Adopting A National Code Of Marketing Of Breastmilk Substitutes, Breastmilk Supplements And Related Products, Penalizing Violations Thereof, And For Other Purposes

Case Overview and Summary

Summary of Executive Order No. 51

Aim and Scope of the Code (Sections 2 and 3):
- The aim is to contribute to safe and adequate nutrition for infants by protecting and promoting breastfeeding, and ensuring proper use of breastmilk substitutes and supplements when necessary, based on adequate information and appropriate marketing.
- The Code applies to the marketing and related practices of breastmilk substitutes, other milk products, foods and beverages marketed as replacements for breastmilk, feeding bottles and teats.

Definitions (Section 4):
- Defines terms like "breastmilk substitute", "complementary food", "container", "distributor", "infant", "health care system", "health worker", "infant formula", "label", "manufacturer", "marketing", "marketing personnel", "sample", and "supplies".

Information and Education (Section 5):
- The government shall ensure objective and consistent information on infant feeding is provided.
- Educational materials shall include clear information on the benefits of breastfeeding, maternal nutrition, negative effects of partial bottle-feeding, and proper use of infant formula.

Provisions for the General Public and Mothers (Section 6):
- Advertising and promotion of covered products require approval from an inter-agency committee.
- Manufacturers and distributors cannot give samples, supplies, or gifts to the public, health institutions, or health workers, except as provided in the Code.
- No point-of-sale advertising, samples, or promotion devices to induce sales directly to consumers.
- No gifts or articles promoting bottle feeding shall be distributed to pregnant women or mothers.
- Marketing personnel cannot advertise or promote covered products to pregnant women or mothers, except as provided.

Provisions for the Health Care System (Section 7):
- The Ministry of Health shall encourage and promote breastfeeding, and provide training to health workers.
- Health care facilities cannot be used for promoting covered products or displaying related materials.
- Health workers paid by manufacturers or distributors are not permitted in the health care system.
- In health education classes, hazards of improper use of breastmilk substitutes shall be emphasized.

Provisions for Health Workers (Section 8):
- Health workers shall encourage and promote breastfeeding.
- Information from manufacturers to health professionals shall be scientific and factual, without implying bottle-feeding is equivalent or superior to breastfeeding.
- No financial or material inducements from manufacturers to health workers or their families, except for research, scholarships, and continuing education as per rules.
- Samples of covered products shall not be provided to health workers, except for professional evaluation or research as per rules.

Provisions for Manufacturer and Distributor Personnel (Section 9):
- Personnel employed in marketing covered products shall not perform educational functions for pregnant women or mothers.

Provisions for Containers and Labels (Section 10):
- Containers and labels shall provide necessary information on appropriate use and not discourage breastfeeding.
- Each container shall have a clear message in Pilipino or English, including the superiority of breastfeeding, use only on advice of a health worker, and instructions for preparation and warnings.
- No pictures or texts idealizing the use of infant formula.
- Terms like "humanized" or "maternalized" shall not be used.
- Labels shall conform to rules and regulations of the Bureau of Food and Drugs.

Quality (Section 11):
- Products shall be of high recognized standard.
- Products shall meet applicable Codex Alimentarius standards and the Codex Code of Hygienic Practice for Foods for Infants and Children.
- Distribution outlets cannot open cans or boxes for retailing by cup, bag, or other form.

Implementation and Monitoring (Section 12):
- An inter-agency committee is created to review, approve or disapprove marketing materials.
- The Ministry of Health is principally responsible for implementation and enforcement, including promulgating rules and regulations, seeking assistance from other agencies, and prosecuting violators.

Sanctions (Section 13):
- Violators shall be punished with 2 months to 1 year imprisonment or a fine of not less than ₱1,000 nor more than ₱30,000, or both.
- Licenses or permits of health workers, distributors, manufacturers, or marketing firms may be suspended or revoked for repeated violations.

Repealing Clause, Separability Clause, and Effectivity (Sections 14-16):
- Repeals or modifies inconsistent laws, orders, issuances, rules and regulations.
- Provisions are separable, and invalidity of any provision shall not affect the others.
- The Executive Order takes effect 30 days after publication in the Official Gazette.