Mexico at the CRC: Steep Decline of Breastfeeding Practices

On May 19 and 20, 2015, the Committee on the Rights of the Child considered the combined fourth and fifth periodic report of Mexico on the situation of the implementation of the Convention on the Rights of the Child in the country. 

On this occasion, IBFAN presented an alternative report to inform the CRC Committee on the situation of infant and young child feeding in Mexico.

General overview of breastfeeding in Mexico

In its alternative report, IBFAN insisted on the high rates of child overweight and obesity as well as on the lack of drinking water and the widespread sale of soft drinks in schools. In 2006, child obesity rose to 36.9% while deaths caused by diabetes progressively increased. 

The report also emphasized the high infant mortality rate (7 per 1, 000 live births for 2012-2013) that even reaches 23.89 per 1,000 live births in remote regions like Chiapas. 

In such a context, it is of concern that breastfeeding rates are low. The 2012 National Health and Nutrition Survey showed that the median duration of breastfeeding was of 10 months only. It also reveals a steep decline of exclusive breastfeeding rates between 2006 and 2012. Regarding the enforcement of the International Code of Marketing of Breastmilk Substitutes, IBFAN report flagged the lack of monitoring and sanctioning mechanism, leading to Code violations within the National Health System. 

IBFAN also denounced the adverse impacts of national nutrition programmes. For example, the programme “Prospera”, Mexico’s largest programme of food assistance, includes distribution of a ready-to-use food supplement, contravening the international recommendations on infant and young child feeding. The Programme Cruzada Contra el Hambre is led in partnership with corporations that violate the International Code and the distribution of Tarjetas Sin Hambre allows poor families to access to a list of 15 subsidized products that includes unhealthy foods such as instant sugar-added coffee (Nescafé Dolca), instant oat cereal Powder milk (Nestlé’s Nido and others) and instant chocolate powder.

IBFAN also noted the Mexico did not ratify the ILO Convention 183 (2000) on Maternity Protection and needs to extend maternity protection to the growing number of women working in the informal sector. 

Finally, IBFAN stressed the need to adopt and implement the Operational Guidance on Infant and Young Child Feeding in Emergencies in order to protect breastfeeding during disasters.

Discussion on infant and young child feeding

The CRC Committee expressed concerns about the high rate of child mortality in indigenous areas. It also raised the issues of child obesity and teenage pregnancies. 

More specifically, the CRC Committee noted the decline of breastfeeding rates and the fact that many mothers receive promotional gifts from baby food companies within hospitals and maternities. It highlighted the lack of enforcement of regulations related to the marketing of breastmilk substitutes and asked which actions are by the government in this regard

The Mexican delegation answered that the mortality rate is currently following a downward trend in Mexico, and that many policies and programmes have been implemented in this regard. The government also mentioned their programmes “Prospera” and “Cruzada Contra el Hambre”, noting that they cover large portions of indigenous regions. For example, some 25% of the beneficiaries of the Prospera programme are from indigenous communities. In addition, the delegation noted that more than 700,000 families have beneficied of the programme “Tarjetas Sin Hambre”. 

In relation with infant and young child feeding, the delegation responded that as part of a national strategy for breastfeeding a new programme on breastfeeding promotion has been launched. It also affirmed that the Ten Steps to Successful Breastfeeding of the Baby-Friendly Initiative are being implemented throughout the country and that several human milk banks have been set up. 

Regarding obesity, the delegation mentioned the national comprehensive strategy for tackling overweight and obesity, which is based on 3 pillars: 1) taxes 2) legal reform and 3) promotion of physical activity. Likewise, a special tax on sugary drink has been implemented as part of this strategy. In relation with the legal reform, the delegation mentioned the integration of a constitutional article prohibiting the sale of sugary drinks in schools, as well as federal legal provisions limiting the advertisement of unhealthy foods on TV during programmes aimed at children and in cinemas. It affirmed that the government carries out awareness-raising activities such as campaigns to measuring waist and promote physical activity and it made reference to the national council on NCDs. The delegation also mentioned the implementation of water fountain in every school as part of the legal undertaken.

