Overcoming Barriers to Implementing the International Code of Marketing of Breast Milk Substitutes—The Rosebud Experience


Poster Presentation

Purpose for the Program

In response to unethical marketing practices of infant artificial substances, such as formula, The World Health Organization (WHO) and the United Nations International Children's Emergency Fund (UNICEF) drafted the International Code of Marketing of Breast Milk Substitutes (the code) in an effort to promote breastfeeding all around the world.

Proposed Change

The code was officially endorsed by WHO and UNICEF 1981 as an official stance against the unethical marketing and promotion of breast milk substitutes. However, within the United States, no formal legislation exists that requires compliance with the code, and violations of the code that inhibit breastfeeding initiation, duration, and exclusivity occur every day. Courageously, the staff and healthcare providers at the Rosebud PHS Indian Hospital (Rosebud) have taken a unique stand against unethical marketing practices within their facility and have overcome many barriers to implementing the code.

Implementation, Outcomes, and Evaluation

Rosebud has been successful at implementing the code in its entirety to include exclusion of artificial substances and infant feeding materials as gifts, creating a commercial free patient education curriculum, and educating the entire hospital staff about their roles and responsibilities related to the promotion of breastfeeding and compliance with the code.

Implications for Nursing Practice

This poster will highlight successful strategies used to overcome barriers of code implementation and create an environment where the promotion of breastfeeding is a priority. These strategies include removal of noncommercialized patient gift packs, acquisition of feeding supplies and artificial substances at fair market value, and education and motivation of staff members about code compliance. Through the implementation of this code, breastfeeding initiation and exclusivity rates have risen significantly at Rosebud. Therefore, the implementation of the code is an evidence-based paradigm for hospitals all over the world.