WHO Code-and violators
I would like to people to especially those in the United States, ask
what the WHO code means and how and who should interpret it. I
struggle with how Evenfloe can be code compliant (visit their web
site) and how another company that has only a bottle with a nipple on
it is a violater.  The CODE states "such materials should not use any
pictures or text which may idealize the use of breastmilk
substitutes." What does the word  "idealize" really mean?
One definition of idealize is: to consider or represent (something) as
ideal or more nearly perfect than is true. Collins Essential English
Dictionary 2nd Edition 2006 (c) HarperCollins Publishers 2004, 2006

The code also unfortunately does not address the feeding of expressed
human milk and related products needed when a mother in unable to
exclusively breastfeed or chooses not to. In the United States the
breastfeeding dyad of 2008 has different expectations and needs
compared to those of 1981.  Even the CDC defines breastfeeding at the
breast or receiving breastmilk.

The Academy of Breasfeeding Medicine even states in its
Supplementation Protocol:
"When supplemental feedings are needed, one of the following
techniques may be used: a supplemental nursing device at breast, cup
feeding, spoon or dropper feeding, finger-feeding, or bottle feeding.
There is little evidence about the safety or efficacy of most
alternative feeding methods and their effect on breastfeeding;"

In 1981 WHO and UNICEF made the  final recommendations:

to continue efforts to promote breast-feeding as well as sound
supplementary feeding and weaning practices as a prerequisite to
healthy child growth and development;

to intensify activities in the field of health education, training and
information on infant and young child feeding;
the marketing of breast-milk substitutes and weaning foods must be
viewed within the framework of the problems of infant and young child
feeding as a whole;

the aim of the code should be to contribute to the provision of safe
and adequate nutrition of infants and young children, and in
particular to promote breast-feeding and ensure, on the basis of
adequate information, the proper use of breast-milk substitutes,

if necessary…
products should meet international standards of quality and
presentation…and their labels should clearly inform the public of the
superiority of breastfeeding."

The Executive Board of the WHO recommended the Code as we know it
today in 1981 and realized in 1981 that it "might be desirable or even
necessary to revise the code at an early date in the light of the
experience obtained in the implementation of its various provisions.
This has not happened since 1981.

I feel the WHO Code needs to be updated and before we continue to
judge and throw spears at LCs and corporations I invite you to really
think about the process that is used to determine compliancy and ask
for the CODE to be updated.

Karen Querna, RN, BSN, IBCLC, RLC
Spokane, WA USA

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