Finally, regarding maternal mortality, the delegation noted that several campaigns aiming at tackling teenage pregnancies have been launched. As a result, a drop of 15% of such pregnancies is expected. It also affirmed that teenage mothers are allowed to deliver in any health service of the country.

Concluding observations 

In its Concluding Observations, the Committee issued both indirect and direct recommendations related to infant and young child feeding to Mexico. 

Addressing specifically infant and young child feeding, the Committee expressed concerns the decline of exclusive breastfeeding (§47d) and recommended Mexico to strengthen the efforts to “promote breastfeeding through educational campaigns and training to professionals” and “adequately implement the International Code of Marketing of Breast-Milk Substitutes and the Child-Friendly Hospital Initiative”(§48d).

Highlighting the persistent child chronic malnutrition in rural and indigenous areas (§47c) and the increasing of overweight and obesity among children (§47e), the Committee also recommended Mexico to draft a national strategy on nutrition that would ensure food security, especially in rural and indigenous areas (§48c), as well as to continue raising awareness on the impact of processed food including and strengthen the regulations restricting the advertising and marketing of junk, salty, sugary and fatty foods and their availability for children (§48e).

Regarding, health services, the Committee stressed the need to ensure the availability and accessibility of quality health services, in particular rural and indigenous children, including by allocation adequate resources (§48a). 

The Committee also expressed concerns over the high child and maternal mortality rates (§47b), recommending the State party to strengthen and reduce maternal and child mortality, including by implementing the OHCHR Technical Guidance on child mortality (A/HRC/27/31).

Finally, regarding environmental health, the Committee expressed concern about the insufficient measures taken by Mexico to address air, water, soil and electromagnetic pollution, which gravely impact on children and maternal health. It thus recommended the State party to assess theses impacts on children and maternal health as a basis to design a well-resourced strategy to remedy the situation, prohibit the import and use of pesticides or chemicals that are banned or restricted for use in exporting countries and examine and adapt its legislative framework to ensure the legal accountability of business enterprises involved in activities having a negative impact on the environment in the light of its General Comment No 16 (2013) on State obligations regarding the impact of the business sector on children’s rights (§51-52a-c).

[Note: Click here to access to a discussion paper prepared by IBFAN Mexico which provides an interpretation of what should be an "adequate" implementation of the International Code of Marketing of Breast-milk Substitutes.]

Ghana at the CRC: Concerns about the Decline of Exclusive Breastfeeding and the High Rate of Neotoal Mortality

On May 21 and 22, 2015, the Committee on the Rights of the Child considered the combined third to fifth periodic report of Ghana on the situation of the implementation of the Convention on the Rights of the Child in the country. The delegation of Ghana was led by Hon.Nana Oye Lithur, Minister of Gender, Children and Social Protection, and Ms. Laadi Ayamba, Chair person, Parliamentary Select Committee.

On this occasion, IBFAN presented an alternative report to inform the CRC Committee on the situation of infant and young child feeding in Ghana.

General overview of breastfeeding in Ghana

IBFAN report highlighted the declining trend in breastfeeding rates, particularly the exclusive breastfeeding rate under 6 months (63% in 2008 to 45.7% in 2011) and early initiation of breastfeeding (52% in 2008 to 45.9% in 2011). This situation is closely connected with the inadequate funding to implement the policies and actions plans on Child Health and Nutrition.

In Ghana, the InternationalCode of Marketing of Breastmilk Substitutes is fully implemented through the BreastfeedingPromotion Regulation 2000 (BPR 2000). However, the Committee in charge of monitoring its implementation was found inactive due to the lack of commitment from the Food and Drugs Authority which results in systematic violations.

In  addition, despite the pre- and in-service training programs aimed at health workers and courses provided by the Ghana Health Service with the support of UNICEF, WHO and other partners, the need for more trained counsellors in health facilities was underlined.

