Violations of the International Code of Marketing of Breast-milk Substitutes: Indonesia context

Abstract

AbstractObjectivesTo measure compliance with the International Code of Marketing of Breast-milk Substitutes (‘the Code’) in Indonesia.DesignThe study was a cross-sectional survey using the Interagency Group on Breastfeeding Monitoring protocol.SettingPublic and private health facilities in six provinces on Java island in Indonesia.SubjectsA total of 874 women (382 pregnant women and 492 breast-feeding mothers of infants below 6 months) and seventy-seven health workers were recruited from eighteen participating health facilities. The study also analysed a total of forty-four labels of breast-milk substitute products, twenty-seven television commercials for growing-up milk (for children >12 months) of nine brands and thirty-four print advertisements of fourteen brands.ResultsThe study found that 20 % of the women had received advice and information on the use of breast-milk substitutes and 72 % had seen promotional materials for breast-milk substitutes. About 15 % reported receiving free samples and 16 % received gifts. Nearly a quarter of the health workers confirmed receiving visits from representatives of breast-milk substitute companies. Two health workers reported having received gifts from the companies. The most common labelling violations found were statements or visuals that discouraged breast-feeding and the absence of mention about the consideration of local climate in the expiration date.ConclusionsViolations of the Code by health workers, breast-milk substitute companies and their representatives were found in all provinces studied. A regular monitoring system should be in place to ensure improved compliance with and enforcement of the Code.