At its business meeting in April 1981, the Ambulatory Pediatric Association voted to urge the United States delegation to the World Health Assembly to vote for the adoption of the International Code of Marketing of Breastmilk Substitutes. (The APA resolution, which summarizes salient features of the Code, is shown in the Table.) This action followed two prior resolutions: one at the 1979 meeting expressing concern about "significant risks to child health ... associated with artificial feeding in the developing world," and the second in 1980, supporting the boycott of Nestle's products. In May 1981, the United States was the only nation to vote against the Code. Following the vote, the US House of Representatives condemned the Administration's position by a vote of 301 to 100, and the Senate expressed its concern by a vote of 89 to 2. In view of the current controversy and the crucial role pediatricians play in influencing feeding practices, we think it important to consider (1) the effects of promotion of infant formulas, (2) criticisms of the Code, and (3) the responsibility of pediatricians toward promotion of infant formula.
Despite claims to the contrary, marketing of infant formula influences maternal feeding practices. In recent testimony before the House Subcommittee on International Economic Policy and Trade, Carl Taylor, Professor and Head of the Department of International Health at the Johns Hopkins School of Hygiene and Public Health presented some evidence:1 Massive advertising and availability of formula have been associated with a decline in breast-feeding in oil-rich Arab countries so that only 15% of mothers are nursing their babies at 3 months of age.
Parental Feeding Practices in the United States and in France: Relationships with Child's Characteristics and Parent's Eating Behavior