The report finally flagged the short duration of the maternity leave which does not cover women working in the informal sector. Finally, the lack of emergency preparedness plan with specific guidelines to ensure protection and support of breastfeeding in emergencies was pointed out.

Discussion on infant and young child feeding

During its discussion with Ghana, the CRC Committee addressed specifically the issue of breastfeeding. It expressed concerned about the high neonatal mortality rate and the decline of exclusive breastfeeding due to the insufficient monitoring on the implementation of the BPR 2000 and the subsequent violations of the International Code. It asked which measures will be taken to this particular issue and asked for more information on breastfeeding promotion to mothers as well as on the implementation of an adequate monitoring and sanction mechanism to enforce the BPR 2000.

First of all, the delegation admitted the lack of financial resources allocated to health. Regarding neonatal mortality, the delegation stated that a new Sub-Committee composed of government representatives, medical staff, technicians and community health workers has been established in 2012. It aims to design and launch a national action plan for the period 2014 to 2018.   In addition, a national meeting on neonatal mortality will be held in July 2015, bringing together all relevant partners at national level, including community health workers.

In relation to the persistent high maternal mortality rates, the delegation highlighted the implementation of a policy on free antenatal and delivery care for all women. As a result, the latest demographical and health survey showed that 97% of pregnant women receive antenatal care and 74% of births are attended by a skilled health professional. Besides, specific trainings are delivered so that midwives are enabled to deliver services at community level, especially in the most remote areas, and physicians as well as technicians are enabled to deal with perinatal conditions such as post-partum hemorrhage. The government recently started a pilot project to provide women delivering at home (30% of pregnant women), a tablet of misoprostol to prevent hemorrhages. The delegation also explained that pregnant teenage girls are granted with free access to antenatal care, although they still sometimes face discrimination on the ground.

Besides, the delegation admitted that the rate of exclusive breastfeeding under 6 months declined between 2008 and 2011. To remedy this situation, the government took measure to increase awareness of health workers through specific trainings. The government also stressed its commitment to strengthen the implementation of the Baby-Friendly Hospital Initiative as well as to enforce the BPR 2000, resulting in the slow rise of the rate of exclusive breastfeeding.

Finally, the delegation declared that misleading advertisements have been reduced since the entering into force of the BPR 200. However, it admitted that baby food manufacturers are still trying to influence health professionals through sponsorship of seminars and conferences.

Concluding observations

In its Concluding Observations, the Committee referred directly and indirectly to infant and young child feeding. 

The Committee first recommended Ghana to improve its data collection system (§16). Then, referring to its General Comment No 16 (2013) on State obligations regarding the impact of the business sector on children’s rights, the Committee urged the State party to establish clear regulations and a nation-wide legislative framework requiring companies operating in the State party to adopt measures to prevent and mitigate their adverse child impact of their operations in the country (§20a) and to require companies to undertake assessments, consultations, and full public disclosure of the environmental, health-related and human rights impacts of their business activities and their plans to address such impacts (§20b).

Regarding health, the Committee expressed concerns about the insufficient funding allocated to health, the low number of qualified and experienced health provider staff as well as an inequitable provision of health services (§49 a-b). Therefore, it called for the allocation of sufficient financial and human resources, particularly to child health and nutrition, providing effecting access to trained and qualified health care (§50a). 

The Committee also highlighted the continuous high maternal and neonatal mortality rates in the State (§49f), stressing AIDS as one of the causes of child mortality (§53c). Thus, it recommended Ghana to reduce mortality rates by improving parental care (§50c) and by providing access to antiretroviral therapy and followed-up treatment for HIV/AIDS infected mothers and their children (§54b, d). It also urged the State party to finalize the National Newborn Strategy and Action Plan (§50b), to improve prenatal care, to prevent communicable diseases (§50c), to implement the OHCHR Technical guidance on child mortality (A/HRC/27/31) (§50h) and to expedite the approval of the National Nutritional policy (§50f). 

