Adopted by the World Health Organization in 1981 Since 1981, 65 countries have enacted legislation implementing all or many of the provisions of the Code and subsequent relevant World Health Assembly resolutions. In the Philippines, we have implemented this through Executive Order No. 51 or the Milk Code
Interestingly, when the Milk Code took effect in 1987, Wyeth introduced follow-on formulas for six months olds and the gifted child. During the time of Code's drafting, follow-on formula was not yet invented. Scope: Breastmilk substitutes, including infant formula; other milk products, foods and beverages, including bottlefed complementary foods, when marketed or otherwise represented to be suitable, with our without modification, for use as a partial or total replacement of breastmilk. Also covers feeding bottles and teats In a recent 2011 study, entitled “Is unimpeded marketing for breast milk substitutes responsible for the decline in breastfeeding in the Philippines? An exploratory survey and focus group analysis”, it was found that 59.1% of mothers of young children recalled an infant formula advertisement message and one-sixth reported a doctor recommended using formula. Those who recalled a message were twice and those who reported a doctor recommended using formula were about 4 times as likely to feed their children infant formula
Why are these violations? Bear Brand Photo was taken by Velvet. The sign on the photo says&quot; WE WELCOME CHILDREN BELOW 7 YEARS OLD WHEN ACCOMPANIED BY THEIR PARENTS OR GUARDIANS.&quot; After taking the picture, she saw a child (about 9-11 months old) with her dad, taking a sample for her to drink. Check out the little boy on the right side of the picture - potential captive consumer for Nestle? Although milk is for older kids, sales personnel give out milk even to young children. Lactum Photo – not too clear but there is a sign on the box that it is a Value Pack – falls under “Premiums or “special sales” which is explicitly prohibited under the Code.
Rooming in is not promoted and encourage. More often than not, babies are in the nursery and mothers have to request for their babies to be roomed-in This is the reason for the Unang Yakap campaign which promotes the Essential Newborn Care protocol with only 4 time-bound essential steps – immediate drying, uninterrupted skin-to-skin contact, proper cord clamping and cutting and Non-separation of the newborn from the mother for early breastfeeding initiation and rooming-in
All private enterprises as well as government agencies, including government-owned and controlled corporations, are required to put up lactation stations. These must be adequately provided with the necessary equipment such as lavatory for hand washing, refrigeration or appropriate cooling facilities for storing breast milk, electrical outlets for breast pumps, a small table; comfortable seats and other items in accordance with standards defined by the Department of Health (DOH). The expenses incurred by a private health and non-health facility, establishment or institution in complying with the new law shall be deductible expenses for income tax purposes up to twice the actual amount incurred. These facilities, establishments or institutions shall secure first a “Working Mother- Baby-Friendly Certificate” from the DOH to be filed with the Bureau of Internal Revenue (BIR) before they can avail of the tax incentive. Government agencies complying with the new law shall receive an additional appropriation or budget equivalent to the savings they may derive as a result of complying with the law. The additional appropriation shall be included in their budget for the next fiscal year. The same law, however, also provides for “exemptions” from compliance “where the establishment of lactation stations is not feasible or necessary due to peculiar circumstances of the workplace or public place taking into consideration, among others, the number of women employees, physical size of the establishment and the average number of women who visit.” Private enterprises may apply to the Secretary of the Department of Labor and Employment (DOLE) for exemption from this law while government agencies can apply to the chairman of the Civil Service Commission. The exemption is valid for a period of two years. “ All health and non-health facilities, establishments or institutions which are exempted in complying with this law but nevertheless opt to comply are entitled to the benefits under the law provided they give their employees the privileges of using the same.” RA 10028 also mandates “lactation periods” for nursing employees who are granted break intervals in addition to the regular time-off for meals to “express milk” or the act of extracting human milk from the breast by hand or by pump. Provided such period shall not be less than a total of 40 minutes for every eight-hour working period. Health institutions are likewise encouraged to set up milk banks for storage of breast milk donated by mothers and which have undergone pasteurization. The stored breast milk will be given to children in the neo-natal intensive care unit whose own mothers are seriously ill. The new law encourages the promotion of breastfeeding by integrating in curriculum in relevant subjects in schools under the Department of Education, Commission on Higher Education and the Technical Education and Skills Development Authority. To further promote the importance and raise awareness of breastfeeding, the new law likewise sets every August of each year as Breastfeeding Awareness Month throughout the Philippines.
