be more systematic in an attempt to deter such promotional activities. The author believes that doctors should also be warned that the baby milk manufacturers try to gain endorsement by association' by allying themselves with prestigious national bodies, such as by sponsoring a paediatric conference.
Finally, Costello accepts that, as with antismoking campaigns, legislation and monitoring are only part of the broader strategy to protect mothers and that positive public opinion towards breast feeding may be even more crucial. He says that training midwives and doctors in lactation counselling (including guidance for HIV positive mothers); breast feeding advertisements; an extension of the baby friendly hospital initiative and financial support for advocacy groups could all go some way to counteract the manufacturers' propaganda.
Dr Anthony Costello, Reader in International Child Health, Institute of Child Health, University College, London
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Professor Harshpal Sachdev, Division of Clinical Epidemiology. Department of Paediatrics, Maulana Azad medical College, New Delhi, India