Regarding breastfeeding, the Committee expressed specific concerns about the decline of breastfeeding rates between 2008 and 2011 and the inadequate monitoring of the BPR 2000 (§49d). It thus recommended Ghana to “continue the promotion of exclusive breastfeeding for six months with appropriate introduction of infant and diet thereafter, aimed at reducing neonatal as under-five mortality” (§50d) and strengthen the monitoring of implementation of the BPR by implementing a deterrent sanctioning system and ensuring that the Food and Drug Authority is committed to enforce the BPR (§50e).

Venezuela at the CRC: Strong Legislation but Lack of Data

On the 1^st and 2^nd September 2014, the Committee on the Rights of the Child considered the combined third to fifth periodic reports of Venezuela on the situation of the implementation of the Convention on the Rights of the Child in the country. The Delegation of Venezuela, led by the Minister of Popular Power for Women and Gender Equality (Ministerio del Poder Popular para la Salud, MPPS), Ms. Andreina Tarazón, was constituted of 31 members, including the General Director of the Health Committee of the Ministry of Popular Power for Education, Ms. Asia Yadira Acosta.

IBFAN presented an alternative report to inform the CRC Committee on the situation of infant and young child feeding in Venezuela.

General overview of breastfeeding in Venezuela

The report highlighted a significant deficit in data collection on infant and young child feeding (IYCF). The available data on IYCF are from 2008 and show that more than 70% of children are not exclusively breastfed until 6 months of age while almost 13% are predominantly breastfed until 6 months of age, although it is considered as an inadequate practice. Some 75% of the children are introduced to complementary food before the recommended age of 6 months. In addition, when bottle feeding, the dilution of the powder milk or formula has shown to be inadequate in more than 70% of cases.

Nonetheless, the Government of Venezuela has shown its will to encourage breastfeeding. Firstly, one of the goals set in the “Plan de la Patria Socialista de la Nación 2013-2019” is to increase exclusive breastfeeding by 70%. Secondly, breastfeeding is promoted as a priority by the MPPS and is referred to in the Organic Law on Children and Adolescents Protection (Ley Orgánica para la Protección de Niños y Adolescentes, LOPNA). Thirdly, the International Code of Marketing of Breastmilk Substitutes, as well as the Baby-Friendly Hospital Initiative (BFHI), were formally implemented into national legislation through two ministerial decisions in 2004. However, in 2010, only 17 out of 204 hospitals were certified as ‘baby-friendly’ and violations of the Code can still be detected, such as the use of health claims, promotion of ‘baby competitions’, corporate sponsoring of  medical events.

Regarding training of health professionals, courses on breastfeeding are organized jointly by the Childcare and Paediatricians Venezuelan Society and the UNICEF. Besides, a course on breastfeeding counselling is organized at national level; since its launch, more than 3,000 accredited breastfeeding counsellors have been trained. Finally, the GALACM-UCV breastfeeding support group also gives training courses on breastfeeding. Nevertheless, in 2009, it is of concern that about 35% of surveyed mothers did not receive information on breastfeeding during pregnancy.

In Venezuela, mothers are entitled to a maternity leave that has been increased from 12 to 20 weeks in 2012. Yet, IBFAN report calls for the extension of the maternity leave up to 40 weeks of corrected age for mothers with premature babies.

Regarding IYCF and VIH/AIDS, a programme on the prevention of vertical transmission is carried out in order to ensure the supply of infant formula during the first year of life for children of HIV-positive mothers. Finally, the national legislation states that breastfeeding should be protected in case of emergencies.

Discussion on infant and young child feeding

The Delegation of Venezuela affirmed that a humanist approach is taken in the field of reproductive health and that the government guarantee the provisions of medical services in this field through the programme Barrio Adentro. A specific programme entitled Misión niño Jesús aimed at pregnant women has been implemented.  In addition, the Delegation stated that the government provides support to improve the nutrition of mothers and children, especially by timely supplementation. Finally, it highlighted that 8 human milk banks have been implemented in  the country.