Laws in the Philippines are implemented through Implementing Rules and Regulations drafted by the agencies tasked to promulgate the same as provided in the law. The Milk Code has been the subject of several changes of rules and regulations. In the mid 1990s the DOH appointed a Milk Code Task Force and tried to enforce strict implementation of its provisions until 2000, when a Health Secretary with close ties to the milk companies revised the regulations in their favor. 2000 - The Task Force Milk Code consultations and resolutions were overturned by an Administrative Order issued by the Secretary of Health where one of its provisions was to allow milk manufacturers to be engaged in all forms of breastfeeding activities such as education, production and development of breastfeeding materials. Under former Sec. Duque, a stricter implementation of the Milk Code was promoted. However, the absolute ban on advertising, promotions, sponsorships or marketing of infant formula, breastmilk substitutes and other related products and the imposition of administrative sanctions were struck down by the Supreme Court. No specific discussions of the IRR. This is a presentation of the improvements because of the RIRR and what is the current status. So this is what we should watch out for and report. (SYLVS – maybe you can talk about our experience during the BF events and the getting of permits issue with BFAD)
Signed in March 2011 but signature was withdrawn because of the requirement of 100 women in reproductive age as employees Signed again in August 2011, published on 28 August 2011 and became effective on 12 September 2011.
Legal Rights of Breastfeeding Mothers
Legal Rights of Breastfeeding Mothers Legal Rights of Breastfeeding Mothers
Relevant Laws and Regulations <ul><li>International Code of Marketing of Breast-milk Substitutes </li></ul><ul><li>Executive Order No. 51 or the Milk Code </li></ul><ul><li>Republic Act No. 7600 or The Rooming-in and Breastfeeding Act of 1992 </li></ul><ul><li>Republic Act No. 10028 or Expanded Breastfeeding and Promotion Act </li></ul><ul><li>IRR and RIRR of the Milk Code </li></ul><ul><li>IRR of Expanded Breastfeeding and Promotion Act </li></ul>Legal Rights of Breastfeeding Mothers
International Code of Marketing Breastmilk Substitutes <ul><li>Aim – protect and promote breastfeeding by ensuring appropriate marketing and distribution of breastmilk substitutes </li></ul><ul><li>Covers infant formula, other milk products, cereals for infants, vegetable mixes, baby teas and juices, follow-up milks when marketed or otherwise represented as partial or total replacement for breastmilk </li></ul><ul><li>Also applies to feeding bottles and teats </li></ul><ul><li>Prohibited acts: </li></ul><ul><ul><li>No advertising to the public </li></ul></ul><ul><ul><li>No free samples to mothers, families or health workers </li></ul></ul><ul><ul><li>No promotion (product displays, posters, free gifts/samples or free or low-cost supplies to any part of health care system) </li></ul></ul>Legal Rights of Breastfeeding Mothers
E.O. No. 51 or the Milk Code <ul><li>Signed into law by former Pres. Cory Aquino on 20 October 1986 </li></ul><ul><li>Important to understand scope: breastmilk substitutes </li></ul><ul><ul><li>Infant formula, other milk products, foods and beverages, feeding bottles and teats </li></ul></ul><ul><li>Regulated acts: </li></ul><ul><ul><li>Advertising – needs prior permission from Inter-Agency Committee </li></ul></ul><ul><li>Prohibited acts: </li></ul><ul><ul><li>Giving of samples and supplies of products, gifts of any sort </li></ul></ul><ul><ul><li>Point-of-sale advertising, promotion device (displays, discount coupons, premiums, special sales, bonus </li></ul></ul><ul><ul><li>Giving of gifts/articles/utensils which promote use of breastmilk substitutes or bottlefeeding </li></ul></ul>Legal Rights of Breastfeeding Mothers
