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The World Health Organization Code and exclusive breastfeeding in China India and Vietnam

机译：世界卫生组织守则和中国印度和越南的独家母乳喂养

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Promoting exclusive breastfeeding (EBF) is a highly feasible and cost‐effective means of improving child health. Regulating the marketing of breastmilk substitutes is critical to protecting EBF. In 1981, the World Health Assembly adopted the World Health Organization International Code of Marketing of Breastmilk Substitutes (the Code), prohibiting the unethical advertising and promotion of breastmilk substitutes. This comparative study aimed to (a) explore the relationships among Code enforcement and legislation, infant formula sales, and EBF in India, Vietnam, and China; (b) identify best practices for Code operationalization; and (c) identify pathways by which Code implementation may influence EBF. We conducted secondary descriptive analysis of available national‐level data and seven high level key informant interviews. Findings indicate that the implementation of the Code is a necessary but insufficient step alone to improve breastfeeding outcomes. Other enabling factors, such as adequate maternity leave, training on breastfeeding for health professionals, health systems strengthening through the Baby Friendly Hospital Initiative, and breastfeeding counselling for mothers, are needed. Several infant formula industry strategies with strong conflict of interest were identified as harmful to EBF. Transitioning breastfeeding programmes from donor‐led to government‐owned is essential for long‐term sustainability of Code implementation and enforcement. We conclude that the relationships among the Code, infant formula sales, and EBF in India, Vietnam, and China are dependent on countries' engagement with implementation strategies and the presence of other enabling factors.
机译：促进纯母乳喂养（EBF）是改善儿童健康的高度可行且具有成本效益的手段。监管母乳替代品的销售对于保护EBF至关重要。 1981年，世界卫生大会通过了世界卫生组织《国际母乳代用品销售守则》（该守则），禁止不道德地广告和促销母乳替代品。这项比较研究旨在（a）探索印度，越南和中国的法规执行和立法，婴儿配方奶粉销售和EBF之间的关系; （b）确定守则实施的最佳做法; （c）确定准则实施可能影响EBF的途径。我们对可用的国家级数据进行了二次描述性分析，并进行了7次高级关键线人访谈。调查结果表明，实施《守则》仅是改善母乳喂养结果的必要步骤，但步骤不足。还需要其他促成因素，例如适当的产假，对卫生专业人员进行母乳喂养培训，通过“爱婴医院倡议”加强卫生系统以及为母亲提供母乳喂养咨询。几种具有强烈利益冲突的婴儿配方食品行业战略被认为对EBF有害。将母乳喂养计划从捐助者主导转变为政府主导，对于守则实施和实施的长期可持续性至关重要。我们得出的结论是，印度，越南和中国的《准则》，婴儿配方奶粉销售和EBF之间的关系取决于各国对实施策略的参与以及其他促成因素的存在。

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