Concluding Observations

In its Concluding Observations, the Committee made several indirect recommendations. With regard to general measures of implementation, it urged Venezuela “to finalize the design of the National Plan of Action for Children and Adolescents (2015-2019)” (§11) as well as “to expeditiously complete and implement its data collection system” (§20).

As far as health issues are concerned, it recommended that Venezuela “collect disaggregated data on children’s health related issues, in particular on child mortality, including under five mortality, maternal mortality, vaccination coverage, nutrition and breastfeeding; allocate adequate human, technical and financial resources to the national public health system; building on data related to the causes, design a strategy to reduce child and maternal mortality, which includes the implementation of the two existing protocols on maternal and neonatal mortality and continue its efforts to reduce malnutrition and increase vaccination coverage” (§53 (a)-(d)). Furthermore, The Committee also addressed the issue of HIV/AIDS mother-to child transmission by requesting the government to “collect disaggregated data on HIV/AIDS related issues, in particular on [...] number of cases of mother-to-child transmissions, [...] and number of children and pregnant women under treatment” and “ensure that all HIV/AIDS positive pregnant women receive adequate treatment” (§61(a),(c)).

The Committee also issued direct recommendations related to infant and young child feeding (§53(e)). It recommended that Venezuela “increase its efforts to promote breastfeeding by developing a comprehensive programme of action to promote exclusive breastfeeding, including training for staff in hospital maternity wards, closely monitor the implementation of the International Code of Marketing of Breast-milk Substitutes and develop awareness raising campaigns”.

Written contribution to the Committee on the Rights of the Child / 2014 Day of General Discussion / Digital Media and Children’s Rights

Breastfeeding protection, an essential component of the child’s right to health

Breastfeeding is recognized as a crucial intervention to provide infants and young children a healthy start in life.[1] It is the single most effective intervention for saving lives:  if applied globally, optimal breastfeeding can annually prevent about 830.000 deaths of children under 5 years. Unfortunately, out of 135 million babies born every year, almost 83 million are not enabled to follow optimal breastfeeding practices.[2]

Enshrined in the article 24 of the Convention on the Rights of the Child on the right of the child to the enjoyment of the ‘highest attainable standard of health’, breastfeeding should be protected against marketing practices that could undermine it. Therefore, the Committee has integrated the 1981 International Code of Marketing of Breastmilk Substitutes (the Code), to date completed and extended by fifteen subsequent relevant WHA resolutions forming an integral part of it, in the CRC General Comment No. 15 (2013), which specifies that besides the States’ obligation to implement and enforce the Code (para 44), baby food companies have the direct obligation to comply with it in all contexts (para 81).

However, the misconduct of baby food companies continues to be a key cause for poor breastfeeding practices, as these companies reap profits from promotion of their products which directly compete with breastfeeding. Recently, the report Breaking the Rules 2014, published by IBFAN’s International Code Documentation Centre, presented more than 800 Code violations by 27 companies in some 81 countries.

Digital media: a new marketing avenue for baby food companies

Since democratization of new technologies and Internet access, a new avenue has opened up for companies to advertise their products on digital media, including social media such as Facebook and YouTube. Mobile and web-based technologies using ‘behavioural targeting’ offer them new opportunities to interact directly with mothers, despite the fact that the article 5 of the Code prohibits baby food companies to seek direct or indirect contact with pregnant women and mothers of infants and young children, regardless of the mean used for making that contact.

Popular bloggers, especially mothers, are roped in to endorse products and thus influence their huge following. Advancing their electronic marketing even further, companies are developing mobile software applications (known as ‘apps’) that millions can download onto their mobile phones, tablets, laptops and PCs. Companies use these apps as direct promotional tools. Several apps are designed to ‘help’ pregnant women and new mothers. Special offers, discounts, contests, product launches and campaign announcements are now available to tech-savvy young mothers and their families.

