Public Health Nutrition

Research Paper

Who's keeping the code? Compliance with the international code for the marketing of breast-milk substitutes in Greater Glasgow

Rhona J McInnesa1 c1, Charlotte Wrighta2, Shogufta Haqa3 and Margaret McGranachana4

a1 Nursing, Midwifery and Allied Health Professions Research Unit, Iris Murdoch Building, University of Stirling, Stirling FK9 4LA, UK

a2 Paediatric Epidemiology and Child Health Unit, Department of Child Health, University of Glasgow, Royal Hospital for Sick Children, Yorkhill, Glasgow, G3 8SJ, UK

a3 Child Health & Parenting, Specialist Child & Youth Health Promotion Team, North Community Health and Care Partnership, Stobhill Hospital Headquarters Building, 300 Balgrayhill Road, Glasgow, G21 3UR, UK

a4 Public Health Resource Unit, NHS Greater Glasgow & Clyde, Dalian House, 350 St Vincent Street, Glasgow, G3 8YY, UK


Objective To evaluate compliance with the World Health Organization's International Code of Marketing of Breast-milk Substitutes in primary care, after the introduction of strict local infant feeding guidelines.

Design An audit form was sent to all community-based health professionals with an infant feeding remit. Walking tours were conducted in a random sample of community care facilities.

Setting Greater Glasgow Primary Care Division.

Subjects (1) Primary-care staff with an infant feeding remit; (2) community health-care facilities.

Main outcome measures Contact with manufacturers of breast-milk substitutes (BMS) and BMS company personnel, free samples or incentives, and advertising of BMS.

Results Contact with company personnel was minimal, usually unsolicited and was mainly to provide product information. Free samples of BMS or feeding equipment were rare but childcare or parenting literature was more prevalent. Staff voiced concerns about the lack of relevant information for bottle-feeding mothers and the need to support the mother's feeding choice. One-third of facilities were still displaying materials non-compliant with the Code, with the most common materials being weight conversion charts and posters.

Conclusions Contact between personnel from primary care and BMS companies was minimal and generally unsolicited. The presence of materials from BMS companies in health-care premises was more common. Due to the high level of bottle-feeding in Glasgow, primary-care staff stated a need for information about BMS.

(Received May 09 2006)

(Accepted October 31 2006)

(Online publication February 20 2007)


c1 *Corresponding author: Email