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PAKISTAN: Important legislation to restrict infant formula milk manufactures

Contributors: Amir Murtaza

The year 2013 brings fresh hopes for the children of Pakistan's Sindh province as Members of the Provincial Assembly have passed into law the "Sindh Protection of Breastfeeding and Child Nutrition Bill 2013".  The immensely important law suggests adequate and appropriate nutrition for infants and children by promoting and protecting breastfeeding in the province of Sindh.  

It is knowledgeable to recall that Pakistan is among the 118 countries of the world who had voted in favor of adopting the International Code of Marketing of Breast-milk Substitutes during the World Health Assembly in May 1981.  However, after elapsing a longtime, in 2002 the country had introduced the Protection of Breast-Feeding and Child Nutrition Ordinance.  The Ordinance in Chapter III Under (2) states that, "No person shall in any manner assert that any designated product is a substitute for mother's milk, or that it is equivalent to or comparable with or superior to mother's milk."  The Protection of Breast-Feeding and Child Nutrition Ordinance 2002 also stressed on formation of a National Board to monitor the implementation of the said Ordinance.

Right after the devolution plan, two provinces, Punjab and Balochistan have also introduced legislation on breastfeeding and child nutrition in line with the Protection of Breast-Feeding and Child Nutrition Ordinance 2002.  The recent introduction of laws on protection of breastfeeding and child nutrition in Sindh makes it clear that now in major areas of the country no commercial milk formula maker or their distributor can assert that their product is a substitute, equivalent or superior to mother's milk.  

It is a fact that breastfeeding plays a very significant role in child survival, growth and development.  Dr. Samina Ahsan, a local pediatrician, informed that, "Breast milk is absolutely the best for infants and children as it contains all the vitamins and nutrients, necessary for them."  She said that breast milk also contains all essential substances that are required to protect the babes from illness and added that, "Breastfeeding is really good for mother's health as well."

Several studies, conducted in Pakistan and other parts of the world, on the benefits of breastfeeding clearly showed that children who are exclusively breastfed have a far lower risk of getting sick or died during the first twelve months of their life than children who weren't breastfed.

Despite clear and recognized benefits of breastfeeding over bottle-feeding the World Health Organization's Global Data Bank on Breastfeeding - which presently covers 94 countries and 65% of the world's infant population - estimates that only 35% of them are exclusively breastfed between 0-4 months of age.  It is important to mention that "Exclusive" breastfeeding is defined as no other food or drink, not even water, except breast milk for at least 4 and if possible 6 months of life, but allows the infant to receive drops and syrups (vitamins, minerals and medicines)".

Pakistan is experiencing a high number of infant mortality rate; however, available data indicates that only 36% of the infants receive exclusive breastfeeding in the country.  Artificial feeding or bottle feeding has become one of the biggest public health problems in Pakistan.  Despite of the fact that bottle feeding enhances the chances of serious illness of the infants, it is an irony that a large number of mothers in Pakistan opt formula milk.  

The most common cause among mothers not to feed their infants is the perception of their feeble health and insufficient milk.  Additionally, working mothers find it difficult to breastfeed their babies, due to lack of available space at their workplace.  

Bushra is a house wife and right after the birth of her first baby boy the local doctor advised her to use a specific brand of baby formula milk.  "My mother and mother-in-law both stressed on me to breastfeed the child; however, a local pediatrician told me that due to pregnancy I have become quite weak therefore I should artificially feed my baby," Bushra said and added that the doctor also prescribed the same baby formula milk to some other mothers of new born babies.   

Health professionals opined that in some health conditions the use formula milk is suitable; however, in normal health conditions baby formula should be avoided in better interest of the child and mother.  

The newly passed Sindh Protection of Breastfeeding and Child Nutrition Bill 2013 have also put obligation on the manufactures of Infant/baby formula milk to publish on its tin or packet in bold characters that "Mother's milk is best for your baby and helps in preventing diarrhoea and other illness."

Infant/baby formula milk manufacturing is a multi-billion dollar industry and the quantum of their trade is increasing rapidly.  No one can deny the fact that sale of one tin or packet of baby formula milk deprives a child to the most suitable food, the breast milk.

The introduction of specific legislation on breastfeeding and child nutrition is a praiseworthy step in right direction.  However, the provincial governments should take immediate actions for strict implementation of the law.  Monitoring committees should be formed, without any further delay.  

Additionally, the government should take notice of the manufacturers of infant/baby formula milk who are using unethical tactics and influencing the health practitioners, merely to enhance the sale of their products and maximize their profit on the cost of the health of innocent children.
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The AHRC is not responsible for the views shared in this article, which do not necessarily reflect its own.

About the Author:
Amir Murtaza is a researcher and can be reached at; amirmurtaza@hotmail.com


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