1. WHO Guidance on Ending the Inappropriate Promotion of Foods for Infants and Young Children
Dept. of Nutrition for Health and Development, WHO World Breastfeeding Conference Johannesburg, South Africa December 13, 2016

2. Development of Guidance
2010: WHA called on Member States to “end inappropriate promotion of food for infants and young children”
2012: WHA requested clarification and guidance on how to end inappropriate promotion
: Scientific and Technical Advisory Group (STAG) convened
July 2015: Recommendations released for public comment and hearings with civil society, private sector, and Member States
April 2016: Final version disseminated
May 2016: Adopted by WHA

3. STAG Background Documents
Review of global and national recommendations for complementary feeding
Current marketing practices and global market analysis for baby food products
Report on existing global and national regulatory environment
In-depth marketing studies in Brazil, Cambodia, Nepal, Norway, Senegal, and Tanzania
Review of health effects of commercially available complementary foods
Review of effects of marketing commercially available complementary foods on attitudes and behaviours

4. Key concerns identified—Interference with Breastfeeding
Follow-on formula, growing-up milk
BMS market is large and growing fast:
$44.8B  $70.6B
Toddler milks is fastest growing category
Promotion of growing up milks is common
Milk consumption inversely associated with
breastfeeding intensity
Covered by International Code? Codex Alimentarius?
Cross-promotion through other complementary food products
“Stages”
Similar colours, designs, slogans,
mascots or symbols as infant formula

5. Key concerns identified—Obesity & NCDs
Some complementary foods high in sugars, trans fat, saturated fat, salt
Consumption of unhealthy snack foods (marketed for older children) is common among young children
Promotion of unhealthy snack foods is very common

6. Key concerns identified—Conflicts of Interest
Using health care to market products
Public-private partnerships
Special concerns for formula industry
Responsibility on both sides

7. Key concerns identified—Benefits of Commercial Products
May provide nutrients otherwise not easily accessible in children’s diet (esp. micronutrients)
Can be inexpensive alternative to improve nutritional status
Convenient and time-saving for families
Complementary foods do not seem to displace breast milk after 6 months of age (although quality of evidence is poor)
Commercially-available vs. home-prepared complementary foods:
No evidence of reduction in stunting, anaemia, or micronutrient deficiencies
Heterogeneous results on nutritional composition

8. Recommendations Purpose: Age range: 6-36 months
protect breastfeeding
prevent obesity and noncommunicable diseases
promote a healthy diet
clear and accurate information on feeding.
Age range: 6-36 months
Foods and beverages targeted to age range (leaves out general family foods)
Excludes supplements and home fortificants
Includes government and non-profit programmes

9. Recommendations
Promotion should be based on the Guiding Principles with emphasis on “suitable, nutrient-rich, home- prepared, and locally available foods”.
Products that function as breast-milk substitutes (including follow-up formula and growing-up milks) are breast-milk substitutes and should not be promoted
Only promote foods meeting all the relevant national, regional and global standards for composition, safety, quality and nutrient levels and are in line with national dietary guidelines. Strengthen Codex standards.

10. Recommendations Messages should: Messages should not:
Include statement on need for breastfeeding through 2 years and no complementary foods before 6 months
State recommended age of introduction
Be easily understood
Messages should not:
Suggest use before 6 months
Discourage breastfeeding or
imply equivalence to breast milk
Promote bottle feeding
Convey endorsements

11. Recommendations No cross promotion of BMS using other products
Differentiate designs, labels, slogans, logos
No direct contact for BMS marketers
Avoid conflicts of interest (health care vs. industry)
No free, reduced-price products
No donations of equipment, supplies or services
No gifts or incentives to health care staff
No gifts or coupons to parents, caregivers and families
No education to parents in health facilities
No sponsorship of meetings of health professionals and scientific meetings

12. Recommendations
Apply WHO set of recommendations on the marketing of foods and nonalcoholic beverages to children. A range of strategies should be implemented to limit the consumption of unhealthy foods.

13. WHA Resolution 69.9 “Welcomes with appreciation” the guidance
Urges Member States to:
take all necessary measures… to end the inappropriate promotion of foods for infants and young children, including in particular implementation of the guidance …while taking into account international obligations
establish a system for monitoring and evaluation of the implementation of the guidance recommendations
to continue to implement the International Code of Marketing of Breast-milk Substitutes

14. WHA Resolution 69.9 Calls for implementation by:
Manufacturers and distributors of foods for IYC
Health care professionals
Media and creative industry
Calls for support from civil society for advocacy and monitoring
Requests WHO to:
Provide technical support to Member States
Review implementation experience and consider revision
Report on implementation in 2018 & 2020
Recognizes Codex

15. Thank you