Creating a corporate culture among parents through websites, social media and apps

Websites facilitate baby food companies’ contact with mothers by offering them gifts (such as a trip to Singapore), free samples and discount prices (such as a ‘Ramadan special package’, offered by Hero[3] on its Egyptian online shop).

Encouraging mothers to spread the word about their products, companies’ websites also foster their participation through a wide range of social activities, such as, for example, photo contests for babies, invitations to baby fairs or mothers blogs.

Thousands of mothers[4] are linked to companies through their Facebook, Twitter or Pinterest pages, where offers of free gifts, promotions and ads violating the Code are regularly posted. Some of these pages even offer ‘live chats’ or ‘carelines’ through which mothers can talk directly to company personnel to get nutritional advice on infant and young child feeding.

Besides, many other companies have developed a phone app for monitoring the feeding routines of infants and for providing advice, such as the one developed by HiPP[5] in Norway. In Slovenia, Novalac[6] even offers parents a local language smart phone ‘baby app’ which allows the company to offer promotions and special deals to parents.

‘Mothers clubs’, or how companies disguise marketing under ‘parents advice’

A new trend for companies is to promote virtual platforms called ‘Nutriclub’, ‘Moms club’ or even ‘Baby club’, connecting with pregnant women and offering mothers one-on-one support, parenting advice, information about pregnancy and child development, together with information on their products. When joining a ‘club’, mothers are offered gifts, promotional offers and invitations to try products. For example, parents who sign up to Wattie’s[7] club are offered the chance to win about USD 520 of free gifts.

Video clips and viral marketing, advanced marketing tools for selling baby foods

Baby food companies are regularly publishing attractive video clips on their websites and social media, but also on TV and as ads on other websites. These video clips are systematically ‘shared’ on YouTube, allowing them to be spread over social media by users. For example, a cute cartoon video clip, recently published by Nestlé, has been viewed over a million times within a month.

These video clips often claim that industrial baby foods have positive effects on babies’ health and contribute to their optimal cognitive development. For example, in a Dumex[8] video clip run on the company’s website and on TV, mothers share their opinion on the good effect of Dumex baby formula to assist the baby’s immune system. Similarly, in Hong Kong, Nestlé’s video clip for infant formula claims that the product promotes ‘gut health, digestion, absorption’. There is overt comparison with breastmilk via the DHA and ARA components which, contrary to systematic reviews of the evidence, are claimed to ‘help baby’s brain and visual development.’

Campaigning on the first 1000 days: the hijack of breastfeeding promotion by companies

The 1000 days between a woman’s pregnancy and her child’s 2^nd birthday is a critical period for long term development. UNICEF and WHO have launched a global campaign for health and development through adequate nutrition during this critical ‘1000 days window of opportunity’. Baby food companies sensed a marketing opportunity and launched their own ‘first 1000 days’, campaigns. Both Nestlé and Danone, baby food leading companies, have co-opted the slogan of the first 1000 days.

Nestlé launched its own first 1000 days advertising campaign called ‘Start Healthy, Stay Healthy’ in order to associate itself with the UN message. Under its campaign, the company reaches out to the public through its website and social media and calls on visitors to join the company in promoting the World Breastfeeding Week 2014 while claiming to support breastfeeding. Apart from targeting mothers, Nestlé sponsors courses organised by professional organisations and even organised ‘scientific conferences’ for doctors in India, despite the explicit prohibition of such events by the Indian Infant Milk Substitutes Act. In Malaysia, the company has pushed the boundaries even further and launched a ‘1500 days’ campaign.

For its part, Danone registered the domain name http://www.first1000days.ie/  under its Nutricia subsidiary. In China, Dumex’s 1000 Days programme, with emphasis on child’s immunity, offers a service tailored for mothers and aimed at providing advice from pregnancy through various stages of early childhood. A book on this 1,000 day programme is distributed free when mothers register on the Dumex website. In Ireland, Danone’s front company Cow & Gate followed the Dumex example by launching the First 1000 Days campaign, using a celebrity couple as ambassadors. Incentives like free recipe books are offered to tempt potential customers.

