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UNICEF and WHO call on Pacific Island countries to strengthen policies on breast-milk substitutes




5 June 2020 – As the Pacific region works on the preparedness and response for the COVID-19 pandemic, there is a need for strong legislation to protect families from false claims about the safety and role of breast-milk substitutes or aggressive marketing practices.

A new report by WHO, UNICEF, and the International Baby Food Action Network (IBFAN) reveals that despite efforts to stop the harmful promotion of breast-milk substitutes, Pacific Island countries have few measures in place to protect parents from misleading information.

UNICEF and WHO encourage women to continue to breastfeed during the COVID-19 pandemic, even if they have confirmed or suspected COVID-19. The active virus of this deadly disease has not been detected in the breast-milk of any mother with confirmed or suspected COVID-19. At this time therefore, there is no evidence that COVID-19 would be transmitted through breastfeeding or by giving breast-milk that has been expressed by a mother who is confirmed or suspected to have COVID-19.

Of the 13 Pacific Island countries studied in the report, only four have in place some form of legal measure related to the International Code of Marketing of Breast-milk Substitutes and subsequent resolutions adopted by the World Health Assembly (the Code). However, only two of these four countries, including Fiji and Palau, have taken regulatory actions substantially aligned with the Code.

UNICEF and WHO strongly recommend that babies be fed nothing but breast-milk for their first six months, after which they should continue breastfeeding – as well as eating other nutritious and safe foods – until two years of age or beyond. Breast-milk saves children’s lives as it provides antibodies that give babies a healthy boost and protect them against many childhood illnesses.

Breastfeeding under threat as health systems stretched thin

Babies who are exclusively breastfed are 14 times less likely to die in the first six months than babies who are not breastfed. However, today, only about 50 per cent of infants six months and below in the Pacific are exclusively breastfed. Inappropriate marketing of breast-milk substitutes continues to undermine efforts by UNICEF, WHO and Pacific Island governments to improve breastfeeding rates and the COVID-19 crisis is intensifying the threat.

“While progress has been made, far too many countries in the Pacific region are falling behind in putting in place and enforcing legal measures to protect babies from breast-milk substitutes,” said Sheldon Yett, UNICEF Pacific Representative. “With thousands of mothers in the region facing strained healthcare systems, fear of infection and lockdowns with COVID-19, UNICEF is working closely with the Pacific Island governments to ensure that we step up efforts to ensure that families receive the support they need to breastfeed their children.”

The Code regulates the promotion of breast-milk substitutes, including advertising, gifts to health workers and distribution of free samples. Labels cannot make nutritional and health claims or include images that idealize infant formula. Instead, labels must carry messages about the superiority of breastfeeding over formula and the risks of not breastfeeding.

“Protecting parents from misleading promotion of formula milk is critical in our region, as such promotion undermines breastfeeding,” said WHO Representative to the South Pacific, Director of the Division of Pacific Technical Support, Dr. Corinne Capuano. “Exclusive breastfeeding is recommended up to six months of age and it’s the perfect food for the newborn.” 

Adoption, monitoring and enforcement of the Code is inadequate in most Pacific Island countries. The report, “Marketing of breast-milk substitutes: National implementation of the International Code – Status report 2020,” provides updated information on the status of country implementation, including which measures have and have not been enacted into law.

UNICEF and WHO are working closely with Pacific Island governments on strengthening protection and support for breastfeeding in the context of COVID-19, and caution against unnecessary and harmful donations of breast-milk substitutes.

The 13 Pacific countries and areas studied in the report include: Cook Islands, Federated States of Micronesia, Fiji, Kiribati, Marshall Islands, Nauru, Niue, Palau, Samoa, Solomon Islands, Tonga, Tuvalu and Vanuatu.

Breastfeeding and COVID-19

Women with confirmed or suspected COVID-19 can breastfeed if they wish to do so but with precautions including:

  • Washing hands frequently with soap and water or using alcohol-based hand rub especially before touching the baby;
  • Wearing a medical mask during any contact with the baby, including while feeding;
  • Sneezing or coughing into a tissue. Then disposing of it immediately and washing hands again;
  • Routinely cleaning and disinfecting surfaces after touching them.

Even if mothers do not have a medical mask, they should follow all the other infection prevention measures listed and continue breastfeeding.


Notes to Editors:

Download the report here

About WHO:

The World Health Organization (WHO) is the United Nation’s specialized agency for international public health. In the Pacific, WHO’s Division of Pacific Technical Support provides tailored, timely support to 21 Pacific island countries and areas. Our main office is in Suva, Fiji, and the Division has six other offices across the region: The Federated States of Micronesia, Kiribati, Samoa, Solomon Islands, Tonga and Vanuatu.

For more information, please contact:

Dr. Margaret Harris, WHO Geneva, +41 79 290 6688, [email protected]

Sabrina Sidhu, UNICEF New York, +1 917 4761537, [email protected]   

Zubnah Khan, UNICEF Pacific, Tel: +679 7157586, [email protected]

JIN Ni, WHO Pacific, Tel: +679 7779722, [email protected]