Violations of the Milk Code Legal Rights of Breastfeeding Mothers
Republic Act No. 7600 <ul><li>Rooming in as a national policy to encourage, protect and support breastfeeding </li></ul><ul><li>Covers all private and government health institution </li></ul><ul><li>Exemptions – mothers who are: </li></ul><ul><ul><li>Seriously ill, taking medications contraindicated to breastfeeding, violent/psychotic or those whose conditions do not permit breastfeeding or rooming-in </li></ul></ul><ul><li>Provide facilities for breastfeeding collection and storage </li></ul>Legal Rights of Breastfeeding Mothers
Legal Rights of Breastfeeding Mothers Salient Points of Republic Act No. 10028 <ul><li>Signed into law by former Pres. Gloria Macapagal-Arroyo on 16 March 2010 </li></ul><ul><li>Setting up of lactation stations in private enterprises (including NGOs) and government offices </li></ul><ul><li>Expenses incurred for setting up stations, lactation programs are deductible expenses for income tax purposes </li></ul><ul><li>Provision of “lactation periods” for breastfeeding employees in addition to meal times (at least a total of 40 minutes for every 8-hour work period) </li></ul><ul><li>Encourage health institutions to put up breast milk banks </li></ul><ul><li>Inclusion of breastfeeding in school curriculums </li></ul><ul><li>Set August every year as Breastfeeding Awareness Month </li></ul>
Legal Rights of Breastfeeding Mothers IRR and RIRR of the Milk Code <ul><li>No more TV ads, billboard, print ads, radio ads for products within the scope of the Code. But companies get around this: </li></ul><ul><ul><li>Re-branding their products. E.g. Enfamama to promote Enfa+ line </li></ul></ul><ul><ul><li>Promoting milk for older kids e.g. 3+ and usually these follow-on milk have the same brands </li></ul></ul><ul><li>No more visible health/nutritional claims – companies still do this for follow-on milk. Check photo. </li></ul><ul><li>Increase of scope: from 0-12 months to 24 months </li></ul><ul><li>Now considers the “total effect” of advertising materials instead of specific prohibitions on text/information </li></ul><ul><li>Prohibition on health/nutrition claims (gifted child, higher IQ) </li></ul><ul><li>No manufacturers, distributors, representatives are allowed in ANY activity on breastfeeding promotion, classes/seminars for women and children </li></ul><ul><li>Compliance and reporting violations are BIG ISSUES </li></ul>Violation: False or misleading information or claim.
Legal Rights of Breastfeeding Mothers <ul><li>Provision of lactation stations and implementation of a workplace policy that protects, promotes and supports the breastfeeding program </li></ul><ul><li>Requires that workplaces comply with the Milk Code </li></ul><ul><li>Requires that employers make sure that staff/employees are made aware of RA10028 and IRR – give information on how women can combine work and breastfeeding </li></ul><ul><li>Lactation periods: 2-3 breastmilk expressions lasting 15-30 minutes each within a workday </li></ul>IRR of RA10028
Your Role as LATCH Counselors <ul><li>Be aware of Milk Code violations and DO NOT VIOLATE THE MILK CODE </li></ul><ul><li>Apprise mothers of their rights under the Rooming in Act - suggest that they print-out Unang Yakap Step by Step Guide before delivery </li></ul><ul><li>Inform them that they can continue to breastfeed even if they return to work and inform them about the lactation room and policy requirements </li></ul><ul><li>Encourage them to talk to HR about setting up lactation rooms/policy at their work place if not available. </li></ul>Legal Rights of Breastfeeding Mothers