How to protect child’s right to health against corporate violations of the Code through the use of digital media

In order to protect breastfeeding and thus, the right of the child to the enjoyment of the highest attainable standard of health, States parties should be urged to:

1. Fully implement the International Code of Marketing of Breastmilk Substitutes and its relevant subsequent WHA resolutions, especially WHA63.23, into their national legislation

It is crucial for Member States to fully implement the Code as it regulates marketing practices of baby food companies to protect the right to health of infants and young children, including against malevolent marketing practices that take place online. More specifically, article 5 of the Code prohibits manufacturers and distributors from providing mothers with free samples of their products, whether directly or indirectly. The provision also forbids promotion tools to induce sales direcly to the consumer at the retail level, such as special displays, discount coupons, as we can find on companies websites, their online shops and social media. Finally, the Code states that the marketing personnel should not seek direct or indirect contact of any kind with mothers of infants or young children. 

Resolution WHA63.23 calls upon the development of legislative, regulatory and effective measures to control the marketing of breastmilk subtitutes in order to give effect to the Code.

2. Ensure effective monitoring of the Code and implement deterrent sanctions against violations

According to the Code, monitoring the application of the Code lies with governments acting individually and collectively through WHO (article 11). Resolution WHA61.20 urges States to scale up efforts to monitor and enforce national measures and to avoid conflicts of interest. 

To meet their obligations, States should therefore be urged to implement deterrent sanctions for Code violations into their legislation. 

3. Launch modern and attractive digital campaigns on breastfeeding promotion and support 

Governments should promote and support optimal breastfeeding practices through modern and attractive media campaigns. Using the same digital media devices than baby food companies, States parties would be able to counter the damages induced by the aggressive marketing practices of the private sector. By maintaining catchy and helpful websites, promoting social media pages and spreading innovative videos through the Web, governments will be able to disseminate the adequate information to a wider public and create a popular trend towards optimal breastfeeding practices. 

4. Implement their Extraterritorial Obligations into legislation

According to the CRC General Comment No. 15 (2013), baby food companies have a direct obligation to comply with the Code in all contexts and thus, to respect to right of the child to the enjoyment of the highest attainable standard of health.

Pursuant to international human rights law, States have the duty to ensure that companies based in their territory do not infringe the human rights of people their countries, but also in other countries where the companies operate.[9] Therefore, the States should be urged to implement legislation aimed at holding home-based companies, including baby food companies, accountable for their human rights violations abroad.

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[1] UNICEF, Pneumonia and diarrhoea : How to tackle the deadliest diseases for world’s poorest children. June 2012. http://www.unicef.org/media/files/UNICEF_P_D_complete_0604.pdf.

[2] Bhutta et al., What works? Interventions for maternal and child undernutrition and survival, The Lancet, 2008, 371 (9610) : 417-440.  http://www.who.int/nutrition/topics/Lancetseries_Undernutrition3.pdf.

Save the Children, Superfood for babies: How overcoming barriers to breastfeeding will save children’s lives, 2013. http://www.savethechildren.org/atf/cf/%7B9def2ebe-10ae-432c-9bd0-df91d2eba74a%7D/SUPERFOOD%20FOR%20BABIES%20ASIA%20LOW%20RES%282%29.PDF.

[3] Hero is a Swiss company.

[4] For example, by May 2013, the Danone Facebook page had received some 53,000 ‘likes’, thus multiplying Danone’s Code violating record.

[5] HiPP is a German company.

[6] Novalac is a French company.

[7] Wattie’s is a brand owned by Heinz, a US company.

[8] Dumex is the Asian subsidiary of Danone, a French company.

[9] Principle 25  (c) (d) (e), Maastricht Principles on Extraterritorial Obligations of States in the area of Economic, Social and Cultural Rights. Available at: http://www.fian.org/fileadmin/media/publications/2012.02.29_-_Maastricht_Principles_on_Extraterritorial_Obligations.pdf