Priority 2 | Whakaarotau 2: Policies, guidelines, regulations and frameworks protect, promote and support breastfeeding and optimal infant feeding

Action

Why we should do this: what the evidence says

Policy and decision makers commit to understanding and meeting maternal and child health obligations under the various relevant national and international treaties, conventions and charters ratified by New Zealand Aotearoa.

Read more about relevant conventions.

Protecting breastfeeding is a public health priority and a human rights obligation (Ralston et al 2020).

Explicitly consider breastfeeding in the development of relevant policies, guidelines, regulations and frameworks across government. These should be developed with wide stakeholder consultation and be free from commercial influences and conflict of interest.

Greater collaboration between sectors is required to promote best practice in protecting breastfeeding parents and their children (Gribble et al 2011).

Evidence has demonstrated that the food industry can be overly influential in advocating their interests to policymakers (Cullerton et al 2016).

Work with food banks and charitable entities to ensure appropriate distribution of milk formulas. If powdered milk formula is required, donated supply should continue for as long as the infant needs.

It is important to ensure interventions are needs-based rather than donor-driven; and to guarantee adequate quality and safety of the diet (IFE Core Group 2017).

The Ministry breastfeeding lead and the Infant and Young Child Feeding Committee (IYCFC) work with other interested parties to establish and support World Breastfeeding Trends Initiative (WBTi) assessments in New Zealand Aotearoa.

The WBTi assessment tool was developed by the International Baby Food Action Network to assess countries’ progress in implementing the WHO/UNICEF Global Strategy for Infant and Young Child Feeding. The WBTi assessment results in a report card on each country’s national practices, policy and programme indicators. As at October 2018, 97 countries, including Australia, have completed a WBTi report (Gupta, Nalubanga, Trejos et al 2020). Read more.

Establish a regular process to review New Zealand Aotearoa’s interpretation of the International Code (The Code in NZ).

The review process should be developed in collaboration with the Ministry breastfeeding lead and the IYCFC.

New Zealand Aotearoa is a signatory to the International Code of Marketing of Breastmilk Substitutes (the Code) and has a responsibility to ensure the Code is upheld (Ministry of Health 2007).

Update and simplify information available about The Code in NZ, giving particular attention to increasing understanding about the ‘grey areas’ and the self-regulation processes.

There is inconsistent knowledge among policy makers, health workers, the NGO sector, consumers and other relevant parties regarding implementation of The Code in NZ (Burgess and Quigley 2011).

Review the current Code complaints procedure and implement required changes to simplify the complaints process.

This should be developed in collaboration with the Ministry breastfeeding lead and the IYCFC.

The 2011 review of the Effectiveness, Implementation and Monitoring of the International Code of Breast-Milk Substitutes in New Zealand concluded that the current process was unnecessarily onerous on complainants (Burgess and Quigley 2011).

Work with the Ministry of Primary Industries and Food Standards Australia New Zealand to review evidence relating to the marketing, labelling and preparation of breast milk substitutes, particularly regarding the safe preparation of powdered milk formulas.

Work is needed to clarify standards and improve safe use and preparation of breast milk substitutes and improve ministerial policy guidance and alignment with international regulations (First Steps Nutrition Trust 2020; Food Standards Australia New Zealand 2017).

Review relevant legal measures currently in place to strengthen the Code in New Zealand and to better align with the WHO International Code and subsequent WHA resolutions.

There is limited understanding about what legal measures are in place to uphold the Code in NZ (Burgess and Quigley 2011).

References

Burgess M, Quigley N. 2011. Effectiveness, implementation and monitoring of the International Code of Breast-Milk Substitutes in New Zealand: A literature and interview-based review. Wellington: Ministry of Health.

Cullerton K, Donnet T, Lee A, et al. 2016. Exploring power and influence in nutrition policy in Australia. Obesity Reviews. 17(12): 1179–1343.

First Steps Nutrition Trust. 2020. The bacterial contamination of powdered infant formula: What are the risks and do we need to review current instructions for safe preparation? London: First Steps Nutrition Trust.

Food Standards Australia New Zealand. 2017. P1028 – Review of infant formula products and other standards in the Code that regulate infant formula. Wellington: Food Standards Australia New Zealand.

Gribble K, McGrath M, MacLaine A, et al. 2011. Supporting breastfeeding in emergencies: Protecting women’s reproductive rights and maternal and infant health. Disasters. 35(4): 720–38.

Gupta A, Nalubanga B, Trejos M, et al. 2020. Making A Difference: An evaluation report of the World Breastfeeding Trends Initiative (WBTi) in Mobilising National Actions on Breastfeeding and IYCF. Breastfeeding Promotion Network of India and IBFAN South Asia. Delhi: WBTi Global Secretariat.

IFE Core Group. 2017. The Operational Guidance on Infant and Young Child Feeding in Emergencies. United Kingdom: IFE Core Group.

Ministry of Health. 2007. Implementing and monitoring the International Code of Marketing of Breast-milk substitutes in New Zealand: The Code in New Zealand. Wellington: Ministry of Health.

Ralston R, Hill S, Silva Gomes F, et al. 2020. Towards preventing and managing conflict of interest in nutrition policy? An analysis of submissions to a consultation on a draft WHO tool. International Journal of Health Policy and Management. x(x): 1–11.

World Health Organization, UNICEF, IBFAN. 2020. Marketing of breast-milk substitutes: National implementation of the international Code: Status Report 2020. Geneva: World Health Organization.

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