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Why Kenya wants tougher laws on breast milk substitutes

8 Apr 2022

A woman breastfeeds her baby. Getty Images

A recent article published in a newspaper in Kenya stated that bottles for feeding babies would be banned in the country from 28 May 2022.

The article caused an uproar among health officials and the public. But the information it presented was not accurate. The Kenyan government has not banned baby feeding bottles.

However, it has provided more stringent measures for the labelling of feeding bottle, teat and pacifier packages. It wants these products’ labels to include a warning that their use can have negative effects on breastfeeding.

This incident highlights the need to revisit Kenya’s Breast Milk Substitutes (Regulation and Control) Act 2012 (BMS act), and examine some of the country’s key regulations around the marketing of breast milk substitutes. These substitutes include infant formulas, follow-on formulas and any other food or drink, alongside feeding bottles and teats, intended for babies and young children.

The Breast Milk Substitutes act was enacted in 2012 to regulate the promotion of breast milk substitutes, which can interfere with breastfeeding. It’s aligned to the World Health Organization’s International Code of Marketing of Breast-milk Substitutes.

Section III of the act outlines the prohibitions on advertising of substitutes. It also covers the rules on education and informational materials, as well as the labelling of packages. For instance, the act requires that any educational materials on substitutes be approved by the cabinet secretary in charge of the health ministry. Health workers and proprietors of health centres are additionally not allowed to accept breast milk substitutes as gifts or donations without the approval of the health ministry.

The Breast Milk Substitutes act doesn’t prohibit the sale of breast milk substitutes or the distribution of factual information. Rather, it aims to ensure parents make informed choices on infant feeding based on evidence, not biased, misleading claims.

Reviewing the law

The health ministry has updated the Breast Milk Substitutes act to improve its clarity and enforcement. The update, titled “Breast Milk Substitutes (Regulation and Control) (General) Regulations 2021”, was published as a legal notice in August 2021. It will be enforced on 30 May 2022. The amendments followed an increase in aggressive, inappropriate marketing by manufacturers of breast milk substitutes in Kenya.

As part of the process, the ministry conducted a regulatory impact assessment on the legislation. The aim of this was to examine and measure the likely benefits, costs and effects of the proposed regulations.

A regulatory impact assessment critically analyses the effects of proposed and existing regulations. This is done to support legislative change, regulation of markets, policy development and parliamentary decision making.

Read more: What's missing in South Africa's strategy to get breastfeeding levels up

The impact assessment focused on the following sections of the BMS act:

  • donations, labelling, and the interaction between health workers and manufacturers or distributors

  • advertising and promotion

  • demonstrations of the use of designated products

  • publication of information, education and communication materials on substitutes

  • penalties for failure to adhere to the BMS act and its regulations.

The new regulations introduce fresh labelling requirements for baby feeding bottles, teats and pacifiers. These products will include a warning in both Swahili and English stating:

Use of bottles, teats and pacifiers can interfere with breastfeeding.

The updated act also includes prohibitions around labelling, marketing and donation of pre-packaged complementary baby foods, which are increasingly being consumed.

The science behind it

The World Health Organization recommends exclusive breastfeeding for the first six months of a child’s life. It also recommends continued breastfeeding up to and beyond two years.

Breast milk has been found to have significant health and nutrition benefits for both the child and mother. These include protection against infant death and common childhood illnesses, such as diarrhoea and pneumonia. Breastfeeding also lowers the risk of breast and ovarian cancers, and diabetes. It additionally improves birth spacing.

Read more: Breastfeeding trends show most developing countries may miss global nutrition targets

For mothers to exclusively breastfeed, they need accurate information on the benefits of breast milk, the importance of breastfeeding and a supportive environment. However, there has been an increase in the marketing and availability of breast milk substitutes. This could influence some mothers to stop breastfeeding.

Promotion tactics, such as the use of health workers to endorse baby formulas, aggressive media advertising and point-of-sale marketing, have been widely used to advance the use of breast milk substitutes. This has created a false sense of superiority of substitutes over breast milk, hence the need for heightened regulations around the marketing of these products.

The implementation of infant and young child feeding strategies, such as legislation around breast milk substitutes, has been associated with an increase in breastfeeding rates. In Kenya, implementation of the BMS act in 2012 was associated with an increase in exclusive breastfeeding rates from 32% to 61% over a five-year period.

The impact

The stringent measures included in the updated act are likely to further improve the exclusive breastfeeding rate in Kenya – at 61%, it is already higher than the global average of 44%. This will lead to further improvements in child health, growth and development.

Read more: Kenya is a breastfeeding success story but still has its challenges

The importance of protecting and promoting breastfeeding is recognised across most of Africa. A recent report by the World Health Organization found that 32 of the continent’s 55 countries have implemented the International Code on Marketing of Breast-milk Substitutes. However, researchers found that adoption has happened at varying levels. For instance, Kenya is moderately aligned with the code, while South Africa is substantially aligned with it.

To complement the enactment of the code, countries must regularly monitor barriers and bottlenecks to exclusive breastfeeding. These can then be addressed and resolved through research, regulatory impact assessments and more effective legislation.

The Conversation

Antonina Mutoro does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Read the full article here.
This content was originally published by The Conversation. Original publishers retain all rights. It appears here for a limited time before automated archiving. By The Conversation

Covid-19 – Johns Hopkins University

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